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A Plasència

Publications and source records attributed to A Plasència.

At least 19 recordsLinked to original sources
PubMed2005

Education level inequalities and transportation injury mortality in the middle aged and elderly in European settings.

OBJECTIVE: To study the differential distribution of transportation injury mortality by educational level in nine European settings, among people older than 30 years, during the 1990s. METHODS: Deaths of men and women older than 30 years from transportation injuries were studied. Rate differences and rate ratios (RR) between high and low educational level rates were obtained. RESULTS: Among men, those of low educational level had higher death rates in all settings, a pattern that was maintained in the different settings; no inequalities were found among women. Among men, in all the settings, the RR was higher in the 30-49 age group (RR 1.46, 95% CI 1.32 to 1.61) than in the age groups 50-69 and > or = 70 years, a pattern that was maintained in the different settings. For women for all the settings together, no differences were found among educational levels in the three age groups. In the different settings, only three had a high RR in the youngest age group, Finland (RR 1.33, 95% CI 1.01 to 1.74), Belgium (RR 1.38; 95% CI 1.13 to 1.67), and Austria (RR 1.49, 95% CI 0.75 to 2.96). CONCLUSION: This study provides new evidence on the importance of socioeconomic inequalities in transportation injury mortality across Europe. This applies to men, but not to women. Greater attention should be placed on opportunities to select intervention strategies tailored to tackle socioeconomic inequalities in transportation injuries.

Accidents, Traffic↗
PubMed2001

Factors associated with severity and hospital admission of motor-vehicle injury cases in a southern European urban area.

OBJECTIVES: To describe the characteristics of motor-vehicle (MV) injury cases admitted to Emergency departments (ED), and to assess factors related to injury severity and hospital admission. SETTING: Subjects were MV injury patients, aged 16 or more, admitted to four EDs in the city of Barcelona (Spain), from July 1995 to June 1996. METHODS: Cross-sectional design. The data analyzed were obtained from the information routinely transmitted from the EDs to the Municipal Institute of Health, based on the processing of ED logs. Severity was assessed with the Abbreviated Injury Scale and the Injury Severity Score. Univariate and bivariate descriptive statistical analyses were performed, as well as multiple logistic regressions. RESULTS: For the 3791 MV-injury cases included in the study period, a larger contribution of cases was noted for males (63.1%), for cases younger than 30 years (55.3%) and for motorcycle or moped occupants (47.1%). After adjusting for age, sex and the presence of multiple injuries, pedestrians, followed by moped and motorcycle occupants were at a higher risk of a more severe injury (OR: 1.77, 1.61 and 1.50 respectively). Correspondingly, these user groups also showed a higher likelihood of a hospital admission (OR: 2.03, 1.92 and 2.00 respectively), when attended to in an ED. Injury cases attended to in the ED during night hours (OR: 2.06) were also at a higher risk of a hospital admission. CONCLUSIONS: In Barcelona, pedestrians and two-wheel MV occupants, besides accounting for two-thirds of MV injury cases, are the user groups with a greater risk of a more severe injury. as well as a higher chance of a hospital admission, independently of demographic and health care factors.

Accidents, Traffic↗
PubMed2001

Trends in young adult mortality in three European cities: Barcelona, Bologna and Munich, 1986-1995.

OBJECTIVE: In recent decades, in most European countries young adult mortality has risen, or at best has remained stable. The aim of this study was to describe trends in mortality attributable to the principal causes of death: AIDS, drug overdose, suicide and motor vehicle traffic accidents, among adults aged between 15 and 34 years in three European cities (Barcelona, Bologna and Munich), over the period 1986 to 1995. METHODS: The population studied consisted of all deaths that occurred between 1986 and 1995 among residents of Barcelona, Bologna and Munich aged from 15 to 34 years. Information about deaths was obtained from mortality registers. The study variables were sex, age, the underlying cause of death and year of death. Causes of death studied were: drug overdose, AIDS, suicide and motor vehicle traffic accidents. Age standardised mortality rates (direct adjustment) were obtained in all three cities for the age range 15-34. To investigate trends in mortality over the study period Poisson regression models were fitted, obtaining the average relative risk (RR) associated with a one year increment. RESULTS: Young adult mortality increased among men in Barcelona and Bologna (RR per year: 1.04, 95% confidence intervals (95%CI): 1.03, 1.06 in Barcelona and RR:1.03, 95%CI:1.01, 1.06 in Bologna) and among women in Barcelona (RR:1.02, 95%CI: 1.01, 1.04), with a change in the pattern of the main causes of death attributable to the increase in AIDS and drug overdose mortality. In Munich, the pattern did not change as much, suicides being the main cause of death during the 10 years studied, although they have been decreasing since 1988 (RR:0.92, 95%CI:0.88, 0.96 for men and 0.81, 95%CI: 0.75-0.87 for women). CONCLUSION: The increase in AIDS mortality observed in the three European cities in the mid-80s and mid-90s has yielded substantial changes in the pattern of the main causes of death at young ages in Barcelona and Bologna. Munich presented a more stable pattern, with suicide as the main cause of death.

Accidents, Traffic↗
PubMed2000

Impact of a helmet law on two wheel motor vehicle crash mortality in a southern European urban area.

BACKGROUND: In Spain, a federal road safety law went into effect in the fall of 1992 extending to urban areas the unrestricted use of safety helmets by all two wheel motor vehicle occupants. OBJECTIVES: To assess the effect of the law in reducing fatal motorcycle crash injuries; to estimate the number of lives saved; and to determine changes in the distribution of severity and anatomical location of injuries. METHODS: Pre-test/post-test design of all deaths of two wheel motor vehicle occupants from 1990-92 (pre-law period) and from 1993-95 (post-law period) detected by the Barcelona Forensic Institute and the city police department. Injuries were coded using the 1990 version of the abbreviated injury scale. Poisson regression methods were used to model trends in mortality ratios and to provide estimates of the number of lives saved. RESULTS: Between 1993 and 1995, 35 lives of two wheel motor vehicle occupants were spared, representing a decrease of 25% in the observed motorcycle crash mortality in the post-law period when compared with what would be expected if no such law had gone into effect. The proportion of deaths with severe head injuries was also reduced from 76% to 67% in the post-law period. CONCLUSIONS: This study offers the first evaluation of a helmet law using combined forensic and police data in a large south European urban area where there is widespread use of motorcycles. Our results confirm the effectiveness of the helmet law, as measured by the reduction in the number of deaths and mortality ratios after the law implementation. The findings reinforce the public health benefits of mandatory non-restricted motorcycle and moped helmet use, even in urban areas with lower traffic speeds.

Accidents, Traffic↗
PubMed2000

Motor-vehicle injury patterns in emergency-department patients in a south-European urban setting.

The objectives are to identify the main injury patterns in the various types of user (of cars, motorcycles/mopeds, bicycles and pedestrians) injured in traffic crashes and treated in hospital emergency services, along with their main demographic characteristics. One-year cumulative survey all of patients attended to emergency departments in Barcelona, Spain, over a 12-month period (1998) for injuries due to motor vehicle crashes. Bivariate descriptive analyses were conducted to identify the different profiles of motor-vehicle injury patients by age, sex, user type, injured body region and type of injuries. ISS scoring was used to determine injury severity. Of the nearly 17,000 injured traffic victims during 1998, 62% were men. Young people between 15 and 39 (71.6%) were most affected. 42% were users of two-wheeled motor vehicles, followed by car occupants (32%) and pedestrians (24%). Neck sprain (33%) was the most common injury among car occupants, multiple contusion and contusion of lower limbs among two-wheeled motor vehicles (23.5% and 14% respectively) and pedestrians (17.3% and 14.4% respectively) and upper limb fractures (20%) among cyclists. Motorcycle and moped users, mainly young males, have the highest probability of suffering injuries, with lower limbs being the most affected anatomical region. Elderly pedestrians sustaining injuries to the lower limbs and the head contribute substantially to the overall injury situation.

Accidents, Traffic↗
PubMed1999

Gender differences in children's hospitalization in Catalonia: another inequality?

The aim of this study was to describe children's hospitalization and to analyse gender differences by selected diagnostic and procedure groups. Using the Clinical Classification for Health Policy Research Version 2 (CCHPR), 81 888 hospitalizations from the Minimum Basic Data Set of Hospital Discharge (CMBDAH) of 1995 related to children under 15 y of age in Catalonia, Spain, were studied. Hospitalization rates, number of days in hospital, average length of stay (d) in hospital and the standardized hospitalization ratio (SHR) (hospitalization rate in boys/hospitalization rate in girls) were computed. Two independent approaches were taken: (i) gender-specific categories were excluded in order to compare hospitalizations by sex; (ii) a selected group of 17 diagnostic and procedure categories were chosen in order to carry out the specific gender comparison. In both approaches, the selected indicators were compared by age groups, and totals were standardized by age using the direct method. An excess of hospitalization in boys was observed (SHR = 1.18; 95% CI: 1.17-1.19). The number of days spent in hospital and hospitalization rates were higher in infants and were also higher for boys than for girls. The average length of stay in hospital was higher in infants and in girls at all ages. These differences were systematic when stratified by health region, admission and discharge circumstances and hospital category. Except for urinary infection, which was higher in girls (SHR: 0.65; CI 95%: 0.54-0.76), the SHR was higher in boys in all diagnostic and procedure categories analysed (all SHR >1). Specific sex categories, injuries and poisonings cannot on their own explain a higher level of hospitalization among boys. More specific studies are needed to explain the role of the family and the healthcare system in gender inequalities in children's hospitalization.

Adolescent↗
PubMed1999

Physical activity assessment in population surveys: can it really be simplified?

BACKGROUND: Several studies have used a simplified approach for the assessment of physical activity such as the frequency of exercise-induced sweating. In this study leisure-time physical activity has been assessed using this and another more detailed measure. SUBJECTS AND METHODS: A sample of 4171 adults answered the Health Interview Survey of Barcelona in 1992. The respondents were classified into categories depending on participation in moderate and/or intense physical activity (> or =20 min) and also according to the frequency of exercise-induced sweating: 0, 1-2 and > or =3 times/week. Agreement between the two measures was calculated using the weighted Kappa (Kw) statistic with 95% confidence intervals (95% CI). Stratified analyses were performed. RESULTS: Prevalence of physical activity > or =3 times/week was lower with the sweat question (12.5%) than with the questions about the frequency of performance of selected activities (19.6%). The physical activity patterns by age, gender and overweight were similar for the two measures, but differed by month of the year. Agreement was lower among the older age categories and was higher among males (Kw = 0.59, 95% CI: 0.57-0.62) than among females (Kw = 0.48, 95% CI: 0.46-0.50). Overall, the agreement was higher in the hotter months (Kw = 0.72 among males and 0.58 among females). CONCLUSIONS: In the assessment of physical activity in the population by means of the sweat question there can be interference from other variables, apart from the intensity of the activity, which influence sweating during the exercise. Further assessments of the validity of exercise-induced sweating in representative samples of the general population would be useful.

Adolescent↗
PubMed1999

Inequalities in mortality according to educational level in two large Southern European cities.

BACKGROUND: In Spain, studies on social inequalities in mortality based on individuals are few due to the poor quality of information on occupation in death certificates. This study looks at the differences in mortality according to educational level, using individual information obtained through the linkage between the Death Register and the Municipal Census, in the cities of Madrid and Barcelona, Spain. METHODS: The study populations were residents of Madrid and Barcelona aged >24 years, who died in 1993 and 1994. Indicators obtained for each city and educational level were: age- and sex-specific mortality rates, and life expectancy at 25 years. Poisson regression models were fitted to obtain the relative risk (RR) of death for each educational level with respect to the reference level (higher education completed), adjusted for age. RESULTS: The mortality rate was lower among individuals with higher educational levels, while life expectancy at 25 years was higher. In both cities men and women with no education showed the highest mortality in all age groups, with very high RR in the youngest age group (RR for men aged 25-34 years = 7.08 in Madrid and 6.02 in Barcelona, whereas in women these RR were 6.33 and 5.63 respectively). In Barcelona the greater part of the overall mortality difference for the group aged 25-34 years was due to AIDS (acquired deficiency syndrome, 33.4% in men and 59.3% in women). CONCLUSION: The present study has found higher mortality (mainly from AIDS) among individuals with no academic qualifications thus drawing attention to the need to implement policies aimed at reducing these inequalities.

Adult↗
PubMed1999

Influence of proxy respondents in children's health interview surveys.

STUDY OBJECTIVES: To study the influence of the proxy respondent on health interview surveys in children. DESIGN: Cross sectional study. SETTING: Children under the age of 15 years drawn from the general population of Catalonia, Spain. PARTICIPANTS: The Catalan Health Interview Survey consisted of a multistage probability sample representative to the population of Catalonia. The sample size was 2433 children younger than 15 years of age. The interviews were answered by proxy respondents (the mother, father, or other carer), with the questionnaire adapted for the proxy respondent. Logistic regression models were used to analyse the relation between the proxy respondent's characteristics and health status and health care utilisation, controlling for the effect of sociodemographic factors. MAIN RESULTS: Proxy respondent's characteristics influenced the reports of chronic conditions and accidents within the last year. Proxy respondents over 55 years (OR = 0.47; 95% CI = 0.26, 0.82), men (OR = 0.69; 95% CI = 0.53, 0.89), the father (OR = 0.66; 95% CI = 0.50, 0.89), and the grandparents (OR = 0.49; 95% CI = 0.26, 0.89), reported a lower rate of chronic conditions. Age of the proxy 55 years or greater (OR = 0.41; 95% CI = 0.20, 0.82), men (OR = 0.70; 95% CI = 0.52, 0.94), fathers (OR = 0.68; 95% CI = 0.49, 0.92), and grandparents (OR = 0.40; 95% CI = 0.18, 0.85) showed a lower probability to report accidents. No variables related to the proxy were associated with physician visits or hospitalisation in the previous year. CONCLUSIONS: Selected characteristics of the proxy respondent can influence responses to health surveys involving children. A minimum set of basic data should be collected from the proxy respondent to evaluate different patterns of response.

Adolescent↗
PubMed1999

Social inequalities in perceived health and the use of health services in a southern European urban area.

People of lower social class have worse health and less access to health services and preventive care. This article describes social class inequalities in health status and use of services, both curative and preventive, in Barcelona, in a country with a national health service. The cross-sectional study uses information from the 1992 Barcelona Health Interview Survey. Social class was designated using an adaptation of the British Registrar General classification. The study variables measured health status, health services utilization, and preventive practices. Bivariate and multivariate analyses were used. Some 88 percent of men in social class I and 81 percent in class V had very good or good perceived health status. For women these figures were 85.2 and 57.6 percent, respectively. Chronic illness increased with lower social class. There were no social class differences in the frequency of physician visits during the two weeks prior to the interview among people with poor perceived health. Some 60.7 percent of women aged over 29 in social class I had periodic cervical smears, but only 32 percent of those in class V; the corresponding figures for mammography were 37.8 and 11.3 percent. The national health service has advantages in terms of access to health services, but more knowledge about the quality of these services is required. The study findings are sufficient to defend the undertaking of equitable health policies, especially in providing access to preventive care for the entire population.

Adolescent↗
PubMed1998

Disabilities resulting from traffic injuries in Barcelona, Spain: 1-year incidence by age, gender and type of user.

The purpose of this study was to examine the 1-year incidence of disabilities resulting from traffic injuries among the population of Barcelona (Spain), as well as its distribution by age, gender and type of motor-vehicle user, taking into account different exposure criteria. This is a population-based cross-sectional study; subjects were all cases (n = 4080) having undergone a medical examination for a traffic injury having occurred in 1993 resulting in a disability among residents in the area of Barcelona. Subjects were considered to have suffered a disability as a result of an injury if they were prevented from carrying out their normal activities for a period of 2 days or more. In 1993, the cumulative incidence rate of disability was 237.9 cases per 100,000 inhabitants, higher for men (287.1) than for women (193.9). The 20-24 year age group showed the highest incidence of disability (607.5). The rate of incidence of disability was 95.5 per 100,000 inhabitants among occupants of two wheeled vehicles, 87.7 among car occupants and 39.9 in pedestrians. When length of exposure to traffic was taken into account, the incidence rate of disability for residents aged > 14 years was 1.09 per 100,000 hours per person per year, similar for both sexes. This study represents a first attempt to use population-based health data to evaluate the incidence of disabilities due to traffic injuries. The results allow the identification of the groups with the greatest risk and who contribute the most to disabilities resulting from injuries, especially young users of two-wheeled motor vehicles.

Accidents, Traffic↗
PubMed1998

The consequences of universalizing health services: children's use of health services in Catalonia.

The purpose of this study was to assess the role of needs and social factors in the use of health services among children under age 15 in Catalonia, Spain, where health care reform was explicitly designed to facilitate universal access to primary care according to health needs. Data from the Catalan Health Interview Survey of 1994, a multistage probability sample (2,433 children under 15 years old), were analyzed. Multiple regression examined the relationship between health needs and number of visits in the last year, controlling for the effect of sociodemographic characteristics. Two logistic regression equations were selected to predict heavy (more than seven visits per year) and light (less than two visits) utilization of services. The multiple regression model explained 14.3 percent of the variance in number of visits, with health status perception, disability, reported chronic condition, restriction of activities, and having had a recent accident by far the most important determinants. No familial socioeconomic characteristics, including social class, education, or family size, influenced the extent of use. In contrast to health systems not designed to achieve either universal access according to need or strong primary care, universal access to health services in Catalonia appears to enhance the use of services among children with health needs, regardless of socioeconomic characteristics.

Adolescent↗
PubMed1997

[The underreporting of perinatal mortality: 10 years' experience of active surveillance in Barcelona].

BACKGROUND: Perinatal mortality is considered a good effectiveness health care indicator during pregnancy, deliver and early perinatal period. The aims of this investigation were to describe the magnitude and tendency of underreporting perinatal mortality in Barcelona, Spain from 1985 to 1994 and to determine underreporting predictive variables. SUBJECTS AND METHODS: Perinatal deaths between 1985 and 1994 were studied according to WHO international statistics criteria and deaths from 1988 to 1994 were also studied according to the WHO national statistics criteria. Sources of information were: Statistical Deaths Certificates and the Active Surveillance Registry that collect information about perinatal deaths directly from hospitals. A perinatal death was considered underreported if it was registered in the Active Surveillance Register but not in the Statistical Death Certificate. RESULTS: 24.5% perinatal deaths were underreported from 1985 to 1995 (according to international statistics criteria) and 24.9% from 1988 to 1994 (according national statistics criteria). In both periods underreporting decreased. Deaths in the first 24 hours of live (OR = 1.8; CI 95% = 1-3), newborns weight between 1,000 and 1,499 g (OR = 1.5; CI 95% = 0.6-3.8), hospitals with mortality registry (OR = 4; CI 95% = 2.2-7.1) and the first years of the study (OR = 0.7; CI 95% = 0.7-0.8) were predictive of underreporting. CONCLUSIONS: Underreporting perinatal deaths decreased during the study period. Deaths of newborns with low birth weight and who lived less than 24 hours were more underreported. The work developed by Active Surveillance Registry contributed to the decense of underreporting perinatal deaths.

Birth Weight↗
PubMed1997

[Mortality trends in the young people of the city of Barcelona, 1983-1993].

BACKGROUND: The aim of this study was to analyze trends in overall and cause specific mortality in young people from 15 to 34 years-old residing in the city of Barcelona (Spain) from 1983 to 1993. METHODS: Data were obtained from death certificates. The overall deaths as well as deaths due to motor vehicle accidents, suicide, AIDS and drug overdose were studied. Annual crude and standardized rates were calculated (direct method) by sex and cause of death. Simple lineal regression analysis was performed to model time trends. RESULTS: Global mortality rates increased from 65.7 per 100,000 inhabitants in 1983 to 114.1 per 100,000 inhabitants in 1993. By causes, AIDS changed from being non existent as a cause of death in 1983 to becoming the main cause of death since 1990 to the present time (standardized rate = 45.6/100,000 inhabitants for men and 18.25 for women in 1993). In addition, this cause has experienced a significant increase among people older than 20 years. Overdose was the only cause with a significant increase in all age groups in men and women. Motor vehicle crashes were the main cause of death in the youngest age group (15-19 years) with significant increases in men. CONCLUSIONS: Since 1990, AIDS and drug overdoses are the principal causes of death in young people in the city of Barcelona. Although this situation has left motor vehicle accidents in the third place, deaths from this cause have also increased.

Accidents, Traffic↗
PubMed1997

Widening social inequalities in mortality: the case of Barcelona, a southern European city.

OBJECTIVE: To analyse trends in mortality inequalities in Barcelona between 1983 and 1994 by comparing rates in those electoral wards with a low socioeconomic level and rates in the remaining wards. DESIGN: Mortality trends study. SETTING: The city of Barcelona (Spain). SUBJECTS: The study included all deaths among residents of the two groups of city wards. Details were obtained from death certificates. MAIN OUTCOME MEASURES: Age standardised mortality rates, age standardised rates of years of potential life lost, and age specific mortality rates in relation to cause of death, sex, and year were computed as well as the comparative mortality figure and the ratio of standardised rates of years of potential life lost. RESULTS: Rates of premature mortality increased from 5691.2 years of potential life lost per 100,000 inhabitants aged 1 to 70 years in 1983 to 7606.2 in 1994 in the low socioeconomic level wards, and from 3731.2 to 4236.9 in the other wards, showing an increase in inequalities over the 12 years, mostly due to AIDS and drug overdose as causes of death. Conversely, cerebrovascular disease showed a reduction in inequality over the same period. Overall mortality in the 15-44 age group widened the gap between both groups of wards. CONCLUSION: AIDS and drug overdose are emerging as the causes of death that are contributing to a substantial increase in social inequality in terms of premature mortality, an unreported observation in European urban areas.

Acquired Immunodeficiency Syndrome↗