Blind classification of e-scooter trips according to their relationship with public transport.

E-scooter services have multiplied worldwide as a form of urban transport. Their use has grown so quickly that policymakers and researchers still need to understand their interrelation with other transport modes. At present, e-scooter services are primarily seen as a first-and-last-mile solution for public transport. However, we demonstrate that 50% of e-scooter trips are either substituting it or covering areas with little public transportation infrastructure. To this end, we have developed a novel data-driven methodology that autonomously classifies e-scooter trips according to their relation to public transit. Instead of predefined design criteria, the blind nature of our approach extracts the city's intrinsic parameters from real data. We applied this methodology to Rome (Italy), and our findings reveal that e-scooters provide specific mobility solutions in areas with particular needs. Thus, we believe that the proposed methodology will contribute to the understanding of e-scooter services as part of shared urban mobility.

Analysis of Extended Information Provided by Bluetooth Traffic Monitoring Systems to Enhance Short-Term Level of Service Prediction.

Bluetooth monitoring systems (BTMS) have opened a new era in traffic sensing, providing a reliable, economical, and easy-to-deploy solution to uniquely identify vehicles. Raw data from BTMS have traditionally been used to calculate travel time and origin-destination matrices. However, we could extend this to include other information like the number of vehicles or their residence times. This information, together with their temporal components, can be applied to the complex task of forecasting traffic. Level of service (LOS) prediction has opened a novel research line that fulfills the need to anticipate future traffic states, based on a standard link-based variable, accepted for both researchers and practitioners. In this paper, we incorporate BTMS's extended variables and temporal information to an LOS classifier based on a Random Undersampling Boost algorithm, which is proven to efficiently respond to the data unbalance intrinsic to this problem. By using this approach, we achieve an overall recall of 87.2% for up to 15-min prediction horizons, reaching 96.6% predicting congestion, and improving the results for the intermediate traffic states, especially complex given their intrinsic instability. Additionally, we provide detailed analyses on the impact of temporal information on the LOS predictor's performance, observing improvements up to a separation of 50 min between last features and prediction horizons. Furthermore, we study the predictor importance resulting from the classifiers to highlight those features contributing the most to the final achievements.

Data-driven analysis of the impact of COVID-19 on Madrid's public transport during each phase of the pandemic.

COVID-19 has become a major global issue with large social-economic and health impacts, which led to important changes in people's behavior. One of these changes affected the way people use public transport. In this work we present a data-driven analysis of the impact of COVID-19 on public transport demand in the Community of Madrid, Spain, using data from ticket validations between February and September 2020. This period of time covers all stages of pandemic in Spain, including de-escalation phases. We find that ridership has dramatically decreased by 95% at the pandemic peak, recovering very slowly and reaching only half its pre-pandemic levels at the end of September. We analyze results for different transport modes, ticket types, and groups of users. Our work corroborates that low-income groups are the most reliant on public transportation, thus observing significantly lower decreases in their ridership during pandemic. This paper also shows different average daily patterns of public transit demand during each phase of the pandemic in Madrid. All these findings provide relevant information for transit agencies to design responses to an emergence situation like this pandemic, contributing to extend the global knowledge about COVID-19 impact on transport comparing results with other cities worldwide.

Intervención educativa sobre estimulación temprana prenatal y hasta el primer año de vida

RESUMEN Introducción: la estimulación temprana favorece el desarrollo del bebé y tiene importantes beneficios. Objetivo: diseñar una intervención educativa sobre la estimulación temprana durante el período de gestación y hasta el primer año de vida, a gestantes pertenecientes al Hogar Materno del municipio Consolación del Sur. Materiales y métodos: se realizó un estudio cuasiexperimental, de intervención educativa, con una muestra constituida por 20 gestantes, a partir de un muestreo no probabilístico de manera intencional. Se tuvieron en cuenta los criterios de inclusión y exclusión. Resultados: la mayoría de las gestantes se encontraban entre 14 y 18 años; el 50 % pertenecían al nivel de escolaridad secundario. Antes de la intervención predominó un nivel de conocimiento bajo en el 50 % de ellas, y luego de la misma el 90 % de las gestantes presentaron un nivel de conocimiento alto. Conclusiones: con la implementación de la intervención educativa propuesta se logró incrementar los conocimientos sobre la estimulación temprana en las gestantes.

ABSTRACT Introduction: early stimulation favors baby development and has important benefits. Objective: to design an educational intervention on early stimulation during the pregnancy period and up to the first year of life to pregnant woman belonging to the Maternal Home of Consolación del Sur municipality. Materials and methods: a quasi-experimental study of educational intervention was carried out in a sample formed by 20 pregnant women, from an intentional non-probabilistic sampling. The inclusion and exclusion criteria were taken into account. Results: most of the pregnant women were aged between 14 and 18 years; 50 % had a secondary school scholarship. Before the intervention, a low level of knowledge prevailed in 50 % of them, and then 90 % of pregnant women had a high level of knowledge. Conclusions: with the implementation of the proposed educational intervention, an increase of knowledge on early stimulation in pregnant women was achieved.

Characterization of COVID-19's Impact on Mobility and Short-Term Prediction of Public Transport Demand in a Mid-Size City in Spain.

COVID-19 has dramatically struck each section of our society: health, economy, employment, and mobility. This work presents a data-driven characterization of the impact of COVID-19 pandemic on public and private mobility in a mid-size city in Spain (Fuenlabrada). Our analysis used real data collected from the public transport smart card system and a Bluetooth traffic monitoring network, from February to September 2020, thus covering relevant phases of the pandemic. Our results show that, at the peak of the pandemic, public and private mobility dramatically decreased to 95% and 86% of their pre-COVID-19 values, after which the latter experienced a faster recovery. In addition, our analysis of daily patterns evidenced a clear change in the behavior of users towards mobility during the different phases of the pandemic. Based on these findings, we developed short-term predictors of future public transport demand to provide operators and mobility managers with accurate information to optimize their service and avoid crowded areas. Our prediction model achieved a high performance for pre- and post-state-of-alarm phases. Consequently, this work contributes to enlarging the knowledge about the impact of pandemic on mobility, providing a deep analysis about how it affected each transport mode in a mid-size city.

Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018.

Although there is a large gap between Black and White American life expectancies, the gap fell 48.9% between 1990 and 2018, mainly due to mortality declines among Black Americans. We examine age-specific mortality trends and racial gaps in life expectancy in high- and low-income US areas and with reference to six European countries. Inequalities in life expectancy are starker in the United States than in Europe. In 1990, White Americans and Europeans in high-income areas had similar overall life expectancy, while life expectancy for White Americans in low-income areas was lower. However, since then, even high-income White Americans have lost ground relative to Europeans. Meanwhile, the gap in life expectancy between Black Americans and Europeans decreased by 8.3%. Black American life expectancy increased more than White American life expectancy in all US areas, but improvements in lower-income areas had the greatest impact on the racial life expectancy gap. The causes that contributed the most to Black Americans' mortality reductions included cancer, homicide, HIV, and causes originating in the fetal or infant period. Life expectancy for both Black and White Americans plateaued or slightly declined after 2012, but this stalling was most evident among Black Americans even prior to the COVID-19 pandemic. If improvements had continued at the 1990 to 2012 rate, the racial gap in life expectancy would have closed by 2036. European life expectancy also stalled after 2014. Still, the comparison with Europe suggests that mortality rates of both Black and White Americans could fall much further across all ages and in both high-income and low-income areas.

Determinants of caregiving burden among informal caregivers of adult care recipients with chronic illness.

AIMS AND OBJECTIVES: This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic disease. The effect of task type and patient-caregiver interaction is also analysed. BACKGROUND: Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient-caregiver interaction. DESIGN: Correlational study. METHODS: One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index-6 Dimensions (DEP-6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies. RESULTS: Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP-6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels. CONCLUSIONS: These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction. RELEVANCE TO CLINICAL PRACTICE: The findings indicate that the socio-sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.

Data-Driven Performance Evaluation Framework for Multi-Modal Public Transport Systems.

Transport agencies require accurate and updated information about public transport systems for the optimal decision-making processes regarding design and operation. In addition to assessing topology and service components, users' behaviors must be considered. To this end, a data-driven performance evaluation based on passengers' actual routes is key. Automatic fare collection platforms provide meaningful smart card data (SCD), but these are incomplete when gathered by entry-only systems. To obtain origin-destination (OD) matrices, we must manage complete journeys. In this paper, we use an adapted trip chaining method to reconstruct incomplete multi-modal journeys by finding spatial similarities between the outbound and inbound routes of the same user. From this dataset, we develop a performance evaluation framework that provides novel metrics and visualization utilities. First, we generate a space-time characterization of the overall operation of transport networks. Second, we supply enhanced OD matrices showing mobility patterns between zones and average traversed distances, travel times, and operation speeds, which model the real efficacy of the public transport system. We applied this framework to the Comunidad de Madrid (Spain), using 4 months' worth of real SCD, showing its potential to generate meaningful information about the performance of multi-modal public transport systems.

[Measurement of dependence based on the care time and the dependency assessment scale]. / La medición de la dependencia a partir del tiempo de cuidado y del baremo de valoración de dependencia.

AIMS: To assign care time to the activities collected in the Dependency Assessment Scale (BVD) and to analyse the relationship between care time and the score received on the BVD. METHODS: A cross-sectional observational study of 148 dependent persons was carried out. Socioeconomic and clinical data, the BVD, the 6-dimensional dependency indicator (DEP-6D), as well as data from a diary with the time of care received, were collected. The median time needed to carry out the activities included in the BVD was estimated from the diary. Following the BVD methodology, those who had their mental functions affected were separated. Each person was assigned two scores, one based on BVD and the other based on the time that the caregivers spent to care for them. The correlation between the two was estimated, and a regression was performed to identify the main explanatory factors for the disparity between the two indicators. RESULTS: BVD and hours of care show a moderate positive correlation. The mental impairment of the dependent person increased the time of care in most activities. The regression analysis suggests that while mental impairment is the main explanatory factor of obtaining a higher assessment with care time than with BVD, being bedridden is the main predictor of having a higher sore with the BVD. CONCLUSIONS: The construct that underlies BVD is moderately related to care time. Future research must contrast the robustness of these results and address whether the normative criteria that underlie the BVD is aligned with the weights that characterise it.

Necesidad y uso de productos de apoyo y facilitadores arquitectónicos en población dependiente / Need and use of assistive devices and architectural facilitators in a dependent population

OBJETIVO: Describir la utilización y percepción de la necesidad de productos de apoyo e identificar su asociación con instrumentos para medir la dependencia y la sobrecarga de cuidados. DISEÑO: Estudio transversal. Emplazamiento: Atención Primaria del área sur de Pontevedra. PARTICIPANTES: Un total de 112 personas cuidadoras informales que atienden a 125 personas dependientes. Mediciones principales: Mediante entrevista personal se recogen datos sobre la utilización y percepción de necesidad de estos productos. Además, se obtienen datos sociodemográficos e información referida al tiempo dedicado al cuidado diario, la sobrecarga del cuidador, el Baremo de Valoración de Dependencia y el indicador de dependencia DEP-6D. Se ha utilizado un contraste de medias para identificar si existen diferencias significativas en dichos indicadores en función de si utilizan o no los productos facilitadores. Se ha calculado una regresión logística para identificar aquellas variables asociadas con tener una necesidad no cubierta. RESULTADOS: Un 60% (IC 95%: 50,9-68,7) de las personas dependientes tienen necesidades no cubiertas de estos dispositivos. Estas necesidades se asocian, principalmente, con una renta familiar baja, un mayor grado de dependencia y una mejor salud del cuidador, aunque en situaciones de gran dependencia y muy mala salud del cuidador estas carencias se suavizan. CONCLUSIONES: Existe una fuerte asociación entre grado de dependencia y utilización de estos productos. Sin embargo, también hay un elevado porcentaje de la muestra con necesidades no cubiertas de estos productos que están asociadas tanto con la situación socioeconómica del hogar como con las características del dependiente y de la persona cuidadora

OBJECTIVE: To describe the use and perception of the need for assistive devices and identify their relationship with instruments to measure dependence and caregiver burden. DESIGN: Cross-sectional study. LOCATION: Primary Health Care in the southern area of Pontevedra. PARTICIPANTS: A total of 112 informal caregivers providing care to 125 dependent persons. Key measurements: Through a personal interview, data was collected on the use and perception of the need for these devices. In addition, sociodemographic data and information on the time dedicated to daily care, caregiver burden, the Dependency Rating Scale, and the DEP-6D dependency indicator were obtained. A contrast mean was used to identify whether there are significant differences in these indicators, depending on whether or not they use the facilitator devices. A logistic regression was performed to identify those variables most associated with not having a need covered. RESULTS: More than half (60%: 95% CI; 50.9-68.7) of dependent persons have unmet needs for these devices. These needs are mainly associated with a low family income, a high degree of dependence, and better health of the caregiver; although in extreme situations of greater dependence and worse health of the caregiver these deficiencies are smoothed out. CONCLUSIONS: There is a strong association between the level of dependence and the use of these devices. However, there is a high percentage of the sample that do not have the products that they need, which are associated with the socioeconomic situation of the household as well as with the characteristics of the dependent person and the caregiver

Data-Driven Analysis of Bicycle Sharing Systems as Public Transport Systems Based on a Trip Index Classification.

Bicycle Sharing Systems (BSSs) are exponentially increasing in the urban mobility sector. They are traditionally conceived as a last-mile complement to the public transport system. In this paper, we demonstrate that BSSs can be seen as a public transport system in their own right. To do so, we build a mathematical framework for the classification of BSS trips. Using trajectory information, we create the trip index, which characterizes the intrinsic purpose of the use of BSS as transport or leisure. The construction of the trip index required a specific analysis of the BSS shortest path, which cannot be directly calculated from the topology of the network given that cyclists can find shortcuts through traffic lights, pedestrian crossings, etc. to reduce the overall traveled distance. Adding a layer of complication to the problem, these shortcuts have a non-trivial existence in terms of being intermittent, or short lived. We applied the proposed methodology to empirical data from BiciMAD, the public BSS in Madrid (Spain). The obtained results show that the trip index correctly determines transport and leisure categories, which exhibit distinct statistical and operational features. Finally, we inferred the underlying BSS public transport network and show the fundamental trajectories traveled by users. Based on this analysis, we conclude that 90.60% of BiciMAD's use fall in the category of transport, which demonstrates our first statement.

Prevención de las conductas sexuales de riesgo en adolescentes del municipio Consolación del Sur / Prevention of sexual behaviors of risk in adolescents from Consolacion del Sur municipality, Pinar del Rio province

RESUMEN Introducción: la prevención de las conductas sexuales de riesgo en adolescentes, constituye una vía para desarrollar comportamientos saludables y responsables hacia la sexualidad. Objetivo: caracterizar el estado actual de la prevención de las conductas sexuales de riesgo en adolescentes del consultorio médico del Policlínico Universitario "5 de Septiembre", de Consolación del Sur. Métodos: estudio observacional, descriptivo y transversal, en el período comprendido entre enero 2016 a junio 2018, de una población de 135 adolescentes donde se seleccionó una muestra de 40 de estos, mediante un muestreo no probabilístico intencional. Se utilizaron métodos teóricos, empíricos y estadísticos. Resultados: 80 de los hombres iniciaron la actividad sexual tempranamente, prevaleció como motivo de inicio el amor, para un 96 %. El 83,3 de los hombres manifestó haber tenido relaciones sexuales bajo el efecto de alguna droga siendo la más común el alcohol. El 56 % de las mujeres tuvieron una pareja en un intervalo de más de seis meses, mientras que el 66,7 % de los hombres habían tenido más de dos parejas en menos de un mes. El condón fue el método más frecuente en hombres y en las muchachas predominó el uso de las tabletas anticonceptivas en más de la mitad. Se evidenciaron dificultades en la identificación de las conductas sexuales sanas y de riesgo. Conclusiones: en los adolescentes predominó dificultades tanto en el conocimiento como en el comportamiento sexual, así como fueron evidenciadas conductas sexuales y de baja percepción de riesgo sobre estas conductas para su salud sexual y reproductiva.

ABSTRACT Introduction: the prevention of sexual behaviors of risk in adolescents is a way to develop healthy and responsible behaviors in relation to sexuality. Objective: to characterize the current state of prevention of the sexual behaviors of risk in adolescents belonging to No-9 medical office at "5 de Septiembre" polyclinic, Consolacion del Sur municipality. Methods: an observational, descriptive and cross-sectional study was conducted from January 2016 to June 2018. From a population of 135 adolescents, a sample of 40 of them was chosen from a non-probabilistic intentional sampling. Theoretical, empirical and statistical methods were applied. Results: 80 of men revealed early initiation of sexual activity, where the motivation of its initiation was love, for a 96 %. The 83,3 of them said having a sexual partner under the influence of drug abuse, being the most common alcohol consumption. The 56 % of women had one sexual partner at intervals of more than six months, while 66,7 % of men had more than two partners in less than one month. of the men they had had more than two couples in less than one month. The condom was the most frequent method in men and in the girls the use of the birth-control pills prevailed in more than the half. Difficulties were evidenced in the identification of the healthy sexual behaviors and of risk Conclusions: in this group of adolescents difficulties regarding knowledge as well as in sexual behavior prevailed. Sexual behaviors of risk and low perception of risk concerning sexual and reproductive health were confirmed.

Functional capacity, bone mineral density and neoformation-resorption bone markers in patients under 18 years of age with reduced mobility. / Capacidad funcional, densidad mineral ósea y marcadores de neoformación-reabsorción ósea en pacientes menores de 18 años con movilidad reducida.

INTRODUCTION: Prolonged immobilization associated with several neurological disorders causes se condary osteoporosis with pathological fractures and persistent bone pain. OBJECTIVES: To establish the association between bone mineral density (BMD), neoformation and bone resorption markers and the degree of functional capacity in children under 18 years of age with reduced mobility. Pa tients and Method: Cross-sectional study conducted in Ciudad Real, Spain between January 1, 2016, and December 31, 2017 with patients aged between 6 and 18 years diagnosed with different neuro logical disorders. The following variables were analyzed: age, sex, pubertal stage, functional capacity according to the Functional Mobility Scale (FMS), which assesses the ability to walk from 5, 50 to 500 meters, BMD, 25-hydroxy-vitamin D, alkaline phosphatase and osteocalcin in blood, and N-terminal telopeptide crosslinks in collagen type I (NTX-I) in urine. BMD, alkaline phosphatase, osteocalcin, and NTX-I values are expressed in Z score according to reference values for age and sex. The Pear son and Spearman correlations were used for data analysis. RESULTS: 36 patients (52.7% girls) with an average age of 8.6±4.7 years. Mean FMS value: 5.3 out of 18. Mean BMD: -1.99 ± 1.7 standard deviations (SD), mean alkaline phosphatase: -2.64 ± 1.08, mean osteocalcin: -2.15 ± 1.39, and mean NTX-I: +3 ± 1.72. There was a significant association between BMD and FMS for 5 meters (r = 0.395; p = 0.017) and for total score (r = 0.365; p = 0.029). There were no significant differences according to the stages of pubertal development. CONCLUSIONS: In this population, there was a decrease in BMD and bone neoformation markers, and an increase of bone resorption markers with no association with pubertal development. Patients with a lower degree of mobility present a lower BMD.

Capacidad funcional, densidad mineral ósea y marcadores de neoformación-reabsorción ósea en pacientes menores de 18 años con movilidad reducida / Functional capacity, bone mineral density and neoformation-resorption bone markers in patients under 18 years of age with reduced mobility

Resumen: Introducción: La inmovilización prolongada asociada a diversas enfermedades neurológicas, causa osteoporosis secundaria con fracturas patológicas y dolor óseo persistente. Objetivos: Establecer la asociación entre densidad mineral ósea (DMO), marcadores de neoformación y reabsorción ósea y grado de capacidad funcional en pacientes menores de 18 años con movilidad reducida. Pacientes y Método: Estudio transversal, realizado entre 1/1/2016 y 31/12/2017 en pacientes de 6 a 18 años diagnosticados de distintas enfermedades neurológicas en Ciudad Real (España). Se analizaron las variables biodemográficas, capacidad funcional según la Functional Mobility Scale (FMS), que valora la movilidad en 5, 50 y 500 metros, DMO, 25-hidroxi-vitamina D, fosfatasa alcalina, osteocalcina en sangre y telopéptido amino terminal de cadena cruzada de colágeno tipo I en orina (NTX-I). Se expresan DMO, fosfatasa alcalina, osteocalcina y NTX-I en Z score según valores de referencia para edad y sexo. Se utilizaron estadísticas descriptivas y correlaciones de Pearson y Spearman. Resulta dos: 36 pacientes (52,7% niñas), edad media de 8,6 ± 4,7 años. Valor medio de FMS: 5,3 sobre 18. DMO media: -1,99 ± 1,7 desviaciones estándar (DE), fosfatasa alcalina media: -2,64 ± 1,08, osteocalcina media: -2,15 ± 1,39, y NTX-I medio: +3 ± 1,72. Hubo asociación significativa entre DMO y FMS para 5 metros (r = 0,395; p = 0,017) y para la puntuación total (r = 0,365; p = 0,029). No se encon traron diferencias significativas según estadios de desarrollo puberal. Conclusiones: En la población estudiada se observa disminución en la DMO y en marcadores de neoformación ósea y elevación de marcadores de reabsorción ósea sin asociación con el desarrollo puberal. Los pacientes con menor grado de movilidad presentan una DMO inferior.

Abstract: Introduction: Prolonged immobilization associated with several neurological disorders causes se condary osteoporosis with pathological fractures and persistent bone pain. Objectives: To establish the association between bone mineral density (BMD), neoformation and bone resorption markers and the degree of functional capacity in children under 18 years of age with reduced mobility. Pa tients and Method: Cross-sectional study conducted in Ciudad Real, Spain between January 1, 2016, and December 31, 2017 with patients aged between 6 and 18 years diagnosed with different neurological disorders. The following variables were analyzed: age, sex, pubertal stage, functional capacity according to the Functional Mobility Scale (FMS), which assesses the ability to walk from 5, 50 to 500 meters, BMD, 25-hydroxy-vitamin D, alkaline phosphatase and osteocalcin in blood, and N-terminal telopeptide crosslinks in collagen type I (NTX-I) in urine. BMD, alkaline phosphatase, osteocalcin, and NTX-I values are expressed in Z score according to reference values for age and sex. The Pear son and Spearman correlations were used for data analysis. Results: 36 patients (52.7% girls) with an average age of 8.6±4.7 years. Mean FMS value: 5.3 out of 18. Mean BMD: -1.99 ± 1.7 standard deviations (SD), mean alkaline phosphatase: -2.64 ± 1.08, mean osteocalcin: -2.15 ± 1.39, and mean NTX-I: +3 ± 1.72. There was a significant association between BMD and FMS for 5 meters (r = 0.395; p = 0.017) and for total score (r = 0.365; p = 0.029). There were no significant differences according to the stages of pubertal development. Conclusions: In this population, there was a decrease in BMD and bone neoformation markers, and an increase of bone resorption markers with no association with pubertal development. Patients with a lower degree of mobility present a lower BMD.

[Need and use of assistive devices and architectural facilitators in a dependent population]. / Necesidad y uso de productos de apoyo y facilitadores arquitectónicos en población dependiente.

OBJECTIVE: To describe the use and perception of the need for assistive devices and identify their relationship with instruments to measure dependence and caregiver burden. DESIGN: Cross-sectional study. LOCATION: Primary Health Care in the southern area of Pontevedra. PARTICIPANTS: A total of 112 informal caregivers providing care to 125 dependent persons. KEY MEASUREMENTS: Through a personal interview, data was collected on the use and perception of the need for these devices. In addition, sociodemographic data and information on the time dedicated to daily care, caregiver burden, the Dependency Rating Scale, and the DEP-6D dependency indicator were obtained. A contrast mean was used to identify whether there are significant differences in these indicators, depending on whether or not they use the facilitator devices. A logistic regression was performed to identify those variables most associated with not having a need covered. RESULTS: More than half (60%: 95% CI; 50.9-68.7) of dependent persons have unmet needs for these devices. These needs are mainly associated with a low family income, a high degree of dependence, and better health of the caregiver; although in extreme situations of greater dependence and worse health of the caregiver these deficiencies are smoothed out. CONCLUSIONS: There is a strong association between the level of dependence and the use of these devices. However, there is a high percentage of the sample that do not have the products that they need, which are associated with the socioeconomic situation of the household as well as with the characteristics of the dependent person and the caregiver.

A meta-analysis of the association between caregiver burden and the dependent's illness.

The caregiver burden is frequently used to refer to the physical and psychological problems that may arise from caring for a dependent relative. We conducted a meta-analysis to see whether Zarit Burden Interview (ZBI) scores differed by dependent's pathology. Results from 125 studies showed that caregivers of individuals with a physical disability have an estimated mean ZBI score (±SE) of 27 ± 2.6 - a score significantly lower than for caregivers of persons with dementia or cognitive impairment (34.1 ± 1.1), mental illness (32.6 ± 1.7), or Alzheimer's (32.5 ± 1). Our analysis of Alzheimer's revealed differences among cases of mildly (25.8 ± 5.2), moderately (35.6 ± 7.8), and severely (42.6 ± 7.9) afflicted dependents.

Aplicación clínica del manejo de los recursos en crisis / Clinical aplication of resources in crisis managment

Las situaciones de crisis en la sala de operaciones son eventos poco frecuentes, con personal trabajando rápido y bajo presión, intentando sobrellevar el incidente con los menores riesgos para el paciente. Se expone un caso clínico en el marco del trabajo de una unidad de anestesia para cirugía de tórax en la cual se presenta una crisis asistencial abordada por un equipo de trabajo capacitado mediante simulación en la aplicación de la herramienta de "Manejo de los Recursos en Crisis (CRM)". Planteamos que la aplicación de esta herramienta por un equipo capacitado en su utilización contribuyó al éxito y buena evolución de un paciente crítico.

Crisis situations on the operation room seldom happen, with staff working fast and under pressure, trying to overcome the incident at the same time as reducing the risks for the patient. Here we expose a clinical case on the frame of work of an anesthesia unit assembled for thorax surgery during which an asistential crisis occurs and is managed by a group of coworkers trained by means of simulation on the appliance of the tool called "Crisis Resource Management (CRM)". We support the idea that the appliance of this tool by a team of professionals trained on its use, contributed to the success and good evolution on a critical patient.