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Introduction: Wide variations in guideline concordance rates for bipolar disorder have been reported. To the authors'' knowledge, no studies have been carried out in Spain. Objective: To evaluate whether maintenance treatment patterns for outpatients with bipolar disorders in usual practice are concordant with evidence-based prescription guidelines. Methods: Cross-sectional data are being collected, starting June 2011, from outpatients diagnosed of bipolar I or II disorders attended at a Mental Health Center in Bilbao (Spain). Information about their maintenance treatment is reviewed, and labelled as “concordant” or “non-concordant”. Medication considered concordant with current guidelines1,3 are lithium (serum levels 0,6–1,2mEq/L obtained within the previous 6 months), valproate (serum levels 50–100μg/mL within the previous 6 months), carbamazepine (serum levels 4–12μg/mL within the previous 6 months), quetiapine (≥300mg/d), olanzapine (≥10mg/d), aripiprazole (≥15mg/d) and, in bipolar II, lamotrigine ≥100mg/d. Adjunctive use of other medications is also recorded. To assess concordance when various drugs are combined, at least one of them needs to be within therapeutic dose. Results: Hitherto, data from 50 patients have been analyzed (66% females; mean age 52,82±13,35; 68% bipolar I). 60% of them present a concordant treatment; 67,64% in the bipolar I subgroup and 43,75% in the bipolar II. Half of the patients are on antidepressants. Conclusions: Despite the still small sample size and need of a multicenter assessment, adherence to guidelines seems suboptimal, mainly respecting bipolar II. Implementing interventions that have proven effective for enhancing evidence-based care and therefore improving outcomes should be considered. [Copyright &y& Elsevier]

Highlights: [•] An assessment of thermal performance of social dwellings is presented. [•] Ten selected dwellings are monitored for 10 months. [•] A holistic approach, based on literature, is followed in the assessment. [•] Energy consumption and thermal comfort are evaluated for every studied dwelling. [•] Problems related to cold homes and energy poverty are also taken into account. [ABSTRACT FROM AUTHOR]

• Affordable and adaptable VIP based internal and external retrofitting solutions. • Implementation of VIP based integral retrofitting solutions in two tertiary buildings. • Space heating energy saving analysis before and after VIP based retrofit. • Envelope heat loss coefficient reduction analysis before and after retrofitting. Vacuum insulation panels (VIPs) represent a huge opportunity to achieve nearly zero energy buildings, especially in the retrofitting of existing buildings. VIPs can be applied in conjunction with façade cladding elements, considerably reducing the heat losses or gains from the building by means of very slim wall construction systems or retrofit solutions. However, the fact that VIPs cannot be cut on-site, can be easily damaged during their handling, installation and use and have an envelope that can cause thermal bridging in the junction between panels or when combined with other materials, has hindered their penetration in the construction market. This paper presents two innovative façade retrofitting solutions, a rear ventilated façade and a stud mounted internal solution, that have tackled all these issues and provide thermal transmittances of 0.28 and 0.14 W/m2 K in relatively slim insulation systems of 10 cm widths. Solutions have been installed on the entire façade of two existing buildings located in Bilbao (Spain) and Malmö (Sweden) subjected to an integral rehabilitation process, covering 2100 m2. Buildings energy use have been monitored before and after the renovation, showing energy cuts of around 35% from pre-intervention status. This paper presents the lessons learnt during the design and installation process of the vacuum insulation integrating solutions in the façade of two existing buildings and the thermal performance results achieved after their retrofitting. [ABSTRACT FROM AUTHOR]