Although the site of Mas Gusó (province of Girona) has been interpreted as a Roman uilla, this is actually a public building. Its existence have to be contextualized within the frame of the structures established by the Roman authority for territorial control closely linked to the creation of a new road network and a tax collection system. We also analyse its survival until the 3rd century AD, which are closely related to the nearby city of Emporiae ; Tradicionalmente considerada una villa el yacimiento de Mas Gusó (provincia de Girona) corresponde en realidad a un edificio público. Su existencia hay que contextualizarla en el marco de las estructuras que la autoridad romana establece para el control territorial muy ligada a la creación de una nueva red viaria y un sistema de recaudación fiscal. También se analizan las razones de su pervivencia hasta el siglo iii d. C. muy ligadas a su relación con la cercana ciudad de Emporiae
Background: Psychomotor agitation (PMA) is a state of motor restlessness and mental tension that requires prompt recognition, appropriate assessment and management to minimize anxiety for the patient and reduce the risk for escalation to aggression and violence. Standardized and applicable protocols and algorithms can assist healthcare providers to identify patients at risk of PMA, achieve timely diagnosis and implement minimally invasive management strategies to ensure patient and staff safety and resolution of the episode. Methods: Spanish experts in PMA from different disciplines (psychiatrists, psychologists and nurses) convened in Barcelona for a meeting in April 2016. Based on recently issued international consensus guidelines on the standard of care for psychiatric patients with PMA, the meeting provided the opportunity to address the complexities in the assessment and management of PMA from different perspectives. The attendees worked towards producing a consensus for a unified approach to PMA according to the local standards of care and current local legislations. The draft protocol developed was reviewed and ratified by all members of the panel prior to its presentation to the Catalan Society of Psychiatry and Mental Health, the Spanish Society of Biological Psychiatry (SEPB) and the Spanish Network Centre for Research in Mental Health (CIBERSAM) for input. The final protocol and algorithms were then submitted to these organizations for endorsement. Results: The protocol presented here provides guidance on the appropriate selection and use of pharmacological agents (inhaled/oral/IM), seclusion, and physical restraint for psychiatric patients suspected of or presenting with PMA. The protocol is applicable within the Spanish healthcare system. Implementation of the protocol and the constituent algorithms described here should ensure the best standard of care of patients at risk of PMA. Episodes of PMA could be identified earlier in their clinical course and patients could be managed in the least invasive and coercive manner, ensuring their own safety and that of others around them. Conclusion: Establishing specialized teams in agitation and providing them with continued training on the identification of agitation, patient management and therapeutic alternatives might reduce the burden of PMA for both the patient and the healthcare system.
