PubMed Health⌕ Search

Biomedical subjects

C Borrell

Publications and source records attributed to C Borrell.

At least 73 records · Page 4Linked to original sources
PubMed1995

Geographic variation in HIV infection among injecting drug users with Barcelona.

In response to a high incidence of AIDS among injecting drug users in Barcelona, Spain, the city established a program in four geographically distinct centers for assistance and surveillance. The centers provided testing, counseling, and monitoring of infectious diseases. In 1991-92, HIV rates were 33% in the northwest center, 39% in the western center, 39% in the east, and 71% in the south. Differences between the rates in the southern center when compared with those in the other centers were very significant (P < or = .001). These data show geographic variation of HIV infection within one city and substantiate the need to provide expanded medical care in the drug misuse treatment setting.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Review of the original articles published by primary care professionals in Catalonia].

OBJECTIVE: To describe the characteristics of the research work published by Primary Care professionals in Catalonia between 1989 and 1991, with an analysis of the preferred research areas, design type and different bibliometric features, with the aim of finding what is the real state of Primary Care research in Catalonia. DESIGN: Descriptive study based on checking all the original articles published between January 1989 and December 1991 in nine Spanish journals in the Primary Care, internal medicine and paediatrics fields. SETTING: Included were studies carried out by Primary Care professionals in Catalonia, either working alone or in collaboration, and which were relevant to Primary Care. MEASUREMENTS AND MAIN RESULTS: A total of 63 articles were surveyed. The average number of authors per article was 5.8 +/- 2.4. The majority of the signatories were Family and Community Medicine (FCM) specialists. 65.1% of articles were by professionals from FCM teaching units. The most common research areas were epidemiology, clinics and prevention. 74.6% of the articles were descriptive. 69.8% used some technique of inferential statistics. The average number of bibliographical quotations was 18.9 +/- 10.4: with the journal Atención Primaria the most quoted. CONCLUSIONS: This study revealed the type of research being undertaken in the Primary Care field in Catalonia.

Periodicals as Topic↗
PubMed1993

[Reproducibility of the use of classifications of causes of death in the context of inquiries in perinatal mortality].

The objective of this study was to verify the reliability of the classifications of perinatal mortality causes. An independent observer coded the cases of perinatal death (n = 152) collected in the Encuesta Confidencial de Mortalidad Perinatal de Barcelona (ECMP, Confidential Perinatal Mortality Inquiry of Barcelona), by using both the Aberdeen classification system (regarding obstetric factors) and the Wigglesworth classification system (according to the initial pathological cause), with the same information used previously by the ECMP Commission. For the Aberdeen classification, the observed concordance index (Po) was 86% and the Kappa coefficient (K) 0.77 (95% CI: 0.68-0.86). For the Wigglesworth classification, the figures were 89% and 0.82 (95% CI: 0.74-0.90), respectively. The disagreement was mainly due to differences in the interpretation of the sequence of death, minimal information available in order to classify the cause of death, and misunderstanding of the existing information. To a lesser extent, the disagreement was caused by a failure to comply with the rules laid down for classifications. The assessment of the causes of death was not significantly influenced by birth weight, gestational age, time of death or the presence of necropsy. These results support the use of classifications of perinatal mortality causes in the context of confidential inquiries.

Autopsy↗
PubMedDate not supplied

[The importance of the gender perspective in health interview surveys].

The identification and measurement of the population health needs should be the first step in health planning. In order to guarantee equity criteria, to know the situation of the whole population, and therefore also that of women, is a key issue. Health interview surveys are a good tool for pinpointing the needs of the population, but mainly they are usually focused on health risk factors that explain men's health status such as health behaviours and paid job. These factors often fail to capture aspects that are relevant for women's health, such as household work. The main objective of this paper is to emphasise the importance of a gender perspective in the design and analysis of health interview surveys, and to propose variables that should be included in health surveys in order to better know gender health inequalities. Likewise, this article deals with the gender concept and its importance as a health inequality factor. Gender is an analytical construct based on the social organisation of the sexes that can be used to better understand the conditions and factors influencing women's and men's health beginning by the social roles that each culture and society assigns to people based on their sex. Health is a complex process determined by a wide range of factors: biological, social, environmental and health services related factors. Gender, because of its close relation to all of them, plays a key role. The gender approach is characterised by the analysis of the social relation between men and women, taking into account that sex is a determinant of social inequalities. This paper presents the variables that health interview surveys should include from a gender approach point of view: reproductive work, productive work, social class, social support, self-perceived health status, quality of life, mental health and chronic conditions. In addition, issues related to the wording of questions, data collection and analysis are discussed.

Aged↗
PubMedDate not supplied

[Social self-positioning as indicator of socioeconomic status].

OBJECTIVE: Self-perceived class results from directly questioning subjects about his or her social class. The aim of this investigation was to analyse self-perceived class in relation to other indicator variables of socioeconomic level. METHODS: Data from the 1994 Catalan Health Interview Survey, a cross-sectional survey of a representative sample of the non-institutionalised population of Catalonia was used. We conducted a discriminant analysis to compute the degree of right classification when different socioeconomic variables potentially related to self-perceived class were considered. All subjects who directly answered the questionnaire were included (N = 12,245). With the aim of obtaining the discriminant functions in a group of subjects and to validate it in another one, the subjects were divided into two random samples, containing approximately 75% and 25% of subjects (analysis sample, n = 9,248; and validation sample, n = 2,997). RESULTS: The final function for men and women included level of education, social class (based in occupation) and equivalent income. This function correctly classified 40.9% of the subjects in the analysis sample and 39.2% in the validation sample. Two other functions were selected for men and women separately. In men, the function included level of education, professional category, and family income (39.2% of classification in analysis sample and 37.2% in validation sample). In women, the function (level of education, working status, and equivalent income) correctly classified 40.3% of women in analysis sample whereas the percentage was 38.9% in validation sample. The percentages of right classification were higher for the highest and lowest classes. CONCLUSION: These results show the utility of a simple variable to self-position within the social scale. Self-perceived class is related to education, income, and working determinants.

Adolescent↗
PubMedDate not supplied

[Characteristics of pregnant women and routine antenatal care in Barcelona, 1994-1999].

OBJECTIVE: To analyse socio-demographic and pregnancy-control aspects of pregnant women residents in Barcelona city and their evolution during the period 1994-1999 using the controls of the Barcelona Birth Defects Registry. METHODS: The information was collected by mean of an interview to the mother and from hospital records. The Mantel-Haenszel method for lineal association was used to analyse trends. A chi-squared test for proportions was used to compare pregnancy-control variables between public and private centers. RESULTS: Data on 1,337 pregnant women were obtained. An increasing proportion of women older than 34 years is observed, from 19% in 1994-95 to 25% in 1998-99. An increase in the social class and a decrease of housewives is noticed. 40% of pregnancies were not planned and half of these finished in induced abortion. These proportions are higher in less than 25 and more than 39 years old mothers. 97% had their first obstetrical visit during the first trimester, almost all had at least an obstetrical ultrasound with a mean of 5.2, although 25% of the mothers did not undergo an ecography during the 5th month. An increase of invasive procedures and caesarean sections (C-section) is shown, with 33% of C-sections in the 98-99 period. The medical control of pregnancies is higher in mothers delivering in private centers, which are 55% of the total. CONCLUSIONS: There is a high lack of pregnancy planning, as well as an increasing pregnancy medicalization, with positive (first trimester visit) and debatable aspects (obstetrical ultrasound, caesarean section and invasive procedures).

Adult↗
PubMedDate not supplied

[Comparability between the ninth and tenth revisions of the International Classification of Diseases applied to coding causes of death in Spain].

OBJECTIVE: To analyze comparability between the ninth and tenth revisions of the International Classification of Diseases (ICD) applied to coding causes of death in Spain. METHODS: According to the ninth and tenth revisions of the ICD, 80,084 statistical bulletins of mortality registered in 1999 were assigned the Basic Cause of Death. The statistical bulletins corresponded to the Autonomous Communities of Andalusia, Cantabria, Murcia, Navarre and the Basque Country, and the city of Barcelona. The underlying causes of death were classified into 17 groups. Simple correspondence, the Kappa index and the comparability ratio for major causes were calculated. RESULTS: A total of 3.6% of deaths changed group due to an increase (36.4%) in infectious and parasitic diseases, mainly because of the inclusion of AIDS, and a corresponding decrease due to the exclusion of endocrine, nutritional and metabolic disorders. Furthermore, myelodysplastic syndrome was moved to the category of neoplasm. The group including nervous system diseases, eye and related diseases, and ear and mastoid apophysis diseases increased (14.7%) at the expense of mental and behavior disorders, due to the inclusion of senile and presenile organic psychosis. Poorly-defined entities increased (14.1%) due to the inclusion of cardiac arrest and its synonyms, together with heart failure, to the detriment of diseases of the vascular system. Diseases of the respiratory system increased (4.8%) due to the inclusion of respiratory failure, previously considered as a poorly defined cause. The correspondence for all causes was 96.4% and kappa's index was 94.9% CONCLUSIONS: The introduction of ICD-10 affects the comparability of statistical series of mortality according to cause. The results of this study allow us to identify the main modifications and to quantify the changes in the major causes of mortality in Spain.

Cause of Death↗
PubMedDate not supplied

[Odds ratio or prevalence ratio? Their use in cross-sectional studies].

BACKGROUND: The most commonly used measures of association in cross-sectional studies are the odds ratio (OR) and the prevalence ratio (PR). Some cross-sectional epidemiologic studies describe their results as OR but use the definition of PR. The main aim of this study was to describe and compare different calculation methods for PR described in literature using two situations (prevalence < 20% and prevalence > 20%). MATERIAL AND METHODS: A literature search was carried out to determine the most commonly used techniques for estimating the PR. The four most frequent methods were: 1) obtaining the OR using non-conditional logistic regression but using the correct definition; 2) using Breslow-Cox regression; 3) using a generalized linear model with logarithmic transformation and binomial family, and 4) using the conversion formula from OR into PR. The models found were replicated for both situations (prevalence less than 20% and greater than 20%) using real data from the 1994 Catalan Health Interview Survey. RESULTS: When prevalence was low, no substantial differences were observed in either the estimators or standard errors obtained using the four procedures. When prevalence was high, differences were found between estimators and confidence intervals although all the measures maintained statistical significance. CONCLUSION: All the methods have advantages and disadvantages. Individual researchers should decide which technique is the most appropriate for their data and should be consistent when using an estimator and interpreting it.

Cross-Sectional Studies↗
PubMedDate not supplied

[Impact of smoking and alcohol consumption on mortality in the population of Barcelona [Spain]: 1983-1998].

OBJECTIVES: To analyze the mortality attributable to smoking and alcohol consumption in the city of Barcelona from 1983 to 1998. METHODS: All deaths among residents of the city of Barcelona from 1983 to 1998 were included. Population data were obtained from the city inhabitants register. The mortality attributable to smoking and alcohol consumption was calculated by population attributable fractions using relative risks from previous studies in the US population. RESULTS: In 1998, 2,205 deaths were attributable to smoking, representing 13.8% of all deaths among the population aged 35 years or older and a decrease of 9.6% compared with deaths in 1983. From 1983 to 1998 there was an increase in smoking-attributable adjusted mortality rates for lung cancer (155.84/100,000 inhabitants in men and 9.39/100,000 in women in 1998) and chronic obstructive pulmonary disease (COPD) (95.89/100,000 in men and 11.29/ 100,000 in women in 1998). In 1998, deaths attributed to alcohol consumption accounted for 4.3% of total mortality, representing a reduction of 26% since 1983. Among men, the primary cause of alcohol-attributable mortality was liver cirrhosis (17.1%), although its relative importance decreased (accounting for 17.1% of alcohol-attributable mortality in 1998 compared with 24.3% in 1983). CONCLUSIONS: The mortality attributable to smoking and alcohol consumption decreased in the city of Barcelona during the study period. Smoking-attributable mortality from lung cancer and COPD increased in both sexes. Alcohol consumption-attributable mortality from liver cirrhosis decreased in men.

Accidents, Traffic↗
PubMedDate not supplied

[Years of potential life lost: comparison of 3 calculation methods].

Two methods of assessing Years of Potential Life Lost (YPLL): 0 to 65 years and 1 to 70 years are compared to a third, 0 to life expectancy which is considered a priori the most appropriate. In addition we would like to corroborate that YPLL is a complementary indicator of the crude rate of mortality. The results show that the first cause of YPLL remains tumors in all the methods. However, differences appear in the second and following causes. Disparities are also found in crude rates as YPLL reflect causes of death of the youngest age groups of the community. The method 0 to life expectancy is considered the least arbitrary and consequently it is recommended to calculate YPLL.

Adolescent↗
PubMedDate not supplied

[Quality of emergency diagnosis of lesions of external causes requiring hospitalization].

OBJECTIVE: To establish the quality of emergency department diagnoses for those patients whose injuries required hospital admission. METHODS: Emergency and hospital discharge diagnostics were retrieved for 339 injured patients. Severity scores (ISS) were calculated using an automatic conversion procedure (ICDMAP). Emergency diagnoses for each patient (grouped into categories) were compared with the hospital discharge ones. Quality was analyzed based on accuracy (Percy groups) and reliability (percentage of concordance) measurements. Severity scores were evaluated using reliability measures (percentage of concordance and intraclass correlation coefficient-ICC-). RESULTS: Mean diagnoses per patient were 1.1 at the emergency department and 1.4 at hospital discharge. In the latter, there were diagnoses in each category except for those more unspecific, where there was a reduction. Overall, emergency information showed under notification. Severity scores were higher with hospital discharge data. There was a 63% percentage of concordance. When grouped into categories, severity scores had an ICC of 0.61 (moderate-good). CONCLUSION: Emergency departments are a potential good source of information about injury severity even for those patients who require hospital admission. Emergency department injury surveillance can be very useful in assessing the magnitude and distribution of injury severity at the population level. Nevertheless for individual severity assessment, use of hospital discharge information is recommended.

Emergencies↗
PubMedDate not supplied

[Social support and perceived health status in non-institutionalized population over 60 years of age].

OBJECTIVES: The purpose of this study is to describe the degree of social support in a sample of non-institutionalized population aged 60 and over and to explore possible relations between social support and perceived health. METHODS: We analyse data coming from Barcelona 1992 Health Survey. Sociodemographic and perceived health variables are analysed together with several social support variables based on the presence and number of available people for instrumental and emotional support necessity and perceived aid need for personal care and daily needs. RESULTS: In the study period, 1156 subjects aged 60 and over were interviewed at home. 20% of the sample (28.9% were women) lived alone and 28.2% (41.7% were women) were widowed. 43% had an extensive social support and 51% had a good emotional support. The men with less emotional support had a worse perceived health (OR = 2.7, IC 95% = 1.3-5.5). Only aid need for daily works in women was associated with worse perceived health (OR = 6.3, IC 95% = 3.2-12.4). CONCLUSIONS: Instrumental and emotional support availability weren't associated with perceived health in women in spite of they lived alone in a greatest proportion. In men, only emotional support absence was associated with worse perceived health.

Aged↗
PubMedDate not supplied

[Habitual physical activity in a population residing in the city of Barcelona].

OBJECTIVES: To describe the sociodemographic distribution of habitual physical activity and to analyse its relationship with self-perceived health status and occupational status, among the population older that 16 years of age in the city of Barcelona, Spain. METHODS: A sample of 1,885 adult men and 2,196 women answered the Health Interview Survey of Barcelona in 1992. Those whose habitual activity required high physical exertion or walking were considered as active. Bivariate and multivariate analyses adjusting logistic regression models were used to study the relationship between habitual physical activity and the rest of variables, for each occupational situation. RESULTS: Fifty six percent of adults reported being physically active. Physical activity was lower among workers than non workers, although workers reported more physical exertion (14.5% in men and 8.0% in women). Physical activity was associated with occupation and educational level among male workers, but only with occupation among female workers. In the non working population, physical activity was lower among those who perceived their health status as fair or poor, compared with those that described it as good or very good, (ORa in men was 0.2, 95% confidence interval = 0.1-0.5; ORa in women was 0.5, 95% confidence interval = 0.3-0.8). CONCLUSIONS: More than half of the Barcelona population were physically active in an habitual manner. Among workers, this activity was mainly determined by the occupation. Non-workers with a poor self-perceived health status did less physical activity.

Adolescent↗
PubMedDate not supplied

[Gender differences in the influence of housework on health].

OBJECTIVE: To analyze the influence of domestic workload on the health of the working population of Catalonia, taking into account its differential impact on males and females. SUBJECTS AND METHODS: The study population were the 2,164 men and 1,215 women interviewed in the Catalonian Health Survey (ESCA) of 1994, with a paid work who were the main responsible for the family unit. The dependent variable was the self-perceived health status that was dichotomized for the bivariate and multivariate analysis. The domestic workload was measured with the number of people living at home (2, 3, 4 or more than 4), living with children younger than 15 and living with older than 65. The adjusting variables were age and occupational social class. The analysis was separated for men and women and crude, adjusted for age, and for all the predictor variables odds ratios (OR) were calculated with their 95% confidence intervals (95%CI). RESULTS: There was no relation between domestic workload and health status among men. Among women the risk or poor health status increased with the number of people living at home with adjusted OR associated to living with more than four persons of 2.35 (95%CI = 1. 33-4.15), as compared with living only with the spouse. Living with older than 65 was protector for women (adjusted OR = 0.63; 95%CI = 0. 39-1.03). CONCLUSIONS: The risk of poor health status associated to the domestic workload among women with paid work, suggests the need of increasing community resources for caring children, as well as, increasing the participation of men in the domestic work. Future health surveys should collect information about the number of people of different age strata living at home.

Adolescent↗
PubMedDate not supplied

[Two patterns of social inequalities in mortality in Barcelona, Spain?].

BACKGROUND: The aims of this study were to describe social inequalities in mortality amongst Basic Health Areas in Barcelona Spain and to analyze the patterns of social inequalities in health. METHODS: This is an ecological study of all deaths of residents in Barcelona in 1989-93. The unit of analysis was the Basic Health Area. Socio-economic and mortality indicators (overall mortality and the main causes of death) were studied. Relative risk estimates between socio-economic and mortality indicators were calculated through Poisson regression models. RESULTS: An unequal socioeconomical and mortality distribution was observed between areas. The following variables were found to be associated with lower socio-economic conditions: overall mortality (RR = 1,48, males), specific mortality: malignant neoplasm of trachea, bronchus and lung (RR = 1, 64, males), chronic liver disease and cirrhosis (RR = 2,33, males), AIDS (RR = 3,42, males and females), drug overdose (RR = 5,18, males and females), tuberculosis (RR = 6,3, males and females), pneumonia, bronchitis, emphysema and asthma (RR = 1,41, males), and external causes (RR = 2,29, males). The increase in risk with deteriorating socioeconomic situation was linear for cirrhosis and bronchitis, emphysema and asthma, and close to linearity for malignant neoplasm of trachea, bronchus and lung. For AIDS, drug overdose, and tuberculosis, the increase in risk was not linear, being much higher for those areas with higher levels of unemployment. CONCLUSIONS: All causes of death that have been found to be associated with social inequalities are related with life-styles (smoking, excessive alcohol consumption and parenteral drug use). There are two patterns of social inequalities in health: AIDS, drug overdose and tuberculosis stand out as pathologies associated to extreme unfavourable socioeconomic situation, for which it is likely that there are some conditions favouring health problems associated with margination.

Acquired Immunodeficiency Syndrome↗