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Carretero-Bravo J, Ramos-Fiol B, Ortega-Martín E, Suárez-Lledó V, Salazar A, O’Ferrall-González C, Dueñas M, Peralta-Sáez JL, González-Caballero JL, Cordoba-Doña JA, Lagares-Franco C, Martínez-Nieto JM, Almenara-Barrios J, Álvarez-Gálvez J. Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16839. [PMID: 36554719 PMCID: PMC9778742 DOI: 10.3390/ijerph192416839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities. METHODS This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model. RESULTS We obtained a model with five patterns (entropy = 0.727): 'Relative Healthy', 'Cardiometabolic', 'Musculoskeletal', 'Musculoskeletal and Mental', and 'Complex Multimorbidity'. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression. CONCLUSIONS We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments.
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Affiliation(s)
- Jesús Carretero-Bravo
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
| | - Begoña Ramos-Fiol
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
| | - Esther Ortega-Martín
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
| | - Víctor Suárez-Lledó
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
| | - Alejandro Salazar
- Department of Statistics and Operational Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
| | | | - María Dueñas
- Department of Statistics and Operational Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
| | - Juan Luis Peralta-Sáez
- Department of Statistics and Operational Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
| | - Juan Luis González-Caballero
- Department of Statistics and Operational Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
| | - Juan Antonio Cordoba-Doña
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
- Preventive Medicine Area, Hospital of Jerez, Ctra. Trebujena, s/n, 11407 Jerez de la Frontera, Spain
| | - Carolina Lagares-Franco
- Department of Statistics and Operational Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
| | | | - José Almenara-Barrios
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
| | - Javier Álvarez-Gálvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avda. Ana de Viya 52, 11009 Cádiz, Spain
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Caldeira TCM, Soares MM, da Silva LES, Veiga IPA, Claro RM. Chronic disease risk and protective behaviors in Brazilian state capitals and the Federal District, according to the National Health Survey and the Chronic Disease Risk and Protective Factors Telephone Survey Surveillance System, 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2021367. [PMID: 35946669 PMCID: PMC9897819 DOI: 10.1590/ss2237-9622202200009.especial] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 11/08/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To describe and compare the results of the main risk and protective factors for chronic non-communicable diseases, in the 26 Brazilian capitals and the Federal District, obtained through the National Health Survey (PNS) and the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) in 2019. METHODS Cross-sectional study, in which the difference in prevalence between health behavior indicators investigated by PNS and VIGITEL was calculated. RESULTS The largest discrepancy between the surveys, PNS (n = 32,111) and VIGITEL (n = 52,443), were observed in relation to leisure-time physical activity (6.8 in percentage points - p.p.), recommended physical activity in the transport domain (7.4 p.p.), and high screen time (21.8 p.p.). Both surveys presented similar prevalence regarding nutritional status, food consumption, smoking, alcohol abuse and negative self-rated health. CONCLUSION Prevalence in both surveys presented small differences, but point to results in the same direction.
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Affiliation(s)
| | - Marcela Mello Soares
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Saúde Pública, Belo Horizonte, MG, Brazil
| | - Luiza Eunice Sá da Silva
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Saúde Pública, Belo Horizonte, MG, Brazil
| | - Izabella Paula Araújo Veiga
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Nutrição e Saúde, Belo Horizonte, MG, Brazil
| | - Rafael Moreira Claro
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Belo
Horizonte, MG, Brazil
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Wong SYS, Zhang D, Sit RWS, Yip BHK, Chung RYN, Wong CKM, Chan DCC, Sun W, Kwok KO, Mercer SW. Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care. Br J Gen Pract 2020; 70:e817-e824. [PMID: 32988955 PMCID: PMC7523921 DOI: 10.3399/bjgp20x713021] [Citation(s) in RCA: 225] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted the psychological health and health service utilisation of older adults with multimorbidity, who are particularly vulnerable. AIM To describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of the COVID-19 pandemic. DESIGN AND SETTING Telephone survey on a pre-existing cohort of older adults with multimorbidity in primary care. METHOD Mental health and health service utilisation outcomes were compared with the outcomes before the onset of the COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon's signed-rank test, and McNemar's test. Loneliness was measured by the De Jong Gierveld Loneliness Scale. The secondary outcomes (anxiety, depression, and insomnia) were measured by the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder tool, and the Insomnia Severity Index. Appointments attendance data were extracted from a computerised medical record system. Sociodemographic factors associated with outcome changes were examined by linear regression and generalised estimating equations. RESULTS Data were collected from 583 older (≥60 years) adults. There were significant increases in loneliness, anxiety, and insomnia, after the onset of the COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% 1 year ago to 22.0% after the onset of the outbreak. In adjusted analysis, being female, living alone, and having >4 chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia. CONCLUSION Psychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after the COVID-19 outbreak.
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Affiliation(s)
- Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Regina Wing Shan Sit
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Benjamin Hon Kei Yip
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger Yat-Nork Chung
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carmen Ka Man Wong
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dicken Cheong Chun Chan
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wen Sun
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kin On Kwok
- JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR; Stanley Ho Centre for Emerging Infectious Diseases, the Chinese University of Hong Kong, Shatin, Hong Kong SAR; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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Bennasar-Veny M, Yañez AM, Pericas J, Ballester L, Fernandez-Dominguez JC, Tauler P, Aguilo A. Cluster Analysis of Health-Related Lifestyles in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1776. [PMID: 32182922 PMCID: PMC7084566 DOI: 10.3390/ijerph17051776] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/05/2020] [Accepted: 03/07/2020] [Indexed: 12/12/2022]
Abstract
Health-related lifestyles in young adults are a public health concern because they affect the risk for developing noncommunicable diseases. Although unhealthy lifestyles tend to cluster together, most studies have analyzed their effects as independent factors. This study assessed the prevalence, association, and clustering of health-related lifestyles (smoking, alcohol consumption, physical activity, and quality of diet) among university students. This cross-sectional study examined a sample of student participants from the University of the Balearic Islands (n = 444; 67.8% females; mean age: 23.1 years). A self-reported questionnaire was used to assess health-related lifestyles. Men that consumed more alcohol, had less healthy diets, were more likely to be overweight, and performed more physical activity. Women had a higher prevalence of low weight and performed less physical activity. Physical activity had a negative association with time using a computer (OR: 0.85; 95% CI: 0.76, 0.95) and a positive association with adherence to the Mediterranean diet (OR: 1.16; 95% CI: 1.02, 1.32). Adherence to the Mediterranean diet had a negative association with tobacco consumption (OR: 0.52; 95% CI: 0.30, 0.91), and positive associations with having breakfast every day (OR: 1.70; 95% CI: 1.05, 2.76) and consuming more daily meals (OR: 1.43; 95% CI: 1.10, 1.87). Cluster analysis indicated the presence of three distinct groups: Unhealthy lifestyles with moderate risk; unhealthy lifestyles with high risk; and healthy lifestyles with low risk. Health promotion interventions in the university environment that focus on multiple lifestyles could have a greater effect than interventions that target any single lifestyle.
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Affiliation(s)
- Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain; (M.B.-V.); (J.P.); (J.C.F.-D.); (A.A.)
| | - Aina M. Yañez
- Research Group on Global Health & Human Development, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain
| | - Jordi Pericas
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain; (M.B.-V.); (J.P.); (J.C.F.-D.); (A.A.)
| | - Lluis Ballester
- Department of Specific Didactics and Pedagogy, Educational and Social Research and Training Research Group, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain;
| | - Juan Carlos Fernandez-Dominguez
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain; (M.B.-V.); (J.P.); (J.C.F.-D.); (A.A.)
| | - Pedro Tauler
- Research Group on Evidence, lifestyles and Health Research, Instituto de Investigación Sanitaria Illes Balears, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain;
| | - Antoni Aguilo
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain; (M.B.-V.); (J.P.); (J.C.F.-D.); (A.A.)
- Research Group on Evidence, lifestyles and Health Research, Instituto de Investigación Sanitaria Illes Balears, Cra. de Valldemossa, Km 7.5, 07122 Palma, Illes Balears, Spain;
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Borgo MV, Pimentel EB, Baldo MP, Souza JBD, Malta DC, Mill JG. Prevalence of cardiovascular risk factors in the population of Vitória according to data from VIGITEL and the National Health Interview Survey of 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190015. [PMID: 31038611 DOI: 10.1590/1980-549720190015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/14/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the prevalence of cardiovascular risk factors in the adult population of Vitória, Espírito Santo, Brazil, in two surveys conducted by telephone interview (VIGITEL) or by clinic and laboratory exams during the National Health Interview Survey (NHIS). METHOD Data were collected from adults (≥ 18 years). In VIGITEL, 1,996 subjects (males = 38%) were interviewed. In NHIS, home visit followed by clinical and laboratory tests was made with 318 individuals (males = 48%) selected in 20 census tracts of the city. The prevalence of risk factors was adjusted to the estimated population of the city in 2013. Data are shown as prevalence and 95% confidence interval (95%CI). RESULTS Similar values of prevalence were found in VIGITEL and NHIS, respectively, for smoking (8.2%; 95%CI 6.7-9.7% vs 10.0; 95%CI 6.4 - 13.6%) and hypertension (24.8%; 95%CI 22.6 - 27.0% vs 27.2%; 95%CI 21.8 - 32.5%). Statistical differences between surveys (p < 0.01) were found for diabetes (6.7%; 95%CI 5.6 - 7.9% vs 10.7%; 95%CI 7.1 - 14.5%), obesity (16.8%; 95%CI 14.1 - 18.1% vs 25.7%; 95%CI 20.4 - 30.9%) and high cholesterol (≥ 200mg/dL) (20.6%; 95%CI 18.6- 22.6% vs 42.3%; 95%CI 36.9 - 47.7%). The prevalence of diabetes was also higher (p < 0.01) in NHIS (6.7 vs 10.7%). CONCLUSION Prevalence of smoking and hypertension, but not obesity, was adequately detected in VIGITEL, because there might have been information bias related to body weight during telephone interviews. Datashow the necessity to improve the diagnosis of dyslipidemias in primary care services, as the control of this risk factor is of utmost importance to prevent cardiovascular diseases.
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Affiliation(s)
- Mariana Veronez Borgo
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo - Vitória (ES), Brasil
| | - Enildo Broetto Pimentel
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo - Vitória (ES), Brasil
| | - Marcelo Perim Baldo
- Departamento de Fisiopatologia, Centro de Ciências Biológicas e da Saúde, Universidade Estadual de Montes Claros - Montes Claros (MG), Brasil
| | - Juliana Bottoni de Souza
- Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Deborah Carvalho Malta
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo - Vitória (ES), Brasil
| | - José Geraldo Mill
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo - Vitória (ES), Brasil
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Bayán-Bravo A, Pérez-Tasigchana RF, López-García E, Martínez-Gómez D, Rodríguez-Artalejo F, Guallar-Castillón P. The association of major patterns of physical activity, sedentary behavior and sleeping with mortality in older adults. J Sports Sci 2018; 37:424-433. [PMID: 30067477 DOI: 10.1080/02640414.2018.1504617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: To identify major patterns of physical activity (PA), sedentary behavior (SB) and sleeping (all self-reported), and their association with long-term mortality. Methods: Cohort of 2,851 individuals aged ≥ 60 from Spain. Mortality was ascertain from 2003 up to July 2013. Patterns of PA, SB and sleeping were identified by factor analysis. Results: During follow-up, 1,145 deaths occurred. The first pattern, named "sedentary and non-active pattern", was characterized by long sleeping or lying time, and not doing even light PA (household chores or walking). The second pattern was named "active and non-sedentary pattern", and was characterized long time devoted to vigorous activities, long walking time, and short seating time. Compared to those in the first quartile of the "sedentary and non-active pattern", those in the highest quartile showed a 71% higher mortality (HR: 1.71; 95%CI: 1.42-2.07; p-trend:<0.001); it corresponds to being 6-year older. By contrast, being in the highest versus the lowest quartile of the "active and non-sedentary pattern" was associated with a 32% lower mortality (HR: 0.68: 0.57-0.82; p-trend:<0.001); it corresponds to being 4-year younger. Conclusion: The "sedentary and non-active" pattern had a large impact on mortality. The "active and non-sedentary" pattern showed an opposite and slightly lower association.
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Affiliation(s)
- Ana Bayán-Bravo
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,b Nefrology Department , Hospital "12 de Octubre" , Madrid , Spain
| | - Raúl F Pérez-Tasigchana
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,c School of Medicine , Universidad San Francisco de Quito , Quito , Ecuador
| | - Esther López-García
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain
| | - David Martínez-Gómez
- d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain.,e Department of Physical Education, Sports and Human Movement , Universidad Autónoma de Madrid , Madrid , Spain
| | - Fernando Rodríguez-Artalejo
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain
| | - Pilar Guallar-Castillón
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain.,f Welch Center for Prevention, Epidemiology, and Clinical Research , Johns Hopkins University , Baltimore , MD , USA
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García-Esquinas E, Ortolá R, Galán I, Soler-Vila H, Laclaustra M, Rodríguez-Artalejo F. Moderate alcohol drinking is not associated with risk of depression in older adults. Sci Rep 2018; 8:11512. [PMID: 30065286 PMCID: PMC6068095 DOI: 10.1038/s41598-018-29985-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/06/2018] [Indexed: 12/20/2022] Open
Abstract
The scarce research on the effects of moderate alcohol consumption on mental health among older adults suggests a protective effect against depression. We prospectively examined the association between patterns of moderate alcohol consumption, depression and psychological distress, using information from 5,299 community-dwelling older adults from the ELSA and Seniors-ENRICA cohorts. A Mediterranean drinking pattern (MDP) was defined as moderate alcohol intake (<40 g/day for men; <24 g/day for women) with a preference for wine and drinking only with meals. Depression was ascertained with the 10-item Geriatric Depression Scale (GDS-10), a self-report of clinically-diagnosed depression, or being on anti-depressant medication (Seniors-ENRICA); and with the 8-item Center for Epidemiologic Studies Depression Scale (CES-D) (ELSA). Psychological distress was assessed with the General Health Questionnaire-12 (GHQ-12). Compared to never drinkers, moderate drinkers showed comparable scores on the ENRICA-GDS-10 (PRR (95%CI): 1.03 (0.84–1.26)), the ENRICA-GHQ-12 (0.88 (0.73–1.06)), the ELSA-CES-D (0.92 (0.79–1.06)) and the ELSA-GHQ-12 (0.75 (0.55–1.01). The MDP was not associated with the GDS-10 or GHQ-12 scores, or with clinically-diagnosed depression; however drinkers with a preference for wine showed an increased number of psychological distress symptoms (1.31 (1.03–1.66)). In conclusion, we found no consistent protective association between moderate alcohol consumption and depression in older adults.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Iñaki Galán
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,National Center for Epidemiology. Instituto de Salud Carlos III, Madrid, Spain
| | - Hosanna Soler-Vila
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain
| | - Martín Laclaustra
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Aragon Institute for Health Research (IIS Aragón), Translational Research Unit, Hospital Universitario Miguel Servet, Zaragoza, Spain.,CIBER of Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Alter DA, Yu W. The Burgeoning Roots of Socioeconomic Inequalities in Health: The Legacy Effect. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2017; 70:138-139. [PMID: 27717778 DOI: 10.1016/j.rec.2016.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Affiliation(s)
- David A Alter
- Cardiac Rehabilitation and Prevention Program, University Health Network-Toronto Rehabilitation Institute, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada.
| | - WeiYang Yu
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Alter DA, Yu W. El rápido crecimiento de las desigualdades socieconómicas en salud: el efecto del legado. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Desigualdades sociales en los factores de riesgo cardiovascular de los adultos mayores de España: estudio ENRICA-Seniors. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Social Inequalities in Cardiovascular Risk Factors Among Older Adults in Spain: The Seniors-ENRICA Study. ACTA ACUST UNITED AC 2016; 70:145-154. [PMID: 27519455 DOI: 10.1016/j.rec.2016.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/27/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To examine the distribution of the main cardiovascular risk factors (CVRF) according to socioeconomic level (SEL) among older adults in Spain. METHODS A cross-sectional study conducted in 2008-2010 with 2699 individuals representative of the noninstitutionalized Spanish population aged ≥ 60 years. Socioeconomic level was assessed using educational level, occupation, and father's occupation. The CVRF included behavioral and biological factors and were measured under standardized conditions. RESULTS In age- and sex-adjusted analyses, higher educational level was associated with a higher frequency of moderate alcohol consumption and leisure time physical activity, and less time spent watching television. An inverse educational gradient was observed for frequency of obesity (odds ratio [OR] in university vs primary level or below education, 0.44; 95% confidence interval [95%CI], 0.33-0.57; P-trend < .01), metabolic syndrome (OR = 0.56; 95%CI, 0.43-0.71; P-trend < .01), diabetes (OR = 0.68; 95%CI, 0.49-0.95; P-trend < .05), and cardiovascular disease (OR = 0.52; 95%CI, 0.29-0.91; P-trend < .05). Compared with a nonmanual occupation, having a manual occupation was associated with a higher frequency of several CVRF; this association was stronger than that observed for father's occupation. Differences in CVRF across SELs were generally greater in women than in men. CONCLUSIONS There are significant social inequalities in CVRF among older adults in Spain. Reducing these inequalities, bringing the levels of CVRF in those from lower SEL in line with the levels seen in higher SEL, could substantially reduce the prevalence of CVRF in the older adult population.
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Affiliation(s)
- Bibiana Pérez-Hernández
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther García-Esquinas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
| | - Auxiliadora Graciani
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Pilar Guallar-Castillón
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther López-García
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Luz M León-Muñoz
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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Linden A. Evaluating the Effectiveness of Home Health as a Disease Management Strategy. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822305281972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Home health (HH) is considered by many to be complementary to existing disease management (DM) programs, or even suitable as a stand-alone DM intervention. The advantage is thought to be with the face-to-face interaction, in contrast to the standard DM telephonic interview. However, much of the literature appears to indicate that telecommunication is as successful as face-to-face contact (typically referred to as “usual care”) for administering health surveys, providing counseling, changing health behaviors, and monitoring physiologic functioning. Given the desire to expand into the area of DM, HH agencies will need to identify and demonstrate areas in which they have a clinical and competitive edge over traditional DM models. This article describes and provides examples of three research designs that may assist the HH industry in evaluating their effectiveness in delivering DM services: the randomized controlled trial, the regression-discontinuity design, and case-control matching on the propensity score.
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Malta DC, Iser BPM, Santos MAS, Andrade SSDA, Stopa SR, Bernal RTI, Claro RM. Estilos de vida nas capitais brasileiras segundo a Pesquisa Nacional de Saúde e o Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas Não Transmissíveis por Inquérito Telefônico (Vigitel), 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18 Suppl 2:68-82. [DOI: 10.1590/1980-5497201500060007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 05/26/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Descrever os principais resultados dos fatores de risco e proteção de doenças crônicas não transmissíveis (DCNT), nas capitais brasileiras e no Distrito Federal, coletados pela Pesquisa Nacional de Saúde (PNS) e pelo Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas Não Transmissíveis por Inquérito Telefônico (Vigitel) no ano de 2013. Métodos Análise de dados advindos da PNS e do Vigitel, pesquisas realizadas no ano de 2013. Foram analisados indicadores sobre tabagismo, consumo de álcool, alimentação e atividade física, segundo sexo, com intervalo de confiança de 95% (IC95%). Resultados: As prevalências encontradas foram: fumantes atuais de cigarro - PNS 12,5% e Vigitel 11,3%; consumo abusivo de bebida alcoólica - PNS 14,9% e Vigitel 16,4%; consumo recomendado de frutas e hortaliças - PNS 41,8% e Vigitel 23,6%; prática de atividade física no tempo livre - PNS 26,6% e Vigitel 33,8%. Conclusão: Os resultados dos indicadores foram semelhantes, em especial quando as perguntas e opções de resposta também eram. As pesquisas são úteis para o monitoramento dos fatores de risco e proteção das DCNT, podendo apoiar programas de promoção da saúde.
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Soler-Vila H, Galán I, Donado-Campos J, Sánchez-Alfonso F, Valencia-Martín JL, Morilla F, León-Muñoz LM, Rodríguez-Artalejo F. Three-year changes in drinking patterns in Spain: a prospective population-based cohort study. Drug Alcohol Depend 2014; 140:123-9. [PMID: 24799288 DOI: 10.1016/j.drugalcdep.2014.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 04/04/2014] [Accepted: 04/05/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study examined changes in alcohol drinking patterns (DP) and associated variables in a Mediterranean country. METHODS Changes in DP between baseline (2008-2010) and follow-up (2012-2013) were examined on a Spanish population-based cohort of 2254 adults (18-59 years) using multinomial logistic regression. Heavy consumption was defined as ≥40 g/day of alcohol in men (≥24 g/day in women) and binge drinking (BD) as the intake of ≥80 g of alcohol in men (≥60 g in women) on one occasion in the previous month. Six patterns were defined: (1) non-drinkers; (2) ex-drinkers; (3) moderate drinkers without BD (MNB); (4) moderate drinkers with BD (MB); (5) heavy drinkers without BD (HNB); and (6) heavy drinkers with BD (HB). RESULTS Overall, 45.2% of participants changed DP during follow-up. Over 24% of non-drinkers and 19.4% of ex-drinkers at baseline qualified as MNB at follow-up. The largest flow was from HNB to MNB (57.1%). Light-drinking patterns experienced the largest gains (ex-drinkers: 37.5% and MNB: 66.7%) by absorbing individuals lost by heavy-drinking patterns (MB: 50.8% and HNB: 48.4%). Men, younger individuals, and current smokers were more likely to report heavy-drinking patterns at one or both assessments. Being married or employed increased the likelihood of reporting light-drinking patterns at both surveys (p<0.05). Improving physical quality of life and exercise were associated with a shift from light- to heavy-drinking pattern during follow-up (p<0.05). CONCLUSIONS DP in Spain changed over 3 years with a tendency to "regress" toward moderate patterns. Repeated measures of alcohol intake may reduce classification errors and biased results when examining the impact of alcohol on health.
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Affiliation(s)
- Hosanna Soler-Vila
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Iñaki Galán
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; National Centre for Epidemiology, Instituto de Salud Carlos III, C/Sinesio Delgado, 4, Madrid 28029, Spain
| | - Juan Donado-Campos
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain
| | - Fernando Sánchez-Alfonso
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain
| | - José Lorenzo Valencia-Martín
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain; Department of Preventive Medicine, Móstoles University Hospital, Calle Río Júcar, 1, Móstoles 28935, Spain
| | - Fernando Morilla
- Department of Computer Science and Automatic Control, Universidad Nacional de Educación a Distancia (UNED), Calle Juan del Rosal 16, 28040 Madrid, Spain
| | - Luz Ma León-Muñoz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, C/Arzobispo Morcillo s/n, Madrid 28029, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Melchor Fernández Almagro, 3-5, Madrid 28029, Spain.
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Garcia-Continente X, Pérez-Giménez A, López MJ, Nebot M. Potencial sesgo de selección en las encuestas telefónicas: teléfonos fijos y móviles. GACETA SANITARIA 2014; 28:170-2. [DOI: 10.1016/j.gaceta.2013.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/16/2013] [Accepted: 05/29/2013] [Indexed: 10/26/2022]
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Navarro-Vidal B, Banegas JR, León-Muñoz LM, Rodríguez-Artalejo F, Graciani A. Achievement of cardiometabolic goals among diabetic patients in Spain. A nationwide population-based study. PLoS One 2013; 8:e61549. [PMID: 23637851 PMCID: PMC3630125 DOI: 10.1371/journal.pone.0061549] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/11/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND No previous study has reported a comprehensive assessment of the attainment of cardiometabolic goals in the diabetic population of a European country. We examined the achievement of cardiometabolic goals among diabetics in Spain. METHODS AND FINDINGS A cross-sectional survey was performed in 2008-2010 among 12,077 individuals representative of the Spanish population aged ≥18 years. Information on cardiometabolic characteristics was collected at the participants' homes through structured questionnaires, physical examination, and fasting blood samples. Attainment of cardiometabolic goals was evaluated according to the most well-known guidelines. A total of 834 individuals had diabetes (fasting serum glucose ≥126 mg/dl, or glycosylated hemoglobin ≥6.5%,) or were being treated with oral antidiabetic drugs or insulin). Among diabetic patients, 661 (79.2%) were aware of their condition. Among the aware diabetic patients, only 11.4% had neither general (body mass index <25 kg/m(2)) nor abdominal obesity (waist circumference ≤102 cm in men and ≤88 cm in women), 8.6% consumed <7% of calories daily from saturated fats, and 41.1% achieved the recommendation on weekly physical activity. About 71% had glycosylated hemoglobin <7%, 22% had blood pressure <130/80 mmHg, and 36% reached the LDL-cholesterol goal of <100 mg/dl. Although a large proportion of aware diabetic individuals received lifestyle medical advice, only 38% of overweight individuals and 20% of daily smokers were offered a specific strategy for weight loss or quitting smoking, respectively. CONCLUSIONS In a European country with universal healthcare coverage, achievement of many cardiometabolic goals, in particular lifestyle, among aware diabetic individuals is poor. This suggests a need for improvement in both clinical guidelines' implementation and patients' adherence.
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Affiliation(s)
- Beatriz Navarro-Vidal
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ; CIBERESP, Madrid, Spain
| | - José R. Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ; CIBERESP, Madrid, Spain
| | - Luz M. León-Muñoz
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ; CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ; CIBERESP, Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPAZ; CIBERESP, Madrid, Spain
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Cooley ME, Finn KT, Wang Q, Roper K, Morones S, Shi L, Litrownik D, Marcoux JP, Zaner K, Hayman LL. Health behaviors, readiness to change, and interest in health promotion programs among smokers with lung cancer and their family members: a pilot study. Cancer Nurs 2013; 36:145-54. [PMID: 22791213 PMCID: PMC4729371 DOI: 10.1097/ncc.0b013e31825e4359] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The diagnosis of lung cancer presents an opportunity to motivate individuals to adopt health-promoting behavior. Little attention has been given to using this opportunity to also motivate relatives to change their health behaviors. OBJECTIVES The objectives of this study were to describe health behaviors and readiness to change lifestyle, identify interest in health promotion programs, and examine concordance of health behaviors among smokers with lung cancer and their family members. METHODS Cross-sectional data were collected once from 37 lung cancer patient-family member dyads. Standardized questionnaires were used to collect data. Descriptive statistics and percent agreement were used for analyses. RESULTS Lung cancer patients and their family members had high rates of continued smoking (43% vs 30%), low intake of fruits and vegetables (92% vs 95%), and high rates of physical inactivity (84% vs 84%). Patients and family members indicated readiness to change behaviors within the next 6 months ranging from 63% for physical activity, 73% for diet, and 88% to quit smoking for patients and 81% for physical activity, 58% for diet, and 91% to quit smoking for family members. Interest in participating in a multiple behavioral risk reduction program was high for patients and family members. CONCLUSIONS The majority of patients and their family members have multiple behavioral risk factors placing them at risk for poor health outcomes. IMPLICATIONS FOR PRACTICE Oncology nurses are in a unique position to provide leadership in assessing health behaviors and implementing evidence-based interventions to enhance outcomes for patient-family member dyads with lung cancer.
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Affiliation(s)
- Mary E Cooley
- Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Validation of obesity based on self-reported data in Spanish women participants in breast cancer screening programmes. BMC Public Health 2011; 11:960. [PMID: 22208614 PMCID: PMC3268784 DOI: 10.1186/1471-2458-11-960] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 12/30/2011] [Indexed: 11/22/2022] Open
Abstract
Background Measurement of obesity using self-reported anthropometric data usually involves underestimation of weight and/or overestimation of height. The dual aim of this study was, first, to ascertain and assess the validity of new cut-off points, for both overweight and obesity, using self-reported Body Mass Index furnished by women participants in breast cancer screening programmes, and second, to estimate and validate a predictive model that allows recalculate individual BMI based on self-reported data. Methods The study covered 2927 women enrolled at 7 breast cancer screening centres. At each centre, women were randomly selected in 2 samples, in a ratio of 2:1. The larger sample (n = 1951) was used to compare the values of measured and self-reported weight and height, to ascertain new overweight and obesity cut-off points with self-reported data, using ROC curves, and to estimate a predictive model of real BMI using a regression model. The second sample (n = 976) was used to validate the proposed cut-off points and the predictive model. Results Whereas reported prevalence of obesity was 19.8%, measured prevalence was 28.2%. The sensitivity and specificity of this classification would be maximised if the new cut-off points were 24.30 kg/m2 for overweight and 28.39 kg/m2 for obesity. The probability of classifying women correctly in their real weight categories on the basis of these points was 82.5% in the validation sample. Sensitivity and specificity for determining obesity using the new cut-off point in the validation sample were 90.0% and 92.3% respectively. The predictive model for real BMI included the self-reported BMI, age and educational level (university studies vs lower levels of education). This model succeeded in correctly classifying 90.5% of women according to BMI categories, but its performance was similar to that obtained with the new cut-off points. Conclusions Quantification of self-reported obesity entails a considerable underestimation of this problem, thereby questioning its validity. The new cut-off points established in this study and the predictive equation both allow for more accurate estimation of these prevalences.
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Cozar JM, Solsona E, Brenes F, Fernández-Pro A, León F, Molero JM, Pérez JF, Rodríguez MP, Huerta A, Pérez-Escolano I. [Clinical management of patient with benign prostatic hyperplasia in Spain]. Actas Urol Esp 2011; 35:580-8. [PMID: 21959065 DOI: 10.1016/j.acuro.2011.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 07/27/2011] [Accepted: 07/31/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To identify clinical management of benign prostatic hyperplasia (BPH) in Spain and its associated health care resources. MATERIAL AND METHODS A qualitative cross-sectional study was conducted through telephone interviews to general practitioners (GP) and urologists. Information about diagnosis, pharmacologic treatment and follow-up was collected. Results were clustered according to the key variables considered as drivers of clinical practice patterns: BPH diagnosis, severity classification, treatment initiation and follow up of patients. RESULTS 153 GP and 154 urologists participated in the study. 7 different clinical patterns were identified in primary care (PC). Resource use during diagnosis is relatively homogeneous, reporting a range of 2.0 to 2.6 visits employed and being the most frequent test performed PSA and urine test. Follow-up is heterogeneous; frequency of follow-up visits oscillates from 3.2 to 7.0 visits/patient/year and type of tests performed is different among patterns and within the same pattern. In Urology, 3 clinical patterns were identified. Resource use is homogeneous in the diagnosis and in the follow-up; urologists employed 2 visits in diagnosis and a range of 2.1 to 3.2 visits/patient/year in the follow-up. The most frequent tests both in diagnosis and follow-up are PSA and digital test. CONCLUSIONS BPH management shows variability in PC, identifying 7 different clinical practice patterns with different resource use during the follow-up among patterns and within the same pattern. The implementation of clinical guidelines could be justified to reduce heterogeneity.
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Affiliation(s)
- J M Cozar
- Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España.
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Ferreira AD, César CC, Malta DC, Souza Andrade ACD, Ramos CGC, Proietti FA, Bernal RTI, Caiaffa WT. Validade de estimativas obtidas por inquérito telefônico: comparação entre VIGITEL 2008 e inquérito Saúde em Beagá. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2011; 14 Suppl 1:16-30. [DOI: 10.1590/s1415-790x2011000500003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 02/20/2011] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Verificar a validade externa das estimativas obtidas por inquérito telefônico, e o impacto do uso do fator de ponderação pós-estratificação na correção das estimativas. MÉTODOS: Foram utilizadas informações de moradores das regiões Oeste e Barreiro de Belo Horizonte (MG), obtidas por inquérito telefônico VIGITEL 2008 (n=440) e por inquérito domiciliar, realizado face a face, Saúde em Beagá (SB) (n=4.048). Estimativas de variáveis relevantes para vigilância epidemiológica foram comparadas entre os estudos, por meio das estatísticas de teste. Inicialmente, compararam-se grupos segundo a posse de linha telefônica fixa e em seguida as estimativas do VIGITEL, com e sem a utilização de peso pós-estratificação, com as estimativas do SB. RESULTADOS: Indivíduos que possuíam telefone fixo residencial apresentaram marcadores de melhores condições econômicas (local de moradia, escolaridade e cor de pele), maior prevalência de doenças crônicas não transmissíveis (DCNT), menor exposição a fatores de risco para DCNT e maior acesso/utilização de serviços de saúde, quando comparados aos demais. A maioria das estimativas do VIGITEL (sem o uso do peso pós-estratificação) foi semelhante às estimativas para a amostra do SB que referiu ter telefone fixo residencial, demonstrando não haver grande impacto da metodologia utilizada na obtenção dos dados (reduzido viés de informação). Mesmo sem utilizar o fator de pós-estratificação, as estimativas do VIGITEL se assemelharam às do SB; após a ponderação, as poucas estimativas viciadas (número de moradores, cor de pele e atividade física) não diferiram mais das obtidas pelo inquérito face a face exceto para a variável "ter plano de saúde", cuja correção da estimativa reduziu a diferença observada, e para as variáveis "consumo de verduras/legumes" e "tabagismo atual", em que não foi possível corrigir as estimativas. CONCLUSÃO: Recomenda-se a vigilância epidemiológica de DCNT por meio de inquéritos telefônicos porque fornecem estimativas aproximadas do que seria esperado para a população total, com menores investimentos financeiros e menor tempo.
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Balboa-Castillo T, León-Muñoz LM, Graciani A, Rodríguez-Artalejo F, Guallar-Castillón P. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health Qual Life Outcomes 2011; 9:47. [PMID: 21708011 PMCID: PMC3142200 DOI: 10.1186/1477-7525-9-47] [Citation(s) in RCA: 200] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 06/27/2011] [Indexed: 12/18/2022] Open
Abstract
Background Evidence on the relation between leisure-time physical activity (LTPA) and health-related quality of life (HRQoL) in older adults is based primarily on clinical trials of physical exercise programs in institutionalized persons and on cross-sectional studies of community-dwelling persons. Moreover, there is no evidence on whether leisure-time sedentary behavior (LTSB) is associated with HRQoL independently of LTPA. This study examined the longitudinal association between LTPA, LTSB, and HRQoL in older community-dwelling adults in Spain. Methods Prospective cohort study of 1,097 persons aged 62 and over. In 2003 LTPA in MET-hr/week was measured with a validated questionnaire, and LTSB was estimated by the number of sitting hours per week. In 2009 HRQoL was measured with the SF-36 questionnaire. Analyses were done with linear regression and adjusted for the main confounders. Results Compared with those who did no LTPA, subjects in the upper quartile of LTPA had better scores on the SF-36 scales of physical functioning (β 5.65; 95% confidence interval [CI] 1.32-9.98; p linear trend < 0.001), physical role (β 7.38; 95% CI 0.16-14.93; p linear trend < 0.001), bodily pain (β 6.92; 95% CI 1.86-11.98; p linear trend < 0.01), vitality (β 5.09; 95% CI 0.76-9.41; p linear trend < 0.004) social functioning (β 7.83; 95% CI 2.89-12.75; p linear trend < 0.001), emotional role (β 8.59; 95% CI 1.97-15.21; p linear trend < 0.02) and mental health (β 4.20; 95% CI 0.26-8.13; p linear trend < 0.06). As suggested by previous work in this field, these associations were clinically relevant because the β regression coefficients were higher than 3 points. Finally, the number of sitting hours showed a gradual and inverse relation with the scores on most of the SF-36 scales, which was also clinically relevant. Conclusions Greater LTPA and less LTSB were independently associated with better long-term HRQoL in older adults.
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Affiliation(s)
- Teresa Balboa-Castillo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ-CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Galán I, Rodríguez-Laso Á, Díez-Gañán L, Cámara E. Prevalence and correlates of skin cancer risk behaviors in Madrid (Spain). GACETA SANITARIA 2011; 25:44-9. [DOI: 10.1016/j.gaceta.2010.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 07/01/2010] [Accepted: 07/09/2010] [Indexed: 10/18/2022]
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Monteagudo Piqueras O, Hernando Arizaleta L, Palomar Rodríguez JA. [Population based norms of the Spanish version of the SF-12V2 for Murcia (Spain)]. GACETA SANITARIA 2010; 25:50-61. [PMID: 20980078 DOI: 10.1016/j.gaceta.2010.09.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 08/03/2010] [Accepted: 09/01/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Questionnaires on perceived health provide information on health results. Reference values are needed to assess these results. Previous studies have provided Spanish population-based norms for the SF-12v1. The aim of this study was to obtain the population-based norms for the Spanish version of the SF-12v2 for Murcia. METHODS A cross-sectional telephone survey was carried out in 3,486 community-dwelling persons aged over 18 years old in the region of Murcia. The central tendency, dispersion and percentiles were calculated for each of the eight scales and the physical and mental summary components (PCS and MCS) of the SF-12v2. Known groups were compared to evaluate construct validity (Student's t-test and ANOVA). RESULTS A total of 3, 381 persons took part in the study (50.5% men). The mean age was 43.6 years in men and 46.0 in women. The mean PSC was 48.6 (± 10.6) and the mean MCS was 53.6 (± 10.7). These scores were higher (more favorable) in men, the youngest age groups, in persons with higher education and in those no chronic illnesses (p=0.000). In all the dimensions and summary components, men had better scores than women. The dimension with the worst score in both men and women was general health and the PCS. CONCLUSIONS These results should be considered as the population-based norms for the Spanish version of the SF-12v2 for Murcia but may also be useful to establish health aims in similar populations.
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Affiliation(s)
- Olga Monteagudo Piqueras
- Servicio de Planificación y Financiación Sanitaria, Consejería de Sanidad y Consumo, Región de Murcia, España.
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Wei JW, Heeley EL, Jan S, Huang Y, Huang Q, Wang JG, Cheng Y, Xu E, Yang Q, Anderson CS. Variations and determinants of hospital costs for acute stroke in China. PLoS One 2010; 5. [PMID: 20927384 PMCID: PMC2946911 DOI: 10.1371/journal.pone.0013041] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 08/31/2010] [Indexed: 12/04/2022] Open
Abstract
Background The burden of stroke is high and increasing in China. We modelled variations in, and predictors of, the costs of hospital care for patients with acute stroke in China. Methods and Findings Baseline characteristics and hospital costs for 5,255 patients were collected using the prospective register-based ChinaQUEST study, conducted in 48 Level 3 and 14 Level 2 hospitals in China during 2006–2007. Ordinary least squares estimation was used to determine factors associated with hospital costs. Overall mean cost of hospitalisation was 11,216 Chinese Yuan Renminbi (CNY) (≈US$1,602) per patient, which equates to more than half the average annual wage in China. Variations in cost were largely attributable to stroke severity and length of hospital stay (LOS). Model forecasts showed that reducing LOS from the mean of 20 days for Level 3 and 18 days for Level 2 hospitals to a duration of 1 week, which is common among Western countries, afforded cost reductions of 49% and 19%, respectively. Other lesser determinants varied by hospital level: in Level 3 hospitals, health insurance and the occurrence of in-hospital complications were each associated with 10% and 18% increases in cost, respectively, whilst treatment in a teaching hospital was associated with approximately 39% decrease in cost on average. For Level 2 hospitals, stroke due to intracerebral haemorrhage was associated with a 19% greater cost than for ischaemic stroke. Conclusions Changes to hospital policies to standardise resource use and reduce the variation in LOS could attenuate costs and improve efficiencies for acute stroke management in China. The success of these strategies will be enhanced by broader policy initiatives currently underway to reform hospital reimbursement systems.
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Affiliation(s)
- Jade W Wei
- The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia.
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Sampling procedures and sample representativeness in a national telephone survey: a Portuguese example. Int J Public Health 2009; 55:261-9. [PMID: 20013144 DOI: 10.1007/s00038-009-0102-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Revised: 07/27/2009] [Accepted: 11/05/2009] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES This paper aims to assess the yielding of the sampling procedures and the representativeness of a sample evaluated in a national telephone survey in Portugal. METHODS The Portuguese telephone book (2007/2008) was the sampling frame for subjects >39 years (n = 1,934). The time spent with interviews and unsuccessful contacts was quantified and the yielding of the contact attempts compared according different schedules. Demographic and health characteristics of the participants were compared with those of the Portuguese population. RESULTS Among eligible individuals, the percentage of refusals was 40.4%, higher on Saturdays (45.2% vs. 30.7%) and evenings (45.2% vs. 36.7%). Evening interviews yielded a higher percentage of men (26.2% vs. 21.0%) and active workers (31.8% vs. 21.8%). Compared to the Portuguese population, our sample included a higher proportion of women (76.7% vs. 54.1%), elderly (>59 years: 61.4% vs. 46.2%) and more educated participants (>4 years: 38.3% vs. 26.3%). Sex- and age-specific estimates of smoking and obesity were similar to those in the Portuguese population. CONCLUSION Despite the difficulties in reaching participants, this strategy may produce unbiased estimates for important health indicators.
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Vasconcelos MEL, Fonseca MJM, Rozenfeld S, Acurcio FA. Acurácia de informações sobre classes de medicamentos obtidas com questionário postal aplicado a idosos - Rio de Janeiro, RJ. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2009. [DOI: 10.1590/s1415-790x2009000400008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVOS: verificar a confiabilidade e a validade das informações sobre medicamentos obtidas em questionário postal, respondido por idosos, sendo a entrevista face a face o padrão-ouro. MÉTODOS: estudo seccional (Perfil de Utilização de Medicamentos por Aposentados Brasileiros), onde foram utilizadas duas abordagens (postal e domiciliar) para coleta de informações de aposentados pelo Instituto Nacional do Seguro Social (INSS) com sessenta anos de idade ou mais. Foram utilizadas também as estatísticas kappa (simples (k), ajustado (PABAK) e ponderado), índices de correlação intra-classe, indicadores de sensibilidade e especificidade, e o gráfico de Luiz et al. RESULTADOS: 234 idosos (M = 42%; F = 58%) responderam às duas abordagens (média = 71,7 anos). A concordância entre postal e entrevista domiciliar foi excelente (k = 0,94) para hipoglicemiantes; muito boa (k = 0,83-0,82) para inibidores da enzima conversora de angiotensina e anti-hipertensivos; boa (k = 0,71) para diuréticos; e razoável (k = 0,47) para antiinflamatórios não esteróides. A concordância foi boa (k = 0,61) para o número total de medicamentos usados. A validade da abordagem postal foi elevada, às vezes total, para os fármacos empregados no tratamento do diabetes (sensibilidade e especificidade = 100%), seguidos dos anti-hipertensivos. Os menores valores obtidos foram para antiinflamatórios não esteróides (sensibilidade = 64%; especificidade = 88%). CONCLUSÃO: a abordagem postal pode ser usada para se obter informações acuradas sobre classes de medicamentos usados por população com idade igual ou superior a 60 anos, considerando idosos com perfil social semelhante ao dos beneficiários do INSS.
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Otero-Rodríguez A, León-Muñoz LM, Balboa-Castillo T, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. Change in health-related quality of life as a predictor of mortality in the older adults. Qual Life Res 2009; 19:15-23. [DOI: 10.1007/s11136-009-9561-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2009] [Indexed: 10/20/2022]
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Monteagudo Piqueras O, Hernando Arizaleta L, Palomar Rodríguez JA. [Reference values of the Spanish version of the SF-12v2 for the diabetic population]. GACETA SANITARIA 2009; 23:526-32. [PMID: 19303170 DOI: 10.1016/j.gaceta.2008.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2008] [Accepted: 11/05/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Perceived health status questionnaires provide important information for health outcomes research. Reference measures are required to interpret the health-related quality of life questionnaires belonging to the short form (SF) health survey family. Previous studies have provided these reference measures for the Spanish general population, but not for specific disease conditions. The aim of the present study was to obtain diabetic population-based norms for the Spanish version of the 12-item short form health survey version II (SF-12v2) in the region of Murcia (Spain). METHODS We performed a cross-sectional telephone survey in 1,500 non-institutionalized patients with type 1 or 2 diabetes, aged 18 years or older and representative of the region of Murcia. The central position, dispersion statistics and percentiles were calculated for each of the eight SF-12v2 scales and summary components (physical and mental). RESULTS The mental component summary (MCS) (mean: 50.5+/-12.8) was higher than the physical component summary (PCS) (42.5+/-11.8). By sex, men had more favorable MCS (53.6+/-11.6) and PCS (44.9+/-11.2) scores than women (MCS: 47.7+/-13.2; PCS: 40.3+/-11.9). The dimension with the highest score was vitality (men: 57.2+/-11.1; women: 51.9+/-12.1), while that with the lowest score was general health (men: 39.0+/-9.7; women: 35.8+/-10.0). When the groups were stratified by age, scores continued to be higher in men than in women. CONCLUSIONS The results of the present study should be taken as the diabetic population-based norms for the Spanish version of the SF-12v2 in the region of Murcia. These results may be useful to establish therapeutics targets, as well as for comparisons with the general, healthy and ill populations.
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Affiliation(s)
- Olga Monteagudo Piqueras
- Servicio de Planificación y Financiación Sanitaria, Consejería de Sanidad y Consumo, Región de Murcia, España.
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Valencia-Martín JL, Galán I, Rodríguez-Artalejo F. Alcohol and self-rated health in a Mediterranean country: the role of average volume, drinking pattern, and alcohol dependence. Alcohol Clin Exp Res 2008; 33:240-6. [PMID: 18976344 DOI: 10.1111/j.1530-0277.2008.00826.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The association between average alcohol consumption and self-rated ill-health is "J-shaped" in Scandinavian and Anglo-Saxon countries, but it has shown an inverse linear relationship in the few studies conducted in Mediterranean countries, based on average volume solely. OBJECTIVE To examine the relationship between alcohol and self-rated health in the general population of a Mediterranean country, by simultaneously taking into account average volume, drinking pattern, and alcohol abuse. METHODS From 2000 to 2005, we conducted telephone interviews on 12,037 persons, representative of the population aged 18 to 64 years in Madrid, Spain. The drinking pattern encompassed binge drinking, beverage preference, and drinking at mealtimes. Alcohol abuse was estimated by the CAGE test. The association between each alcohol-related variable and self-rated suboptimal (fair, poor, or very poor) health was estimated from logistic regression, with adjustment for the remaining alcohol-related variables and other potential confounders. RESULTS In comparison with never-drinkers, suboptimal health was less frequent among occasional drinkers [odds ratio (OR) 0.72; 95% confidence interval (CI): 0.61 to 0.86], average moderate drinkers (OR 0.57; 95% CI: 0.48 to 0.69), and excessive drinkers (OR 0.51; 95% CI: 0.36 to 0.72), but more frequent among former drinkers with > or =1 year of abstinence (OR 1.30; 95% CI: 1.03 to 1.64). Frequency of suboptimal health was likewise higher in subjects with > or =3 episodes of binge drinking (OR 1.55; 95% CI: 1.12 to 2.14) or alcohol abuse (OR 1.47; 95% CI: 1.22 to 1.76). No differences were observed in suboptimal health according to beverage preference or drinking at mealtimes. RESULTS in each gender were similar to those for total study participants. CONCLUSIONS Occasional, moderate, and excessive consumption of alcohol are associated with better self-rated health, even after adjustment for drinking pattern and alcohol abuse. In contrast, former-drinking, frequent binge drinking, and alcohol abuse are all associated with suboptimal self-rated health.
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Affiliation(s)
- José Lorenzo Valencia-Martín
- CIBER en Epidemiología y Salud Pública (CIBERESP), Universidad Autónoma de Madrid, C/Arzobispo Morcillo 4, Madrid, Spain.
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Rodríguez-Artalejo F, Guallar-Castillón P, Villar Álvarez F, Banegas JR. Análisis crítico y propuestas de mejora de los sistemas de información sobre enfermedades cardiovasculares en España. Med Clin (Barc) 2008. [DOI: 10.1016/s0025-7753(08)72264-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Valencia-Martín JL, Galán I, Rodríguez-Artalejo F. The joint association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. Addiction 2008; 103:749-57. [PMID: 18412753 DOI: 10.1111/j.1360-0443.2008.02165.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies on alcohol-related road safety have not assessed the joint impact of average volume of alcohol and binge drinking. AIM To examine the joint and separate association of average volume of alcohol and binge drinking with hazardous driving behaviour and traffic crashes. METHODS Data were drawn from telephone interviews conducted in the period 2000-2005, with 12 037 individuals representative of the population aged 18-64 years in the Madrid region, Spain. The threshold between average moderate and heavy volumes was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of >or= 80 g of alcohol in men and >or= 60 g in women, during any drinking occasion in the preceding 30 days. Individuals were classified into the following categories: (i) non-drinkers; (ii) moderate drinkers with no binge drinking (MDNB); (iii) moderate drinkers with binge drinking (MDB); (iv) heavy drinkers with no binge drinking (HDNB); and (v) heavy drinkers with binge drinking (HDB). Analyses were performed using logistic regression, with adjustment for sex, age and educational level. FINDINGS Frequency of inadequate seat-belt use increased progressively across categories of alcohol consumption, with odds ratio (OR) 1 in non-drinkers, 1.19 [95% confidence interval (CI) 1.06-1.33] in MDNB, 1.69 (1.41-2.03) in MDB, 1.68 (1.24-2.29) in HDNB and 2.41 (1.83-3.18) in HDB (P for trend <0.001). Compared with MDNB, alcohol-impaired driving was also more frequent in MDB (OR 7.43; 95% CI: 5.52-10.00), HDNB (OR 7.31; 95% CI: 4.37-12.25) and in HDB (OR 15.50; 95% CI: 10.62-22.61). Lastly, compared with non-drinkers, frequency of traffic crashes increased progressively across categories of alcohol consumption (P for trend=0.028), although it only reached statistical significance in HDB (OR 2.01; 95% CI: 1.00-4.09). CONCLUSIONS Self-reported average volume of alcohol and binge drinking are both associated with self-reported hazardous driving behaviour and traffic crashes. The strength of the association is greater when average heavy consumption and binge drinking occur jointly.
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León-Muñoz LM, López-García E, Graciani A, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F. Functional status and use of health care services: Longitudinal study on the older adult population in Spain. Maturitas 2007; 58:377-86. [DOI: 10.1016/j.maturitas.2007.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 09/14/2007] [Accepted: 09/18/2007] [Indexed: 12/01/2022]
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Guallar-Castillón P, Sagardui-Villamor J, Banegas JR, Graciani A, Fornés NS, López García E, Rodríguez-Artalejo F. Waist circumference as a predictor of disability among older adults. Obesity (Silver Spring) 2007; 15:233-44. [PMID: 17228052 DOI: 10.1038/oby.2007.532] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Few studies have addressed the association between abdominal obesity, as measured by waist circumference (WC), and disability in the elderly. Moreover, those studies were cross-sectional and yielded inconsistent results. The objective of this study was to examine longitudinally the association between WC and self-reported disability among older adults. RESEARCH METHODS AND PROCEDURES A prospective cohort study was conducted from 2001 to 2003 in 3235 persons (1411 men and 1824 women) representative of the non-institutionalized Spanish population ages 60 years and older. Baseline information was collected by home-based personal interviews and measurement of WC, weight, and height. Two years later, information on disability was obtained by telephone interview. The association of interest was summarized with odds ratios obtained by logistic regression. RESULTS Among persons reporting no disability at baseline, WC predicted disability 2 years later. After adjustment for age, education, tobacco use, alcohol consumption, and physical activity, men in the highest WC quintile had 2.17 (95% confidence interval, 1.15 to 4.09) times more risk of mobility disability and 4.77 (95% confidence interval, 2.50 to 9.13) times more risk of agility disability than those in the lowest quintile. Additional adjustment for BMI, chronic diseases, and cognitive function led to only a slight reduction in this association. Results were similar for women. No statistically significant association was observed between WC and restriction of daily activities, limitation in instrumental activities of daily living, and limitation in bathing or dressing, in either men or women. DISCUSSION WC predicts mobility and agility disability in old age. Avoidance of the highest values of WC might decrease the risk of disability in older adults.
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Affiliation(s)
- Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
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Rey E, Elola-Olaso CM, Rodríguez-Artalejo F, Locke GR, Díaz-Rubio M. Prevalence of atypical symptoms and their association with typical symptoms of gastroesophageal reflux in Spain. Eur J Gastroenterol Hepatol 2006; 18:969-75. [PMID: 16894310 DOI: 10.1097/01.meg.0000230081.53298.03] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The association between typical and atypical symptoms of gastroesophageal reflux (GER) has received little attention in population-based studies. This study therefore sought to examine the prevalence of atypical symptoms, and their association with typical GER symptoms in Spain. METHODS A telephone survey using a validated questionnaire was conducted in 2002 on 2500 subjects aged 40-79 years, randomly selected from the general population of Spain. The questionnaire included items on typical GER symptoms (heartburn and acid regurgitation) and several atypical symptoms (chest pain, dysphagia, belching, dyspepsia, globus, hoarseness, hiccups, chronic cough and asthma). The association between typical GER symptoms and each atypical symptom was summarized using odds ratios obtained from logistic regression. RESULTS The response rate was 71.2%. A total of 60.8% (95% confidence interval 59.0-62.8%) of subjects reported suffering from at least one atypical symptom during the year preceding the interview. The prevalence rates varied from 26.7% for hoarseness to 6.6% for asthma. The prevalence of atypical symptoms was higher among the 791 subjects with typical GER symptoms than among the 1709 subjects reporting no typical GER symptoms (79.6 versus 52.2%). It was also higher among those reporting frequent typical GER symptoms compared with those reporting occasional symptoms (87.8 versus 58%). After adjustment for age, sex, coffee, alcohol and tobacco consumption, and psychosomatic symptoms, an association (P<0.05) was observed between typical symptoms and the respective atypical symptoms, with odds ratios ranging from 1.4 for asthma to 4.6 for belching. After additional adjustment for the remaining atypical symptoms, chest pain, dysphagia, dyspepsia, belching and globus were each independently associated with typical reflux symptoms. CONCLUSION The prevalence of atypical GER symptoms is extremely high. There is an association between typical and atypical GER symptoms, particularly chest pain, dysphagia, dyspepsia, belching and globus.
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Affiliation(s)
- Enrique Rey
- Digestive Disease Service, Hospital Clinico San Carlos, Complutense University, Madrid, Spain.
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Carrasco JM, Lope V, Pérez-Gómez B, Aragonés N, Suárez B, López-Abente G, Rodríguez-Artalejo F, Pollán M. Association between health information, use of protective devices and occurrence of acute health problems in the Prestige oil spill clean-up in Asturias and Cantabria (Spain): a cross-sectional study. BMC Public Health 2006; 6:1. [PMID: 16390547 PMCID: PMC1368965 DOI: 10.1186/1471-2458-6-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Accepted: 01/03/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper examines the association between use of protective devices, frequency of acute health problems and health-protection information received by participants engaged in the Prestige oil spill clean-up in Asturias and Cantabria, Spain. METHODS We studied 133 seamen, 135 bird cleaners, 266 volunteers and 265 paid workers selected by random sampling, stratified by type of worker and number of working days. Information was collected by telephone interview conducted in June 2003. The association of interest was summarized, using odds ratios (OR) obtained from logistic regression. RESULTS Health-protection briefing was associated with use of protective devices and clothing. Uninformed subjects registered a significant excess risk of itchy eyes (OR:2.89; 95%CI:1.21-6.90), nausea/vomiting/dizziness (OR:2.25; 95%CI:1.17-4.32) and throat and respiratory problems (OR:2.30; 95%CI:1.15-4.61). There was a noteworthy significant excess risk of headaches (OR:3.86: 95%CI:1.74-8.54) and respiratory problems (OR:2.43; 95%CI:1.02-5.79) among uninformed paid workers. Seamen, the group most exposed to the fuel-oil, were the worst informed and registered the highest frequency of toxicological problems. CONCLUSION Proper health-protection briefing was associated with greater use of protective devices and lower frequency of health problems. Among seamen, however, the results indicate poorer dissemination of information and the need of specific guidelines for removing fuel-oil at sea.
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Affiliation(s)
- José Miguel Carrasco
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Virginia Lope
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nuria Aragonés
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Berta Suárez
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Gonzalo López-Abente
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Marina Pollán
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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