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Introducción: En marzo de 2020 se decretó un confinamiento en España muy estricto, de al menos 6 semanas de duración, y para toda la población. Esto provocó grandes cambios en la vida de las personas en general, de niños y adolescentes y sus familias en particular. Objetivos: Estudiar la experiencia subjetiva del confinamiento por la pandemia por SARS-CoV-2 en España de los padres de niños y adolescentes, en población general y población clínica. Material y métodos: Se realizó una encuesta ad hoc y se aplicó un cuestionario de variables sociodemográficas y clínicas, así como el Cuestionario de Capacidades y Dificultades SDQ. La encuesta se compartió a través de redes sociales. Se envió también a padres de pacientes de salud mental en seguimiento en el centro de salud mental de zona. Resultados: Un total de 243 progenitores participaron en el estudio. Un 17,7% trabajaban como sanitarios o en residencias y el 79% de la muestra vivía en la Comunidad de Madrid. En general, la percepción de los padres sobre la experiencia de los hijos/as obtuvo puntuaciones positivas. Un total de 241 progenitores completaron el cuestionario SDQ. En las comparaciones por profesión, lugar de residencia o antecedentes de salud mental, estos 3 fueron factores de riesgo para obtener mayores puntuaciones en el SDQ. Conclusiones: Profesión de riesgo en los padres, lugar de residencia o seguimiento en salud mental pueden afectar más negativamente a los hijos, según perciben los padres. Será necesario realizar estudios a medio largo plazo para valorar el impacto real de la pandemia en las familias y sus integrantes.

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O impacto da economia partilhada no âmbito do alojamento e a criação de plataformas com base do modelo de negócio P2P, como a Airbnb, tem sido bastante significativo no setor turístico. O crescimento do número de utilizadores destas plataformas de partilha de bens ou serviços tem sido exponencial. Esta investigação aborda os vários conceitos associados à economia partilhada e procura perceber quais as razões que estão na base do seu crescimento. Pretende-se também perceber quais são as principais motivações de um indivíduo para hospedar-se num alojamento P2P, mais concretamente através da Airbnb. Durante a revisão de literatura percebemos que o sucesso deste modelo de negócio prende-se com a mudança do perfil do consumidor e com a alteração das suas preferências e interesses. Contudo, os avanços da tecnologia representam um papel fulcral como fio condutor para o desenvolvimento destas plataformas. Através da aplicação de um inquérito foi possível concluir que estas motivações estão relacionadas principalmente com fatores económicos e tecnológicos. O facto de a Airbnb ser uma solução mais barata e a eficiência desta plataforma representam grande influência na intenção de reserva. O fator social também representa alguma importância para os inquiridos na medida em que, através dos residentes locais, conseguem obter informações privilegiadas acerca de uma cidade. The impact of the shared economy on accommodation rental services and the creation of platforms based on the P2P business model, such as Airbnb, have been quite significant in the tourism sector. The growth of people using these platforms that enables the sharing of goods and services has been exponential. This research approaches several concepts associated to sharing economy and it tries to understand the underlying reasons for its growth. It is also intended to notice which are an individual's main motivations to accommodate in P2P lodging, more concretely on Airbnb. Through the literature we noticed that the success of this business model is related to changes in the consumer behaviour as well as their preferences and interests. However, advances in technology play a key role in the development of these platforms. This investigation also tried to notice which motivations drive a person to make a reservation in a P2P accommodation, more specifically on Airbnb. Through the application of a survey it was possible to determine that these motivations are related mainly to economic and technological factors. Because of the cheaper price of Airbnb and its efficiency, there is great intent to reserve using this platform. There is also a social factor that represents importance to the users of Airbnb since they are able to get privileged information concerning the city through local residents.

OBJECTIVE The use of some forms of hormone therapy (HT) is associated with an increase in mammographic density-a major risk factor for breast cancer. The role of isoflavones, however, is unclear. Here, we quantify the prevalence of HT and isoflavone use among postmenopausal Spanish women, determine associated risk factors, and explore the relationship between these therapies and mammographic density. METHODS This cross-sectional study included 2,754 postmenopausal women who underwent breast cancer screening in seven geographical areas. Mammographic density was evaluated using Boyd's semiquantitative scale. Multinomial logistic regression models were adjusted to assess risk factors associated with both therapies. Ordinal regression models were fitted to study the association between HT and isoflavone consumption with mammographic density. RESULTS The prevalence of ever-use of HT was 12%, whereas that of the current use was 2.3%. Isoflavone lifetime prevalence was 3.7%, and current use was 1.7%. The most common HT types were tibolone and estrogens. Surgical menopause, oral contraceptive use, educational level, population density, and years since menopause were positively associated with HT, whereas body mass index and parity were inversely associated. Mammographic density was not associated with current or past HT use. However, women who reported having consumed isoflavones in the past and those who started their use after menopause had a higher mammographic density when compared with never-users (odds ratio 1.98, 95% CI 1.21-3.25, P = 0.007; and odds ratio 1.60, 95% CI 1.01-2.53, P = 0.045 respectively). CONCLUSIONS Our results show a low prevalence of HT and isoflavone use in postmenopausal Spanish women. In this population, HT use was not associated with mammographic density, whereas some categories of isoflavone users had higher density.

Summary Objective To assess the impact of Clostridium difficile infection (CDI) on hospital resources and costs in Spain and Italy. Methods CDI data were collected from institutions in Spain and Italy. Each patient was matched with two randomly selected uninfected controls in the same institution. Patient outcomes were assessed for the first and second episodes of CDI and for patients aged ≤65 and >65 years. The impact of CDI on hospital length of stay (LOS) was used to calculate CDI-attributable costs. A multivariate analysis using duration of stay as the continuous outcome variable assessed the independent effect of CDI on hospital costs and LOS. Results LOS attributable to CDI ranged from 7.6–19.0 days in adults and was 5.0 days in children; the increases were greater in adults in Italy than in Spain. Attributable costs per adult patient ranged from €4396 in Madrid to €14 023 in Rome, with the majority of the cost being due to hospitalization. For children, the total attributable cost was €3545/patient. Conclusions These data show that the burden of CDI is considerable in Spain and Italy. Treatments that can reduce LOS, disease severity, and recurrence rates, as well as effective infection control measures to prevent transmission, have the potential to reduce the burden of CDI.

We study the epidemiology, molecular basis, clinical risk factors, and outcome involved in the clonal dissemination of VIM-1-producing Klebsiella pneumoniae isolates in the hospital setting. All patients infected/colonized by carbapenem-nonsusceptible K. pneumoniae (CNSKP) in 2009 were included. Molecular epidemiology was studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Antibiotic resistance genes were analyzed by PCR and sequencing. Plasmids were studied by PFGE with S1 nuclease digestion and for incompatibility group by a PCR-based replicon typing scheme. Risk factors associated with CNSKP colonization/infection were assessed by an observational case-control study. All 55 patients studied were infected ( n = 28) or colonized ( n = 27) by VIM-1-producing K. pneumoniae . All but one acquired isolates of a single clone (PFGE cluster 1 [C1], sequence type 15 [ST15]), while another clone (PFGE C2, ST340) was detected in four patients. C1 isolates also produced the new extended-spectrum β-lactamase SHV-134. bla VIM-1 was carried in a class 1 integron and an untypeable plasmid of ∼50 bp. The number of days that the patient received mechanical ventilation, the use of parenteral nutrition, previous treatment with linezolid, and treatment with extended-spectrum cephalosporins for more than 7 days were detected to be independent risk factors for CNSKP acquisition. The VIM-1-producing K. pneumoniae ST15 clone has a high capacity to spread among intensive care unit patients with severe underlying conditions. A high rate of associated mortality and great difficulty in controlling the spread of this clone, without permanent behavioral changes in the personnel, were observed.

BACKGROUND: Measurement of obesity using self-reported anthropometric data usually involves underestimation of weight and/or overestimation of height. The dual aim of this study was, first, to ascertain and assess the validity of new cut-off points, for both overweight and obesity, using self-reported Body Mass Index furnished by women participants in breast cancer screening programmes, and second, to estimate and validate a predictive model that allows recalculate individual BMI based on self-reported data. METHODS: The study covered 2927 women enrolled at 7 breast cancer screening centres. At each centre, women were randomly selected in 2 samples, in a ratio of 2:1. The larger sample (n = 1951) was used to compare the values of measured and self-reported weight and height, to ascertain new overweight and obesity cut-off points with self-reported data, using ROC curves, and to estimate a predictive model of real BMI using a regression model. The second sample (n = 976) was used to validate the proposed cut-off points and the predictive model. RESULTS: Whereas reported prevalence of obesity was 19.8%, measured prevalence was 28.2%. The sensitivity and specificity of this classification would be maximised if the new cut-off points were 24.30 kg/m2 for overweight and 28.39 kg/m2 for obesity. The probability of classifying women correctly in their real weight categories on the basis of these points was 82.5% in the validation sample. Sensitivity and specificity for determining obesity using the new cut-off point in the validation sample were 90.0% and 92.3% respectively. The predictive model for real BMI included the self-reported BMI, age and educational level (university studies vs lower levels of education). This model succeeded in correctly classifying 90.5% of women according to BMI categories, but its performance was similar to that obtained with the new cut-off points. CONCLUSIONS: Quantification of self-reported obesity entails a considerable underestimation of this problem, thereby questioning its validity. The new cut-off points established in this study and the predictive equation both allow for more accurate estimation of these prevalences. This study was supported by the Research Grant FIS PI060386 from Spain's Health Research Fund (Fondo de Investigación Sanitaria); the EPY 1306/06 Collaboration Agreement between Astra-Zeneca and the Carlos III Institute of Health (Instituto de Salud Carlos III); and a grant from the Spanish Federation of Breast Cancer patients (FECMA 485 EPY 1170-10). Sí