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Aim The increase in survival of patients with breast cancer has largely been due to early detection and treatment advances, which has led to longer follow-up and treatment of these patients. The principal aim of this work is to describe the presence of mental health comorbidities and analyze their influence on survival in women who are long-term breast cancer survivors. Methods This retrospective multicenter cohort study is part of the SURBCAN Study, a cohort of 4,088 women who are long-term breast cancer survivors diagnosed between 2000 and 2006 who were followed-up on between 2012 and 2016. A descriptive analysis of the study population’s characteristics and prevalence of mental health comorbidities was performed. A Cox regression analysis was performed to study the influence of mental health comorbidity on all-cause mortality. Results A total of 42.2% of patients presented with at least one mental health comorbidity, notable among which were anxiety disorders and depression and mood disorders, with a prevalence of 37.6% and 21.1%, respectively. The presence of a mental health comorbidity was associated with a poor prognosis (HR: 2.13; 95% CI: 1.70–2.66), as was more advanced tumor stages. Conclusions The presence of mental health comorbidities in women who are long-term breast cancer survivors is associated with lower survival. Individualized follow-up in which the patient’s mental health status is specifically monitored is recommended.

The disease management of long-term breast cancer survivors (BCS) is hampered by the scarce knowledge of multimorbidity patterns. The aim of our study was to identify multimorbidity clusters among long-term BCS and assess their impact on mortality and health services use. We conducted a retrospective study using electronic health records of 6512 BCS from Spain surviving at least 5 years. Hierarchical cluster analysis was used to identify groups of similar patients based on their chronic diagnoses, which were assessed using the Clinical Classifications Software. As a result, multimorbidity clusters were obtained, clinically defined and named according to the comorbidities with higher observed/expected prevalence ratios. Multivariable Cox and negative binomial regression models were fitted to estimate overall mortality risk and probability of contacting health services according to the clusters identified. 83.7% of BCS presented multimorbidity, essential hypertension (34.5%) and obesity and other metabolic disorders (27.4%) being the most prevalent chronic diseases at the beginning of follow-up. Five multimorbidity clusters were identified: C1-unspecific (29.9%), C2-metabolic and neurodegenerative (28.3%), C3-anxiety and fractures (9.7%), C4-musculoskeletal and cardiovascular (9.6%) and C5-thyroid disorders (5.3%). All clusters except C5-thyroid disorders were associated with higher mortality compared to BCS without comorbidities. The risk of mortality in C4 was increased by 64% (adjusted hazard ratio 1.64, 95% confidence interval 1.52-2.07). Stratified analysis showed an increased risk of death among BCS with 5 to 10 years of survival in all clusters. These results help to identify subgroups of long-term BCS with specific needs and mortality risks and to guide BCS clinical practice regarding multimorbidity.

Consum de drogues; Adolescents; Comportament Consumo de drogas; Adolescentes; Comportamiento Consumption of drugs; Teenagers; Behavior L'objectiu general d'aquesta recerca és analitzar els discursos dels i les adolescents al voltant de les drogues, des d'una perspectiva de gènere. Dins d'aquest, els objectius específics se centren a identificar quin és l'impacte sobre el consum de drogues de la socialització diferencial de gènere, identificar la incidència del gènere en els discursos i pràctiques relatades al voltant de les experiències adolescents del consum, i determinar com aquest influeix de forma diferencial en les posicions i estratègies desenvolupades pels i les adolescents.

The variety of quasi-Nelson algebras (QNAs) has been recently introduced and characterised in several equivalent ways: among others, as (1) the class of bounded commutative integral (but non-necessarily involutive) residuated lattices satisfying the Nelson identity, as well as (2) the class of (0, 1)-congruence orderable commutative integral residuated lattices. Logically, QNAs are the algebraic counterpart of quasi-Nelson logic, which is the (algebraisable) extension of the substructural logic ℱℒew (Full Lambek calculus with Exchange and Weakening) by the Nelson axiom. In the present paper, we collect virtually all the results that are currently known on QNAs, including solutions to certain questions left open in earlier publications. Furthermore, we extend our study to some subreducts of QNAs, that is, classes of algebras corresponding to fragments of the algebraic language obtained by eliding either the implication or the lattice operations.

L'entorn de la Colònia Güell es troba en una situació d'interrogant a causa dels constants canvis que travessa la nostra societat. L'emergència climàtica, la dependència econòmica i energètica conjuntament amb planejaments urbans nuls, amenacen l'entorn amb uns grans valors patrimonials, històrics i naturals. Tot i això, la Colònia Güell presenta una identitat social i cultural que resisteix constantment a les amenaces amb un moviment d'associacions veïnals molt potent. Arran de les participacions ciutadanes dutes a terme durant els darrers anys, es detecta una voluntat de recuperar l'autosuficiència que caracteritzava la colònia industrial associada a la vida en comunitat, lligada a la necessitat de generar serveis comunitaris d'escala de barri i a la necessitat de protegir la biodiversitat del lloc. L'edifici ofereix una oportunitat per potenciar i transformar el patrimoni cultural, agrícola i natural, permetent la reintegració social a través de la diversitat funcional del programa amb una sèrie de serveis comunitaris en forma de tallers i espais polivalents que reactiven les relacions de convivència entre els habitants de la Colònia, agricultors i els visitants que hi accedeixen. El projecte es basa en buscar l'equilibri i la simbiosi entre els veïns, els residents de l'Escola Agrària i els visitants, entenent que les capacitats de cada persona poden reforçar-se mútuament per a benefici de tots, reactivant l'entorn natural i patrimonial privilegiat. El entorno de la Colonia Güell se encuentra en una situación de interrogante a causa de los constantes cambios que atraviesa nuestra sociedad. La emergencia climática, la dependencia económica y energética junto con planeamientos urbanos nulos, amenazan el entorno con grandes valores patrimoniales, históricos y naturales. Sin embargo, la Colonia Güell presenta una identidad social y cultural que resiste constantemente a las amenazas con un movimiento de asociaciones vecinales muy potente. A raíz de las participaciones ciudadanas llevadas a cabo durante los últimos años, se detecta una voluntad de recuperar la autosuficiencia que caracterizaba a la colonia industrial asociada a la vida en comunidad, ligada a la necesidad de generar servicios comunitarios de escala de barrio ya la necesidad de proteger la biodiversidad del sitio. El edificio ofrece una oportunidad para potenciar y transformar el patrimonio cultural, agrícola y natural, permitiendo la reintegración social mediante la diversidad funcional del programa con una serie de servicios comunitarios en forma de talleres y espacios polivalentes que reactivan las relaciones de convivencia entre los habitantes de la Colonia, agricultores y los visitantes que acceden a ella. El proyecto se basa en buscar el equilibrio y la simbiosis entre los vecinos, los residentes de la Escola Agraria y los visitantes, entendiendo que las capacidades de cada persona pueden reforzarse mutuamente para beneficio de todos, reactivando el entorno natural y patrimonial privilegiado. The Colonia Güell environment is in a questionable situation due to the constant changes that our society is going through. The climatic emergency, the economic and energetic dependence together with null urban planning, threaten the environment with great patrimonial, historical and natural values. However, Colonia Güell has a social and cultural identity that constantly resists the threats with a very powerful movement of neighborhood associations. Following the citizen participations carried out during the last years, a desire to recover the self-sufficiency which characterized the industrial colony linked to community life, related to the need to generate community services on a neighborhood scale and the need to protect the biodiversity of the site, has been detected. The proposed building offers an opportunity to enhance and transform the cultural, agricultural and natural heritage, allowing social reintegration through the functional diversity of the program with a series of community services in the form of workshops and multipurpose spaces that reactivate the relationships of coexistence between the inhabitants of the Colony, farmers and visitors who access it. The aim of the project is to seek balance and symbiosis between neighbors, residents of the Escola Agraria and visitors, understanding that the capabilities of each person can mutually reinforce each other for the benefit of all, reactivating the privileged natural and heritage environment.

Quasi-Nelson algebras are a non-involutive generalisation of Nelson algebras that can be characterised in several ways, e.g. as (i) the variety of bounded commutative integral (not necessarily involutive) residuated lattices that satisfy the Nelson identity; (ii) the class of (0, 1)-congruence orderable commutative integral residuated lattices; (iii) the algebraic counterpart of quasi-Nelson logic, i.e. the (algebraisable) extension of the substructural logic \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathcal {FL}_{ew}$$\end{document} by the Nelson axiom. In the present paper we focus on the subreducts of quasi-Nelson algebras obtained by eliding the implication while keeping the two term-definable negations. These form a variety that (following A. Sendlewski, who studied the corresponding fragment of Nelson algebras) we dub weakly pseudo-complemented quasi-Kleene algebras. We develop a Priestley-style duality for these algebras (in two different guises) which is essentially an application of the general approach proposed in the paper A duality for two-sorted lattices by A. Jung and U. Rivieccio.

Objective: our objective was to evaluate the cost-effectiveness of the use of peripherally inserted central venous catheters (PICCs) by a vascular access team (VAT) versus central venous catheters (CVCs) for in-hospital total parenteral nutrition (TPN). Methods: the study used a cost-effectiveness analysis based on observational data retrospectively obtained from electronic medical records from 2018 to 2019 in a teaching hospital. We included all interventional procedures requiring PICCs or CVCs with the indication of TPN. We recorded the costs of insertion, maintenance, removal, and complications. The main outcome measure was the incidence rate of catheter-associated bacteremia per 1000 catheter days. Cost-effectiveness analysis was performed from the hospital perspective within the context of the publicly funded Spanish health system. Confidence intervals for costs and effectiveness differences were calculated using bootstrap methods. Results: we analyzed 233 CVCs and 292 PICCs from patients receiving TPN. Average duration was longer for PICC (13 versus 9.4 days, P < 0.001). The main reason for complications in both groups was suspected infection (9.77% CVC versus 5.18% PICC). Complication rates due to bacteremia were 2.44% for CVC and 1.15% for PICC. The difference in the incidence of bacteremia per 1000 catheter days was 1.29 (95% confidence interval, -0.89 to 3.90). Overall, costs were lower for PICCs than for CVCs: the difference in mean overall costs was -€559.9 (95% confidence interval, -€919.9 to -€225.4). Uncertainty analysis showed 86.37% of results with lower costs and higher effectiveness for PICC versus CVC.Conclusions: placement of PICC by VAT compared with CVC for TPN reduces costs and may decrease the rate of bacteremia.