Integrating Dehumanization and Attachment in the Prediction of Teen Dating Violence Perpetration.

Dehumanization has the potential to account for different abusive behaviors because it involves making negative judgments of others that make it easier to harm them. However, research has not resorted to this mechanism to analyze teen dating violence (TDV) perpetration, nor has it examined its association with the broader representations of others linked to attachment. The first objective of this study was to analyze whether dehumanization of one's partner (lesser perceived agency and experience) and attribution of evilness were associated with a higher level of TDV perpetration and specific attachment styles. The second objective was to develop a structural equation model (SEM) that allowed integration of the links between all these factors. Participants in this cross-sectional study were 1799 adolescents who completed a survey in high schools. The results showed that those who were classified as high in TDV perpetration did perceive lower agency, lower experience, and higher evilness in their partners. The dehumanized perception of one's partner was found to vary according to the attachment styles, with those highest in avoidance (dismissive and fearful) dehumanizing their partners the most. The SEM showed that dehumanization is related to avoidant and not to anxious attachment. It also pointed to the relevance of attribution of evilness in predicting TDV perpetration. The invariance of the model was tested across gender subsamples. These findings allow better understanding of how violence may arise in early relationships and where to focus intervention with adolescents.

Lacticaseibacillus rhamnosus GG and Saccharomyces cerevisiae boulardii supplementation exert protective effects on human gut microbiome following antibiotic administration in vitro.

Antibiotic-induced dysbiosis of the microbial community has been associated with several gastrointestinal symptoms. The impact of repeated administration of Lacticaseibacillus rhamnosus GG (CNCM-I-4798) (formerly known as Lactobacillus rhamnosus GG), Saccharomyces cerevisiae boulardii (CNCM-I-1079) and their combination (associated in Smebiocta/Smectaflora Protect®) in supporting recovery of gut microbiota functionality and composition during and following amoxicillin:clavulanic acid administration was evaluated in vitro. Antibiotic dosage negatively affected SCFA production, coinciding with detrimental effects on Bacteroidetes, Firmicutes and Bifidobacterium spp. in the simulated proximal colon, while Akkermansia muciniphila was significantly reduced in the distal colon. L. rhamnosus GG and S. boulardii were able to thrive in both colon regions upon dosing, with S. boulardii even showing protective effects on the survival of L. rhamnosus GG during antibiotic administration. The impact of the probiotic strains on microbiome recovery revealed that supplementation with L. rhamnosus GG and/or S. boulardii resulted in a stimulating effect on the most abundant bacterial groups within the bacterial community of each donor. For one of the donors tested, co-dosing of L. rhamnosus GG and S. boulardii resulted in superior short-chain fatty acid recovery accompanied by a stronger increase in abundance of Bifidobacteriaceae. Overall, the current study provides first evidence that combined supplementation of L. rhamnosus GG and S. boulardii might be an interesting candidate in limiting detrimental effects of amoxicillin:clavulanic acid on the human gut microbiome, though further studies are warranted to confirm these findings.

Lactobacillus rhamnosus GG and Saccharomyces cerevisiae boulardii exert synergistic antipathogenic activity in vitro against enterotoxigenic Escherichia coli.

Short-term colonic in vitro batch incubations were performed to elucidate the possible synergistic effects of Lactobacillus rhamnosus GG (CNCM-I-4798) and Saccharomyces cerevisiae boulardii (CNCM-I-1079) (associated in Smebiocta/Smectaflora Protect®) on the colonic microbial fermentation process, as well as their antipathogenic activity against enterotoxigenic Escherichia coli (LMG2092) (ETEC). These incubations adequately simulate the native microbiota and environmental conditions of the proximal colon of both adult and toddler donors, including the colonic mucosal layer. Results indicated that both strains were capable of growing together without showing antagonistic effects. Co-cultivation of both strains resulted in increased butyrate (stimulated by L. rhamnosus GG), propionate (stimulated by S. boulardii), and ethanol (produced by S. boulardii) production compared to the control incubations, revealing the additive effect of both strains. After inoculation of ETEC under simulated dysbiotic conditions, a 40 and 46% reduction in the concentration of ETEC was observed upon addition of both strains during the experiments with the adult and toddler donor, respectively. Furthermore, ETEC toxin levels decreased upon S. boulardii inoculation, probably due to proteolytic activity of this strain, with a synergistic effect being observed upon co-cultivation of L. rhamnosus GG and S. boulardii resulting in a reduction of 57 and 46% for the adult and toddler donor, respectively. Altogether, the results suggest that both probiotics together may help microbiota functionality, in both adults and toddlers and under healthy or impaired conditions, which could be of great interest when the colonic microbiota is dysbiotic and therefore sensitive to pathogenic invasion such as during antibiotic treatment.

XVI Congreso SEINAP. Fórmulas extensamente hidrolizadas / XVI Congreso SEINAP. Extensively hydrolized formulas

No disponible

Bloodstream infections caused by Escherichia coli producing AmpC ß-lactamases: epidemiology and clinical features.

The aim of the study was to investigate the epidemiology and clinical features of bloodstream infections due to Escherichia coli producing AmpC ß-lactamases (AmpC-Ec-BSI). In a multi-centre case-control study, all third-generation-cephalosporin-resistant Escherichia coli BSI (3GC-Ec-BSI) isolates were analysed. Acquired bla AmpC (bla ac-AmpC) detection was done by polymerase chain reaction (PCR) and sequencing. Chromosomal bla AmpC (bla c-AmpC) expression was quantified by real-time PCR. Cases were patients with AmpC-Ec-BSI. Controls were patients with cephalosporin-susceptible E. coli BSI, matched 1:1 by sex and age. Demographics, comorbidities, intrinsic and extrinsic risk factors for antimicrobial resistance, clinical presentation and outcomes were investigated. Among 841 E. coli BSI, 17 were caused by AmpC-Ec (2 %). Eleven isolates (58.8 %) had bla ac-AmpC and six were bla c-AmpC overproducers. The mean age of cases was 66.2 years and 71 % were men. Cases were more frequently healthcare-related (82 vs. 52 % controls, p < 0.05) and presented more intrinsic and extrinsic risk factors. At least one risk factor was present in 94.1 % of cases vs. 41.7 % of controls (p = 0.002). Severity and length of stay (LOS) were higher among cases (mean Pitt Score 2.6 vs. 0.38 in controls, p = 0.03; LOS 17.5 days vs. 6 in controls, p = 0.02). Inappropriate empirical therapy (IET) was administered to 70.6 % of cases and 23.5 % of controls (p < 0.003). No differences were found in terms of cure rate at the 14th day and mortality. Bloodstream infections due to AmpC-Ec (mostly plasmid-mediated) are infrequent in our area. AmpC-Ec-BSI affects mainly patients with intrinsic risk factors and those with previous antibiotic exposure. A high proportion received IET.

Simulación clínica en enfermería comunitaria / Clinical simulation in nursing community

Introducción: La finalidad de esta investigación fue evaluar los resultados de aprendizaje del alumno en relación con las competencias en enfermería comunitaria y valorar la satisfacción de éstos respecto a la simulación clínica en este contexto. Material y métodos: Estudio descriptivo observacional realizado en el primer semestre del curso 2014/2015 en el Campus Docent Sant Joan de Déu. Se hizo un análisis cualitativo de la conducción de 30 debriefings donde se evaluaron los resultados de aprendizaje en relación con los siguientes ítems (aspectos emocionales, toma de decisiones, valoración integral del paciente, valoración del paciente en atención domiciliaria, comunicación, educación sanitaria y habilidades técnicas). La satisfacción de los estudiantes se evaluó mediante un cuestionario compuesto por ocho ítems valorados mediante una escala ordinal (contenidos, coordinación, tiempo, metodología, utilidad, material, conocimientos y expectativas) y se realizó un análisis descriptivo de cada uno de ellos. Resultados: El análisis de los debriefings mostró que los alumnos tienen dificultades para realizar la valoración del paciente con los instrumentos que se utilizan en la práctica clínica; sin embargo, presentan buenas habilidades comunicativas con el usuario y la familia. Respecto al grado de satisfacción, participaron en la cumplimentación del cuestionario 47 estudiantes de tercer curso de grado y la puntuación media total de los alumnos fue de 9,08 ± 0,85. La utilidad del taller fue valorada con una media superior a 9. Conclusiones: La simulación clínica es una metodología docente valorada satisfactoriamente por parte de los alumnos que permite trabajar objetivos relacionados con habilidades técnicas y con habilidades no técnicas

Introduction: The purpose of this research was to evaluate the learning outcomes of students in relation to competencies in community nursing and rating the satisfaction regarding the clinical simulation in this context. Material and methods: Descriptive observational study conducted in the first semester of the academic year 2014 / 2015 on the Campus Docent Sant Joan de Déu. A qualitative analysis of driving 30 debriefings where assessed learning outcomes in relation to the following items (emotions, decision-making, comprehensive patient assessment, assessing the patient in home care, communication, health education and technical skills) was made. Student satisfaction was assessed using a questionnaire consisting of 8 items valued using an ordinal scale (content, coordination, time, methodology, tool, material, knowledge, expectations) and we performed a descriptive of each analysis. Results: The analysis of the debriefings showed that students have difficulties to conduct the assessment of the patient with the instruments that are used in clinical practice, however have good communicative skills with the user and the family. Regarding the degree of satisfaction, participated in filling in the questionnaire, 47 students in third year of degree, the total average score of students was 9.08 ± 0.85. The usefulness of the workshop was appraised with a superior half to 9. Conclusions: Clinical simulation is a valued teaching methodology successfully by students, which allows work related technical skills and abilities not technical objectives

What do people mean when speaking of evilness?

The term evilness started to become popular in social psychology after the publication in 1999 of the special issue edited by Arthur G. Miller, «Perspectives on evil and violence». It is usually used to define behaviors that are extremely and strongly harmful. However, the concept is still imprecise and needs to be empirically delineated. This article attempts to answer the following questions. What is evilness? What is the difference between aggression and evilness? We conducted several studies with three goals: to analyze how laypersons and experts define evilness, to verify whether laypeople distinguish between different intensities of evilness, and to determine the dimensions that predict aggression and evilness. The results offer preliminary answers to the three questions (AU)

El término maldad comienza a difundirse en psicología social tras la publicación en 1999 del monográfico editado por Arthur G. Miller, «Perspectives on evil and violence». Usualmente se emplea para definir acciones extremas e intensamente dañinas, pero el concepto es impreciso y necesita ser delimitado empíricamente. Este artículo trata de responder a las preguntas ¿Qué es la maldad? ¿Qué diferencias existen entre la maldad y el concepto tradicional de agresión? Para ello, llevamos a cabo varios estudios con tres objetivos: analizar cómo legos y expertos definen la maldad, verificar si las personas legas diferencian niveles de intensidad de la maldad y determinar las dimensiones predictivas de la maldad y la agresión. Los resultados ofrecen respuestas preliminares a las tres cuestiones (AU)

Bloodstream infections in adults: importance of healthcare-associated infections.

OBJECTIVE: The objective of this study was to evaluate the characteristics of bloodstream infections occurring among outpatients having recent contact with the health care system compared to hospital and community-acquired infections. METHODS: Prospective observational cohort study of adult patients with bloodstream infections at three teaching hospitals. Bloodstream infection was defined as hospital-acquired if the first positive blood culture was performed more than 48 h after admission. Other bloodstream infections were classified as healthcare-associated or community-acquired. RESULTS: A total of 1157 episodes of bloodstream infections were studied; 581 (50.2%) were community-acquired, 295 (25.5%) were hospital-acquired, and 281 (24.3%) were health care-associated. Of the 281 health care-associated bloodstream infections, 68 (24%) occurred in patients residing in a nursing home, 104 (37%) in patients receiving intravenous therapy, health care at home, chemotherapy or attending dialysis, and 169 (60%) in patients hospitalized during the 90 days before their bloodstream infection (some patients belonged to more than one risk category). The highest prevalence rate of MRSA infections occurred in healthcare-associated infections (5%) (p<0.001). A significantly higher mortality rate was seen in the group with healthcare-associated infections (27.5%) than in community-acquired infections (10.4%) (p<0.001). CONCLUSIONS: Our results confirm that healthcare-associated bloodstream infections show important differences from community-acquired bloodstream infections and suggest that empirical antibiotic therapy should be similar to hospital-acquired bloodstream infections, taking into account the epidemiologic characteristics of each region.

Consejería a adolescentes: descripción epidemiológica y motivos de consulta / Teenager counselling in primary care

Background: Teenager counseling to recognize risks and reinforce strengths is carried out in a primary care outpatient clinic since 2003. Aim: To describe the epidemiology and causes for consultation in this teenage counseling program. Material and methods: Retrospective review of the records of 116 teenagers (median age 13 years, 67 percent females) that received teenager counseling. Results: Seventy percent of women and 50 percent of men came from nuclear families. More than two thirds were primogenital. Most adolescents were accompanied by their mother, that were the main adult raw model. Fifty percent had dysfunctional families. All were attending school regularly and 21 percent of women and 29 percent of men had repeated a school level. Sixty eight percent of women and 62 percent of men declared to have a life project. Twenty percent were worried about their physical appearance. Seventy seven percent of women and 62 percent of men considered themselves as "happy". Thirty six percent of women and 14 percent of men smoked. The figures for alcohol consumption were 21 percent and 14 percent, respectively. The causes for consultation were obesity, overweight, unspecific symptoms, behavioral problems, bad school achievement, communication problems or pregnancy. Reasons for counseling were family dysfunction, low self esteem, bad school achievement and information about sexuality. Conclusions: The information obtained could help to improve the interdisciplinary work and to coordinate counseling with the family and schools.

Invasive pneumococcal disease among children in a health district of Barcelona: early impact of pneumococcal conjugate vaccine.

This study evaluated the impact of heptavalent pneumococcal conjugate vaccine (HPCV) on invasive pneumococcal disease (IPD) in children aged < or = 5 years in Barcelona, Spain. The incidence of IPD, vaccine uptake and prevalence of nasopharyngeal colonisation were analysed in two different periods: 1999-2001 (pre-licence period), and 2002-2004 (post-licence period). In total, 121 cases of IPD were identified. The overall incidence of IPD decreased from 96.9 cases/100,000 to 90.6 cases/100,000 (OR 0.93, 95% CI 0.69-1.26, p 0.71) between the two periods. The proportion of cases caused by non-vaccine-related serotypes (NVS) increased from 21% to 43.7% (OR 2.9, 95% CI 1.2-7, p 0.01). IPD was diagnosed in seven vaccinated children, six of whom were infected by NVS. There was a trend of diminishing prevalence of resistance to penicillin and macrolides in 2002-2004. The incidence of empyema increased from 1.7 to 8.5/100,000 (OR 4.5, 95% CI 0.91-18, p 0.06). The rate of vaccination ranged from 4.8% to 34%. It was concluded that the rates of IPD in this area did not decrease following the introduction of HPCV. The low uptake of vaccine and the greater proportion of colonisation/infection by NVS probably explain these findings. A trend of increasing empyema was also apparent. A decrease in the prevalence of penicillin and macrolide resistance paralleled the progressive uptake of vaccine.

La percepción de semejanza integrupal y la identificación con el endogrupo: ¿incrementa o disminuye el prejuicio? / The perception of intergroup similarity and ingroup identification: do they increase or reduce prejudice?

El presente estudio analiza el papel de la semejanza intergrupal y la identidad en las relaciones intergrupales. Se trata de determinar la relación de la percepción de semejanza endo-exogrupal y la identidad endogrupal, con las actitudes hacia varios grupos de inmigrantes. Para ello, 400 estudiantes de Secundaria respondieron un cuestionario compuesto por tres escalas: identificación con el endogrupo, similitud intergrupal y una escala de distancia social. El análisis multidimensional de las escalas de similitud mostró que las personas atienden fundamentalmente a dos dimensiones: la similitud de estatus y la similitud actitudinal o cultural. Estas dimensiones permitieron organizar a los inmigrantes en tres categorías: grupos semejantes grupos diferentes de alto estatus y grupos diferentes de bajo estatus. Finalmente, el análisis de las respuestas a las escalas de distancia social indicó que es la semejanza intergrupal la que explica un porcentaje mayor de su varianza (AU)

This study examines the role played by intergroup similarity and identity in intergroup relations. The main purpose was to determine the relation between ingroup/outgroup perceived similarity and ingroup identification, with attitudes towards several immigrants groups. 400 secondary school students answered a questionnaire composed by three scales: ingroup identification, perceived intergroup similarity, and social distance. Multidimensional analysis of similarity scales showed that people basically employ two dimensions: status similarity and attitudinal similarity. These two dimensions allowed to determine three outgroup categories: similar groups, high status dissimilar groups and low status dissimilar group. Lastly, the analysis of the answer to social distances scales showed that similarity explains the greatest percentage of variance (AU)

[Complications of enteral nutrition at home. Results of a multicentre trial]. / Complicaciones de la nutrición enteral domiciliaria. Resultados de un estudio multicéntrico.

AIM: In spite of the increasing number of home enteral nutrition (HEN) patients, only few articles had reported the frequency of complications related to this treatment. Our multicentric study analyzes the HEN complications in relation to access device and time of treatment. METHOD: 92 HEN patients from 8 hospitals were randomly selected. Patients were distributed in relation to the time of treatment and access device (nasogastric tube and percutaneous or surgical gastrostomies). After an educational program, they were filled in an initial questionnaire and repeated it the days 15 and 30. They received a mean of 1650 Kcal of enteral solution. A total of 2760 HEN prospective days were analyzed. RESULTS: In prospective study 42% of patients had some complication (112 episodes). The most frequent were gastrointestinal (55%) and mechanical (29%); 0.16 complications of patient-year were registered. The most common complications were: extraction (15%), constipation (13%), vomiting (12%) and diarrhoea (10%). The gastrostomy group had more gastrointestinal complications. In retrospective evaluation, percutaneous gastrostomy group had the lowest ratio of complications and nasogastric tube group required more tube replacements (4 vs 2) and had 1.96 episodes/patient (percutaneous group 1.85 and surgical gastrostomy 3.1 episodes/patient). CONCLUSION: HEN is safe with low incidence of complications. An adequate educational program is very important and we expect, in the future, to establish an proper National Home Care System.

Complicaciones de la nutrición enteral domiciliaria. Resultados de un estudio multicéntrico / Complications of enteral nutrition at home. Results of a multi-centre trial

Objetivo: A pesar del número creciente de nutrición enteral domiciliaria (NED), sólo algunos artículos recogen la frecuencia de sus complicaciones. Este estudio multicéntrico analiza estas complicaciones en relación a la vía de acceso y la duración del soporte nutricional. Método: Seleccionamos aleatoriamente 92 pacientes con NED de 8 hospitales y se distribuyeron en relación a la duración del soporte y a la vía de acceso: sonda nasogástrica (SNG) y gastrostomías percutánea o quirúrgica. Tras un programa educativo, los pacientes completaron un cuestionario inicial que se repitió en los días 15 y 30.Recibieron una media de 1.650 kcal de fórmula enteral. Se analizaron un total de 2.760 días prospectivos de NED. Resultados: En la fase prospectiva, el 42 por ciento de los pacientes tuvo alguna complicación (112 episodios). Los más frecuentes fueron digestivos (55 por ciento) y mecánicos (29 por ciento); se registraron 0,16 complicaciones por paciente-año. Las complicaciones más comunes fueron: extracción (15 por ciento), estreñimiento (13 por ciento), vómitos (12 por ciento) y diarrea (10 por ciento). El grupo de gastrostomía tuvo más complicaciones digestivas. En el análisis retrospectivo, el grupo de gastrostomía percutánea tuvo menos complicaciones y el de SNG requirió más recambios de sondas (4 frente a 2) y tuvieron 1,96 complicaciones/paciente (grupo de gastrostomía percutánea 1,85 y quirúrgica 3,1). Conclusión: La NED es segura y presenta una baja incidencia de complicaciones. Un programa educativo adecuado es muy útil y esperamos, en el futuro, contribuir a un mejor sistema de atención domiciliaria (AU)

Aim: In spite of the increasing number of home enteral nutrition (HEN) patients, only few articles had reported the frequency of complications related to this treatment. Our multicentric study analyzes the HEN complications in relation to access device and time of treatment. Method: 92 HEN patients from 8 hospitals were randomly selected. Patients were distributed in relation to the time of treatment and access device (nasogastric tube and percutaneous or surgical gastrostomies). After an educational program, they were filled in an initial questionnaire and repeated it the days 15 and 30. They received a mean of 1650 Kcal of enteral solution. A total of 2760 HEN prospective days were analyzed. Results: In prospective study 42% of patients had some complication (112 episodes). The most frequent were gastrointestinal (55%) and mechanical (29%); 0.16 complications of patient-year were registered. The most common complications were: extraction (15%), constipation (13%), vomiting (12%) and diarrhoea (10%). The gastrostomy group had more gastrointestinal complications. In retrospective evaluation, percutaneous gastrostomy group had the lowest ratio of complications and nasogastric tube group required more tube replacements (4 vs 2) and had 1.96 episodes/patient (percutaneous group 1.85 and surgical gastrostomy 3.1 episodes/patient). Conclusion: HEN is safe with low incidence of complications. An adequate educational program is very important and we expect, in the future, to establish an proper National Home Care System (AU)

Isotherms and sequential extraction procedures for evaluating sorption and distribution of heavy metals in soils.

Heavy metals are potentially toxic to human life and the environment. Their contaminating effect in soils depends on chemical associations. Hence, determining the chemical form of a metal in soils is important to evaluate its mobility and bioavailability. We utilized a sequential extraction procedure and sorption isotherms (monometal and competitive) to evaluate the mobility and distribution of Cd, Cu, Ni, Pb, and Zn in four soils differing in their physicochemical properties: Calcixerollic Xerochrepts (Cx1 and Cx2), Paralithic Xerorthent (Px) and Lithic Haplumbrept (Lh). Most of the metals retained under point B conditions of sorption isotherms were extracted from the more mobile fractions: exchangeable and carbonates, in contrast with the profiles of the original soils where metals were preferently associated with the residual fraction. In soils having carbonate concentration under 6% (Cx1 and Lh), the exchangeable fraction was predominant, whereas in calcareous soils (Cx2 and Px) metals extracted from carbonates predominated. Partitioning profiles were in accordance with the affinity sequences deduced from the initial slope of isotherms and showed that the soils had a greater number of surface sites and higher affinity for Pb and Cu than for Cd, Ni, or Zn. In general, the simultaneous presence of the cations under study increased the percentages of metals released in the exchangeable fraction. The tendency towards less specific forms was more noticeable in Cx2 and Px soils and for Ni, Zn, and Cd. The affinity of inorganic surfaces was larger for Zn than for Cd or Ni, but the affinity of organic surfaces was larger for Cd or Ni than for Zn.

Variability of mercury and selenium levels in clutches of Audouin's gulls (Larus audouinii) breeding at the Chafarinas Islands, Southwest Mediterranean.

We determined mercury and selenium in 43 eggs (eggshell, albumen, and yolk) which belong to different clutch sizes of Audouin's gull from the Chafarinas Islands. The results were compared with those obtained previously with the same species at the Ebro Delta. Both, the intra- and the interclutch sources of variability have been examined. There is an effect of the female on mercury and selenium concentrations in a clutch, which supports the use of eggs as monitoring tools. The distribution pattern of mercury among albumen, yolk and eggshell, the dynamics of this element during the laying process, as well as data concerning egg formation strategies suggest that the mercury in the albumen corresponds mainly to the mercury acquired by the female while feeding in the breeding area. The mercury and selenium levels of the eggs from the Chafarinas Islands were lower than those of the Ebro Delta, which can be due to differences in both the marine contamination and the diet in the two colonies.

Competitive sorption of heavy metal by soils. Isotherms and fractional factorial experiments.

Competing ions strongly affect heavy metal sorption onto the solid surfaces of soil. This study evaluated competitive sorption of Cd, Cu, Ni, Pb and Zn on three soils: Calcixerollic Xerochrept, Paralithic Xerorthent and Lithic Haplumbrept. Monometal and competitive sorption isotherms were obtained at 25 degrees C. The individual effect of ions on retention of the others was ascertained by a fractional factorial analysis design. Most of the sorption isotherms belonged to type L subtype 2 in the classification of Giles. In competitive sorption the initial linear part was shorter and the knee sharper when compared with monometal sorption isotherms. Parameters related to sorptive capacity, such as Point B, Langmuir monolayer and Freundlich distribution coefficient, were higher in monometal than in competitive sorption, and in basic soils than in acidic soil. Calcium desorbed at different points of the sorption isotherms indicated that cationic exchange with Ca was the main retention mechanism in calcareous soils. For Pb, the ratio Ca desorbed/Pb sorbed was close to one; for Cu, Ni and Zn the ratio ranged from 1.20 to 1.37, probably due to partial dissolution of calcium carbonates by hydrolytic processes during retention. On the other hand, Cd had a ratio around 0.6 reflecting another additional retention mechanism, probably surface complexation. Fractional factorial design confirmed that the presence of the cations investigated reduced the amount of the five metals retained, but the presence of Cu and Pb in the system depressed Ni, Cd and Zn sorption more than the inverse. Cation mobility was enhanced when equilibrium concentration increased and the effect was higher in Ca-saturated soils.

Epidemiology of an unusually prolonged outbreak of typhoid fever in Terrassa, Spain.

An unusually prolonged outbreak of typhoid fever, from 1988 to 1994, in Terrassa (Barcelona, Spain), was caused by a casual food handler who was a carrier. The pattern of this outbreak suggested intermittent low-level exposure to Salmonella typhi. We found 70 patients with S. typhi infections, 52 of whom were available for study. Medical records were reviewed and patients were interviewed with use of a standard questionnaire. Phage typing and pulsed-field gel electrophoresis (PFGE) for strain subtyping were used to confirm the epidemiological data. The 27 outbreak strains shared the same phage type and the same PFGE pattern. Four sporadic strains shared the same phage type as the outbreak strain. PFGE was found to be useful for differentiating strains for epidemiological purposes.