PubMed Health⌕ Search

Biomedical subjects

M Nebot

Publications and source records attributed to M Nebot.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Trends in smoking among school children: Barcelona, 1987-1996].

OBJECTIVE: Despite the growth of aids and of other causes of premature death, smoking is the main single cause of avoidable mortality in Spain. Given the addictive nature of tobacco and the difficulties experienced by many smokers to quit, the primary prevention of smoking is crucial. In recent years several initiatives have been developed to this end. The objective of this paper is to monitor smoking among schoolchildren by repeated surveys over a decade, to ascertain the impact of current interventions and to reorient them according to evidence. DESIGN: Cross sectional surveys over a decade, from 1987 to 1996, while several smoking prevention efforts were developed. Survey instruments were similar self administered and anonymous questionnaires. SITE: Schools in Barcelona (Catalonia, Spain). PARTICIPANTS: Around 1000 participants in each survey were selected through representative samples of 8th grade students (predominantly 13-14 years old), stratified by school type and size in each round. MAIN RESULTS: Ever smoking declined, specially for boys (global decline 12.4%, p = 0.05). There is a clear and steady decline, statistically significant, in the proportion smoking in the month prior to the survey (global decline 50.5%, p < 0.0001). The proportion of regular smokers declines from 1987 to 1994, and then is stabilized (global decline 23%, p < 0.05). The proportion of daily smokers fluctuates, but globally it is the lowest of the decade in 1996. No changes are visible in the proportion who declare buying tobacco for personal use. DISCUSSION: From 1987 to 1996 several smoking indicators show a decline among 8th grade schoolchildren in Barcelona, Spain. The pattern suggests a decline in global smoking experimentation and in the intensity of experimentation, with a small reduction in the prevalence of regular use, while the small proportion of daily smokers at this young age does not change.

Adolescent↗
PubMed1999

Age at starting smoking and number of cigarettes smoked in Catalonia, Spain.

BACKGROUND: Few studies have investigated the association between age at starting smoking and the average number of cigarettes smoked per day in adulthood. To provide further evidence on this issue, we analyzed data from the Catalan Health Interview Survey (CHIS). METHODS: The CHIS was conducted in 1994 on a randomly selected sample (N = 15,000) of the population of Catalonia, Spain. A total of 4,897 current or exsmokers (3,276 males and 1,621 females) were included for analysis. Age-standardized proportions of subjects smoking <15, 15-24, and >/=25 cigarettes/day, age-standardized mean number of cigarettes smoked per day, and multivariate odds ratios (OR) of being a heavy smoker (>/=25 cigarettes/day) according to age at starting smoking (<15, 15-17, 18-19, >/=20 years) were computed. RESULTS: Men who started smoking before the age of 15 smoked on average 5.5 cigarettes more than those who started at age 19 or over. Women who started smoking early in life smoked, on average, 6.8 cigarettes/day more than women who started later. The proportion of smokers of <15 cigarettes/day was higher among subjects who started smoking later. Both for males and for females, the OR of being a heavy smoker significantly increased with decreasing age at starting smoking (OR = 2.4 for males and 4.5 for females who started at age <15 versus >/=20 years). The level of education did not modify the relationship in males, whereas the association with age at starting was only apparent for more educated women. CONCLUSIONS: This study confirms that age at starting smoking is inversely and strongly associated to the number of cigarettes smoked per day. Thus, actions aimed at the prevention or delay of smoking onset among adolescents would have an important beneficial effect.

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

Tuberculosis infection and disease among schoolchildren: the influence of the HIV epidemic and of other factors.

BACKGROUND: The HIV/AIDS epidemic has caused an excess of tuberculosis cases in Spain and in other countries, but its impact on tuberculosis infection is less well understood. This study presents a massive screening undertaken to estimate the prevalence of tuberculous infection in a cohort of primary school entrants. The evolution of the risk of infection is studied by comparison with previous data in the same population. METHODS: Tuberculin skin test screening with 2TU of PPD RT 23 of first grade students in the primary schools of Barcelona, in the 1994-95 school year (cohort born in 1988). Information was also sought from families of unscreened children. Contacts of PPD+ children were traced to locate index cases. The results were also linked to the case registry of the tuberculosis control programme. RESULTS: The prevalence of tuberculin reactors free of BCG vaccination among the 11,080 schoolchildren screened belonging to the 1988 cohort was 0.76%. A 3% annual decline in the annual risk of infection is estimated by comparison with previous data. The identification of 24 cases with a previous history of tuberculosis disease and of 13 cases with active disease diagnosed after the screening was possible by the follow up of these tuberculin positive children and of the information provided by families of unscreened pupils. The screening detected 1.5 new cases of tuberculosis per 1000 tuberculin tests performed. Tuberculosis infection could be traced to HIV infected tuberculosis cases for at least 6% of the positive schoolchildren. CONCLUSIONS: The decline of the annual risk of infection continues in Barcelona, although at a slower pace than before the HIV/AIDS epidemic, probably attributable to the influence of injecting drug users with smear positive tuberculosis and HIV/AIDS.

Child↗
PubMed1999

[The knowledge and application of regulations on smoking in secondary teaching centers].

OBJECTIVES: Despite the growing body of legal and normative regulations regarding promotion, sales and consumption of cigarettes, a few studies have already pointed to a low enforcement and commitment of these restrictions. This study explores the degree of awareness and compliance of these norms in the secondary school. DESIGN: Cross-sectional, observational study. A telephone survey was carried out. PARTICIPANTS: A simple of school principals or deputy principal was surveyed. MEASUREMENTS: A questionnaire was designed to obtain respondents knowledge of the current policies regarding smoking, as well as on the existence of visible signals in the school wards. Besides, opinion on tolerance towards smoking behavior among the school teachers was ascertained. RESULTS: Virtually at the respondents (98.8%) declared to know the existence of the regulations, although only 74.4% declared to have specific regulations at the school level. Smoking by teachers was allowed in their own offices in 61.6% of the centers. In open grounds, only 4.7% of the centers authorized adults to smoke while 18.6% permitted to smoke to the students. Public centers were less restrictive than private centers. DISCUSSION: Principals of secondary schools are aware of the existing, policy, and in most cases largely restrict public consumption. However, there are still some important gaps regarding signals, consumption in outdoor public spaces and teachers consumption in their own offices. Specific interventions seem to be necessary to overcome this situation.

Adolescent↗
PubMed1998

[Smoking and school children: context, opinions and behavior].

BACKGROUND: This paper studies smoking epidemiology in school-age students. MATERIAL AND METHODS: A cross-sectional survey of 8th grade students (13-14 years-old) in the schools of Barcelona (Catalonia, Spain) in 1987, 1992 and 1994. RESULTS: The perception of smoking in the students environment has decreased. The proportion of regular smokers decreases, from 12.6% in 1987 to 9.5% in 1994 (p < 0.05) (an annual decrease of 3.5%) although the proportion who experiment with tobacco remains table. CONCLUSIONS: There is a decrease in the prevalence of regular smoking in the school-age population (13-14 years-old) in Barcelona (Spain).

Adolescent↗
PubMed1998

[Smoking initiation in students: cross-sectional and longitudinal study of predictive factors].

BACKGROUND: This study examines the evolution of tobacco use among schoolchildren in sixth and seventh grades in Barcelona (11-13 years) and identifies smoking risk factors through cross-sectional and follow-up analysis. POBLATION AND METHODS: The cohort consists of 1,003 students attending 13 schools who served as control units for a study assessing the effects of a school-based addictive substances prevention program. Participants answered the same questionnaire in 1990 and 1991. Risk factors for the experimentation and for regular smoking are studied through cross-sectional and prospective studies. RESULT: In a year, smokers increase from 9.7% to 18.9% and regular smokers rise from 1.1% to 5.5%. The initial cross-sectional analysis finds stronger associations than the follow-up one. Some variables loose their significance in the longitudinal analysis. Among non-smokers, the strongest predictors to emerge are intention to smoke, the belief that smoking is fun, peers, siblings and mother consumption, and being male; however girls appear to consolidate the consumption more than boys among the cohort of triers. CONCLUSIONS: Tobacco use prevalences are consistent with other studies developed in our city. Social environment emerges as an important predictor; friends, siblings and mothers tobacco use and gender are the main risk factors.

Adolescent↗
PubMed1997

[Maternity in adolescents in the districts and neighborhoods of Barcelona: its association with the socioeconomic level and the prevalence of low weight at birth. The Working Group of Maternal-Child Health of the Municipal Institute of Health of Barcelona].

OBJECTIVE: To describe the distribution of birth rates and low birth weight among teenagers from the health districts and neighbourhoods of Barcelona and their association with social and economic level. DESIGN: Environmental study. SETTING: City of Barcelona. METHODS: The birth rates for under-20 year olds resident in Barcelona for the periods 1980-1982, 1987-1992 and 1990-1992 were calculated. The index of family economic capacity (IFEC) was used as a social and economic indicator. The coefficient of Spearman was used as a correlative measurement. MEASUREMENTS AND MAIN RESULTS: Between the periods 1980-1982 and 1990-1992, a 65% drop in the adolescent birth rate was observed. The correlation of birth rates with the IFEC for the district fell from -0.91 to -0.69 in the same period. CONCLUSIONS: Adolescent birth rates have very uneven geographical distribution, which correlates with the distribution of income. The percentage of low weight at birth is higher in the poorest districts, but the association with IFEC is much weaker.

Academies and Institutes↗
PubMed1996

[Inequalities in health at birth: Barcelona, 1990-1991].

OBJECTIVE: To study demographic and health related variables included in the municipal birth registry. Differences among municipal districts are assessed, as an approach to the study of inequalities in pregnancy, in birth and in its care. DESIGN: Observational study, based on secondary utilization of vital statistics data. SITE: The city of Barcelona (Catalonia, Spain), for the 1990-1991 years. PARTICIPANTS: Births from women who are city residents. MAIN RESULTS: Births concentrate around maternal ages of 25-29 years and 30-34. Adolescent mothers (less than 20 years) represent only a proportion of 1.9% of all births, and births from women above 34 years 13.7%, although only 2.1% of all births are from mothers above 40 years of age. Low birth weight (less than 2,500 g) occurs in 5.6% of all births. Preterm births (less than 37 weeks) occur in 4.7% of all deliveries. Teen age fertility, births to women above 34 years, low birth weight and preterm deliveries are compared across districts. Overall, four out of ten women use a public hospital for delivery, but this varies greatly among districts. There is no information on the father for 1.6% of all births. CONCLUSIONS: The completeness of this information source is high and the municipal registry is a useful database for the analysis of inequalities in small areas, using health related indicators which have higher frequency than more traditional indicators based on rare events (such as infant mortality). Differences among areas are found, related to life conditions and to prenatal and birth care.

Abortion, Induced↗
PubMed1996

[Prevalence and characteristics associated with tobacco use in a general population in Barcelona from 1983 to 1992].

OBJECTIVES: To describe the evolution of smoking habits in the general population of Barcelona from 1983 to 1992 and motivation of smokers and the perceived social pressure to leave smoking in 1992. DESIGN: Cross-sectional descriptive study of trends. PLACE AND PARTICIPANTS: From 1983 to 1992 two health surveys were conducted with independent samples of the general population not living in an institution (n = 3,134 and n = 5,004, respectively) with an age > or = 15 years and resident in Barcelona. RESULTS: Prevalence of smoking for the study period among males had decreased significantly, from 54.6% to 46.2%, whereas in females a non-significant increase was observed, from 20.9% to 25.4%. The most marked decrease in smoking among males has occurred in the upper socioeconomic levels (I and II), whereas the increase among women has occurred in the lower socioeconomic levels (IV and V). In 1992 half of smokers of both sexes admitted the wish to leave smoking and a third part to have tried to do so sometime. Approximately 30% of smokers report to have been required to stop smoking indoor sometime. CONCLUSIONS: From 1983 and 1992 a decrease was observed in overall differences of smoking prevalence among both sexes, whereas differences associated with socioeconomic levels increased, with a higher consume in the mid-low levels. More than half of smokers wish to leave smoking, which indicates the need for spreading and reinforcing methods to leave smoking among predisposed smokers.

Adolescent↗
PubMed1995

[Identification and recording of risk factors both at reformed and non-reformed primary care centers].

OBJECTIVE: To identify factors associated with carrying out preventive activities in primary care. DESIGN: A crossover study through a self-administered questionnaire. SETTING: Reformed and non-reformed centres of the primary care sub-division of the Barcelona Health Region, Catalan Health Institute. PARTICIPANTS: 134 doctors from reformed centres (primary care teams) and 138 from non-reformed primary care centres (PCC). MEASUREMENTS AND MAIN RESULTS: Doctors from the reformed centres used records to a much greater extent (75.3% as against 26.3% for tobacco consumption; 76.2% as against 27.9% for alcohol consumption). Together with the type of centre, some professional characteristics were linked to the likelihood of carrying out preventive activities. These included, in particular, professionals' high valuation of their own effectiveness and professional practices such as the habitual use of a safety belt and anti-flu injections. CONCLUSIONS: In the reformed centres preventive activities are much more integrated. To optimise their use other important aspects, such as training in skills and improving professionals' perception of their own effectiveness, will have to be considered.

Adult↗
PubMed1995

[Adolescents faced with addictive substances: tobacco, alcohol and noninstitutionalized drugs].

BACKGROUND: A large share of premature mortality is Spain in related with the abuse of addictive substances: tobacco, alcohol and non-institutionalized drugs. Adolescence is a key period for the adoption of their use. An accurate knowledge of the attitudes, beliefs, environmental perceptions and behaviours of teen-agers is necessary for the design and evaluation of preventive interventions. METHODS: Data were obtained from a survey conducted in 1992 on smoking, alcohol and non-institutionalized drugs in 8th grade students (13-14 years old) of a representative sample of the schools of the city of Barcelona (Catalonia, Spain). RESULTS: Up to 44.1% have ever smoked, 10.9% are regular smokers and 15.5% have bought tobacco at some point. There are no differences in smoking patterns by sex at this age. Even if 35.5% never drink alcohol, 1.7% drink it daily, 15.5% drink on week-ends and 62.9% at family celebrations, while 13.5% have bought alcohol at some point and 22.4% report having got drunk at least once. There are no differences by sex in alcohol use at this age. Concerning non-institutionalized drugs, 35.4% of the students think that many adults use them, and 22.4% say that some friends have tried them. CONCLUSIONS: The results show the increasing penetration of tobacco and alcohol in the personal environment of the students, and the process of initiation. Compared with previous studies in this population, we can estimate a modest and non-significant reduction of regular smoking, and a reduction in daily and regular alcohol use.

Adolescent↗
PubMed1994

[Risk factors of pregnancy in teenagers using family planning. Work Group on Sexuality and Adolescence].

BACKGROUND: Pregnancy and maternity during adolescence constitutes an obstetric and perinatal risk factor and reason for increased social alarm. Nonetheless, the predisposing factors have been little studied in Spain. METHODS: The demographic data and information on the age of onset of sexual relations, contraceptive methods used, in addition to the reason for the first visit, corresponding to the users of six municipal family planning centers in Barcelona who were under the age of 20 years at the time of the first visit were analyzed. Likewise, the principal incidences in the follow up, including pregnancies, abortions and changes in contraceptive methods were collected. RESULTS: From October 1989 to September 1990 823 first visits corresponding to adolescents were registered. Forty-five percent (380) were under the age of 18 years with 716 (87%) having initiated full sexual relations with more than two years having passed prior to the first visit to the center in 183 cases (26%). The most frequent reason for the visit to the center was to request contraception (48%). The lack of labor and academic activity, in addition to the infrequent use of condoms were associated to pregnancy as the reason for the consultation in 42 cases. Twenty-four adolescents became pregnant during follow up being associated to the early initiation of sexual relations, with an interval of two or more years prior to attending the center and a change in contraceptive method. CONCLUSIONS: The delay in attending family planning centers and the use of little effective contraceptive methods are risk factors for undesired pregnancy in adolescence.

Adolescent↗
PubMed1994

[Usefulness of physical examination at school].

OBJECTIVE: To evaluate the utility of school health examinations performed at four years of age. DESIGN: Evaluation of the results of school health examinations performed on 5,709 children are presented, with the follow up of selected problems found (overweight, growth failure, strabismus, reduced uncorrected visual acuity, hearing loss, psychomotor development and speech development impairment, hydrocele, cryptorchism, haematuria, dental caries and heart murmur). SETTING: 4-year old kindergarten children assessed in the school health program in the city of Barcelona (Catalonia, Spain). MAIN RESULTS: The examination identified 1,177 suspected defects in 960 children. Through a telephone interview with the families of 745 of these children, it was found that only 34.1% were previously unknown to families. The most frequently unknown problem was dental caries. Professional help was sought for 54.3% of the suspected defects. Only 10.5% of the suspected problems began any sort of treatment. The most frequently treated problems wer previously uncorrected refractive defects of the vision. Families report that 8.2% of the suspected problems improve. CONCLUSIONS: These results suggest that the current health output of school health examinations in our city is modest, and that their cost-opportunity should be reviewed.

Child, Preschool↗