Identification of Barrett's esophagus (BE) with the treatment of dysplasia is essential to prevent esophageal adenocarcinoma (EAC). Moreover, determination of BE prevalence is important to define ...subsequent management strategies. However, precise estimates on BE prevalence from several European countries are lacking. We aimed to determine BE prevalence in a Southern European country.
A cross-sectional, multicenter study from November 2019 to February 2020 was performed defining BE as a columnar extent in the distal esophagus greater than or equal to 1 cm with intestinal metaplasia.
A total of 1550 individuals, 51% male with a mean age of 62 (SD = 15) years undergoing upper endoscopy were included. The overall BE prevalence was 1.29% (95% confidence interval: 0.73-1.85); significantly higher in men 2.05% (1.06-3.04) vs. women 0.53% (0.01-1.04). Of the 20 BE patients, eight were newly diagnosed and 12 were under surveillance. The median extent was C3 (min 0; max 16) M4.5 (min 2; max 16). One patient each had EAC (0.06%) and high-grade dysplasia (0.06%) at the time of endoscopy. There was no difference in prevalence between geographical regions, centers, use of sedation or experience of endoscopists. Considering all reports, 93% used standardized terminology, 23% accurate photodocumentation and 69% photodocumented the esophagogastric junction (EGJ). Furthermore, 80% used Prague classification, 55% Seattle protocol, 60% distance to the squamocolumnar junction, 75% to the EGJ and 40% to the hiatal pinch. When considering only reports with EGJ photodocumentation or Prague classification, the prevalence was 1.78% (0.91-2.64) or 1.03% (0.53-1.53).
We report for the first time BE prevalence in Southern Europe and report a low overall prevalence in an unselected population. Future studies need to determine progression rates and how to improve quality metrics.
Since the past few years, the smart city paradigm has been influencing sustainable urban water resources management. Smart metering schemes for end users have become an important strategy for water ...utilities to have an in-depth and fine-grained knowledge about urban water use. Beyond reducing certain labor costs, such as those related to manual meter reading, such detailed and continuous flow of information is said to enhance network efficiency and improve water planning by having more detailed demand patterns and forecasts. Research focusing on those initiatives has been very prolific in countries such as Australia. However, less academic attention has been paid to the development of smart metering in other geographies. This paper focuses on smart water metering in Spain and, more particularly, documents and reflects on the experience of the city of Alicante (southeastern Spain), a pioneer case of massive deployment of remote reading of water meters at the household level and for large urban customers. Through data and interviews with water managers from the water utility, we shed light on the costs and early benefits, as well as the potentialities and (unexpected) problems of this technology to contribute to more sustainable urban water cycles.
The late Miocene flora from La Bisbal d'Empordà (Catalonia, Spain) provides significant data for characterising the coastal vegetation from the north-eastern Iberian Peninsula during a key period in ...Neogene climatic evolution. To this end, a historical leaf collection from La Bisbal d'Empordà was re-examined, analysed from a palaeoenvironmental viewpoint and compared with data provided by the associated small mammal fauna. This flora dates from 9.6–9.7 Ma in age (early Tortonian) according to small mammal biostratigraphy.
The fossil-bearing beds were deposited in the floodplain of a meandering river system. Three palaeoecological assemblages were recognized: 1) Helophytic plant stems related to a wetland community. 2) Torn leaves of Fraxinus sp., Ulmus sp., Zelkova sp., Cedrelospermum sp. Populus balsamoides, Alnus gaudinii, Carpinus sp., Platanus sp., Acer tricuspidatum, Daphnogene sp. and, Laurophyllum sp. which would have belonged to a riparian forest located beyond the wetland community, with Fraxinus being the plant growing in closest proximity; 3) Isolated complete Paliurus seeds, interpreted as mainly wind-transported, which provide evidence of an open and more arid landscape situated distally from the floodplain. The small mammal assemblages associated with this flora are consistent with this palaeoenvironmental interpretation. The paucity of small arboreal mammal taxa and insectivores suggests limited forested vegetation areas, while the more common terrestrial species indicate better developed open landscapes. Our results show a more heterogeneous environment than previously thought and that the riverine processes impinged the flora, somewhat limiting the climatic conclusions that might be derived from leaf physiognomic analyses such as CLAMP.
•Vallesian plants and small mammals from fluvial facies in NE Catalonia are studied.•Sedimentological and taphonomic analyses show both humid and arid environments.•Riparian vegetation was dominated by Fraxinus, Populus, Zelkova, Acer, and Daphnogene.•Paliurus, cricetids, lagomorphs and insectivores thrived in open landscapes.•Taphonomic biases (transport, predators) contributed to an inflated signal for humidity.
Sri Lankans constitute one of Italy's oldest foreign communities. A comparative geographic study of Sri Lankans’ settlement patterns in three main municipalities of South Italy (Naples, Palermo, and ...Catania) is performed in the present work. The uniqueness of the analysis relies on the fact that, to the authors’ knowledge, no other existing studies comparatively examine the spatial segregation of Sri Lankan communities in different southern European municipalities. Moreover, implementing a single geographic reference grid allowed the homogenisation of different areal unit arrangements and the comparison between urban contexts. Original results have emerged from the empirical analysis, detecting peculiar and similar residential behaviour in Sri Lankans’ settlement patterns across the three municipalities analysed, jointly influenced by work specialisation and variations in the local cost of living. In particular, the high levels of Sri Lankan concentration detected in the wealthiest neighbourhoods revealed complex dynamics underlying the urban spatial segregation, beyond the mere centre-periphery dichotomy.
Nightlife scenes in central Madrid have been profoundly affected due to the expansion of tourist-oriented night-time leisure activities during the last three decades. This paper examines a range of ...tensions that have recently appeared in the La Latina neighbourhood due to the conflictual coexistence between the slow and locally-oriented everyday practices remaining in this territoir and the rapid colonisation of this central quarter of Madrid by neoliberal economies of the 'Tourist City'. Particularly, we focus on some long-term, middle-class residents who reproduce exclusionary narratives against the rapid expansion of low cost tourist-oriented nightlife, while advocating a civilised and distinctive tourism. We argue this may be seen as a renaissance of a sanitised 'middle-class culture' created by the fascist regime in the second half of the twentieth century. Recent middle-class' protests in Spain's largest cities hide a new struggle about 'who is legitimised' and 'who not' to reclaim the re-appropriation of the city centre.
The European debt crisis stimulated debate about the future of national health systems. The objective of this article is to contribute to this debate by examining any changes in the scope and content ...of universal coverage and underlying pattern of solidarity in South Europe. Access to health care provides the vantage point for our analysis. Inequalities in access are scrutinized along a number of dimensions by using data from various sources. Our main conclusions clearly show that the public health care systems in Italy and, particularly, in Spain weathered the crisis pretty well and retained their universalistic features. Nonetheless, rising supplemental private coverage (of an “occupational‐mutualist” type) adversely impacts access, but it is unclear how this will unfold in the near future. Tackling fragmentation through expansion and equalization of coverage, though for a comparatively “lean” basket of provisions, has been the focus of reforms in Portugal and Greece. This keeps private spending high and sustains inequalities, whereas any prospects for a stronger variant of universalism remain an open question.
Purpose
The paper aims to investigate food security research in Southern Europe and selected Eastern Mediterranean countries.
Design/methodology/approach
An electronic literature search was conducted ...using Medline/PubMed and Scopus, to identify articles and reviews that were published in the English language, between January 2014 and December 2019. Thirty-three publications met the criteria for review.
Findings
Depending on the population sample and the measurement tool, reported food insecurity differed significantly between and within countries. In Portugal, food insecurity ranged from 11 to 70%; in France, from 6.3 to 77.7%; and in Greece, from 17.3 to 82%.
Research limitations/implications
Research investigating food insecurity issues and its true prevalence across southern European and Eastern Mediterranean countries are relatively limited.
Originality/value
Food insecurity levels in the above countries vary significantly, and the different methodologies often used render the results difficult to compare.
Since the 2008 financial crisis, politics of austerity in Europe have engendered far-reaching socioeconomic and political transformations. The recent refugee 'crisis' has also deeply affected the ...sociopolitical terrain. Contrary to past arguments about the reduced significance of the nation state, Europe is experiencing a resurgence of nationalisms. Simultaneously, often as a counter-response, several European cities are experiencing an emergence of social practices that claim urban politics as a dynamic field of action and contestation potentially transcending national boundaries. Such practices tended to adopt a 'right to the city' approach. Currently, we observe a greater range of argumentations that re-signify the arena of 'urban citizenship.' In this paper, we discuss how crises and the urban intersect and affect citizenship rights and practices in different cities in Southern Europe. From a 'meta-analysis' of urban claims and practices, we argue that, starting at the municipal level, urban citizenship reconfigures the political. Through the entanglement of different scales and actors, emerging practices of solidarity and needs-based claims, and alliances between differently entitled subjects, involving both natives and foreigners, challenge and reshape institutions of governance and reactivate the field of urban politics against austerity and securitization.
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