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Blanco-Ferreiro A, Candal-Pedreira C, Sendón B, Santiago-Pérez MI, Rey-Brandariz J, Varela-Lema L, Mourino N, Ruano-Ravina A, García G, Pérez-Ríos M. Self-perceived body weight and weight status: analysis of concordance by age group and sex. Public Health 2024; 229:160-166. [PMID: 38447299 DOI: 10.1016/j.puhe.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/29/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Previous studies suggest that there is discordance between actual weight status and body-weight perception. This fact has implications when it comes to designing public health interventions. The aim of this study was to estimate the prevalence of the different categories of weight status and body-weight perception and to analyse their concordance in a representative Spanish population sample. STUDY DESIGN Cross-sectional study. METHODS Data were sourced from the 2018 Galician Risk Behaviour Data System, with the target population being all persons aged 16 years and above. We collected data on self-perceived body weight and assessed weight status on the basis of body mass index (BMI). BMI was estimated using self-reported measures of weight and height. To estimate concordance, Cohen's kappa coefficient, both unweighted and weighted with Cicchetti weights, was calculated. RESULTS Data were obtained for 7853 individuals aged 16 years and above, whereas the overall unweighted concordance was 0.393 (95%CI: 0.377-0.409), with an agreement percentage of 61.6%, weighted concordance was 0.503 (0.490-0.517), with an agreement percentage of 86.6%. The highest concordance between self-perceived body weight and weight status was observed in women. By age group, the highest concordance was observed in the youngest group (16-24 years) for the BMI categories of underweight and overweight, and in the 45-64 age group for the category of obesity. CONCLUSIONS The results highlight the existence of differences between self-perceived body weight and weight status, according to sex and age.
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Affiliation(s)
- A Blanco-Ferreiro
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - C Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
| | - B Sendón
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - M I Santiago-Pérez
- Epidemiology Department, Directorate-General of Public Health, Santiago de Compostela, Spain
| | - J Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - L Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - N Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - A Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - G García
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - M Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
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Guerra-Tort C, López-Vizcaíno E, Santiago-Pérez MI, Rey-Brandariz J, Candal-Pedreira C, Varela-Lema L, Schiaffino A, Ruano-Ravina A, Perez- Rios M. Validation of a small-area model for estimation of smoking prevalence at a subnational level. Tob Induc Dis 2023; 21:112. [PMID: 37664442 PMCID: PMC10472341 DOI: 10.18332/tid/169683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/05/2023] [Accepted: 07/16/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION Small-area estimation methods are an alternative to direct survey-based estimates in cases where a survey's sample size does not suffice to ensure representativeness. Nevertheless, the information yielded by small-area estimation methods must be validated. The objective of this study was thus to validate a small-area model. METHODS The prevalence of smokers, ex-smokers, and never smokers by sex and age group (15-34, 35-54, 55-64, 65-74, ≥75 years) was calculated in two Spanish Autonomous Regions (ARs) by applying a weighted ratio estimator (direct estimator) to data from representative surveys. These estimates were compared against those obtained with a small-area model applied to another survey, specifically the Spanish National Health Survey, which did not guarantee representativeness for these two ARs by sex and age. To evaluate the concordance of the estimates, we calculated the intraclass correlation coefficient (ICC) and the 95% confidence intervals of the differences between estimates. To assess the precision of the estimates, the coefficients of variation were obtained. RESULTS In all cases, the ICC was ≥0.87, indicating good concordance between the direct and small-area model estimates. Slightly more than eight in ten 95% confidence intervals for the differences between estimates included zero. In all cases, the coefficient of variation of the small-area model was <30%, indicating a good degree of precision in the estimates. CONCLUSIONS The small-area model applied to national survey data yields valid estimates of smoking prevalence by sex and age group at the AR level. These models could thus be applied to a single year's data from a national survey, which does not guarantee regional representativeness, to characterize various risk factors in a population at a subnational level.
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Affiliation(s)
- Carla Guerra-Tort
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Esther López-Vizcaíno
- Servizo de Difusión e Información, Instituto Galego de Estatística, Xunta de Galicia, Santiago de Compostela, Spain
| | - María I. Santiago-Pérez
- Servizo de Epidemioloxía, Dirección Xeral de Saúde Pública, Xunta de Galicia, Santiago de Compostela, Spain
| | - Julia Rey-Brandariz
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Candal-Pedreira
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Epidemiología y Salud Pública, Centro de Investigación Biomédica en Red (CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Anna Schiaffino
- Departament de Salut, Direcció General de Planificació en Salut, Generalitat de Catalunya, Barcelona, Spain
| | - Alberto Ruano-Ravina
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Epidemiología y Salud Pública, Centro de Investigación Biomédica en Red (CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Monica Perez- Rios
- Área de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Epidemiología y Salud Pública, Centro de Investigación Biomédica en Red (CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Santiago-Pérez MI, López-Vizcaíno E, Pérez-Ríos M, Guerra-Tort C, Rey-Brandariz J, Varela-Lema L, Martín-Gisbert L, Ruano-Ravina A, Schiaffino A, Galán I, Candal-Pedreira C, Montes A, Ahluwalia J. Small-area models to assess the geographical distribution of tobacco consumption by sex and age in Spain. Tob Induc Dis 2023; 21:63. [PMID: 37215189 PMCID: PMC10194049 DOI: 10.18332/tid/162379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/31/2023] [Accepted: 03/19/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION Complete and accurate data on smoking prevalence at a local level would enable health authorities to plan context-dependent smoking interventions. However, national health surveys do not generally provide direct estimates of smoking prevalence by sex and age groups at the subnational level. This study uses a small-area model-based methodology to obtain precise estimations of smoking prevalence by sex, age group and region, from a population-based survey. METHODS The areas targeted for analysis consisted of 180 groups based on a combination of sex, age group (15-34, 35-54, 55-64, 65-74, and ≥75 years), and Autonomous Region. Data on tobacco use came from the 2017 Spanish National Health Survey (2017 SNHS). In each of the 180 groups, we estimated the prevalence of smokers (S), ex-smokers (ExS) and never smokers (NS), as well as their coefficients of variation (CV), using a weighted ratio estimator (direct estimator) and a multinomial logistic model with random area effects. RESULTS When smoking prevalence was estimated using the small-area model, the precision of direct estimates improved; the CV of S and ExS decreased on average by 26%, and those of NS by 25%. The range of S prevalence was 11-46% in men and 4-37% in women, excluding the group aged ≥75 years. CONCLUSIONS This study proposes a methodology for obtaining reliable estimates of smoking prevalence in groups or areas not covered in the survey design. The model applied is a good alternative for enhancing the precision of estimates at a detailed level, at a much lower cost than that involved in conducting large-scale surveys. This method could be easily integrated into routine data processing of population health surveys. Having such estimates directly after completing a health survey would help characterize the tobacco epidemic and/or any other risk factor more precisely.
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Affiliation(s)
- María I. Santiago-Pérez
- Epidemiology Department, Directorate-General of Public Health, Galician Regional Health Authority, Santiago de Compostela, Spain
| | - Esther López-Vizcaíno
- Diffusion and Information Service, Galician Institute of Statistics, Santiago de Compostela, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Carla Guerra-Tort
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Lucía Martín-Gisbert
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Anna Schiaffino
- Directorate-General of Health Planning, Health Department, Catalonian Regional Authority, Barcelona, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Agustín Montes
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Jasjit Ahluwalia
- Department of Medicine, Alpert School of Medicine, Brown University, Providence, United States
- Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, United States
- Legoretta Cancer Center, Division of Biology and Medicine, Brown University, Providence, United States
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Ríos MP, López-Medina DC, Tort CG, Brandariz JR, Lema LV, Santiago-Pérez MI, Candal C, Montes A, López MJ, Dalmau R, Provencio M, Fernández E, Blanco A, Ravina AR. Mortality attributable to environmental tobacco smoke exposure in Spain in 2020. Arch Bronconeumol 2023; 59:305-310. [PMID: 36967344 DOI: 10.1016/j.arbres.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Exposure to environmental tobacco smoke (ETS) is associated with increased mortality and morbidity. The objective of this study was to estimate the impact of ETS exposure in Spain on mortality in 2020 in the population aged 35 years and over. METHODS A method of estimating attributable mortality (AM) based on the prevalence of ETS exposure was applied. Prevalence data were obtained from a representative study conducted in Spain and the relative risks were derived from a meta-analysis. AM point estimates are presented along with 95% confidence intervals (95% CI), calculated using a bootstrap naive procedure. AM, both overall and by smoking habit, was estimated for each combination of sex, age group, and cause of death (lung cancer and ischemic heart disease). A sensitivity analysis was performed. RESULTS A total of 747 (95% CI 676-825) deaths were attributable to ETS exposure, of which 279 (95% CI 256-306) were caused by lung cancer, and 468 (95% CI 417-523) by ischemic heart disease. Three-quarters (75.1%) of AM occurred in men and 60.9% in non-smokers. When chronic obstructive pulmonary disease and cerebrovascular disease are included, the burden of AM is estimated at 2242 deaths. CONCLUSIONS ETS exposure is associated with 1.5% of all deaths from lung cancer and ischemic heart disease in the population aged 35 and over. These data underline the need for health authorities to focus on reducing exposure to ETS in all settings and environments.
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Fernández-García A, Pérez-Ríos M, Fernández-Villar A, Candal-Pedreira C, Naveira-Barbeito G, Santiago-Pérez MI, Rey-Brandariz J, Represas-Represas C, Malvar-Pintos A, Ruano-Ravina A. Hospitalizations due to and with chronic obstructive pulmonary disease in Galicia: 20 years of evolution. Rev Clin Esp 2022; 222:569-577. [PMID: 35882597 DOI: 10.1016/j.rceng.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This work aims to analyze the evolution of COPD-related hospitalizations in Galicia from 1996 to 2018 both as main cause of admission (DUE TO COPD) or when coded in any diagnostic order (WITH COPD), assessing the influence of age, sex, seasonality, and other main causes of the hospitalization. METHODS An analysis was conducted of administrative healthcare database (CMBD) data on index COPD-related hospitalizations in Galicia from 1996 to 2018. Crude, specific, and standardized rates were calculated for the entire sample and according to age and sex groups. RESULTS In the period from 1996 to 2018, there were 310,883 index admissions WITH COPD in Galicia, of which 29.6% were DUE TO COPD. Both WITH COPD and DUE TO COPD admission rates increased, mainly in men. There was a clear seasonality that was especially relevant in the DUE TO COPD group. The mean male-to-female ratio was approximately 4:1 in both groups, although it was lower in the extreme age groups, with no change over time. The mean age at admission increased three years in men during this period; there were no changes among women. The main causes of admission in those not hospitalized DUE TO COPD were heart failure and pneumonia. CONCLUSION The combined evaluation of records of hospital admissions WITH COPD and DUE TO COPD offers additional information for a better understanding of the trends of this disease and allows for establishing hypotheses that explain the results described, providing information for better healthcare planning.
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Affiliation(s)
- A Fernández-García
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Hospital POVISA, Vigo, Pontevedra, Spain
| | - M Pérez-Ríos
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, La Coruña, Spain.
| | - A Fernández-Villar
- Servicio de Neumología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Grupo NeumoVigo I+i, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Servicio de Neumología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - C Candal-Pedreira
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
| | - G Naveira-Barbeito
- Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, La Coruña, Spain
| | - M I Santiago-Pérez
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, La Coruña, Spain
| | - J Rey-Brandariz
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
| | - C Represas-Represas
- Servicio de Neumología, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain; Grupo NeumoVigo I+i, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Servicio de Neumología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - A Malvar-Pintos
- Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, La Coruña, Spain
| | - A Ruano-Ravina
- Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, La Coruña, Spain
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Ecénarro-Montiel A, Baleato-González S, Santiago-Pérez MI, Sánchez-González J, Montesinos P, García-Figueiras R. Using the modified Dixon technique to evaluate incidental adrenal lesions on 3T MRI. Radiologia (Engl Ed) 2018; 60:485-492. [PMID: 30078508 DOI: 10.1016/j.rx.2018.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To use the mDIXON-Quant sequence to quantify the fat fraction of adrenal lesions discovered incidentally on CT studies. To analyze the relation between the signal loss between in-phase and out-of-phase T1-weighted sequences and the fat fraction in mDIXON-Quant. To compare the sensitivity and specificity of the two methods for characterizing adrenal lesions. MATERIAL AND METHODS This prospective descriptive study included 31 patients with incidentally discovered adrenal lesions evaluated with 3T MRI using in-phase and out-of-phase T1-weighted sequences and mDIXON-Quant; the fat fraction of the adrenal lesions was measured by mDIXON-Quant and by calculating the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences. RESULTS The percentage of signal loss was significantly higher in the group of patients with adenoma (61.3% ± 20.4% vs. 5.1% ± 5.8% in the group without adenoma, p<0.005). The mean fat fraction measured by mDIXON-Quant was also higher for the adenomas (26.9% ±10.8% vs. 3.4% ± 3.0%, p<0.005).The area under the ROC curve was 0.99 (0.96 - 1.00) for the percentage of signal loss and 0.98 (0.94 - 1.00) for the fat fraction measured by mDIXON-Quant. The cutoffs obtained were 24.42% for the percentage of signal loss and 9.2% for the fat fraction measured by mDIXON-Quant. The two techniques had the same values for diagnostic accuracy: sensitivity 96% (79.6 - 99.9), specificity 100% (39.8 - 100.0), positive predictive value 100% (85.8 - 100.0), and negative predictive value 80% (28.4 - 99.5). CONCLUSION The fat fraction measured by the modified Dixon technique can differentiate between adenomas and other adrenal lesions with the same sensitivity and specificity as the percentage of signal loss between in-phase and out-of-phase T1-weighted sequences.
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Affiliation(s)
- A Ecénarro-Montiel
- Servicio de Radiología, Hospital Clínico Universitario, Santiago de Compostela, España.
| | - S Baleato-González
- Servicio de Radiología, Hospital Clínico Universitario, Santiago de Compostela, España
| | - M I Santiago-Pérez
- Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, España
| | | | - P Montesinos
- Clinic Scientist, Philips Iberia, Madrid, España
| | - R García-Figueiras
- Servicio de Radiología, Hospital Clínico Universitario, Santiago de Compostela, España
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Pérez-Ríos M, Santiago-Pérez MI, Malvar Pintos A, Suanzes Hernández J, Hervada Vidal X. [How many kids are there with excess weight? What information should be published?]. Rev Esp Salud Publica 2018; 92:e201806026. [PMID: 29882524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE In epidemiological studies, there is no consensus on which references should be used to characterize the weight status of schoolchildren after estimating their body mass index. The aim of this study is to evaluate the influence that different criteria have on the characterization of the weight status of Galician schoolchildren from 6 to 15 years old and to identify the criterion that best characterizes central obesity. METHODS Cross-sectional study on a sample of 7.438 schoolchildren representative by sex and age of the Galician population of 6 to 15 year olds. The prevalence of central obesity and underweight, normal weight, overweight and obesity was estimated using the reference standards of the World Health Organization (WHO), Cole, Orbegozo-2011 and the Enkid study. In order to identify the criterion that best characterizes central obesity, the positive predictive values of obesity and the negative ones of overweight and obesity were calculated. RESULTS The characterization of schoolchildren according to their weight status was different depending on the reference used with estimates that vary by 20.4 percentage points being prevalence of excess weight using WHO references 41.5% while with Enkid it is 21.1%. The reference with the best predictive capacity of central obesity was those proposed by Cole. CONCLUSIONS The variability observed in the characterization of the weight status of schoolchildren asso- ciated with the use of different reference criteria is very important. If central obesity is a good indicator of excess of weight, the reference proposed by Cole would be the one with the best capacity to characterize the child and youth population, related to the best predictive capacity.
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Affiliation(s)
- Mónica Pérez-Ríos
- Subdirección de Información sobre Saúde e Epidemioloxía. Dirección Xeral de Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela
- Departamento de Medicina Preventiva y Salud Pública. Universidad de Santiago de Compostela. Santiago de Compostela
| | - María I Santiago-Pérez
- Subdirección de Información sobre Saúde e Epidemioloxía. Dirección Xeral de Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela
| | - Alberto Malvar Pintos
- Subdirección de Información sobre Saúde e Epidemioloxía. Dirección Xeral de Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela
| | - Jorge Suanzes Hernández
- Subdirección de Programas de Fomento de Estilos de Vida Saudables. Dirección Xeral de Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela
| | - Xurxo Hervada Vidal
- Subdirección de Información sobre Saúde e Epidemioloxía. Dirección Xeral de Saúde Pública. Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela
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Pérez-Ríos M, Santiago-Pérez MI, Leis R, Malvar A, Suanzes J, Hervada X. [Prevalence of malnutrition in Spanish schoolchildren]. An Pediatr (Barc) 2017; 89:44-49. [PMID: 29102499 DOI: 10.1016/j.anpedi.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 08/14/2017] [Accepted: 09/01/2017] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION AND AIMS The term malnutrition includes malnutrition due to excess or obesity, underweight as well as stunted growth. Its prevalence in a population can be estimated using anthropometric variables. The aim of this study is to estimate the prevalence of malnutrition in Galician schoolchildren aged 6 to 15years in the school year 2013-2014. METHODS A cross-sectional study was conducted on a representative sample by gender and age of the Galician population of 6 to 15years old. The prevalence of obesity, underweight, and short stature was estimated by age and gender using the reference standards proposed by the World Health Organisation. RESULTS Of the total of 7,438 schoolchildren weighed and measured, 16.4% had malnutrition. The prevalence of obesity was 14.8%, underweight was 0.7%, and short stature for age was estimated at 1%. Obesity was more prevalent among boys. As regards underweight and short stature, when there were differences, prevalence was higher among girls. CONCLUSIONS In Galicia, 16 out of every 100 schoolchildren aged 6 to 15years had malnutrition, with that due to excess or obesity being the most frequent. Prevalence of underweight and short stature did not exceed 1%. This data shows that primary prevention measures should be promoted at an early age to reduce malnutrition due to excess or adiposity, in particular.
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Affiliation(s)
- Mónica Pérez-Ríos
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España; Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
| | - María I Santiago-Pérez
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España
| | - Rosaura Leis
- Servicio de Pediatría, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Alberto Malvar
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España
| | - Jorge Suanzes
- Subdirección de Programas de Fomento de Estilos de Vida Saudables, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España
| | - Xurxo Hervada
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela, La Coruña, España
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Tarrazo M, Pérez-Ríos M, Santiago-Pérez MI, Malvar A, Suanzes J, Hervada X. Cambios en el consumo de tabaco: auge del tabaco de liar e introducción de los cigarrillos electrónicos. Gaceta Sanitaria 2017; 31:204-209. [DOI: 10.1016/j.gaceta.2016.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/27/2016] [Accepted: 06/02/2016] [Indexed: 11/29/2022]
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Pérez-Ríos M, Santiago-Pérez MI, Rodríguez-Camacho E, Malvar A, Suanzes J, Hervada X. [Physical inactivity in Galicia (Spain): trends and the impact of changes in the definition]. Gac Sanit 2017; 29:127-30. [PMID: 25444389 DOI: 10.1016/j.gaceta.2014.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To estimate the prevalence of physical inactivity during leisure time in Galicia (Spain) between 2007 and 2011 and to assess the impact of including non-leisure time activities in the definition of physical inactivity. METHODS A cross-sectional study was conducted in the population aged 16 years and older (n=19,235). Physical activity was assessed by the Minnesota Questionnaire. In 2011, inactivity was estimated by including daily activities. RESULTS Between 2007 and 2011, the prevalence of inactivity in Galicia remained stable (p=0.249) and close to 50%. This prevalence was higher among women and those who worked or were in education. Inactivity decreased from 47% to 16% when non-leisure time activities were included in the definition. CONCLUSIONS Between 2007 and 2011 in Galicia, the prevalence of inactivity remained high and stable. This prevalence was significantly decreased when non-leisure time activities were included in the definition.
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Affiliation(s)
- Mónica Pérez-Ríos
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Innovación e Xestión da Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela (A Coruña), España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
| | - María I Santiago-Pérez
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Innovación e Xestión da Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España
| | - Elena Rodríguez-Camacho
- Servicio de Medicina Preventiva y Salud Pública, Complexo Hospitalario Universitario de A Coruña (A Coruña), España
| | - Alberto Malvar
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Innovación e Xestión da Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España
| | - Jorge Suanzes
- Subdirección de Programas de Fomento de Estilos de Vida Saudables, Dirección Xeral de Innovación e Xestión da Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España
| | - Xurxo Hervada
- Subdirección de Información sobre Saúde e Epidemioloxía, Dirección Xeral de Innovación e Xestión da Saúde Pública, Consellería de Sanidade, Xunta de Galicia, Santiago de Compostela (A Coruña), España
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Raña P, Pérez-Ríos M, Santiago-Pérez MI, Crujeiras RM. Impact of a comprehensive law on the prevalence of tobacco consumption in Spain: evaluation of different scenarios. Public Health 2016; 138:41-9. [PMID: 27076441 DOI: 10.1016/j.puhe.2016.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 12/16/2015] [Accepted: 03/04/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Since 2011, smoking legislation was hardened in Spain, banning tobacco consumption in all hospitality venues. Law 42/2010 was the first comprehensive tobacco control policy enacted in Spain. The aim of this paper is to evaluate the effect that this intervention has had in reducing the prevalence of tobacco consumption, setting up three scenarios on the basis of different theoretical levels of effect of the law. METHODS A predictive model based on Markov Chains was developed to distinguish the effect of tobacco control policies in different scenarios. STUDY DESIGN The model developed uses population, smoking rates and smoking characteristics from a non-transmissible disease surveillance system developed in Galicia (namely SICRI). RESULTS Results show that tobacco control policies hardly affect the predicted trend in a temporal frame of 10 years, with relative reduction in the predicted male smoking prevalence of 20.4% with no intervention, reaching a reduction of 26.1% under the maximum effect of the policies. CONCLUSIONS In the global population the effects of the law in the predicted prevalence have been barely perceived. For people under 25 years of age, interventions have had an important and positive effect, which proves that policies affecting this age group should be hardened.
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Affiliation(s)
- P Raña
- Department of Mathematics, University of A Coruña, Spain
| | - M Pérez-Ríos
- Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Santiago de Compostela, Spain; Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Spain.
| | - M I Santiago-Pérez
- Epidemiology Unit, Galician Directorate for Public Health, Galician Health Authority, Santiago de Compostela, Spain
| | - R M Crujeiras
- Department of Statistics and Operations Research, University of Santiago de Compostela, Spain
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Vidal-Pardo JI, Pérez-Castro TR, López-Álvarez XL, Santiago-Pérez MI, García-Soidán FJ, Muñiz J. Effect of an educational intervention in primary care physicians on the compliance of indicators of good clinical practice in the treatment of type 2 diabetes mellitus [OBTEDIGA project]. Int J Clin Pract 2013; 67:750-8. [PMID: 23668834 DOI: 10.1111/ijcp.12145] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 01/27/2013] [Indexed: 01/12/2023] Open
Abstract
AIM To evaluate the effect of an educational intervention among primary care physicians on several indicators of good clinical practice in diabetes care. METHODS Two groups of physicians were randomly assigned to the intervention or control group (IG and CG). Every physician randomly selected two samples of patients from all type 2 diabetic patients aged 40 years and above and diagnosed more than a year ago. Baseline and final information were collected cross-sectionally 12 months apart, in two independent samples of 30 patients per physician. The educational intervention comprised: distribution of educational materials and physicians' specific bench-marking information, an on-line course and three on-site educational workshops on diabetes. External observers collected information directly from the physicians and from the medical records of the patients on personal and family history of disease and on the evolution and treatment of their disease. Baseline information was collected retrospectively in the control group. RESULTS Intervention group comprised 53 physicians who included a total of 3018 patients in the baseline and final evaluations. CG comprised 50 physicians who included 2868 patients in the same evaluations. Measurement of micro-albuminuria in the last 12 months (OR = 1.6, 95% CI: 1.1-2.4) and foot examination in the last year (OR = 2.0, 95% CI: 1.1-3.6) were the indicators for which greater improvement was found in the IG. No other indicator considered showed statistically significant improvement between groups. CONCLUSIONS The identification of indicators with very low level of compliance and the implementation of a simple intervention in physicians to correct them is effective in improving the quality of care of diabetic patients.
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Affiliation(s)
- J I Vidal-Pardo
- Servicio de Endocrinoloxía, Complexo Hospitalario Lucus Augusti. Servicio Galego de Saúde, Lugo, Spain
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Muñiz J, Gómez-Doblas JJ, Santiago-Pérez MI, Lekuona-Goya I, Murga-Eizagaetxebarría N, de Teresa-Galván SS E, Cruz-Fernández JM, Castro-Beiras A. The effect of post-discharge educational intervention on patients in achieving objectives in modifiable risk factors six months after discharge following an episode of acute coronary syndrome, (CAM-2 Project): a randomized controlled trial. Health Qual Life Outcomes 2010; 8:137. [PMID: 21092191 PMCID: PMC3002321 DOI: 10.1186/1477-7525-8-137] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 11/22/2010] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES We investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached, improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome. BACKGROUND There is room to improve mid-term adherence to clinical guidelines' recommendations in coronary heart disease secondary prevention, specially non-pharmacological ones, often neglected. METHODS In CAM-2, patients discharged after an acute coronary syndrome were randomly assigned to the intervention or the usual care group. The primary outcome was reaching therapeutic objectives in various secondary prevention variables: smoking, obesity, blood lipids, blood pressure control, exercise and taking of medication. RESULTS 1757 patients were recruited in 64 hospitals and 1510 (762 in the intervention and 748 in the control group) attended the six-months follow-up visit. After adjustment for potentially important variables, there were, between the intervention and control group, differences in the mean reduction of body mass index (0.5 vs. 0.2; p < 0.001) and waist circumference (1.6 cm vs. 0.6 cm; p = 0.05), proportion of patients who exercise regularly and those with total cholesterol below 175 mg/dl (64.7% vs. 56.5%; p = 0.001). The reported intake of medications was high in both groups for all the drugs considered with no differences except for statins (98.1% vs. 95.9%; p = 0.029). CONCLUSIONS At least in the short term, lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention.
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Affiliation(s)
- Javier Muñiz
- Instituto Universitario de Ciencias de la Salud de la Universidad de A Coruña, Spain.
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López-Vizcaíno ME, Vidal-Rodeiro CL, Santiago-Pérez MI, Vázquez-Fernández E, Hervada-Vidal X. An evaluation of spatio-temporal models for the estimation of the mortality relative risk from breast cancer in Galicia, Spain. J Cancer Epidemiol Prev 2003; 7:181-93. [PMID: 12846489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND Disease mapping is now a big focus of interest in the area of Public Health, and the geographical distribution of a disease has an important role in understanding its origin or its causes. The purpose of this work is to review and evaluate different techniques to map the mortality risk of a disease in small geographical areas. METHODS Three different methods have been studied. The first one is a classical approach consisting of mapping SMRs, which are maximum likelihood estimates of the relative risk under a Poisson model of death counts. In a second step we consider Poisson and negative binomial regression to fit the rates and finally we use a Bayesian approach that assumes a hierarchical model where the death counts follow a Poisson distribution conditioned by the prior information. These methods have been applied to the study of geographical variation in female breast cancer mortality from 1976 to 1999 in the districts of Galicia, Spain. RESULTS Mapping the SMRs using the first method has important drawbacks and there are difficulties to distinguish the mortality pattern. With the second method we achieved some improvements. The Bayesian methodology produces smoother maps with a clear mortality pattern. DISCUSSION These methods are powerful tools for identifying areas with elevated risk. The Bayesian methodology has many advantages over the other methods that had been analysed in this work.
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Vidal-Rodeiro CL, Santiago-Pérez MI, Paz-Esquete J, López-Vizcaíno ME, Cerdeira-Caramés S, Hervada-Vidal X, Vázquez-Fernández E. [Space-time distribution of suicide in Galicia, Spain [1976-1998]]. Gac Sanit 2001; 15:389-97. [PMID: 11734151 DOI: 10.1016/s0213-9111(01)71592-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To study the space-time distribution of suicide in Galicia from 1976 to 1998, taking into account gender, age, season and method of suicide. METHODS For each sex crude and age-adjusted rates per province and age-specific rates per period (1978-84, 1985-91, 1992-98) were calculated. To estimate mortality risk and time trends in the municipalities, a Bayesian hierarchical model was used. RESULTS In the last few years mortality from suicide has increase considerably. Age-adjusted rates of 6 per 105 at the beginning of the study rose to 10 per 105 at the end. The increase was greatest among men. The higher rates were observed in the elderly, although in terms of time trends the highest increase occurred among adolescents and young adults. In both sexes the main method of suicide was hanging. Less common methods were jumping from a height and shooting. The greatest number of suicides took place during the spring and summer months. In terms of spatial distribution, a high number of suicides were committed in the province of Lugo; in the municipalities, mortality risk decreased from North to South and an inverse temporal trend was observed in both sexes. This differed from the space-time patterns of suicides committed using methods other than hanging. CONCLUSIONS Suicide is an important health problem in Galicia not only because to its magnitude but also because of the increasing rates, especially among young people. Geographical and temporal analysis can identify priority areas where preventive policies should be implemented.
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Affiliation(s)
- C L Vidal-Rodeiro
- Servicio de Información sobre Saúde Pública. Dirección Xeral de Saúde Pública. Consellería de Sanidade e Servicios Sociais. Xunta de Galicia
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