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AIM: To compare the efficacy of the treatment with transcutaneous perineal electrostimulation versus intracavitary electrostimulation to reduce the frequency of urinary incontinence after radical prostatectomy and the impact on the quality of life (QoL). METHODS: This single-blind equivalence-randomized controlled trial equally (1:1) randomly allocated men with urinary incontinence post radical prostatectomy into surface electrodes perineal group (intervention group, IG) and intra-anal probe group (control group, CG). Outcomes included changes in the 24h-Pad Test (main variable), and ICIQ-SF (International Consultation on Incontinence Questionnaire Short-Form), SF-12 (Short Form Health Survey), and I-QOL (incontinence quality of life questionnaire) questionnaires. Clinical data were collected at baseline, 6 and 10 weeks. For the comparisons between variables, χ2 test and Student's t test were used. Equivalence was analyzed by estimating the mean change (90% confidence interval) of urinary incontinence based on the Pad Test. The analysis was performed for the per-protocol and the intention-to-treat populations. Statistical significance level was set at p < 0.05. RESULTS: Seventy patients were included, mean age 62.8 (SD 9.4) years. Mean baseline 24h-Pad Test was 328.3 g (SD 426.1) and a significant decrease (p < 0.001) in the grams of urine loss at 5 weeks (159.1 g in the IG and 121.7 g in the CG), and at 10 weeks of treatment (248.5 g in the IG and 235.8 g in the CG) was observed. However, the final difference in the grams of urine loss between both treatments showed the absence of statistical significance (p = 0.874). In both groups, the ICIQ-SF, I-QOL, and SF-12 questionnaires revealed a significant improvement in QoL. CONCLUSION: Surface and intra-anal electrostimulation treatments reduced significantly losses of urine, but differences in grams of urine loss throughout the therapy between groups were not significant, suggesting that the efficacy of the two treatments is not statistically different. Nonetheless, the improvement observed in both groups was statistically significant and clinically relevant.

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OBJECTIVES: To evaluate the results of the first 24 months of a postprescription review with feedback-based antimicrobial stewardship program in a European referral children's hospital. STUDY DESIGN: We performed a pre-post study comparing antimicrobial use between the control (2015-2016) and the intervention periods (2017-2018) expressed in days of therapy/100 days present. Quality of prescriptions was evaluated by quarterly cross-sectional point-prevalence surveys. Length of stay, readmission rates, in-hospital mortality rates, cost of systemic antimicrobial agents, and antimicrobial resistance rates were included as complementary outcomes. RESULTS: Total antimicrobial use and antibacterial use significantly decreased during the intervention period (P = .002 and P = .001 respectively), and total antifungal use remained stable. A significant decline in parenteral antimicrobial use was also observed (P < .001). In 8 quarterly point-prevalence surveys (938 prescriptions evaluated), the mean prevalence of use of any antimicrobial among inpatients was 39%. An increasing trend in the rate of optimal prescriptions was observed after the first point-prevalence survey (P = .0898). Nonoptimal prescriptions were more common in surgical than in medical departments, in antibacterial prescriptions with prophylactic intention, and in empirical more than in targeted treatments. No significant differences were observed in terms of mortality or readmission rates. Only minor changes in antimicrobial resistance rates were noted. CONCLUSIONS: Our antimicrobial stewardship program safely decreased antimicrobial use and expenditure, and a trend toward improvement in quality of prescription was also observed.

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INTRODUCTION: Physical fitness level in children and adolescents is determined, partly, by the specific social and cultural context of each country. There is a lack of information about physical fitness level of Catalan children and its relation with parental socioeconomic and education level and anthropometric parameters. The aim of this study is to assess the physical fitness level of Catalan children and to examine the association with family environment and parental anthropometric characteristics and smoking. METHODS AND MATERIALS: This is an observational, cross-sectional, descriptive and analytic study of 8- and 9-year-old schoolchildren. Physical fitness level was assessed with "ALPHA-FITNESS battery" and familiar environment and progenitors' characteristics with ALADINO family questionnaire. Differences between group means were assessed using Student's t test and analysis of variance (ANOVA) and relation between variables by Pearson correlation coefficient. RESULTS: 269 children participated, 146 male (54.2%). Higher parental education level is associated to a better cardiorespiratory condition in their offspring. Those children whose fathers have higher education have a lower waist perimeter and lower body mass index. Children whose parents are not regular smokers have a better physical fitness. A positive correlation between body mass indexes of parents and children is observed, while a negative correlation between the maternal body mass index and both the musculoskeletal and cardiorespiratory conditions of the children is found. CONCLUSION: Children's physical fitness is related with education level, body mass index and smoking pattern of their parents

INTRODUCCIÓN: El nivel de condición física de la población infantil está determinado, en parte, por el contexto sociocultural específico de cada país. Hay una carencia de datos sobre el nivel de condición física de los niños catalanes y la relación de esta con las características del entorno familiar y de los progenitores. El objetivo del trabajo es medir el nivel de condición física de niños catalanes y su relación con el entorno familiar y las características antropométricas y tabaquismo de los progenitores. MATERIALES Y MÉTODOS: Estudio observacional transversal descriptivo y analítico de escolares de 8 y 9 años. El nivel de condición física se evaluó mediante la "Batería ALPHA-FITNESS" y las características del entorno familiar y de los progenitores con el cuestionario del estudio ALADINO. Las medias se compararon con la t de Student y el análisis de la varianza (ANOVA) y la relación entre variables con el coeficiente de correlación de Pearson. RESULTADOS: Participaron 269 niños/as, 146 niños (54,2%). A mayor nivel de estudios de los progenitores, mayor condición cardiorespiratoria de los niños/as, mientras que el nivel de estudios del padre está inversamente relacionado con el perímetro de cintura y el índice de masa corporal. Los niños/as con padres no fumadores habituales tienen mejor condición física. Se observa una correlación positiva entre el índice de masa corporal de los progenitores y el de los niños/as, y negativa entre el índice de masa corporal de la madre y la condición musculoesquelética y cardiorespiratoria de los hijos/as. CONCLUSIÓN: El nivel de condición física de los niños/as está relacionado con el nivel educativo, el índice de masa corporal y el hábito tabáquico de los dos progenitores

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Fundamentos: La ingesta regular de un desayuno de buena calidad se ha asociado con una elección de alimentos más saludable a lo largo del día. La dieta mediterránea ha sido considerada como un patrón alimentario saludable y se ha relacionado con una mejora en el estado de salud tanto en adultos como en niños y adolescentes. El objetivo del estudio fue evaluar la relación entre la calidad del desayuno y la adherencia a la dieta mediterránea en escolares de primaria. Métodos: Se estudiaron escolares de entre 8 y 9 años. La calidad del desayuno se evaluó con el cuestionario del estudio ALADINO y según los criterios del estudio enKid, y la evaluación de la adherencia a la dieta mediterránea con el cuestionario KIDMED. Resultados: Participaron 269 escolares, 146 niños (54,2%). La mayoría realizaba un desayuno de calidad mala (32,5%) o media (54,1%). La puntuación media del índice KIDMED fue de 7,2 (1,9). Un desayuno de buena calidad incrementó más de 4 veces (OR 4,6, IC 95% 1,4-15,1) la probabilidad de una alta adherencia a la dieta mediterránea, en relación a un desayuno de pésima-mala calidad. Conclusiones: Los escolares que consumían un desayuno de mejor calidad mostraron una mayor adherencia a la DM (AU)

Background: The intake of a healthy breakfast has been associated to a healthier food choice throughout the day. The Mediterranean diet is considered a healthy eating pattern and has been associated with an improvement in the health status of both adults and children and adolescents. The aim of this study was to assess the relationship between adherence to the Mediterranean diet and the breakfast quality in primary school children. Methods: The studied population was school children aged 8 and 9 years. The breakfast quality was assessed with the ALADINO questionnaire and according to the enKid study criteria, and the assessment of adherence to the Mediterranean diet was carried out using the KIDMED questionnaire. Results: 269 school children participated, 146 male (54.2%). Most of them had a breakfast of poor (32.5%) or medium (54.1%) quality. The average score of the KIDMED index was 7.2 (1.9). Having a breakfast of good quality increased more than four-fold (OR 4.6, IC 95% 1.4-15.1) the probability of a high adherence to the Mediterranean diet, in relation to a bad-poor quality breakfast. Conclusions: School children who consumed a better quality breakfast showed greater adherence to Mediterranean dietto the Mediterranean diet and also a moderate physical activity, being greater among boys and younger (AU)

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OBJECTIVE: Confidence in cooking skills is relevant in health. The objective was to study the status of cooking skills and consumption of ready meal among university students in the city of Barcelona, assessing their association with sociodemographic variables and confidence in some culinary skills and knowing how to cook. METHODS: Cross-sectional study, carried out during the 2014-2015 academic year, 525 students (81.3% women, median age 21 years) using an on-line questionnaire. Bivariate and multivariate analyses were performed; odds ratios and 95% confidence intervals were estimated. RESULTS: Between 53% and 89% of the students reported feeling very confident in 10 of the 18 cooking skills. No statistically significant differences were observed by sex, and between 62% and 86% of those over 21 years expressed great confidence in 9 competitions. The consumption of ready meal was prevalent (49.4%) and associated with age (OR=0.95 95% CI: 0.91-0.99), gender (male, OR=1.98 95% CI: 1.23-3.18) and not knowing how to cook (OR=2.25 95% CI: 1.10-4.60). In students who knew how to cook, eating ready meal was associated with gender (male, OR =1.67 95% CI: 1.00 to 2.77) and no longer feel confident in preparing more than one food at one time (OR = 1.73 95% CI: 1.58 to 2.60). CONCLUSIONS: Students at a university in Barcelona have a level in cooking skills which could be improved, and consume ready meals usually.

OBJETIVO: Las competencias culinarias pueden tener relevancia en la salud. El objetivo del estudio fue conocer el estado de las competencias culinarias y el consumo de alimentos procesados o preparados en estudiantes universitarios en Barcelona así como su asociación con variables sociodemográficas y la confianza en algunas competencias culinarias y el saber cocinar. METODOS: Diseño transversal, durante el curso 2014-2015, con 525 estudiantes (81,3% mujeres, edad mediana 21 años), mediante un cuestionario en línea. Se realizaron análisis bivariados y multivariados con modelos de regresión logística. Como medida de asociación se estimó la odds ratio y su intervalo de confianza del 95%. RESULTADOS: Entre el 53% y el 89% de los estudiantes declararon sentirse muy confiados en 10 de las 18 competencias culinarias estudiadas. No se observaron diferencias estadísticamente significativas por sexo y entre el 62% y el 86% de las personas mayores de 21 años expresaron mucha confianza en 9 competencias. La prevalencia del consumo de alimentos procesados o preparados fue del 49,4% y se asoció a la edad (OR=0,95 IC95%: 0,91-0,99), al sexo (hombre, OR=1,98 IC95%: 1,23-3,18) y a no saber cocinar (OR=2,25 IC95%: 1,10-4,60). Entre quienes sabían cocinar este consumo se asoció al sexo (hombre, OR=1,67 IC95%: 1,00-2,77) y a no tener confianza en preparar más de un alimento al mismo tiempo (OR=1,73 IC95%: 1,58-2,60). CONCLUSIONES: Los estudiantes universitarios de Barcelona tienen competencias culinarias mejorables y consumen alimentos procesados o preparados habitualmente.

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Fundamentos: Las competencias culinarias pueden tener relevancia en la salud. El objetivo del estudio fue conocer el estado de las competencias culinarias y el consumo de alimentos procesados o preparados en estudiantes universitarios en Barcelona así como su asociación con variables sociodemográficas y la confianza en algunas competencias culinarias y el saber cocinar. Métodos: Diseño transversal, durante el curso 2014-2015, con 525 estudiantes (81,3% mujeres, edad mediana 21 años), mediante un cuestionario en línea. Se realizaron análisis bivariados y multivariados con modelos de regresión logística. Como medida de asociación se estimó la odds ratio y su intervalo de confianza del 95%. Resultados: Entre el 53% y el 89% de los estudiantes declararon sentirse muy confiados en 10 de las 18 competencias culinarias estudiadas. No se observaron diferencias estadísticamente significativas por sexo y entre el 62% y el 86% de las personas mayores de 21 años expresaron mucha confianza en 9 competencias. La prevalencia del consumo de alimentos procesados o preparados fue del 49,4% y se asoció a la edad (OR=0,95 IC95%: 0,91-0,99), al sexo (hombre, OR=1,98 IC95%: 1,23-3,18) y a no saber cocinar (OR=2,25 IC95%: 1,10-4,60). Entre quienes sabían cocinar este consumo se asoció al sexo (hombre, OR=1,67 IC95%: 1,00-2,77) y a no tener confianza en preparar más de un alimento al mismo tiempo (OR=1,73 IC95%: 1,58-2,60). Conclusiones: Los estudiantes universitarios de Barcelona tienen competencias culinarias mejorables y consumen alimentos procesados o preparados habitualmente (AU)

Background: Confidence in cooking skills is relevant in health. The objective was to study the status of cooking skills and consumption of ready meal among university students in the city of Barcelona, assessing their association with sociodemographic variables and confidence in some culinary skills and knowing how to cook. Methods: Cross-sectional study, carried out during the 2014-2015 academic year, 525 students (81.3% women, median age 21 years) using an on-line questionnaire. Bivariate and multivariate analyses were performed; odds ratios and 95% confidence intervals were estimated. Results: Between 53% and 89% of the students reported feeling very confident in 10 of the 18 cooking skills. No statistically significant differences were observed by sex, and between 62% and 86% of those over 21 years expressed great confidence in 9 competitions. The consumption of ready meal was prevalent (49.4%) and associated with age (OR=0.95 95% CI: 0.91-0.99), gender (male, OR=1.98 95% CI: 1.23-3.18) and not knowing how to cook (OR=2.25 95% CI: 1.10-4.60). In students who knew how to cook, eating ready meal was associated with gender (male, OR =1.67 95% CI: 1.00 to 2.77) and no longer feel confident in preparing more than one food at one time (OR = 1.73 95% CI: 1.58 to 2.60). Conclusions: Students at a university in Barcelona have a level in cooking skills which could be improved, and consume ready meals usually (AU)

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Introducción El estudio del impacto de la estructura sobre los resultados se ha basado principalmente en el número de intervenciones. El objetivo de este trabajo fue desarrollar un índice de capacidad estructural para hospitales de agudos con cirugía oncológica. Métodos Estudio transversal por encuesta, relativa a las características estructurales de los centros que habían realizado alguna intervención quirúrgica de oncología digestiva en Cataluña en 2004. Se desarrolló un índice sobre la base de la maximización de la fiabilidad, y se seleccionaron las variables por sus características métricas y también conceptuales. Resultados De los 45 centros seleccionados se obtuvo respuesta válida de 37. El conjunto de variables incluidas en el índice (relacionadas con la docencia, la gestión de casos y la tecnología) presentó buenas propiedades métricas (alfa de Cronbach: 0,92 y correlación ítem-total >0,7).Conclusiones El índice desarrollado permite clasificar los centros hospitalarios atendiendo a sus especificidades tecnológicas, organizativas y de gestión (AU)

Introduction The study of the impact of structure on outcomes has mainly been focused on the number procedures. The aim of our study was to develop a structure capacity index for hospitals for oncological surgery. Methods Cross-sectional study by means of a questionnaire related to the structural characteristics of hospitals that had performed gastrointestinal oncological surgery in Catalonia during 2004. Variables were considered for the index according to their measurement and conceptual properties. Results A response was obtained from 37 out of 48 hospitals. Variables with good conceptual and measurement properties (Cronbach alpha 0.92 and Item-Total correlation >0.7) were included in the index. These variables were related to teaching, management and technology. Conclusions The index has acceptable levels of reliability and validity, and can be a useful tool to classify hospitals according to their technological characteristics and management strategies (AU)

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INTRODUCTION: The study of the impact of structure on outcomes has mainly been focused on the number procedures. The aim of our study was to develop a structure capacity index for hospitals for oncological surgery. METHODS: Cross-sectional study by means of a questionnaire related to the structural characteristics of hospitals that had performed gastrointestinal oncological surgery in Catalonia during 2004. Variables were considered for the index according to their measurement and conceptual properties. RESULTS: A response was obtained from 37 out of 48 hospitals. Variables with good conceptual and measurement properties (Cronbach alpha 0.92 and Item-Total correlation >0.7) were included in the index. These variables were related to teaching, management and technology. CONCLUSIONS: The index has acceptable levels of reliability and validity, and can be a useful tool to classify hospitals according to their technological characteristics and management strategies.

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BACKGROUND AND OBJECTIVE: To describe and to analyze the evolution of the mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV), the clinical and epidemiological characteristics and the use of antiretrovirals (ARV) in the HIV infected pregnant women and their new-borns alive between 1987 and 2003 in Catalonia. MATERIAL AND METHOD: The available clinical-epidemiological and treatment data were obtained from 4 reference hospitals that take care of most of the children born to HIV infected mothers in Catalonia. Two of the hospitals had a data base designed to the follow up of their patients, whereas in the other 2 data were gathered by reviewing clinical registries. For the analysis, 3 periods, based on the recommendations of treatment ARV during pregnancy, were settled down: 1987-1993; 1994-1996, and 1997-2003. RESULTS: 1,105 mother-infant pairs were studied. HIV MTCT was reduced from 20.4% to 3.5% from first to third period of study (p < 0.001). The median age of the mothers increased from 24.6 to 30.5 years of age (p < 0.001). The proportion of women infected by sexual transmission increased from 17.2% to 58.8% (p < 0.001), whereas that of parenteral transmission decreased from the 79.2% to 43.5% (p < 0.001). In the last period, 74.1% of mother-child pairs received complete ARV prophylaxis regimens and 21.6% partial ones. The rate of elective caesarean-section went up from 32.2% to 58.2% (p < 0.001). CONCLUSIONS: The rates of MTCT in our setting have followed the same trend as in other countries of our surroundings. The observed changes reflect the variations in the characteristics of the epidemic in the general population. The implementation of the recommendations on ARV prophylaxis has begun early and it has extended progressively without getting to be total. Additional strategies for the universal coverage of the screening test during pregnancy are still needed.

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FUNDAMENTO Y OBJETIVO: Describir y analizar la evolución de la transmisión vertical (TV) del virusde la inmunodeficiencia humana (VIH), las características clinicoepidemiológicas y el uso deantirretrovirales (ARV) en las gestantes infectadas por el VIH y sus recién nacidos vivos entre1987 y 2003 en Cataluña.MATERIAL Y MÉTODO: Se obtuvieron los datos clinicoepidemiológicos y de tratamiento disponiblesde los 4 hospitales de referencia que más hijos de madres infectadas atienden en Cataluña.Dos de ellos disponían de una base de datos propia, diseñada para el seguimiento de sus pacientes,mientras que en los otros 2 los datos se recogieron mediante revisión de historias clínicas.Para el análisis se establecieron 3 períodos en función de las recomendaciones de tratamientoARV durante el embarazo: 1987-1993; 1994-1996, y 1997-2003.RESULTADOS: Se estudió a 1.105 parejas madres-hijo. La tasa de TV se redujo del 20,4 al 3,5% entreel primer y el tercer períodos de estudio (p < 0,001). La mediana de edad de las madres se incrementódesde los 24,6 a los 30,5 años (p < 0,001). La proporción de mujeres infectadas por transmisiónsexual pasó del 17,2 al 58,8% (p < 0,001), mientras que la de transmisión parenteral pasó del 79,2al 43,5% (p < 0,001). En el último período un 74,1% de parejas madre-hijo recibió profilaxis ARVcompleta y un 21,6% parcial. Las cesáreas programadas pasaron del 32,2 al 58,2% (p < 0,001).CONCLUSIONES: Las tasas de TV en nuestro medio han seguido la misma tendencia que en otrospaíses de nuestro entorno. Los cambios observados reflejan las variaciones en las característicasde la epidemia en la población general. La adopción de las recomendaciones de la profilaxisARV se ha iniciado con prontitud y se ha extendido progresivamente sin llegar a ser total. Sonaún necesarias estrategias para la universalización de la prueba de cribado durante el embarazo

BACKGROUND AND OBJECTIVE: To describe and to analyze the evolution of the mother-to-child transmission(MTCT) of the human immunodeficiency virus (HIV), the clinical and epidemiologicalcharacteristics and the use of antiretrovirals (ARV) in the HIV infected pregnant women andtheir new-borns alive between 1987 and 2003 in Catalonia.MATERIAL AND METHOD: The available clinical-epidemiological and treatment data were obtainedfrom 4 reference hospitals that take care of most of the children born to HIV infected mothersin Catalonia. Two of the hospitals had a data base designed to the follow up of their patients,whereas in the other 2 data were gathered by reviewing clinical registries. For the analysis, 3periods, based on the recommendations of treatment ARV during pregnancy, were settleddown: 1987-1993; 1994-1996, and 1997-2003.RESULTS: 1,105 mother-infant pairs were studied. HIV MTCT was reduced from 20.4% to 3.5%from first to third period of study (p < 0.001). The median age of the mothers increased from24.6 to 30.5 years of age (p < 0.001). The proportion of women infected by sexual transmissionincreased from 17.2% to 58.8% (p < 0.001), whereas that of parenteral transmission decreasedfrom the 79.2% to 43.5% (p < 0.001). In the last period, 74.1% of mother-child pairs receivedcomplete ARV prophylaxis regimens and 21.6% partial ones. The rate of elective caesarean-sectionwent up from 32.2% to 58.2% (p < 0.001).CONCLUSIONS: The rates of MTCT in our setting have followed the same trend as in other countriesof our surroundings. The observed changes reflect the variations in the characteristics of the epidemicin the general population. The implementation of the recommendations on ARV prophylaxishas begun early and it has extended progressively without getting to be total. Additional strategiesfor the universal coverage of the screening test during pregnancy are still needed

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