Fine-Grained Species Recognition With Privileged Pooling: Better Sample Efficiency Through Supervised Attention.

We propose a scheme for supervised image classification that uses privileged information, in the form of keypoint annotations for the training data, to learn strong models from small and/or biased training sets. Our main motivation is the recognition of animal species for ecological applications such as biodiversity modelling, which is challenging because of long-tailed species distributions due to rare species, and strong dataset biases such as repetitive scene background in camera traps. To counteract these challenges, we propose a visual attention mechanism that is supervised via keypoint annotations that highlight important object parts. This privileged information, implemented as a novel privileged pooling operation, is only required during training and helps the model to focus on regions that are discriminative. In experiments with three different animal species datasets, we show that deep networks with privileged pooling can use small training sets more efficiently and generalize better.

Whole-body vibration and back pain-related work absence among heavy equipment vehicle mining operators.

OBJECTIVE: To determine the association between several whole-body vibration (WBV) exposure estimates and back pain-related work absence. METHODS: Exposures (based on the weighted daily root mean square acceleration, A(8); the daily vibration dose value, VDV(8); and the daily equivalent static compression dose, Sed(8)) of 2302 workers during 4 years were estimated using each worker's monthly vehicle operation records and WBV measurements from 11 different types of heavy equipment vehicles in a large coal mine. Company payroll data provided work absence during the concurrent 4 years of exposure. Cox regression models estimated the associations between the different WBV metrics and time to first work absence related to back pain. An adjusted R2 statistic provided a measure of model fit. RESULTS: All estimated metrics of WBV exposures were positively and significantly associated with back pain-related absence. HRs varied from 2.03 to 12.39 for every 0.21 m/s2 increase in the A(8)-based exposures; from 1.03 to 1.18 for every 1.72 m/s1.75 increase in VDV(8)-based exposures; and from 1.04 to 1.07 for every 0.06 MPa increase in Sed(8)-based exposures. Models using the estimated VDV(8) metric for the z axis fit the data best as measured by the R2 statistic. CONCLUSION: Higher WBV exposures were associated with back pain-related absences in this population, which appears after a few years of follow-up. Introducing controls to lower exposure levels may help reduce back pain-related work absences.

Antibiotic prophylaxis habits in dental implant surgery among dentists in Spain. A cross-sectional survey.

BACKGROUND: The use of antibiotics to prevent dental implant failures and postoperative infections remains a controversial issue. The objectives of this study were to assess the current antibiotic prescribing patterns and antibiotic prescribing frequency of dentists in Biscay (Spain) in conjunction with routine dental implant surgery among healthy patients and to determine whether any consensus has been reached by such practitioners and last published evidence was being followed. MATERIAL AND METHODS: Observational cross-sectional study: electronic survey. This study was reported according to the STROBE guidelines. This anonymous questionnaire contained open-ended and close-ended questions. An email was sent 26 October 2017 to all the registered members of the Biscay dentists' College (n=989). The collected data were analyzed using STATA® 14 software, and 95% confidence intervals (CI) were used to assess the frequency of prescription for each antibiotic regimen. RESULTS: The survey was responded to by a total of 233 participants (response rate=23.56%). Overall, 210 participants finished the survey completely, and 23 surveys were answered partially. The questionnaire was responded to by 122 females (58.1%) and 88 males (41.9%). Of the participants, 88% (n=207) always routinely prescribed prophylactic antibiotics in conjunction with dental implant surgery (95% CI: 84.79-92.88%). Approximately 9% (n=22) prescribed antibiotics sometimes (95% CI: 5.68-13.19%), and only 4 dentists (1.72%) never prescribed antibiotics (95% CI: 0.04-3.38%). Overall, 179 of 233 respondents prescribed both pre- and postoperative antibiotics (78.85%, 95% CI: 72.96-83.97%), 13 prescribed antibiotics only preoperatively (5.73%, 95% CI: 3.08-9.59%), and 35 prescribed antibiotics exclusively after routine dental implant surgery (15.42%, 95% CI: 10.98-20.78%). CONCLUSIONS: Most of the dentists working in Biscay routinely prescribe prophylactic antibiotics in conjunction with dental implant surgery among healthy patients. A large range of prophylactic regimens are prescribed and the most recently published evidence is not being followed.

Assessment of Whole-Body Vibration Exposure in Mining Earth-moving Equipment and Other Vehicles Used in Surface Mining.

This study characterized whole-body vibration exposures in a set of vehicles that operate in open-pit mines and compared three different daily exposure parameters based on the ISO 2631-1:1997 and ISO 2631-5:2004 standards. Full-shift, 6 to 12-hour, continuous whole-body vibration measurements were collected from 11 representative types of vehicles in terms of hours of operation and number of vehicles used. For each type of vehicle, the exposure parameters (A(8), VDV(8), and Sed(8)) were calculated for each axis (x, y, and z), and in addition, shear or horizontal (∑xy) and vector sum (∑xyx) whole-body vibration exposure. Findings showed that: (i) substantially higher shear and vector sum whole-body vibration exposures indicated relatively high levels of exposure on the non-predominant axis; (ii) the predominant axis of exposure varied across the different type of vehicles; (iii) there were differences in whole-body vibration exposure parameters regarding the standards-based predictions of potentially adverse health outcomes (the impulsive exposure parameters VDV(8) and Sed(8) were higher and reduced acceptable vehicle operation times by one-half to two-thirds relative to A(8) exposures); and (iv) based on the predominant exposures and the time to reach daily vibration action limits, the operation of most mining vehicles would be limited to less than 8 hours a day. Differences in whole-body vibration exposure parameters impact the prediction of potentially adverse health outcomes and may introduce some uncertainty regarding how to best characterize a vehicle operator's actual exposure.

Job rotation: Effects on muscular activity variability.

Job rotation strategies have been used for years as an administrative intervention to reduce the risk of musculoskeletal disorders. The benefits of job rotation have been hypothesized to occur via changes in muscular activity variability (MAV). However, the effect of job rotation on MAV has not been fully analyzed in a literature review. A wide search was conducted to identify studies testing the effect of different job rotation strategies on MAV. Twenty-six studies of acceptable quality were included. Several studies on different types of tasks supported the view that job rotation can increase muscular activity variability, particularly with strategies such as alternating tasks and pace changes. However, it remains uncertain whether such variability changes immediately translate into benefits for the worker because little evidence was found that showed simultaneous changes in different muscular groups. Additionally, variability was occasionally achieved at the expense of average activity in the assessed muscles.

Comparison of tablet and disk diffusion methods for fluconazole and voriconazole in vitro activity testing against clinical yeast isolates.

We have compared a commercially available tablet diffusion method for the in vitro antifungal susceptibility testing of fluconazole (FCZ) and voriconazole (VCZ) with the disk diffusion method M44 (CLSI) with 282 clinical yeast isolates. The superior stability of antifungal agents in tablets can explain the differences for each category of susceptibility by both methods.Neo-Sensitabs tablets antifungal susceptibility testing showed an excellent correlation (0.98 for FCZ and 0.98 for VCZ at 24h and 0.96 for FCZ and 0.94 for VCZ at 48 h ), a reduced percentage of disagreements (4.6% and 8.2% for FCZ at 24h and 48 h respectively; 1.1% and 2.1% for VCZ at 24h and 48 h respectively) and the absence of statistically significant difference in comparison with the reference protocol for performing antifungal susceptibility testing with the agar diffusion method.

[Identification of items for creating a questionnaire for the assessment of instrumental activities of daily living (IADL) in elderly patients]. / Identificación de ítems para la creación de un cuestionario de valoración de actividades instrumentales de la vida diaria en personas mayores.

OBJECTIVE: To identify items to design a questionnaire to assess IADL in the elderly in the community. DESIGN: Delphi study. LOCATION: Community setting, primary health care. PARTICIPANTS: Fifty seven multidisciplinary experts (family doctors, geriatricians, physiotherapists, social workers, male nurses) who are members of the Spanish Society of Family and Community Medicine or the Spanish Geriatrics and Gerontology Society. METHODS: Three consecutive questions sent via e-mail or fax. First: what items you would take into account in a questionnaire to assess IADL in the elderly? Second: out of the groupings select 10 you consider to be of special relevance? Third: among the 14 more most selected items, select, by scoring from 1 to 10, the ones you consider more important? In the end we obtained the 10 items to include in the questionnaire according to their scores. RESULTS: Thirty experts answered the 3 mailings. The 53 initial proposals were grouped into 24 items. In the end we obtained the following selection (from higher to lower score): dealing with medication, use of the telephone, housework, handling money, walking outside the home, security measures and risk avoidance, shopping, dealing with doors and keys, transport use, and means of social contact. CONCLUSIONS: Only 2 items could have gender influence (in contrast to other questionnaires), as "shopping" does not refer only to the household ones and "housework" also includes activities carried out by males. The most important items are "dealing with medication" (due to the high prevalence of problems and clinical outcomes) and "the use of the telephone" (survival item).

Identificación de ítems para la creación de un cuestionario de valoración de actividades instrumentales de la vida diaria en personas mayores / Identification of items for creating a questionnaire for the assessment of instrumental activities of daily living (IADL) in elderly patients

Objetivo. Seleccionar ítems para diseñar un cuestionario de valoración de las actividades instrumentales de la vida diaria (AIVD) en personas mayores residentes en la comunidad. Diseño. Estudio Delphi. Emplazamiento. Medio comunitario, atención primaria. Participantes. Un total de 57 expertos multidisciplinarios (médicos de familia, geriatras, fisioterapeutas, trabajadores sociales, enfermeros) pertenecientes a la Sociedad Española de Medicina de Familia y Comunitaria (semFYC) o a la Sociedad Española de Geriatría y Gerontología (SEGG). Métodos. Se realizaron 3 envíos consecutivos por correo electrónico o fax. En el primer envío se interrogaba acerca de qué ítems incluirían en un cuestionario para valorar las AIVD en personas mayores; en el segundo se pedía que seleccionaran, de los ítems agrupados, los 10 que consideraran más relevantes, y un tercero se solicitaba que, de los 14 ítems más seleccionados, puntuaran de 1 a 10 los más trascendentes. Así pues, se obtuvieron ordenados por puntuación los 10 ítems que debían ser incluidos. Resultados. A los 3 correos contestaron 30 expertos. Las 53 propuestas iniciales se agruparon en 24 ítems y finalmente se seleccionaron (de mayor a menor puntuación) los siguientes: utilización de los fármacos, uso del teléfono, tareas domésticas, utilización del dinero, deambulación fuera del domicilio, medidas de seguridad y evitación de riesgos, realización de compras, uso de puertas y llaves, uso del transporte y medios de relación social. Conclusiones. Sólo 2 ítems podrían estar influidos por el sexo (en contraposición con otros cuestionarios disponibles), aunque «la realización de compras» no se limita a las domésticas y en «tareas domésticas» se incluyen actividades también realizadas por los varones. Los ítems más relevantes son «utilización de los fármacos» (importancia por prevalencia/repercusión clínica) y «empleo del teléfono» (ítem de subsistencia)

Objective. To identify items to design a questionnaire to assess IADL in the elderly in the community. Design. Delphi study. Location. Community setting, primary health care. Participants. Fifty seven multidisciplinary experts (family doctors, geriatricians, physiotherapists, social workers, male nurses) who are members of the Spanish Society of Family and Community Medicine or the Spanish Geriatrics and Gerontology Society. Methods. Three consecutive questions sent via e-mail or fax. First: what items you would take into account in a questionnaire to assess IADL in the elderly? Second: out of the groupings select 10 you consider to be of special relevance? Third: among the 14 more most selected items, select, by scoring from 1 to 10, the ones you consider more important? In the end we obtained the 10 items to include in the questionnaire according to their scores. Results. Thirty experts answered the 3 mailings. The 53 initial proposals were grouped into 24 items. In the end we obtained the following selection (from higher to lower score): dealing with medication, use of the telephone, housework, handling money, walking outside the home, security measures and risk avoidance, shopping, dealing with doors and keys, transport use, and means of social contact. Conclusions. Only 2 items could have gender influence (in contrast to other questionnaires), as "shopping" does not refer only to the household ones and "housework" also includes activities carried out by males. The most important items are "dealing with medication" (due to the high prevalence of problems and clinical outcomes) and "the use of the telephone" (survival item)

[Theoretical foundations for the creation of a register of patients diagnosed with mental retardation of a genetic origin: an epidemiological and public health perspective]. / Fundamentos teóricos para la creación de un registro de pacientes diagnosticados de retraso mental de origen genético: perspectiva desde la epidemiología y la salud pública.

INTRODUCTION: The need to quantify and classify the cases of mental retardation with a genetic origin (MRGO) has led the GIRMOGEN (Genetic Mental Retardation Research Group) to promote a computerised register of cases of MRGO. AIMS. To draw up a suitable protocol for the design and development of a register of these characteristics, to theoretically define the phases that make up the overall process of designing and developing the register, and to create a register of patients diagnosed with MRGO following the phases set out in that procedure. MATERIALS AND METHODS: A nine-phase circular sequential method was used. The first consists of an initial approach phase and the process continues until the final production and research phase is reached, which is managed by a single computer program or application. The intermediate phases between the initial approach and the production are as follows: planning, requirements, analysis and design, security (legal cover and confidentiality), implementation, trials and testing, and evaluation. RESULTS: The circular sequential design and development process resulted in a relational database system managed by a computer application called GIRMOGEN-Pro v. 1.0. CONCLUSIONS: This software allows cases to be registered in real time and constitutes a multi-centre system that makes it possible to register cases at different geographical locations. It allows a correct epidemiological analysis to be performed, reduces the chances of biases occurring, and also makes it possible to control for confusion and interaction among variables. Technically it meets the standards set out by current law regulating personal health-related information.

[The design and implementation of a computer application for managing a register of patients diagnosed with genetic mental retardation]. / Diseño e implementación de una aplicación informática para la gestión de un registro de pacientes diagnosticados de retraso mental de origen genético.

INTRODUCTION: In order to conduct studies of mental retardation of a genetic origin over the GIRMOGEN network, a computerised register of cases needs to be set up. MATERIALS AND METHODS: This register requires the implementation of a computer application consisting of a series of management programs together with the actual database. The aims of this work are: a) To analyse all the infrastructural, scientific and technical conditioning factors that allow the computer application and the databases associated to the register to be designed; b) To design all the elements that go to make up the application, namely, the application engine, consisting of all the programs responsible for providing all the operative capabilities, and the database for storing all the data structures with the variables related to the research; c) Implementing all the designs that are developed; and d) Drawing up the security protocols and work procedures involved in running the application. RESULTS: The result of all this process is the Girmogen-Pro software application, which includes all the capabilities needed to enable it to fulfil the scientific goals of the study. It includes the security measures required to comply with the current laws regarding the handling of files containing personal information. Furthermore, the data structures that will constitute the registers to be used in the study were also been built. CONCLUSIONS: This process does not end with the implementation of the designs, since an ongoing assessment process is also performed with the aim of optimising the data structures that contain the variables that go to make up the register, so as to ensure it fits the scientific objectives of the study as well as possible.

[Epidemiology of genetic mental retardation. An analysis of the needs, importance, aims, characteristics, value and limitations of a register of cases of mental retardation of genetic origin]. / Epidemiologia del retraso mental de origen genetico. Analisis de la necesidad, importancia, objetivos, caracteristicas, utilidad y limitaciones de un registro de casos de retraso mental de origen genetico.

INTRODUCTION: The need to identify, quantify and classify the cases of mental retardation with a genetic origin (MRGO) has led the GIRMOGEN (Genetic Mental Retardation Research Group) to promote a computerised register of cases of MRGO. Aims and development. The fundamental goals of this work are to present the problem of MRGO from the epidemiological point of view and to argue for the need and importance of registering these pathologies. It also aims to analyse the usefulness and the different studies that can be implemented on the basis of a register of this kind, and to state the limitations of the register. CONCLUSIONS: The creation of case registers essentially built upon databases that can be updated online over the Internet is a novel methodology in the area of preventive medicine and public health. The process of constructing such a system is time-consuming and complex, and there are practically no references available in the literature concerning the theoretical aspects of its design and development. Before undertaking the building of a registry system of this kind, a prior analysis of the need for, as well as the importance, characteristics, value and limitations of the register must be carried out.

Epidemiología del retraso mental de origen genético. Análisis de la necesidad, importancia, objetivos, características, utilidad y limitaciones de un registro de casos de retraso mental de origen genético / Epidemiology of genetic mental retardation. An analysis of the needs, importance, aims, characteristics, value and limitations of a register of cases of mental retardation of genetic origin

Introducción. La necesidad de conocer, cuantificar yclasificar los casos de retraso mental de origen genético (RMOG),ha impulsado a GIRMOGEN (Grupo de Investigación en RetrasoMental de Origen Genético) a promover el desarrollo de un registroinformatizado de casos de RMOG. Objetivos y desarrollo. Losobjetivos fundamentales del presente trabajo son presentar el problemadel RMOG desde el punto de vista epidemiológico, y argumentarla necesidad e importancia del registro de estas patologías;analizar la utilidad y las diferentes investigaciones que se puedenimplementar a partir de un registro de estas características, y ponerde manifiesto las limitaciones del registro. Conclusiones. Laelaboración de registros de casos fundamentados en bases de datosactualizables en línea en Internet es una metodología nueva en elárea de la medicina preventiva y la salud pública. El proceso deconstrucción es laborioso, complejo y prácticamente carente de referenciasbibliográficas relativas a los aspectos teóricos de su diseñoy desarrollo. Antes de decidir la construcción de un sistema deregistro de este tipo, es necesario analizar la necesidad, la importancia,las características, la utilidad y las limitaciones del registro

Introduction. The need to identify, quantify and classify the cases of mental retardation with a genetic origin (MRGO)has led the GIRMOGEN (Genetic Mental Retardation Research Group) to promote a computerised register of cases ofMRGO. Aims and development. The fundamental goals of this work are to present the problem of MRGO from theepidemiological point of view and to argue for the need and importance of registering these pathologies. It also aims toanalyse the usefulness and the different studies that can be implemented on the basis of a register of this kind, and to state thelimitations of the register. Conclusions. The creation of case registers essentially built upon databases that can be updatedonline over the Internet is a novel methodology in the area of preventive medicine and public health. The process ofconstructing such a system is time-consuming and complex, and there are practically no references available in the literatureconcerning the theoretical aspects of its design and development. Before undertaking the building of a registry system of thiskind, a prior analysis of the need for, as well as the importance, characteristics, value and limitations of the register must becarried out

Fundamentos teóricos para la creación de un registro de pacientes diagnosticados de retraso mental de origen genético: perspectiva desde la epidemiología y la salud pública / Theoretical foundations for the creation of a register of patients diagnosed with mental retardation of a genetic origin: an epidemiological and public health perspective

Introducción. La necesidad de cuantificar y clasificarlos casos de retraso mental de origen genético (RMOG), ha impulsadoa GIRMOGEN (Grupo de Investigación en Retraso Mental de Origen Genético) a promover el desarrollo de un registro informatizadode casos de RMOG. Objetivos. Elaborar un protocolo de diseñoy desarrollo adaptado a un registro de estas características,definir teóricamente las fases que componen el proceso global dediseño y desarrollo del registro, y crear un registro de pacientesdiagnosticados de RMOG, siguiendo las fases de dicho procedimiento.Materiales y métodos. Se empleó un método secuencial circular,compuesto por nueve fases; se parte de una fase de planteamientoinicial, para culminar en la fase de producción e investigación,gestionado por un único programa o aplicación informática.Las fases intermedias entre el planteamiento inicial y la producciónson: planificación, requerimientos, análisis y diseño, seguridad(cobertura legal y confidencialidad), implementación, tests ypruebas, y evaluación. Resultados. Como resultado del proceso secuencialcircular de diseño y desarrollo, se obtuvo un sistema relacionalde bases de datos gestionado por una aplicación informáticadenominada GIRMOGEN-Pro v. 1.0. Conclusión. Permite el registrode casos en tiempo real. Constituye un sistema multicéntricoque posibilita el registro de casos en diferentes puntos geográficos.Permite un correcto análisis epidemiológico, disminuye la probabilidadde sesgo, y posibilita el control de la confusión e interacciónentre variables. Se ajusta técnicamente a la legislación vigente enmateria de datos de carácter personal relacionados con la salud

Introduction. The need to quantify and classify the cases of mental retardation with a genetic origin (MRGO) has ledthe GIRMOGEN (Genetic Mental Retardation Research Group) to promote a computerised register of cases of MRGO. Aims.To draw up a suitable protocol for the design and development of a register of these characteristics, to theoretically define thephases that make up the overall process of designing and developing the register, and to create a register of patients diagnosedwith MRGO following the phases set out in that procedure. Materials and methods. A nine-phase circular sequential methodwas used. The first consists of an initial approach phase and the process continues until the final production and research phase isreached, which is managed by a single computer program or application. The intermediate phases between the initial approachand the production are as follows: planning, requirements, analysis and design, security (legal cover and confidentiality),implementation, trials and testing, and evaluation. Results. The circular sequential design and development process resulted ina relational database system managed by a computer application called GIRMOGEN-Pro v. 1.0. Conclusions. This softwareallows cases to be registered in real time and constitutes a multi-centre system that makes it possible to register cases at differentgeographical locations. It allows a correct epidemiological analysis to be performed, reduces the chances of biases occurring,and also makes it possible to control for confusion and interaction among variables. Technically it meets the standards set outby current law regulating personal health-related information

Diseño e implementación de una aplicación informática para la gestión de un registro de pacientes diagnosticados de retraso mental de origen genético / The design and implementation of a computer application for managing a register of patients diagnosed with genetic mental retardation

Introducción. Para la realización del estudio en retrasomental de origen genético por la red GIRMOGEN se necesita lacreación de un registro informatizado de casos. Materiales y métodos.Este registro requiere la implementación de una aplicacióninformática, consistente en una serie de programas de gestión y lapropia base de datos. Los objetivos de este trabajo son: a) El análisisde todos los condicionantes infraestructurales, científicos y técnicosque permiten llevar a cabo el diseño de la aplicación informáticay las bases de datos asociadas al registro; b) El diseño de todoslos elementos de la aplicación: el motor de la aplicación, consistenteen todos los programas encargados de proporcionar todas susfuncionalidades operativas, y la base de datos donde alojar todaslas estructuras de datos con las variables relacionadas con la investigación;c) La implementación de todos los diseños realizados; y d)La elaboración de los protocolos de seguridad y procedimientos detrabajo en el uso de la aplicación. Resultados. Como resultado detodo este proceso, se ha obtenido la aplicación Girmogen-Pro, en laque se han implementado todas las funcionalidades necesarias parasu adecuación a los propósitos científicos del estudio. Se han incluidolas medidas de seguridad derivadas del cumplimiento de la normativalegal vigente sobre tratamiento de ficheros de datos decarácter personal, y se han construido las estructuras de datos quecompondrán los registros a utilizar en el estudio. Conclusión. Esteproceso no termina con la implementación de los diseños, ya queexiste un proceso continuo de evaluación encaminado a optimizarlas estructuras de datos que contienen las variables que componenel registro, con objeto de adaptarse lo mejor posible a los objetivoscientíficos del estudio

Introduction. In order to conduct studies of mental retardation of a genetic origin over the GIRMOGEN network,a computerised register of cases needs to be set up. Materials and methods. This register requires the implementation of acomputer application consisting of a series of management programs together with the actual database. The aims of this workare: a) To analyse all the infrastructural, scientific and technical conditioning factors that allow the computer application andthe databases associated to the register to be designed; b) To design all the elements that go to make up the application, namely,the application engine, consisting of all the programs responsible for providing all the operative capabilities, and the databasefor storing all the data structures with the variables related to the research; c) Implementing all the designs that are developed;and d) Drawing up the security protocols and work procedures involved in running the application. Results. The result of all thisprocess is the Girmogen-Pro software application, which includes all the capabilities needed to enable it to fulfil the scientificgoals of the study. It includes the security measures required to comply with the current laws regarding the handling of filescontaining personal information. Furthermore, the data structures that will constitute the registers to be used in the study werealso been built. Conclusions. This process does not end with the implementation of the designs, since an ongoing assessmentprocess is also performed with the aim of optimising the data structures that contain the variables that go to make up theregister, so as to ensure it fits the scientific objectives of the study as well as possible

Utilidad del cuestionario de Barber para seleccionar a personas de 75 años o más con riesgo de hospitalización, institucionalización o muerte / Utility of the Barber questionnaire to select individuals aged 75 years or more at risk of hospitalisation, institutionalisation or death

Introducción y objetivo: analizar la asociación del cuestionario de Barber (CB) positivo con hospitalización-institucionalización-muerte al año, en una consulta de atención primaria en población de 75 años o mayor. Material y métodos: estudio de cohortes, CB positivo/negativo; 133 personas. Valoración inicial: CB, edad, sexo, índice de Barthel, cuestionario de Pfeiffer. Resultados: edad media, 80,6 años (P75, 83 años); el 45,5% eran varones. CB positivo, 62,9% (intervalo de confianza [IC] del 95%, 54,5-71,3); el 72,3%, ≤ 2 puntos. Sólo una respuesta afirmativa al ítem 2, y ninguna al 4. Barthel alterado, el 27,6% del total; Pfeiffer, el 19,4%. Asociación CB positivo-Barthel y Barthel-Pfeiffer alterados (p < 0,0001). Riesgo relativo (RR) = 2,1 (IC del 95%, 0,8-5,4) para hospitalización, y 2,3 (IC del 95%, 0,9-5,7) para los 3 eventos en conjunto, si el CB era positivo; 23,8 (IC del 95%, 3,0-182,9) y 37,2 (IC del 95%, 4,9-283,2) para mortalidad; 2,7 (IC del 95%, 1,3-5,6) y 2,5 (IC del 95%, 1,2-5,1) para hospitalización; 2,8 (IC del 95%, 1,4-5,7) y 2,5 (IC del 95%, 1,2-5,3) para los 3 eventos, si el índice de Barthel o el cuestionario de Pfeiffer estaban alterados, respectivamente. RR de eventos en conjunto = 2,6 (IC del 95%, 1,2-5,4) si el ítem 6 («problemas le impiden valerse autónomamente») es positivo, y 4,9 (IC del 95%, 2,4-10,0) si es el ítem 9 («hospitalización previa»); ambos ítems son las únicas variables que obtienen RR estadísticamente significativos en la regresión logística. El valor predictivo positivo (VPP) del CB, considerando eventos acaecidos, es del 27,7%. Conclusiones: es uno de los escasos estudios realizados en España sobre la utilidad del CB. Éste presenta importantes limitaciones para uso como cribado: pobre VPP, deficiente validez de contenido, asociación con deterioro funcional o cognitivo condicionan los resultados. Los ítems 9 y 6 y la alteración funcional predicen mejor los eventos adversos

Introduction and objective: to analyse the association between positive-Barber questionnaire (BQ) and hospital-institutional admissions and death within a year, in individuals aged 75 years old or older in a primary care centre. Material and methods: cohort study: positive/negative BQ. 133 persons. Initial assessment: BQ, age, gender, Barthel index, Pfeiffer questionnaire. Results: Mean age: 80.6 (P75 83 years old). Males: 45.5%. Positive BQ: 62.9% (95%CI 54.5-71.3), 72.3% ≤2 points. Only one person answered affirmatively to item 2 and none to item 4. Altered Barthel score 27.6% of the total; Pfeiffer 19.4%. Association positive BQ-Barthel and Barthel-Pfeiffer, both altered (p <0.0001). Relative risk (RR, considering density of incidence): 2.1 (95%CI 0.8-5.4) for hospitalisation, and 2.3 (95%CI 0.9-5.7) for three events as a whole, if BQ was positive; 23.8 (95%CI 3.0-182.9) and 37.2 (95%CI 4.9-283.2) for mortality, 2.7 (95%CI 1.3-5.6) and 2.5 (95%CI 1,2-5,1) for hospitalisation, 2.8 (95%CI 1.4-5.7) and 2.5 (95%CI 1.2-5.3) for three events, if Barthel or Pfeiffer was altered, respectively. RR considering the three events as a whole was 2.6 (95%CI 1.2-5.4) if item 6 ("problems which limit his/her autonomy") was positive, and 4.9 (IC95% 2.4-10.0) when item 9 ("previous hospitalisation") was positive; these two items were the only variables with significant RR in the regression analysis. The positive predictive value of the BQ, when considering events occurred, was 27.7%. Conclusions: The present study is one of the few studies in Spain on the utility of the BQ. This questionnaire presents considerable limitations for use in screening with poor predictive value and deficiencies in content validity, while association with deteriorated functional-cognitive status can influence the results. Items 9 and 6 and functional alteration better predict adverse events

Salmonella enteric infections in Gipuzkoa, Spain, 1983-2000.

The incidence of Salmonella enteric infections in Gipuzkoa, Spain, was estimated by studying a stable population between 1983 and 2000. Only stool culture confirmed cases were included. The annual mean rate of infection in children under 2 years old was 1121 per 100,000 (CI 95%; 1060-1181). This age group had the highest relative risk (RR), 16.2-fold higher than the RR of those aged over 14 years. Salmonella Enteritidis was the most prevalent serovar (80.4% of all patients), followed by Salmonella Typhimurium (11.7%).

Congenital anomalies in Glasgow between 1982 and 1989 and chromium waste.

BACKGROUND: The former site of a factory in Glasgow and nearby areas were found to be heavily polluted by chromium waste. This gave rise to local concern on possible health effects. As part of a wider study answering this concern, congenital malformations were investigated. METHODS: A descriptive geographical study was carried out. A 10 km circle centred on the factory site was designated as the study area and subdivided into one circle of 2 km radius and eight 1 km wide rings. Significant differences in relative risk between the circle and rings and a decreasing trend of risk with distance from the centre would point towards a teratogenic role of the chromium waste. Relative risks by rings were obtained by Poisson regression. Relative risks by deprivation categories were also obtained, with most results adjusted by these categories. RESULTS: Significant differences in risk appeared, with the area containing the polluted soil having the lowest risk. Aggregations of rings showed a central area with a relatively low risk, followed by an intermediate one with the highest risk and an external area with risk also high. Relative risk appeared to increase sharply between the most affluent category and the rest, then growing steadily with increasing deprivation but decreasing slightly for the most deprived. CONCLUSIONS: Relative risk shows a significant peak in an area 2-4 km away from the pollutant, which does not point towards a possible teratogenic effect of the chromium waste. Relative risk of congenital malformations for the more affluent sector of the population appeared to be markedly lower than that for the rest.

A study of leukaemia in Glasgow in connection with chromium-contaminated land.

BACKGROUND: In 1991, soil pollution was found around the site of a former chromium-processing factory in Glasgow, Scotland. Levels of chromium in soil were above limits considered as safe, although a risk assessment concluded that population exposure was likely to be below occupational levels. As an excess incidence of leukaemia has been suspected in the area, it was decided to investigate a possible relationship between the pollutant and the illness. METHODS: The ensuing study was descriptive-geographical. In the absence of better data, levels of exposure were assumed to decrease with distance from the centre of the polluted area. Leukaemia and population figures were obtained for each of nine concentric rings by aggregation of data available at the Enumeration District level. The null study hypothesis was that relative risk (as measured by Poisson regression) would not follow a definite trend with distance from the centre. Sex, age and levels of deprivation were taken into account. RESULTS: Relative risks by variables other than distance followed previously known patterns for leukaemia. No evident pattern by distance was found. After regroupings inside the variables, a significant excess of leukaemia was found for intermediate distances from the pollutant. CONCLUSIONS: No evidence was found of a possible relationship between soil pollution by chromium and leukaemia in the general population. Nonetheless, the excess noticed by the study warrants further research.