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Tharrey M, Bohn T, Klein O, Bulaev D, Van Beek J, Nazare JA, Franco M, Malisoux L, Perchoux C. Local retail food environment exposure and diet quality in rural and urban adults: A longitudinal analysis of the ORISCAV-LUX cohort study. Health Place 2024; 87:103240. [PMID: 38593577 DOI: 10.1016/j.healthplace.2024.103240] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Despite growing interest in understanding how food environments shape dietary behaviors, European longitudinal evidence is scarce. We aimed to investigate the associations of 9-year average and change in exposure to local retail food environments with the diet quality of residents in Luxembourg. We used data from 566 adults enrolled in both waves of the nationwide ORISCAV-LUX study (2007-2017). Dietary quality was assessed by the Diet Quality Index-International (DQI-I). Exposure to "healthy" and "less healthy" food outlets was assessed by both absolute and relative GIS-based measurements. The results showed a 56.3% increase in less healthy food outlets over the period. In adjusted linear mixed models, high (vs. low) 9-year average exposure to less healthy food outlets was associated with lower DQI-I, when examining spatial access (β = -1.25, 95% CI: -2.29, -0.22) and proportions (β = -1.24, 95% CI: -2.15, -0.33). Stratified analyses showed these associations to be significant only among urban residents. There was no association between change in exposure to less healthy food outlets and DQI-I. Increased exposure to healthy outlets in rural areas, using absolute measurements, was associated with worsened DQI-I. Neighborhood socioeconomic status did not moderate the above associations. Findings suggest that the proliferation of less healthy food outlets may have contributed to the deterioration of the diet quality of urban residents, and support the use of relative measurements to fully capture the healthiness of food environments.
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Affiliation(s)
- Marion Tharrey
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg; Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg.
| | - Torsten Bohn
- Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Olivier Klein
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg
| | - Dmitry Bulaev
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Juliette Van Beek
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg; Department of Geography and Spatial Planning, Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch/Alzette, Luxembourg
| | - Julie-Anne Nazare
- Centre de Recherche en Nutrition Humaine Rhône-Alpes, CarMeN Laboratory, Univ-Lyon, INSERM, INRAe, Claude Bernard Lyon 1 University, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Manuel Franco
- Surgery and Medical and Social Sciences Department, Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Laurent Malisoux
- Department of Precision Health, Luxembourg Institute of Health, 1A-B Rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Camille Perchoux
- Department of Urban Development and Mobility, Luxembourg Institute of Socio-Economic Research, 11 Porte des Sciences, 4366, Esch-sur-Alzette, Luxembourg
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Plans-Beriso E, Gullon P, Fontan-Vela M, Franco M, Perez-Gomez B, Pollan M, Cura-Gonzalez I, Bilal U. Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain. J Epidemiol Community Health 2024:jech-2023-221198. [PMID: 38453450 DOI: 10.1136/jech-2023-221198] [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: 07/24/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Evidence has shown contradicting results on how the density of urban green spaces may reduce socioeconomic inequalities in type 2 diabetes (equigenic hypothesis). The aim of this study is to test whether socioeconomic inequalities in diabetes prevalence are modified by park density. METHODS We designed a population-wide cross-sectional study of all adults registered in the primary healthcare centres in the city of Madrid, Spain (n=1 305 050). We obtained georeferenced individual-level data from the Primary Care Electronic Health Records, and census-tract level data on socioeconomic status (SES) and park density. We modelled diabetes prevalence using robust Poisson regression models adjusted by age, country of origin, population density and including an interaction term with park density, stratified by gender. We used this model to estimate the Relative Index of Inequality (RII) at different park density levels. FINDINGS We found an overall RII of 2.90 (95% CI 2.78 to 3.02) and 4.50 (95% CI 4.28 to 4.74) in men and women, respectively, meaning that the prevalence of diabetes was three to four and a half times higher in low SES compared with high SES areas. These inequalities were wider in areas with higher park density for both men and women, with a significant interaction only for women (p=0.008). INTERPRETATION We found an inverse association between SES and diabetes prevalence in both men and women, with wider inequalities in areas with more parks. Future works should study the mechanisms of these findings, to facilitate the understanding of contextual factors that may mitigate diabetes inequalities.
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Affiliation(s)
- Elena Plans-Beriso
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Pedro Gullon
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Mario Fontan-Vela
- Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Manuel Franco
- Social and Cardiovascular Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, Spain
| | - Beatriz Perez-Gomez
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Marina Pollan
- Department of Epidemiology of Chronic Diseases, National Center For Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Isabel Cura-Gonzalez
- Primary Care Research Unit, Madrid Health Service, Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
- Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
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Bultó Gonzalvo R, Bernardello Ureta M, Cervera Alcaide J, Sanchez Rodriguez M, Franco M, Freixa Sala R, Areal Calama J, Agreda Castañeda F. Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate. Actas Urol Esp 2024; 48:150-154. [PMID: 37604401 DOI: 10.1016/j.acuroe.2023.08.008] [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: 05/19/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION AND AIM Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. MATERIAL AND METHODS A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. RESULTS A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. CONCLUSIONS Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.
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Affiliation(s)
- R Bultó Gonzalvo
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain.
| | - M Bernardello Ureta
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - J Cervera Alcaide
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - M Sanchez Rodriguez
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - M Franco
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - R Freixa Sala
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - J Areal Calama
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
| | - F Agreda Castañeda
- Servicio de Urología, Hospital Universitari Germans Trias I Pujol, Badalona, Barcelona, Spain
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Legido-Quigley H, Berrojalbiz I, Franco M, Gea-Sánchez M, Jaurrieta S, Larrea M, Minue S, Padilla J, Valderas JM, Zapata T. Towards an equitable people-centred health system for Spain. Lancet 2024; 403:335-337. [PMID: 37683682 DOI: 10.1016/s0140-6736(23)01858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Affiliation(s)
| | - Itxaso Berrojalbiz
- Department of Treasury and Finance, Barcelona, Spain; Department of Treasury and Finance, Biscay, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, Grup d'Estudis Societat, Salut, Educació, Cultura de les Cures, University of Lleida, Lleida, Spain; Republican Left of Catalonia Party, Lleida, Spain
| | | | - Muriel Larrea
- People's Party in Gipuzkoa, Gipuzkoa, Spain; Health Committee of the Basque Parliament, Vitoria, Spain
| | - Sergio Minue
- Escuela Andaluza de Salud Pública, Granada, Spain
| | - Javier Padilla
- Mas Madrid Left-Green Madrid Regional Party, Madrid, Spain
| | - Jose Maria Valderas
- Centre for Research in Health System Performance, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Family Medicine, National University Health System, Singapore
| | - Tomas Zapata
- Health Workforce and Service Delivery, WHO Regional Office for Europe, Copenhagen, Denmark
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5
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Berenguer J, Calvo-Alcántara MJ, Alvaro-Meca A, Estévez JC, Basanta M, Ruiz S, Matáix ÁL, Bienzóbas C, Cosano L, Silva AP, Salas P, Gullón P, Franco M, Arribas JR, Molero JM, Hernán MA. Three Years of the Coronavirus Disease 2019 Pandemic in a European Region: A Population-Based Longitudinal Assessment in Madrid Between 2020 and 2022. Open Forum Infect Dis 2024; 11:ofad635. [PMID: 38173846 PMCID: PMC10763997 DOI: 10.1093/ofid/ofad635] [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: 08/09/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
Background Our objective was to assess the health impact of coronavirus disease 2019 (COVID-19) during 2020-2022 in the Madrid region. Methods We included all individuals registered in the Madrid Health System Registry as of 31 December 2019, and followed them until 31 December 2022. Using a unique personal identifier, we linked the databases of primary care, hospitals, pharmacies, certified laboratories performing diagnostic tests, vaccines, and mortality. Results Of 6 833 423 individuals, 21.4% had a confirmed COVID-19 diagnosis, and 1.5% had a COVID-19 hospitalization (primary diagnosis). Thirty-day mortality was 1.6% for confirmed COVID-19 (from 11.4% in first semester 2020 to 0.4% in first semester 2022). Thirty-day mortality was 10.8% for COVID-19 hospitalizations (from 14.0% in first semester 2020 to 6.0% in second semester 2022). There were 24 073 deaths within 30 days of a confirmed COVID-19 diagnosis. Advanced age, male sex, higher socioeconomic deprivation, and comorbidities were associated with higher mortality. Conclusions By linking administrative and clinical databases, we characterized the burden of the COVID-19 pandemic in Madrid over 3 years. Our analysis proposes a high-level framework for comparisons of the burden of COVID-19 across areas worldwide.
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Affiliation(s)
- Juan Berenguer
- Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | | | - Alejandro Alvaro-Meca
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
- Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
| | - José C Estévez
- Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | - Miguel Basanta
- Dirección General de Sistemas de Información y Equipamientos Sanitarios, Madrid, Spain
| | - Sergio Ruiz
- Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | - Ángel L Matáix
- Subdirección General de Farmacia y Productos Sanitarios, Madrid, Spain
| | - César Bienzóbas
- Dirección General de Inspección y Ordenación Sanitaria, Madrid, Spain
| | - Lourdes Cosano
- Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Aura P Silva
- Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Pilar Salas
- Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Pedro Gullón
- Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Manuel Franco
- Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - José R Arribas
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
- Infectious Diseases, Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
- Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Miguel A Hernán
- CAUSALab, Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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de Loyola González-Salgado I, Rivera-Navarro J, Gutiérrez-Sastre M, Conde P, Franco M. Conducting member checking within a qualitative case study on health-related behaviours in a large European city: Appraising interpretations and co-constructing findings. Health (London) 2024; 28:3-21. [PMID: 35822544 DOI: 10.1177/13634593221109682] [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] [Indexed: 11/16/2022]
Abstract
Although member checking is a well-established strategy for appraising credibility, there is a lack of research reporting procedures and outcomes when using this strategy. In recent years, scholars have implemented new member checking strategies along with several epistemological stances. In this work, researchers conducted member checking in three neighbourhoods with different socioeconomic status in Madrid, Spain. Attendance at member checking meetings was lower than expected. Member checking meetings were conducted in public halls within each neighbourhood and lasted approximately 2 hours. During the first hour, researchers introduced the aim of the meetings and shared summarized research findings with attendees using a slideshow. During the second hour, attendees had the opportunity to comment on any aspect of the research. Researchers used grounded theory coding strategies and a constructivist approach informed the analysis of the transcribed member checking meetings. One core category emerged, and it was named 'Co-constructing findings and side effects of the interaction between researchers and participants in member checking'. Member checking attendees contributed to co-constructing findings by means of underscore and disagreement. It is possible that these meetings might have caused side effects such as unintended comparisons between neighbourhoods and negative health-related behaviours. Attendees wondered how the findings could improve their neighbourhoods. The meetings allowed interaction between participants and researchers and resulted in appraising and co-constructing qualitative research findings. More research is needed to advance knowledge about member checking.
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Affiliation(s)
| | | | | | | | - Manuel Franco
- University of Alcalá, Spain
- City University of New York, USA
- Johns Hopkins Bloomberg School of Public Health, USA
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Teixidó-Compañó E, Sureda X, Bosque-Prous M, Villalbí JR, Puigcorbé S, Colillas-Malet E, Franco M, Espelt A. Understanding how alcohol environment influences youth drinking: A concept mapping study among university students. Adicciones 2023; 35:469-482. [PMID: 36200225 DOI: 10.20882/adicciones.1705] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the study was to identify the environmental factors that influence alcohol consumption, according to university students, and assess the relative importance and the frequency attributed to each factor. A study using Concept Mapping methodology was performed with a sample of nursing students, who participated in two face-to-face data collection sessions. In session 1, a consensus about the environmental aspects that influence their alcohol consumption was obtained. In session 2, the statements obtained were rated according to their relative importance and frequency in alcohol use (1 = minimum; 5 = maximum). Subsequently, all data were analyzed with the RCMAP of the statistical package R 3.6.1.Approximately 60 students participated in each session. Most were women aged 20 to 24. In session 1, a total of 55 statements were obtained and classified into 7 different clusters: Advertising (9 statements); Family environment (4 statements); Social pressure (12 statements); Responsibilities/norms (4 statements); Holidays and leisure time (7 statements); Emotional situations (8 statements); Accessibility (11 statements). Factors related to social pressure, holidays and leisure time, and alcohol accessibility were considered the most important and frequent in alcohol consumption. In contrast, alcohol advertising was considered the least important (mean 2.6 out of 5) and frequent (mean 2.1 out 5) factor. In conclusion, the factors considered most relevant among nursing students match those having more resources allocated for prevention and health promotion, except for alcohol advertising, which was perceived as less important and frequent compared with the other factors.
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Affiliation(s)
- Ester Teixidó-Compañó
- Facultat de Ciències de la Salut de Manresa. Universitat de Vic Universitat Central de Catalunya (UVicUCC) Universitat Pompeu Fabra (UPF). Barcelona.
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Rivera-Navarro J, de Loyola González-Salgado I, Ramos-Truchero G, Gravina L, Díez J, Caballero S, Franco M. Factors influencing dietary inequalities among adolescents in Madrid and Bilbao: a qualitative research project. Gac Sanit 2023; 37:102325. [PMID: 37598578 DOI: 10.1016/j.gaceta.2023.102325] [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] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To describe the design and methodology of a qualitative study to explore the main factors influencing dietary inequalities in adolescents in Madrid and Bilbao, Spain. METHOD The study area included six neighborhoods (three in each city) of different socioeconomic status (SES): low, medium, and high. We sampled 12 secondary schools (six in each city: two per socioeconomic level). Our methodology comprised: 1) developing an ad hoc index to classify all neighborhoods according to their SES; 2) selecting the study area and sample; 3) conducting semi-structured interviews (n=36) and focus groups (n=24). Grounded theory and phenomenological analysis will be employed in data analysis. Initially, we found factors influencing in adolescents' diet such as gender, family environment, and SES. CONCLUSIONS Systematizing the selection of neighborhoods and secondary schools, along with using appropriate methods, could serve as a foundation for future studies on health inequalities among adolescents.
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Affiliation(s)
- Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain.
| | | | - Guadalupe Ramos-Truchero
- Sociology and Social Work Department, Education and Social Work Faculty, Valladolid University, Valladolid, Spain
| | - Leyre Gravina
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country, País Vasco University, Bilbao, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Alcalá University, Madrid, Spain
| | - Silvia Caballero
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country, País Vasco University, Bilbao, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Alcalá University, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Vidal R, Rivera-Navarro J, Gravina L, Díez J, Franco M. Correlates of eating behaviors in adolescence: a systematic review of qualitative studies. Nutr Rev 2023:nuad088. [PMID: 37432794 DOI: 10.1093/nutrit/nuad088] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
CONTEXT Nutrition plays a critical role in adolescence. Adolescents are vulnerable to the impact of different factors that distance them from healthy habits, increasing their risk of chronic diseases in adulthood. Qualitative methodologies allow for a better understanding of these factors. OBJECTIVE This systematic review aims to consolidate qualitative research evidence from the past 10 years to analyze the facilitators and barriers influencing adolescents' eating behaviors. DATA SOURCES Databases searched for relevant studies were Scopus, Medline/PubMed, PsycINFO, and Web of Science. DATA EXTRACTION A total of 4176 records were identified. The authors used the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative Research) quality-assessment tool. RESULTS Fifty articles with qualitative or mixed methodologies were finally included. The most applied techniques were focus groups and semi-structured interviews. The factors influencing adolescents' diets were classified into 4 dimensions: individual, social, community, and macrosystem factors. The most influential were the following-(1) at the individual level: gender (facilitator or barrier), taste and appearance of food (barrier), and lack of time (barrier); (2) at the social level: parents' and caregivers' influence (facilitator or barrier), peer group influence (barrier), and socioeconomic position (barrier); (3) at the community level: school food environment (facilitator or barrier), neighborhood food environment (barrier), household food environment (facilitator or barrier), food insecurity (barrier), and availability and affordability of ultra-processed foods (barrier); and (4) at the macrosystem level: digital tools (facilitator or barrier). CONCLUSIONS This systematic review identified several facilitators and barriers influencing eating behaviors among adolescents. Qualitative research provides a rich source of knowledge to inform interventions aimed at improving adolescents' diets. Qualitative research is very useful for collecting researches that help to implement intervention programs that improve adolescent nutrition.
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Affiliation(s)
- Raquel Vidal
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain
| | - Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain
| | - Leyre Gravina
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Gullón P, Fontán-Vela M, Díez J, Nieuwenhuijsen M, Rojas-Rueda D, Escobar F, Franco M. Who benefits from green spaces? Surrounding greenness and incidence of cardiovascular disease in a population-based electronic medical records cohort in Madrid. Int J Hyg Environ Health 2023; 252:114221. [PMID: 37421937 DOI: 10.1016/j.ijheh.2023.114221] [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: 12/16/2022] [Revised: 05/06/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
The objective was to study the association between surrounding greenness and the incidence of cardiovascular diseases (CVD) with a four years follow-up in almost half a million high CVD-risk women and men, as well as its differential effect by area-level deprivation in Madrid. We analyzed 2015-2018 primary healthcare electronic medical records for 437,513 high CVD risk individuals representing more than 95% of the population of that age range residing in Madrid. The outcome variable was any cardiovascular event. We measured surrounding residence greenness at 200 m, 300 m, 500 m, and 1000 m through the Normalized Difference Vegetation Index (NDVI). We assessed socioeconomic deprivation through a census-based deprivation index. We estimated the 4-year relative risk of CVD by an increase in 0.1 units of NDVI and then stratified the models by quintiles of deprivation (Q5 the most deprived). We found that for every increase in 0.1 units of NDVI at 1000 m there was a 16% decrease in CVD risk (RR = 0.84 95% CI 0.75-0.94). CVD risk for the remaining distance exposures (at 200 m, 300 m, and 500 m) were none statistically significant. In general, the protective effect of green spaces was present in medium-deprivation areas and males, but the associations were inconsistent across deprivation levels. This study highlights the relevance of evaluating the interaction between physical and social urban components to further understand possible population prevention approaches for cardiovascular diseases. Future studies should focus on the mechanisms of context-specific interactions between social inequalities and green spaces' effects on health.
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Affiliation(s)
- Pedro Gullón
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - Mario Fontán-Vela
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Centro Superior de Investigaciones Sociológicas, Ministerio de Ciencia e Innovación, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), 08036, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Calle Colegios 2, Alcalá de Henares, 28801, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcala, Alcala de Henares, 28871, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, 21205-2217, USA
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11
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Salvador C, Gullón P, Franco M, Vicedo-Cabrera AM. Heat-related first cardiovascular event incidence in the city of Madrid (Spain): Vulnerability assessment by demographic, socioeconomic, and health indicators. Environ Res 2023; 226:115698. [PMID: 36931379 DOI: 10.1016/j.envres.2023.115698] [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] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
While climate change and population ageing are expected to increase the exposure and vulnerability to extreme heat events, there is emerging evidence suggesting that social inequalities would additionally magnify the projected health impacts. However, limited evidence exists on how social determinants modify heat-related cardiovascular morbidity. This study aims to explore the association between heat and the incidence of first acute cardiovascular event (CVE) in adults in Madrid between 2015 and 2018, and to assess how social context and other individual characteristics modify the estimated association. We performed a case-crossover study using the individual information collected from electronic medical records of 6514 adults aged 40-75 living in Madrid city that suffered a first CVE during summer (June-September) between 2015 and 2018. We applied conditional logistic regression with a distributed lag non-linear model to analyse the heat-CVE association. Estimates were expressed as Odds Ratio (OR) for extreme heat (at 97.5th percentile of daily maximum temperature distribution), compared to the minimum risk temperature. We performed stratified analyses by specific diagnosis, sex, age (40-64, 65-75), country of origin, area-level deprivation, and presence of comorbidities. Overall, the risk of suffering CVE increased by 15.3% (OR: 1.153 [95%CI 1.010-1.317]) during extreme heat. Males were particularly more affected (1.248, [1.059-1.471]), vs 1.039 [0.810-1.331] in females), and non-Spanish population (1.869 [1.28-2.728]), vs 1.084 [0.940-1.250] in Spanish). Similar estimates were found by age groups. We observed a dose-response pattern across deprivation levels, with larger risks in populations with higher deprivation (1.228 [1.031-1.462]) and almost null association in the lowest deprivation group (1.062 [0.836-1.349]). No clear patterns of larger vulnerability were found by presence of comorbidity. We found that heat unequally increased the risk of suffering CVE in adults in Madrid, affecting mainly males and deprived populations. Local measures should pay special attention to vulnerable populations.
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Affiliation(s)
- Coral Salvador
- Centro de Investigación Mariña, Universidade de Vigo, Environmental Physics Laboratory (EPhysLab), Ourense, Spain; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Pedro Gullón
- Universidad de Alcalá, Grupo de Investigación en Epidemiología y Salud Pública Facultad de Medicina y Ciencias de La Salud, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia
| | - Manuel Franco
- Universidad de Alcalá, Grupo de Investigación en Epidemiología y Salud Pública Facultad de Medicina y Ciencias de La Salud, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, 21205-2217, USA.
| | - Ana M Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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12
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Cereijo L, Gullón P, Del Cura I, Valadés D, Bilal U, Franco M, Badland H. Exercise facility availability and incidence of type 2 diabetes and complications in Spain: A population-based retrospective cohort 2015-2018. Health Place 2023; 81:103027. [PMID: 37087897 DOI: 10.1016/j.healthplace.2023.103027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND To study the association between exercise facility availability and type 2 diabetes incidence and its complications, and to explore effect modification by socioeconomic status (SES) and sex in the Madrid adult population. METHODS A multilevel longitudinal design, based on a population-based retrospective cohort including 1,214,281 residents of Madrid (Spain) aged 40-75 years from 2015 to 2018. Outcomes were type 2 diabetes incidence and macrovascular (cardiac ischemia and/or stroke) and microvascular (chronic kidney disease, retinopathy, and/or peripheral vascular disease) complications in those with diabetes at baseline. Exercise facility availability was defined as the count of exercise facilities in a 1000 m street network buffer around each participant's residence. Poisson regression models with robust standard errors were used to estimate the risk ratios (RR). Interactions were explored with SES tertiles and by sex. RESULTS Residents living in areas with lower exercise facility availability showed higher risk of type 2 diabetes (RRtertile3vs1 = 1.25, CI95% 1.21-1.30) as well as macrovascular (RRTertile3vs1 = 1.09 CI95% 1.00-1.19), and microvascular (RRTertile3vs1 = 1.10 CI95% 1.01-1.19) complications. Associations were strongest in low SES areas for type 2 diabetes (RRtertile3vs1-LOW-SES = 1.22, CI95% 1.12-1.32; RRtertile3vs1-HIGH-SES = 0.91, CI95% 0.85-0.98) and microvascular complications (RRtertile3vs1-LOW-SES = 1.12, CI95% 0,94-1,33; RRtertile3vs1-HIGH-SES = 0.88, CI95% 0.73-1.05). CONCLUSIONS Living in areas with lower availability of exercise facilities was associated with a greater risk of type 2 diabetes and its complications. Increasing exercise opportunities, particularly in low SES areas, could help reduce the social gradient of diabetes and its complications.
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Affiliation(s)
- Luis Cereijo
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de investigación en epidemiología y salud pública, Alcalá de Henares, Madrid, Spain; Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Grupo de investigación en gestión y entrenamiento deportivo, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - Pedro Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de investigación en epidemiología y salud pública, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - Isabel Del Cura
- Unidad de investigación de atención primaria, Gerencia de Atención Primaria, Madrid, Spain; Departamento de especialidades médicas y salud pública, University Rey Juan Carlos, Madrid, Spain; Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC) & Red de la Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPs) ISCIII, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañon. IiSGM, Madrid, Spain.
| | - David Valadés
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Grupo de investigación en gestión y entrenamiento deportivo, Alcalá de Henares, Madrid, Spain.
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Manuel Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de investigación en epidemiología y salud pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Hannah Badland
- Centre for Urban Research, RMIT University, Melbourne, Australia.
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Fontán-Vela M, Gullón P, Bilal U, Franco M. Social and ideological determinants of COVID-19 vaccination status in Spain. Public Health 2023; 219:139-145. [PMID: 37178560 PMCID: PMC10080268 DOI: 10.1016/j.puhe.2023.04.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES This study analysed the association between social and ideological determinants with COVID-19 vaccine accessibility and hesitancy in the Spanish adult population. STUDY DESIGN This was a repeated cross-sectional study. METHODS The data analysed are based on monthly surveys conducted by the Centre for Sociological Research between May 2021 and February 2022. Individuals were classified according to their COVID-19 vaccination status into (1) vaccinated (reference group); (2) willing to vaccinate but not vaccinated, proxy of lack of vaccine accessibility; and (3) hesitant, proxy of vaccine hesitancy. Independent variables included social (educational attainment, gender) and ideological determinants (voting in the last elections, importance attached to the health vs the economic impact of the pandemic, and political self-placement). We estimated odds ratio (OR) and 95% confidence interval (CI) conducting one age-adjusted multinomial logistic regression model for each determinant and then stratified them by gender. RESULTS Both social and ideological determinants had a weak association with the lack of vaccine accessibility. Individuals with medium educational attainment had higher odds of vaccine hesitancy (OR = 1.44, CI 1.08-1.93) compared with those with high educational attainment. People self-identified as conservative (OR = 2.90; CI 2.02-4.15) and those who prioritised the economic impact (OR = 3.80; CI 2.62-5.49) and voted for parties opposed to the Government (OR = 2.00; CI 1.54-2.60) showed higher vaccine hesitancy. The stratified analysis showed a similar pattern for both men and women. CONCLUSIONS Considering the determinants of vaccine uptake and hesitancy could help to design strategies that increase immunisation at the population level and minimise health inequities.
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Affiliation(s)
- M Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Centro Superior de Investigaciones Sociológicas, Ministerio de Ciencia e Innovación, Spain
| | - P Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - U Bilal
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - M Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-2217, USA
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Bautista D, Romero-Sánchez C, Franco M, Angel J. Expression of Homing Receptors in IgM +IgD +CD27 + B Cells and Their Frequencies in Appendectomized and/or Tonsillectomized Individuals. Immunol Invest 2023:1-15. [PMID: 36943113 DOI: 10.1080/08820139.2023.2187303] [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] [Indexed: 03/23/2023]
Abstract
BACKGROUND In humans, blood circulating IgM+IgD+CD27+ B cells are considered analogous to those described in the marginal zone of the spleen and are involved in important immunological processes. The homing receptors they express, and the organs involved in their development (for example, intestinal organs in rabbits) are only partially known. We recently reported that this population is heterogeneous and composed of at least two subsets: one expressing high levels of IgM - IgMhi B cells - and another low levels - IgMlo B cells. OBJECTIVES To evaluate the expression of homing receptors on IgD+CD27+ IgMhi and IgMlo B cells and quantify their frequencies in blood of control and appendectomized and/or tonsillectomized volunteers. MATERIALS AND METHODS Using spectral flow cytometry, the simultaneous expression of 12 previously reported markers that differentiate IgMhi B cells and IgMlo B cells and of α4β7, CCR9, CD22 and CCR10 were evaluated in blood circulating B cells of control and appendectomized and/or tonsillectomized volunteers. RESULTS The existence of phenotypically defined IgMlo and IgMhi B cell subsets was confirmed. They differentially expressed intestinal homing receptors, and the expression of α4β7 and CCR9 seems to determine new IgM subpopulations. IgMlo and IgMhi B cells were detected at lower frequencies in the appendectomized and/or tonsillectomized volunteers relative to controls. CONCLUSIONS Human blood circulating IgD+CD27+ IgMlo and IgMhi B cell subsets differentially express homing receptors, and it is necessary to investigate if mucosal organs are important in their development.
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Affiliation(s)
- Diana Bautista
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- GIBAT, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
| | - Consuelo Romero-Sánchez
- Cellular and Molecular Immunology Group/INMUBO, Universidad El Bosque, Bogotá, Colombia
- Clinical Immunology Group, Hospital Militar Central/Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Manuel Franco
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juana Angel
- Instituto de Genética Humana, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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15
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Romero I, Díez J, Del Cura I, Franco M, Gullón P. Diet Quality Changes by Educational Level among Adults in Spain from 2017 to 2021. Nutrients 2023; 15:nu15040858. [PMID: 36839216 PMCID: PMC9961002 DOI: 10.3390/nu15040858] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
Despite increasing attention on addressing socioeconomic disparities in diet quality, longitudinal studies are scarce. Furthermore, the effects of the COVID-19 pandemic on diet-related outcomes are yet to be fully understood. We examined changes in diet quality by educational level among adults in Madrid, Spain. We used data from recruitment (in 2017) and from 2021. At baseline, our sample included 1358 adults aged 40-75 years who were free of cardiovascular disease and completed a validated diet quality screener. Of them, 931 answered the survey in the follow-up visit in 2021. We used participants' diet quality index scores (range: 18-54; higher scores indicate better diet quality) as the dependent variable. As our independent variable, we assessed participants' educational levels (low, medium, and high). We fitted a multinomial regression using the categories of educational level as the main predictor, adjusting for age, sex, country of origin, and household composition. During the study period, 78.0% of participants sustained their diet quality, 11.6% improved it, and 10.4% moved away from a healthier dietary pattern. In descriptive analyses, we observed an increase in diet quality among less-educated females. Unadjusted multinomial models showed that a lower educational level predicted both increases and decreases in diet quality over the period. Even though the median diet quality scores did not change significantly, we observed heterogeneous changes over the four years. Variability within diet, with some improving and some worsening, seems to have increased among participants with lower educational levels. Future studies should look at the determinants of change in these population subgroups.
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Affiliation(s)
- Isabel Romero
- Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Aragón, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
- Correspondence:
| | - Isabel Del Cura
- Primary Care Research Unit, Madrid Health Service, 28035 Madrid, Spain
- Department of Preventive Medicine and Public Health, Universidad Rey Juan Carlos, 28933 Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC) & Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Institute of Health Carlos III, 28029 Madrid, Spain
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, 17165 Stockholm, Sweden
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Pedro Gullón
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
- Center for Urban Research, RMIT University, Melbourne 3004, Australia
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Díez J, Taulet G, Fontán-Vela M, González-Rábago Y, Cereijo L, Sandín-Vázquez M, Rodríguez E, Franco M, Borrell C, Bilal U, Gullón P. Trends and determinants of social inequities in cardiovascular risk factors in Spain: a mixed-methods study. Gaceta Sanitaria 2023; 37:102298. [PMID: 37004266 DOI: 10.1016/j.gaceta.2023.102298] [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] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 04/03/2023]
Abstract
This sequential mixed-methods study aims to: 1) assess spatial and temporal trends in cardiovascular risk factors by socioeconomic position from 2001 to 2020 in Spain; 2) explore public health professionals' perspectives regarding interventions that might have impacted these inequities; and 3) analyze determinants on social inequities in cardiovascular risk factors. First, we will measure the change in absolute and relative social inequities in eight cardiovascular risk factors through time trend analysis using repeated cross-sectional data from both National and European Health Surveys for Spain from 2001 to 2020. Second, we will interview key informants -both at the regional and national level-, to contextualize data obtained in phase 1 and capture the content and variation of policies across regions. Third, we will use econometric methods to analyze how these identified interventions have impacted these social inequities within and across regions.
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Londoño-Cañola C, Serral G, Díez J, Martínez-García A, Franco M, Artazcoz L, Ariza C. Retail Food Environment around Schools in Barcelona by Neighborhood Socioeconomic Status: Implications for Local Food Policy. Int J Environ Res Public Health 2022; 20:ijerph20010649. [PMID: 36612971 PMCID: PMC9819657 DOI: 10.3390/ijerph20010649] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 05/14/2023]
Abstract
Childhood obesity is a relevant public health problem. The school food environment has been identified as an important factor for promoting healthy eating behaviors. This study assessed the availability of and proximity to unhealthy food stores around schools (n = 22) in the city of Barcelona and its association with neighborhood socioeconomic status (NSES). We conducted this cross-sectional study between 2019 and 2020. First, we identified all food retailers (n = 153) within a 400-m buffer around each school and identified those selling unhealthy food products. Then, we used Poison regression models to measure the association between NSES and the healthy food availability index (HFAI), adjusting for population density and distance. A total of 95% of the food establishments studied were classified as unhealthy (n = 146). In all, 90% of schools that had, at least, two unhealthy retailers in their proximity. There were significant differences in the mean distance to unhealthy establishments according to neighborhood SES and population density (p < 0.05). We found a positive association between schools located in higher SES neighborhoods and a higher availability and affordability of healthy food products (IIR = 1.67, 95% CI = 1.45−1.91 p = 0.000). We found strong social inequalities in the supply of healthy foods in Barcelona. Local food policy interventions addressing retail food environment around schools should consider socioeconomic inequalities.
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Affiliation(s)
- Catalina Londoño-Cañola
- Agència de Salut Pública de Barcelona, Public Health Agency, 08023 Barcelona, Spain
- Departament de Ciències Experimentals i de la Salut (DCEXS), Universitat Pompeu Fabra, 08003 Barcelona, Spain
- Correspondence:
| | - Gemma Serral
- Agència de Salut Pública de Barcelona, Public Health Agency, 08023 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28801 Madrid, Spain
| | - Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690 Alicante, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28801 Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lucía Artazcoz
- Agència de Salut Pública de Barcelona, Public Health Agency, 08023 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Carlos Ariza
- Agència de Salut Pública de Barcelona, Public Health Agency, 08023 Barcelona, Spain
- Ciber de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Institut d’Investigació Biomédica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
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Ares-Blanco S, Polentinos-Castro E, Rodríguez-Cabrera F, Gullón P, Franco M, del Cura-González I. Inequalities in glycemic and multifactorial cardiovascular control of type 2 diabetes: The Heart Healthy Hoods study. Front Med (Lausanne) 2022; 9:966368. [PMID: 36569128 PMCID: PMC9769119 DOI: 10.3389/fmed.2022.966368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/10/2022] [Accepted: 09/26/2022] [Indexed: 12/12/2022] Open
Abstract
Aim This study aimed to analyze glycemic control and multifactorial cardiovascular control targets in people with type 2 diabetes (T2DM) in primary care according to sex and socioeconomic status (SES). Materials and methods This is an observational, cross-sectional, and multicenter study. We analyzed all the patients with T2DMM aged between 40 and 75 years in Madrid city (113,265) through electronic health records from 01 August 2017 to 31 July 2018. SES was defined by an area-level socioeconomic index stratified by quintiles (1st quintile: more affluent). Outcomes Outcomes included glycemic control (HbA1c ≤ 7%), 3-factor cardiovascular control [HbA1c ≤ 7%, blood pressure (BP), < 140/90 mmHg, LDL < 100 mg/ml] and 4-factor control [HbA1c ≤ 7%, blood pressure (BP) < 140/90 mmHg, LDL < 100 mg/ml, and BMI < 30 kg/m2]. Multilevel logistic regression models analyzed factors associated with suboptimal glycemic control. Results In total 43.2% were women. Glycemic control was achieved by 63% of patients (women: 64.2% vs. men: 62.4%). Being more deprived was associated with suboptimal glycemic control (OR: 1.20, 95% CI: 1.10-1.32); however, sex was not related (OR: 0.97, 95% CI: 0.94-1.01). The optimal 3-factor control target was reached by 10.3% of patients (women: 9.3% vs. men: 11.2%), especially those in the 5th quintile of SES. The 4-factor control was achieved by 6.6% of the sample. In the 3-factor control target, being women was related to the suboptimal 3-factor control target (OR: 1.26, 95% CI: 1.19- 1.34) but only belonging to SES 4th quintile was related to the unachieved target (OR: 1.47, 95% CI: 1.04-2.07). Conclusion Suboptimal glycemic control was associated with being less affluent and suboptimal 3-factor control target was associated with being women.
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Affiliation(s)
- Sara Ares-Blanco
- Federica Montseny Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain,Medical Specialties and Public Health, School of Health Sciences, University Rey Juan Carlos, Alcorcón, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain,*Correspondence: Sara Ares-Blanco,
| | - Elena Polentinos-Castro
- Medical Specialties and Public Health, School of Health Sciences, University Rey Juan Carlos, Alcorcón, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain,Primary Care Research Unit, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain,Health Services Research on Chronic Patients Network (REDISSEC and RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Pedro Gullón
- Public Health and Epidemiology Research Group, Universidad de Alcalá, Alcala de Henares, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, Universidad de Alcalá, Alcala de Henares, Spain,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Isabel del Cura-González
- Medical Specialties and Public Health, School of Health Sciences, University Rey Juan Carlos, Alcorcón, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain,Primary Care Research Unit, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain,Health Services Research on Chronic Patients Network (REDISSEC and RICAPPS), Instituto de Salud Carlos III, Madrid, Spain
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Fernández-Escobar C, Díez J, Martínez-García A, Bilal U, O'Flaherty M, Franco M. Food availability and affordability in a Mediterranean urban context: associations by store type and area-level socio-economic status. Public Health Nutr 2022; 26:1-9. [PMID: 36274648 DOI: 10.1017/s1368980022002348] [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] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although food environments have been highlighted as potentially effective targets to improve population diets, evidence on Mediterranean food environments is lacking. We examined differences in food availability and affordability in Madrid (Spain) by store type and area-level socio-economic status (SES). DESIGN Cross-sectional study. Trained researchers conducted food store audits using the validated Nutrition Environment Measures Survey in Stores for Mediterranean contexts (NEMS-S-MED) tool to measure the availability and price of twelve food groups (specific foods = 35). We computed NEMS-S-MED scores and summarised price data with a Relative Price Index (RPI, comparing prices across stores) and an Affordability Index (normalising prices by area-level income). We compared the availability and affordability of 'healthier-less healthy' food pairs, scores between food store types (supermarkets, specialised, convenience stores and others) and area-level SES using ANOVA and multi-level regression models. SETTING City of Madrid. 2016 and 2019 to cover a representative sample. PARTICIPANTS Food stores within a socio-economically diverse sample of sixty-three census tracts (n 151). RESULTS Supermarkets had higher food availability (37·5/49 NEMS-S-MED points), compared to convenience stores (13·5/49) and specialised stores (8/49). Supermarkets offered lower prices (RPI: 0·83) than specialised stores (RPI: 0·97) and convenience stores (RPI: 2·06). Both 'healthy' and 'less healthy' items were more available in supermarkets. We found no differences in food availability or price by area-level SES, but affordability was higher in higher-income areas. CONCLUSIONS Supermarkets offered higher food availability and affordability for healthy and less healthy food items. Promoting healthy food availability through supermarkets and specialised stores and/or limiting access to convenience stores are promising policy options to achieve a healthier food environment.
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Affiliation(s)
- Carlos Fernández-Escobar
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | - Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, 03690Alicante, Spain
| | - Usama Bilal
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Martin O'Flaherty
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Manuel Franco
- Public Health and Epidemiology Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Bacigalupe A, Martín U, Franco M, Borrell C. [Socioeconomic inequalities and COVID-19 in Spain. SESPAS Report 2022]. Gac Sanit 2022; 36 Suppl 1:S13-S21. [PMID: 35781142 PMCID: PMC9244668 DOI: 10.1016/j.gaceta.2022.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 12/14/2022]
Abstract
La pandemia de COVID-19 ha mostrado su carácter sindémico, ya que al contagio por coronavirus se une la alta prevalencia de enfermedades crónicas en un contexto de gran desigualdad social, con un claro gradiente en todas ellas. Los objetivos de este artículo son: 1) mostrar un marco conceptual que permita identificar los determinantes de la desigualdad social en la COVID-19; 2) mostrar la evidencia disponible sobre las desigualdades socioeconómicas en diversos aspectos relacionados con la COVID-19 en España; y 3) realizar recomendaciones para monitorizar, comunicar e intervenir con políticas para la disminución de las desigualdades sociales en la COVID-19, mostrando ejemplos desarrollados en España. El marco conceptual incluye factores determinantes estructurales e intermedios que reflejan los diferentes ejes de desigualdad que caracterizan el carácter sindémico de la COVID-19. La revisión de la literatura publicada en España hasta julio de 2021 describe un gradiente socioeconómico en la COVID-19, aunque con hallazgos no siempre consistentes, así como un impacto desigual de muchas medidas de control de la pandemia. Las propuestas para la disminución de las desigualdades sociales en la COVID-19 incluyen: 1) garantizar la monitorización y la investigación con perspectiva de equidad; 2) reducir las desigualdades en COVID-19 a través de sus factores determinantes intermedios y estructurales; y 3) diseñar modelos de comunicación y marcos de comprensión de la pandemia que den prioridad explicativa a la desigualdad social. Teniendo en cuenta la naturaleza sindémica de la COVID-19 y el conocimiento acumulado, los sistemas de vigilancia, las intervenciones y la comunicación deben incluir la perspectiva de la equidad.
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Affiliation(s)
- Amaia Bacigalupe
- Departamento de Sociología y Trabajo Social, Universidad del País Vasco, Leioa, Bizkaia, España; Grupo de Investigación en Determinantes Sociales de la Salud y Cambio Demográfico-OPIK, Leoia, Bizkaia, España.
| | - Unai Martín
- Departamento de Sociología y Trabajo Social, Universidad del País Vasco, Leioa, Bizkaia, España; Grupo de Investigación en Determinantes Sociales de la Salud y Cambio Demográfico-OPIK, Leoia, Bizkaia, España
| | - Manuel Franco
- Grupo de Epidemiología Social y Cardiovascular, Universidad de Alcalá, Madrid, España; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Institut d'Investigació Biomèdica Sant Pau, Barcelona, España
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21
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Arboleda A, Franco M, Amado L, Naranjo F, Giraldo BF. Coherence Analysis between the Surface Diaphragm EMG Envelope Signal and the Respiratory Signal derived from the ECG in Patients assisted by Mechanical Ventilation. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:1923-1926. [PMID: 36085957 DOI: 10.1109/embc48229.2022.9871572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Prolonged use of mechanical ventilation (MV) can lead to greater complications for a patient. In clinical practice, it is important to identify patients who could fail in the extubation process. However, accurately predicting the outcome of this process remains a challenge. The diaphragm muscle is one of the most active elements in the breathing process. On the other hand, there are several techniques to derive respiratory information from the ECG signal. Signals derived from diaphragmatic activity and from the ECG, such as the envelope of the surface diaphragm electromyographic signal (sEMGi) and the respiratory signal derived from the electrocardiogram (ECG) could contribute to analyze the respiratory response in patients assisted by MV. This work proposes the analysis of the coherence between sEMGi and EDR signals to determine possible differences in the respiratory pattern between successful and failed patients undergoing weaning. 40 patients with MV, candidates for weaning trial process and underwent a spontaneous breathing test were analyzed, classified into: a successful group (SG: 19 patients) that maintained spontaneous breathing after the test, and a failed group (FG: 21 patients) that required reconnection to the MV. The cross correlation, power spectral density and magnitude squared coherence (MSC) of the sEMGi and the EDR signals were estimated. According to the results, the MSC parameters such as area under the curve and mean coherence value presented statistically significance differences between the two groups of patients (p = 0.024). Our results suggest that both sEMGi and EDR signals could provide information about the behavior of the respiratory system in these patients. Clinical Relevance- This study analyzes the correlation and the coherence between the envelope of the surface electromyographic signal and the respiratory signal derived from the ECG to characterize the respiratory pattern of successful and failed patients on weaning process.
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22
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Gullón P, Cuesta-Lozano D, Cuevas-Castillo C, Fontán-Vela M, Franco M. Temporal trends in within-city inequities in COVID-19 incidence rate by area-level deprivation in Madrid, Spain. Health Place 2022; 76:102830. [PMID: 35636072 PMCID: PMC9127049 DOI: 10.1016/j.healthplace.2022.102830] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 01/26/2023]
Abstract
Patterns of exposure and policies aiming at reducing physical contact might have changed the social distribution of COVID-19 incidence over the course of the pandemic. Thus, we studied the temporal trends in the association between area-level deprivation and COVID-19 incidence rate by Basic Health Zone (minimum administration division for health service provision) in Madrid, Spain, from March 2020 to September 2021. We found an overall association between deprivation and COVID-19 incidence. This association varied over time; areas with higher deprivation showed higher COVID-19 incidence rates from July to November 2020 and August-September 2021, while, by contrast, higher deprivation areas showed lower COVID-19 incidence rates in December 2020 and July 2021.
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Affiliation(s)
- Pedro Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Centre for Urban Research, RMIT University, Melbourne, Australia.
| | - Daniel Cuesta-Lozano
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Enfermería y Fisioterapia, Alcalá de Henares, Madrid, Spain
| | - Carmen Cuevas-Castillo
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain
| | - Mario Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Instituto de Lengua, Literatura y Antropología, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Manuel Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, 21205-2217, USA
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23
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Bernabé-Díaz JA, Franco M, Vivo JM, Quesada-Martínez M, Fernández-Breis JT. An automated process for supporting decisions in clustering-based data analysis. Comput Methods Programs Biomed 2022; 219:106765. [PMID: 35367914 DOI: 10.1016/j.cmpb.2022.106765] [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] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Metrics are commonly used by biomedical researchers and practitioners to measure and evaluate properties of individuals, instruments, models, methods, or datasets. Due to the lack of a standardized validation procedure for a metric, it is assumed that if a metric is appropriate for analyzing a dataset in a certain domain, then it will be appropriate for other datasets in the same domain. However, such generalizability cannot be taken for granted, since the behavior of a metric can vary in different scenarios. The study of such behavior of a metric is the objective of this paper, since it would allow for assessing its reliability before drawing any conclusion about biomedical datasets. METHODS We present a method to support in evaluating the behavior of quantitative metrics on datasets. Our approach assesses a metric by using clustering-based data analysis, and enhancing the decision-making process in the optimal classification. Our method assesses the metrics by applying two important criteria of the unsupervised classification validation that are calculated on the clusterings generated by the metric, namely stability and goodness of the clusters. The application of our method is facilitated to biomedical researchers by our evaluomeR tool. RESULTS The analytical power of our methods is shown in the results of the application of our method to analyze (1) the behavior of the impact factor metric for a series of journal categories; (2) which structural metrics provide a better partitioning of the content of a repository of biomedical ontologies, and (3) the heterogeneity sources in effect size metrics of biomedical primary studies. CONCLUSIONS The use of statistical properties such as stability and goodness of classifications allows for a useful analysis of the behavior of quantitative metrics, which can be used for supporting decisions about which metrics to apply on a certain dataset.
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Affiliation(s)
| | - Manuel Franco
- Dept. Statistics and Operations Research, University of Murcia, IMIB-Arrixaca, Spain
| | - Juana-María Vivo
- Dept. Statistics and Operations Research, University of Murcia, IMIB-Arrixaca, Spain
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24
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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Visioli F, Franco M, Martínez-González MÁ. Front of package labels and olive oil: a call for caution. Eur J Clin Nutr 2022; 76:502-504. [PMID: 34302127 DOI: 10.1038/s41430-021-00989-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Francesco Visioli
- Department of Molecular Medicine, University of Padova, Padova, Italy. .,IMDEA-Food, CEI UAM+CSIC, Madrid, Spain.
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, Madrid, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine & Public Health, Medical School-IDISNA, University of Navarra, Pamplona, Spain.,CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Pastor A, Espelt A, Villalbí JR, Moure L, Fuentes S, Shortt N, Valiente R, Borrell LN, Franco M, Sureda Llull X. Availability and promotion of alcohol across different outlet typologies and under different area-level socioeconomic status. Adicciones 2022; 34:23-36. [PMID: 32677698 DOI: 10.20882/adicciones.1367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We aimed to characterize the availability and promotion of alcohol at alcohol outlets in Madrid and to compare them according to type of outlet and area-level socioeconomic status. We used the OHCITIES instrument to characterise the alcohol outlets in 42 census tracts of Madrid in 2016. We specified alcohol availability as the density of alcohol outlets and the number of alcohol outlets with extended opening hours (12 or more). We registered any type of promotion associated to alcohol outlets that could be perceived from outside the outlet. We calculated and compared proportions of availability and promotion by alcohol outlet (on- and off-premise) using chi-squared and Fisher Exact tests. We estimated the availability and promotion of alcohol densities per census tract according to area-level socioeconomic status. To assess statistical significance, we used Kruskal-Wallis tests. We recorded 324 alcohol outlets, 241 on-premise and 83 off-premise. Most of the outlets had extended opening hours (73.77%) and at least one sign promoting alcohol (89.51%). More on-premise outlets had extended opening hours and higher presence of alcohol promotion than off-premise (p < 0.001). Higher density of alcohol outlets, extended opening hours and presence of alcohol promotion were found in higher socioeconomic areas (all p < 0.001). These results were also observed for on-premise alcohol outlets. Alcohol availability and promotion were associated with alcohol outlets in Madrid. Future alcohol policies regulating the availability and promotion of alcohol should consider outlet types and area-level socioeconomic status.
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Abiétar DG, Beltrán Aguirre JL, García AM, García-Armesto S, Gutiérrez-Ibarluzea I, Segura-Benedicto A, Franco M, Hernández-Aguado I. [Future National Public Health Agency: an opportunity for the public health system in Spain]. Gac Sanit 2022; 36:265-269. [PMID: 35120795 DOI: 10.1016/j.gaceta.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/26/2022]
Abstract
The creation of a national centre for public health, with adequate resources, will make it possible to face the public health challenges of the present and the future in our country. To this end, the proposed state agency, should hold functions based on advanced public health organizational schemes, while linking with the sustainable development goals. The coordination of a national public health strategy built on a collaborative network of networks would also be essential, as developing an innovative, benchmarked and prioritised public health communication strategy, among other tasks. The lack of resources, the current relative disconnection of essential public health functions at the state level, and the inequity in their development of these functions at the regional and municipal levels, favour the development of the agency project as a network of networks. In this paper we give ideas for a process that seems decisive for Spanish public health in the 21st century.
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Affiliation(s)
- Daniel G Abiétar
- Servicio de Epidemiología y Evaluación, Hospital del Mar, Barcelona, España; Departamento de Salud Comunitaria, Epidemiología y Vigilancia de la Salud, Facultad de Ciencias de la Salud y de la Vida, Universidad Pompeu Fabra, Barcelona, España.
| | - Juan Luis Beltrán Aguirre
- Falcutad de Derecho, Departamento de Derecho Administrativo, Universidad Pública de Navarra, Pamplona, Navarra, España
| | - Ana M García
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España
| | | | - Iñaki Gutiérrez-Ibarluzea
- Gestión del Conocimiento y Evaluación de Tecnologías Sanitarias en BIOEF, Fundación Vasca de Innovación e Investigación Sanitarias, Barakaldo, Bizkaia, España
| | | | - Manuel Franco
- John Hopkins Bloomberg School of Public Health, Baltimore, MD, Estados Unidos
| | - Ildefonso Hernández-Aguado
- Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández, Elche, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Martín-Moreno JM, Arenas A, Bengoa R, Borrell C, Franco M, García-Basteiro AL, Gestal J, González López-Valcárcel B, Hernández Aguado I, Legido-Quigley H, March JC, Minué S, Muntaner C, Vives-Cases C. [Insight on how to assess and improve the response to the COVID-19 pandemic]. Gac Sanit 2022; 36:32-36. [PMID: 33518411 PMCID: PMC7834448 DOI: 10.1016/j.gaceta.2020.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.
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Affiliation(s)
- José M. Martín-Moreno
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina e INCLIVA, Universitat de València, Valencia, España,Autor para correspondencia
| | - Alex Arenas
- Departament d’Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Tarragona, España
| | | | - Carme Borrell
- Agència de Salut Pública de Barcelona, Barcelona, España,CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Manuel Franco
- Grupo de Investigación en Epidemiología y Salud Pública, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alberto L. García-Basteiro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, España,Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Juan Gestal
- Universidad de Santiago de Compostela, España
| | | | | | - Helena Legido-Quigley
- London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, University of Singapore
| | | | - Sergio Minué
- Escuela Andaluza de Salud Pública, Granada, España
| | - Carles Muntaner
- University of Toronto y Center for Urban Health Solucions, Li Ka Shing Knowledge Institute, Canadá
| | - Carmen Vives-Cases
- CIBER de Epidemiología y Salud Pública (CIBERESP), España,Universidad de Alicante, España
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Cereijo L, Gullón P, Del Cura I, Valadés D, Bilal U, Badland H, Franco M. Exercise facilities and the prevalence of obesity and type 2 diabetes in the city of Madrid. Diabetologia 2022; 65:150-158. [PMID: 34709424 PMCID: PMC8660723 DOI: 10.1007/s00125-021-05582-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS We aimed to study the association between the availability of exercise facilities and the likelihood of obesity and type 2 diabetes in the adult population of Madrid, Spain. METHODS We analysed the electronic medical records of all 1,270,512 residents of Madrid aged 40-75 years in 2017. Exercise facility availability was defined as the count of exercise facilities in a 1000 m street network buffer around each residential building entrance. Poisson regression with standard errors clustered at census tract level was used to assess prevalence ratios of exercise facility availability tertiles and obesity and type 2 diabetes. We also examined stratified results by tertiles of area-level socioeconomic status (SES) and sex. RESULTS People living in areas with lower availability of exercise facilities had a higher prevalence of obesity (prevalence ratio [PR] 1.22 [95% CI 1.20, 1.25]) and diabetes (PR 1.38 [95% CI 1.34, 1.43]). We observed effect modification by area-level SES (p<0.001), with stronger associations for residents living in low-SES areas and no association for residents living in high-SES areas. Associations with type 2 diabetes were stronger among women compared with men, while associations with obesity were similar by sex. CONCLUSIONS/INTERPRETATION People living in areas with low availability of exercise facilities had a higher prevalence of obesity and type 2 diabetes, and this association was strongest in low-SES areas and for women. Understanding the potential role of exercise facilities in driving inequities in obesity and type 2 diabetes prevalence may inform interventions to reduce health inequities.
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Affiliation(s)
- Luis Cereijo
- Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Universidad de Alcalá, Madrid, Spain
- Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Grupo de investigación en gestión y entrenamiento deportivo, Alcalá de Henares, Universidad de Alcalá, Madrid, Spain
- Centre for Urban Research, RMIT University, Melbourne, VIC, Australia
| | - Pedro Gullón
- Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Universidad de Alcalá, Madrid, Spain.
| | - Isabel Del Cura
- Gerencia de Atención Primaria, Unidad de Investigación de Atención Primaria, Madrid, Spain
- Departamento de Especialidades Médicas y Salud Pública, University Rey Juan Carlos, Madrid, Spain
- Red de Investigación en Servicios de Salud y Enfermedades Crónicas (REDISSEC) ISCIII, Madrid, Spain
| | - David Valadés
- Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Grupo de investigación en gestión y entrenamiento deportivo, Alcalá de Henares, Universidad de Alcalá, Madrid, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Hannah Badland
- Centre for Urban Research, RMIT University, Melbourne, VIC, Australia
| | - Manuel Franco
- Facultad de Medicina y Ciencias de la Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Universidad de Alcalá, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kairenius P, Qin N, Tapio I, Mäntysaari P, Franco M, Lidauer P, Stefański T, Lidauer M, Junnikkala S, Niku M, Kettunen H, Rinne M. The effects of dietary resin acid inclusion on productive, physiological and rumen microbiome responses of dairy cows during early lactation. Livest Sci 2022. [DOI: 10.1016/j.livsci.2021.104798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Baldelli R, Nicastri E, Petrosillo N, Marchioni L, Gubbiotti A, Sperduti I, Di Giacinto P, Rizza L, Rota F, Franco M, Lania A, Aimaretti G, Ippolito G, Zuppi P. Thyroid dysfunction in COVID-19 patients. J Endocrinol Invest 2021; 44:2735-2739. [PMID: 34101132 PMCID: PMC8185485 DOI: 10.1007/s40618-021-01599-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE "Non thyroidal illness syndrome" (NTIS) or "euthyroid sick syndrome" (ESS) is a possible biochemical finding in euthyroid patients with severe diseases. It is characterized by a reduction of serum T3 (fT3), sometimes followed by reduction of serum T4 (fT4). The relationship between thyroid hormones levels and mortality is well known and different studies showed a direct association between NTIS and mortality. The sudden spread of the 2019 novel coronavirus (SARS-CoV 2) infection (COVID-19) and its high mortality become a world healthcare problem. Our aim in this paper was to investigate if patients affected by COVID-19 presented NTIS and the relationship between thyroid function and severity of this infection. METHODS We evaluated the thyroid function in two different groups of consecutive patients affected by COVID-19 with respect to a control group of euthyroid patients. Group A included patients hospitalized for COVID-19 pneumonia while patients requiring intensive care unit (ICU) for acute respiratory syndrome formed the group B. Group C identified the control group of euthyroid patients. RESULTS Patients from group A and group B showed a statistically significant reduction in fT3 and TSH compared to group C. In group B, compared to group A, a further statistically significant reduction of fT3 and TSH was found. CONCLUSIONS COVID-19 in-patients can present NTIS. FT3 and TSH serum levels are lower in patients with more severe symptoms.
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Affiliation(s)
- R Baldelli
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy
| | - E Nicastri
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - N Petrosillo
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - L Marchioni
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - A Gubbiotti
- Biochemical Clinical Unit, A.O. San Camillo Forlanini, Rome, Italy
| | - I Sperduti
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - P Di Giacinto
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy
| | - L Rizza
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy
| | - F Rota
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy
| | - M Franco
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy.
| | - A Lania
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, MI, Italy
| | - G Aimaretti
- SCDU of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - G Ippolito
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Rome, Italy
| | - P Zuppi
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo Forlanini, Rome, Italy
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López-Bueno JA, Díaz J, Sáchez-Guevara C, Sánchez-Martínez G, Franco M, Gullón P, Núñez-Peiró M, Linares C. Heat waves effect on daily mortality in districts in Madrid: The effect of sociodemographic factors. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although there is significant scientific evidence on the impact of heat waves, there are few studies that analyze the effects of sociodemographic factors on the impact of heat waves below the municipal level.
Methods
The objective of this study was to analyze the role of income level, percent of the population over age 65, existence of air conditioning units and hectares (Ha) of green zones in districts in Madrid, in the impact of heat on daily mortality between January 1, 2010 and December 31, 2013. Seventeen districts were analyzed, and Generalized Linear (GLM) Poisson Regression Models were used to calculate relative risks (RR) and attributable risks (RA) for the impact of heat waves on mortality due to natural causes (CIEX:A00-R99). The pattern of risks obtained was analyzed using GLM univariates and multivariates of the binomial family (link logit), introducing the socioeconomic and demographic variables mentioned above.
Results
The results indicate that heat wave had an impact in only three of the districts analyzed. In the univariate models, all of the variables were statistically significant, but Ha of green zones lost significance in the multivariate model. Income level, existence of air conditioning units, and percent of the population over age 65 in the district remained as variables that modulate the impact of heat wave on daily mortality in the municipality of Madrid. Income level was the key variable that explained this behavior.
Conclusions
The results obtained in this study show that there are factors below the municipal level (district level) that should be considered as focus areas for health policy in order to decrease the impact of heat and promote the process of adaptation to heat in the context of climate change.
Key messages
There are factors below the municipal level which should be considered for health policy in order to decrease health heat impacts. Privation hamper isolation of ageing people from extreme outdoor temperatures. Therefore, in some cases poverty could become the key risk factor that explain the vulnerability to heat waves.
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Affiliation(s)
- JA López-Bueno
- National School of Health, Carlos III Institute of Health, Madrid, Spain
| | - J Díaz
- National School of Health, Carlos III Institute of Health, Madrid, Spain
| | - C Sáchez-Guevara
- School of Architecture, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - M Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, Madrid, Spain
| | - P Gullón
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, Madrid, Spain
| | - M Núñez-Peiró
- School of Architecture, Universidad Politécnica de Madrid, Madrid, Spain
| | - C Linares
- National School of Health, Carlos III Institute of Health, Madrid, Spain
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López-Bueno JA, Díaz J, Sánchez-Guevara C, Sánchez-Martínez G, Franco M, Gullón P, Núñez-Peiró M, Linares C. Cold spell effect on daily mortality in districts in Madrid considering sociodemographic variables. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
While there is much research that focuses on the association between cold spell and their impacts on daily mortality at the city level, we analyze the impact related to social context and demographic variables at levels lower than the municipal.
Methods
The objective of this study was to determine the role of the percentage of people over age 65, income level and percentage of homes without heating in the analysis of the impact of cold waves on daily mortality between January 1, 2010 and December 31, 2013 in different districts of the municipality of Madrid. We calculated Relative Risks (RR) and Attributable Risks (RA) for each of 17 districts to determine correlations between the effect of cold waves and daily mortality due to natural causes (CIEX: A00-R99) using Generalized Linear Models (GLM) of the Poisson family (link log). The pattern of risks obtained by district was analyzed using binomial family models (link logit), considering socioeconomic and demographic variables.
Results
In terms of results, an impact of cold on mortality was detected in 9 of the 17 districts analyzed. The analysis of risk patterns revealed that the probability of detecting an impact in a district increases in a statistically significant way (p-value <0.05) with a higher percentage of homes without heating systems and a higher percentage of population over age 65.
Conclusions
The results obtained identify the factors that should be considered in public health policies that target the district level to reduce the impact of cold waves.
Key messages
Ageing and the absence of heating systems are key variables which explain vulnerability to cold spell. Cold spell related mortality risks can be reduced by applying prevention health public plans.
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Affiliation(s)
- JA López-Bueno
- National School of Health, Carlos III Institute of Health, Madrid, Spain
| | - J Díaz
- National School of Health, Carlos III Institute of Health, Madrid, Spain
| | - C Sánchez-Guevara
- School of Architecture, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - M Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Madrid, Spain
| | - P Gullón
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Madrid, Spain
| | - M Núñez-Peiró
- School of Architecture, Universidad Politécnica de Madrid, Madrid, Spain
| | - C Linares
- National School of Health, Carlos III Institute of Health, Madrid, Spain
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Garcia Saldivia M, Ilarraza Lomeli H, Rojano Castillo J, Rius Suarez M, Franco M, Villegas D, Negrete D, Guerrero T, Sandoval C, Sanchez Cornejo A, Ruan J. Results of a hybrid cardiovascular rehabilitation program (in-hospital plus home) in patients with low income. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
One of the main problems facing cardiovascular rehabilitation (CR) is patient care and adherence. However, due to the low level of economic income of the patients who are cared for in our center, the possibility of going to CR in a conventional way is very difficult since they do not have the necessary resources to cover transportation, cost of the sessions, among others.
It has been shown that the greater the number of sessions attended by the patient, the greater the reduction in cardiovascular risk, however the role of a hybrid program with a decreased number of face-to-face sessions has not been established.
Purpose
Present the results of a hybrid training program (in-hospital plus home) in a low-income population. Education through supervised sessions plus home physical training in a patient with bases for exercise can improve their adherence with better results.
Methods
A cohort of patients with heart disease who were referred to the Cardiovascular Rehabilitation program between May 2017 and February 2019 was included. The socioeconomic level was classified into 6 strata according to occupation, income, housing, economic dependents, place of origin and family health status. After risk stratification, the patients participated in a hybrid program that consisted of 6 in-hospital sessions, once a week, in which the training to be carried out at home was prescribed by means of a triptych. An exercise test was performed before and after completing the program, as well as psychological and nutritional intervention. Statistical analysis was performed using SPSS 21.0 software. All p values less than 0.05 were considered significant.
Results
In the study period, of the total number of patients discharged for heart disease from the hospital, 61% were referred to cardiovascular rehabilitation, of which only 45% (n=39) completed the program, the reasons for dropping out were multiple and the lowest socioeconomic level (1) was the most frequent (figure 1). The main referral diagnosis was ischemic heart disease in 82%. The majority of patients were men, 95%. A significant improvement was observed in load METs, maximum heart rate, heart rate recovery (figure 2).
Conclusion
The implementation of a hybrid cardiovascular rehabilitation program (in-hospital + home) was associated with an improvement in the exercise test parameters of patients who successfully completed the program.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- M Garcia Saldivia
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - H Ilarraza Lomeli
- National Institute of Cardiology Ignacio Chavez, Cardiac Rehabilitation, Mexico City, Mexico
| | - J Rojano Castillo
- National Institute of Cardiology Ignacio Chavez, Cardiac Rehabilitation, Mexico City, Mexico
| | - M Rius Suarez
- National Institute of Cardiology Ignacio Chavez, Cardiac Rehabilitation, Mexico City, Mexico
| | - M Franco
- National Institute of Cardiology Ignacio Chavez, Cardiac Rehabilitation, Mexico City, Mexico
| | - D Villegas
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - D Negrete
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - T Guerrero
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - C Sandoval
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - A Sanchez Cornejo
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
| | - J Ruan
- Hospital Regional de Alta Especialidad de Ixtapaluca, Cardiac Rehabilitation, Ixtapaluca, Mexico
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Mendoza-Cortés D, Arteaga-Wences Y, Félix-Bernal A, Estrada-Angulo A, Castro-Pérez B, Ríos-Rincón F, Urías-Estrada J, Franco M, Vasconcellos GS, Acedo TS, de Carvalho VV, Perdigão A, Plascencia A. PSXIV-13 Supplemental essential oil blends plus 25-hydroxy-vitamin-D3 improve carcass characteristics in cattle finished under tropical conditions. J Anim Sci 2021. [DOI: 10.1093/jas/skab235.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
A total of 90 young crossbreed bulls (initial weight=228.04±7.06 kg) were used in a 171-day feeding trial in order to evaluate the combination of supplemental blend of essential oils (Crina® Ruminants; DSM Nutritional Products) plus 25-hydroxy-vitamin-D3 (HyD®, DSM Nutritional Products; EO+HyD) on growth performance and carcass characteristics in cattle finishing under tropical conditions. Cattle were blocked by weight into 2 blocks and randomly allocated to 2 treatments (9 pens/treatment, 5 bulls/pen). Cattle were fed with a steam-flaked corn-based diets (average diet NEm= 1.95 Mcal/kg during first 84-d, and 2.15 Mcal/kg during the remaining 87-d). Treatments consisted of: 1) EO+HyD supplementation along fattening period (171-d), or 2) supplementation with monensin (Rumensin®, Elanco Animal Health; 20 mg/kg diet) during the first 84-d and monensin (20 mg/kg diet) plus virginiamycin (Stafac®, Phibro Animal Health; 20 mg/kg diet) during remaining time (87-d). The average THI during course of the experiment was 76.67±2.7 with a maximum of 85.46±2.2 and minimum of 68.29±2.6. There were no statistical differences (P > 0.10) between EO+HyD and ionophores/antibiotic supplemented cattle on DM intake (7.575 vs 7.534 kg/d), average daily gain (1.433 vs 1.406 kg), or gain-to-feed ratio (0.189 vs 0.187). However, cattle fed with EO+HyD tended (P = 0.07) to have heavier carcass weight in 5.2 kg (304.9 vs 299.7 kg), showed greater LM area (89.89 vs. 82.77 cm², P < 0.01) and greater estimated retail yield (1.6%, P = 0.02) than cattle receiving ionophores/antibiotic mixture. Cattle receiving EO+HyD showed more percentage of carcass classified as Choice (14.28 vs 13.33%) and “Select” (59.52 vs 44.44%) and lower percentage of carcass classified as “Standard” (26.20 vs 42.23%). The combination of a blend of essential oils plus 25-hydroxy-Vit-D3 (EO+HyD) in finishing phase improve carcass characteristics. Supplemental EO+HyD is a viable alternative to supplemental monensin, or monensin plus virginiamycin used in growing-finishing diets for feedlot cattle.
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Mendoza-Cortés D, Ramos-Méndez JL, Félix-Bernal A, Estrada-Angulo A, Franco M, Vasconcellos GS, Acedo TS, de Carvalho VV, Perdigão A, Barreras A, Plascencia A, Urías-Estrada J. PSVII-24 Blend of essential oils plus 25-hydroxy-vitamin-D3 as alternative to the use monensin on growth performance and dietary energetics in feedlot cattle raised under high ambient temperature. J Anim Sci 2021. [DOI: 10.1093/jas/skab235.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Ninety young crossbreed bulls (approximately 25% Zebu breeding with the remainder represented by continental and British breeds in various proportions, initial weight=228.04±7.06 kg) were used in a 84-day feeding trial to assess the effects of treatments in feedlot cattle fed transition diets during high ambient temperatures. Treatments consisted of a steam-flaked corn-based diets (average 1.95 Mcal ENm/kg) supplemented with: 1) 20 mg monensin/kg diet (MON, Rumensin, Elanco Animal Health, Indianapolis, IN], and 2) 100 mg of blend of essential oils /kg diet plus 0.1 mg 25-hydroxy-vitamin-D3/kg diet (EO+HyD; CRINA® Ruminants and HyD®, DSM Nutritional Products, Basel, Switzerland). Both dry matter intake (DMI) and climatic variables were measured daily and the temperature humidity index (THI) was estimated. Daily maximal THI remained over 80 during the whole trial (avg. THI = 82.67). Cattle supplemented with EO+HyD increased average daily gain in 8.7% (1.446 vs. 1.320 kg/day, P < 0.01), gain-to-fed ratio in 4.5% (0.199 vs. 0.190; P = 0.03), final weight in 10.05 kg (349.48 vs. 339.43; P = 0.04) and tended (P = 0.07) to shown greater dietary net energy (2.5%) and observed-to-expected dietary NE ratio (3%). Even when EO+HyD tended to increase (4.3%; P = 0.06) DM intake, intake pattern variation were not different (P = 0.38) between MON and EO+HyD (Figure 1). Then, difference in ADG and final BW between MON and EO+HyD was not only a reflection of difference in energy intake, was also caused by difference in efficiency of energy utilization during conditions of high ambient temperature (a reduction of 7% in the estimated increase of coefficient of maintenance by heat load). Results indicate that supplementation with a combination of essential oil blend plus 25-hydroxy-vitamin-D3 can have greater beneficial effects than supplemental monensin on daily weight gain, final weight and feed intake during initiation-transition phase of cattle raised under high ambient temperature.
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Arteaga-Wences Y, Estrada-Angulo A, Franco M, Vasconcellos GS, Acedo TS, de Carvalho VV, Perdigão A, Castro-Pérez B, Ríos-Rincón F, Urías-Estrada J, Barreras A, Plascencia A. PSXI-26 Blend of essential oils supplemented alone or combined with exogenous amylase compared with virginiamycin on performance of finishing lambs. J Anim Sci 2021. [DOI: 10.1093/jas/skab235.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Forty-eight Pelibuey × Katahdin (27.87±4.71 kg) intact lambs were used in a growth-performance trial lasted 87 days to assess the effects of treatments. Lambs were assigned to one of six weight groupings in 24 pens (6 replicas per treatment). Basal diet was comprised by cracked corn (14% CP and 2.08 Mcal ENm/kg) and was supplemented as follows: 1) No additives (Control); 2) supplemented with a blend of essential oils at dose of 150 mg EO/kg diet DM (EO, CRINA® Ruminants, DSM Nutritional Products); 3) supplemented with 150 mg EO plus 560 mg alpha-amylase/kg diet DM (EO+ENZ, RONOZYME® Rumistar, DSM Nutritional Products), and 4) supplemented with antibiotic virginiamycin (VM, Stafac 500, Phibro Animal Health) at dose of 28 mg virginiamycin/kg diet DM. Growth performance and dietary energetics were very similar (P > 0.97) between EO and VM. In such way that, compared to Control, lambs supplemented with EO and VM tended (P = 0.09) to shown greater final weight (3.1%) and average daily gain (ADG; 5.9%) without difference on DMI (P = 0.99); thus, gain-to-feed ratio (GF) and observed dietary net energy (NE) were average improved in 5.7% (P < 0.01). Compared to Controls, combining EO plus ENZ tended to increased DMI (6.8%, P = 0.09), but increased in 10.4% ADG (P < 0.01) and in 4.4% (P = 0.02) feed efficiency. Lambs supplemented with EO shown lower (P ≤ 0.10) kidney-pelvic-heart fat than Controls and VM lambs. Compared to Controls, additive supplementation decreased (P ≤ 0.03) the relative weight of intestines, the effect being more pronounced with EO supplementation. Compared to VM, supplemental EO (alone or combined with enzyme) shown lower (10.1%, P ≤ 0.04) visceral fat. Supplemental essential oils is a viable alternative to virginiamycin in finishing high-energy diets for lambs. Combining essential oils plus amylase can be a strategy to promote better daily gain weights allowing target final weight at shorter time.
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Fontán-Vela M, Valiente R, Franco M, Gullón P. An integrated approach to create a spatial database of parks for urban health research. Gac Sanit 2021; 36:67-69. [PMID: 34627658 DOI: 10.1016/j.gaceta.2021.07.005] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/05/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022]
Abstract
The role of urban parks has gained interest in urban health research. However, there are currently no clear definitions of these urban assets as exposure variable across the literature, which do have implications for the analysis. In this study, we exhibit an approach to design a comprehensive spatial database of urban parks in cities, using the example of Madrid. This approach consisted of the combination of different spatial databases containing information about parks and green spaces in the city of Madrid, and then a spatial processing to keep only those that met the selected criteria for urban park definition: accessible for pedestrians (to have at least one path around or through the area) and with the minimum size suitable (bigger than 0.50ha) for physical activity. This approach can be helpful to design spatial databases that enable conducting epidemiological studies on the relationship between urban parks and population health.
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Affiliation(s)
- Mario Fontán-Vela
- Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Servicio de Medicina Preventiva, Hospital Universitario Infanta Leonor, Madrid, España.
| | - Roberto Valiente
- Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Departamento de Geología, Geografía y Medio Ambiente, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Manuel Franco
- Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pedro Gullón
- Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España; School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia
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40
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Solis M, Cappelletti N, Bonetto C, Franco M, Fanelli S, Amalvy J, Mugni H. Attenuation of insecticide impact by a small wetland in a stream draining a horticultural basin in Argentina. Sci Total Environ 2021; 785:147317. [PMID: 33933765 DOI: 10.1016/j.scitotenv.2021.147317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
Horticulture has greatly increased in Argentina in recent decades mainly due to increasing greenhouse utilization and agrochemical consumption, thus representing a threat to adjacent water bodies. Riparian wetlands, however, could attenuate agrochemical contamination. The present work therefore compared insecticide concentrations in bottom sediments in addition to sediment toxicity to the amphipod Hyalella curvispina and investigated the macroinvertebrate composition upstream and downstream from a natural wetland in a small stream draining a basin undergoing intense horticultural production. The wetland surface was covered by macrophytes, mainly Thypha sp., and the insecticide concentrations measured downstream from the wetland were significantly lower, at roughly 19% of the upstream values. The growth rates of H. curvispina were significantly higher when exposed to the sediments downstream from the wetland, while the macroinvertebrate-assemblage composition was significantly different upstream and downstream: the snail Pomacea canaliculata was the dominant species upstream while the amphipod H. curvispina was dominant downstream. Pomacea canaliculata is often the dominant species in the regional streams draining agriculture and horticultural basins. Hyalella curvispina is sensitive to pesticide toxicity and is often dominant in streams draining extensive livestock basins and within a biosphere reserve. We conclude that riparian wetlands effectively attenuate horticulture contamination in pampean streams and should therefore be preserved and restored.
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Affiliation(s)
- M Solis
- Instituto de Limnología "Dr. Raúl Ringuelet" (CONICET-UNLP), Bv 120 n° 1437, CP 1900 La Plata, Argentina.
| | - N Cappelletti
- Grupo de investigación en Geología Ambiental (GIGA), Universidad Nacional de Avellaneda (UNDAV), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Avellaneda, Argentina
| | - C Bonetto
- Instituto de Limnología "Dr. Raúl Ringuelet" (CONICET-UNLP), Bv 120 n° 1437, CP 1900 La Plata, Argentina
| | - M Franco
- Universidad Nacional de Avellaneda, Mario Bravo 1460, CP 1870, Avellaneda, Argentina
| | - S Fanelli
- Instituto de Limnología "Dr. Raúl Ringuelet" (CONICET-UNLP), Bv 120 n° 1437, CP 1900 La Plata, Argentina
| | - J Amalvy
- Centro de Investigación y Desarrollo en Ciencia y Tecnología de Materiales, CITEMA (UTN/CICPBA). Av. 60 y 124, CP 1923 Berisso, Buenos Aires, Argentina
| | - H Mugni
- Instituto de Limnología "Dr. Raúl Ringuelet" (CONICET-UNLP), Bv 120 n° 1437, CP 1900 La Plata, Argentina
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Fontán-Vela M, Rivera-Navarro J, Gullón P, Díez J, Anguelovski I, Franco M. Active use and perceptions of parks as urban assets for physical activity: A mixed-methods study. Health Place 2021; 71:102660. [PMID: 34454253 DOI: 10.1016/j.healthplace.2021.102660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/23/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
Parks are potential key urban assets for improved population health; however, their use is not equal among all social groups. Individual and contextual factors could influence residents' perceptions of parks and how they interact with and, eventually, benefit from them. The use of complementary methodologies provides a deeper understanding of the relationship between park use, physical activity (PA), and residents' perceptions. Thus, we designed a mixed-methods study to analyze differences in park use and PA, and the perceptions of parks as urban assets for PA. We selected six parks from three neighborhoods in Madrid (Spain) with different neighborhood socioeconomic status (NSES) for systematic social observation. We registered park users by age, PA level (low, medium, and high), gender, and NSES using the System for Observing Play and Recreation in Communities (SOPARC) audit tool adapted for iOS software (iSOPARC). We also conducted 37 semi-structured interviews and 29 focus groups to analyze residents' perceptions of parks as urban assets for PA in the same neighborhoods. We adopted a convergent-parallel design to analyze both quantitative and qualitative data, and to describe the convergence and divergence areas between them. Parks within the high-NSES were more visited, showing a higher proportion of people performing high PA (11.9%) as compared to residents of the middle (9.3%) and low-NSES (3.2%). Female visitors showed lower PA levels compared to men, especially for parks within high-NSES. The following issues were reported as influence urban park use and perceptions: park maintenance and area perception, works constraints, insecurity and crime, differential perceptions by age, and the availability of organized activities in the parks. Residents from high-NSES reported fewer barriers to park use compared to residents from the other areas, who reported limitations such as less leisure time due to job constrains or perceived insecurity in parks. Senior participants reported that having parks with organized activities and a design oriented towards different age-groups are valuable. Our study shows consistency between the fewer and less intense use of parks registered in the middle and low-NSES neighborhoods, and the more barriers for PA reported in this areas during the qualitative analysis. Mixed-methods provided an insight of the potential causes leading to the differences in park use and PA within cities, which is essential in terms of environmental justice and health equity. Thus, a mixed-methods comprehensive approach to public health problems can help designing public policies addressing relevant factors related to urban health inequities.
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Affiliation(s)
- Mario Fontán-Vela
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Preventive Medicine Department, Infanta Leonor University Hospital, 28031, Madrid, Spain
| | - Jesús Rivera-Navarro
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Sociology and Communication, University of Salamanca, 37007, Salamanca, Spain
| | - Pedro Gullón
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; School of Global, Urban and Social Studies, RMIT University, Melbourne, Australia.
| | - Julia Díez
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain
| | - Isabelle Anguelovski
- Catalan Institution for Research and Advanced Studies (ICREA), Universitat Autònoma de Barcelona (UAB), Institute for Environmental Sciences and Technology (ICTA), Barcelona Laboratory for Urban Environmental Justice and Sustainability, Medical Research Institute Hospital Del Mar (IMIM), 08003, Barcelona, Spain
| | - Manuel Franco
- Universidad de Alcalá, Facultad de Medicina y Ciencias de La Salud, Departamento de Cirugía, Ciencias Médicas y Sociales, Grupo de Investigación en Epidemiología y Salud Pública, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Rivera-Navarro J, Bonilla L, Gullón P, González-Salgado I, Franco M. Can we improve our neighbourhoods to be more physically active? Residents' perceptions from a qualitative urban health inequalities study. Health Place 2021; 77:102658. [PMID: 34462206 DOI: 10.1016/j.healthplace.2021.102658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Abstract
The objective of our study was to identify neighbourhood factors which prevent and encourage physical activity, according to the residents' perspective. We used qualitative methods, conducting 37 semi-structured interviews and 29 focus groups. The main results were that the type of physical activity that took place in every neighbourhood was different; access to sports facilities varied due to prices and safety issues; garbage and obstacles on sidewalks were a serious limitation to physical activity; economic instability had an impact on physical activity. These results might lead the perception and insights of residents to be considered in public health interventions.
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Affiliation(s)
- Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain.
| | - Lidia Bonilla
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Pedro Gullón
- Surgery and Medical and Social Sciences Department, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ignacio González-Salgado
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Manuel Franco
- Surgery and Medical and Social Sciences Department, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Rivera-Navarro J, Brey E, Franco M. Immigration and use of public spaces and food stores in a large city: A qualitative study on urban health inequalities. J Migr Health 2021; 1-2:100019. [PMID: 34405171 PMCID: PMC8352102 DOI: 10.1016/j.jmh.2020.100019] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 11/25/2022] Open
Abstract
In the low- and middle-SES neighbourhoods there were a difficult coexistence with immigrants. Some of the interviewees and participants in FGs identified the immigrants who lived in their neighbourhoods as a threat, specially in the use of the public space. The food stores managed by immigrants were rejected and denounced by scarce quality of their foods. Demand for small traditional food stores in all neighbourhoods. The lack of social contact can be harmful for the health of immigrants and native residents.
The analysis of urban health transformations must include the study of how neighbourhoods are influenced by demographic changes such as immigration. The objective of this study was to analyse how the relationship between native and immigrant residents in neighbourhoods with different socio-economic levels influenced the use of urban health assets, such as public spaces and food stores. Three Madrid neighbourhoods of different socio-economic levels were selected and studied by conducting 37 semi-structured interviews and 29 focus groups. Data analysis was based on qualitative sequential discourse. The main finding was that the presence of immigrants in Madrid neighbourhoods, especially with low and medium socio-economic levels, was perceived negatively, affecting the use of public spaces and food stores. This negative perception unfolded in three dimensions: (1) difficulties for natives and immigrants to live together; (2) limitations on using public spaces caused by a feeling of insecurity; (3) criticism of immigrant food stores, especially Chinese-run food stores. Our findings showed a worrisome lack of social contact between immigrants and native residents, which affected the use of urban health assets, such as public spaces and food stores.
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Affiliation(s)
- Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Elisa Brey
- Applied Sociology Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.,Surgery and Medical and Social Sciences Department, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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la Fuente IMD, Pastor A, Conde P, Vázquez MS, Ramos C, Bosque-Prous M, Franco M, Sureda X. Changes in perceptions of the alcohol environment among participants in a Photovoice project conducted in two districts with different socio-economic status. PLoS One 2021; 16:e0254978. [PMID: 34358236 PMCID: PMC8345849 DOI: 10.1371/journal.pone.0254978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
Perceptions of the alcohol environment may influence alcohol consumption patterns. The purpose of this study was to describe changes in perceptions of the urban alcohol environment as experienced by residents of two districts with different socio-economic status after taking part in a Photovoice study. The study was conducted in Madrid, Spain, in a district with a high socio-economic status (HSES) and another district with a low socio-economic status (LSES). A Photovoice project was conducted with 26 participants divided into four groups based on sex and district. Groups met over five sessions in which they discussed photographs taken by the participants themselves on the subject of alcohol in their neighbourhood. A qualitative, descriptive and thematic analysis of participants' discourses was performed to explore changes in their perceptions of the alcohol environment over the project sessions. Changes in perceptions of the alcohol environment were observed in all groups over the project. The process of change varied by districts' socio-economic characteristics and gender. Greater changes in perceptions of the alcohol environment were observed in HSES, especially among women, as the participants had a much more positive initial view of their alcohol environment. In LSES, participants showed a more critical perception of the alcohol environment from the beginning of the study, and this broadened and intensified over the course of the sessions. Changes in perceptions also varied by thematic categories, including some categories that were discussed from the start (e.g. socialising and alcohol consumption) and categories that only emerged in later sessions (e.g. alcohol advertising). Involvement in a Photovoice project has favoured a shift in the participant's perceptions of their alcohol environment towards more critical positions, widening their scope of perceived elements and raising their awareness of specific problems, such as alcohol advertising and social role of alcohol consumption in relation to alcohol exposure.
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Affiliation(s)
- Irene Molina-de la Fuente
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Malaria and Neglected diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, Spain
- Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Paloma Conde
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Sandín Vázquez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Carmen Ramos
- Public Health Institute of Madrid, Madrid City Council, Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. Baltimore, Maryland, United States of America
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, United States of America
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, l’Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
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Valiente R, Escobar F, Urtasun M, Franco M, Shortt NK, Sureda X. Tobacco Retail Environment and Smoking: A Systematic Review of Geographic Exposure Measures and Implications for Future Studies. Nicotine Tob Res 2021; 23:1263-1273. [PMID: 33155040 DOI: 10.1093/ntr/ntaa223] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/29/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes. METHODS We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes. RESULTS Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%). CONCLUSION Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment. IMPLICATIONS Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance.
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Affiliation(s)
- Roberto Valiente
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Francisco Escobar
- Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Urtasun
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Cooperativa APLICA, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health, School of Geosciences, University of Edinburgh, Edinburgh, UK
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
- Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
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Trias-Llimós S, Bilal U, Franco M, Blanes A, Riffe T. [Decrease in life expectancy in 2020 and SARS-CoV-2 seroprevalence]. Gac Sanit 2021; 36:396-397. [PMID: 34412926 PMCID: PMC8316063 DOI: 10.1016/j.gaceta.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/05/2022]
Affiliation(s)
- Sergi Trias-Llimós
- Centre d'Estudis Demografics, Centres de Recerca de Catalunya, Bellaterra, Barcelona, España.
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Manuel Franco
- Grupo de Investigación en Salud Pública y Epidemiología, Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amand Blanes
- Centre d'Estudis Demografics, Centres de Recerca de Catalunya, Bellaterra, Barcelona, España
| | - Tim Riffe
- Ikerbasque, Fundación Vasca para la Ciencia, Bilbao, España; OPIK, Departamento de Sociología, Universidad del País Vasco EHU/UPV, Leioa, Bizkaia, España
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Gullón P, Díez J, Cainzos-Achirica M, Franco M, Bilal U. Social inequities in cardiovascular risk factors in women and men by autonomous regions in Spain. Gac Sanit 2021; 35:326-332. [PMID: 32674863 PMCID: PMC7985704 DOI: 10.1016/j.gaceta.2020.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To describe social inequities in cardiovascular risk factors in women and men by autonomous regions in Spain. METHOD We used data from 20,406 individuals aged 18 or older from the 2017 Spanish National Health Survey. We measured socioeconomic position using occupational social class and used data on self-reported cardiovascular risk factors: high cholesterol, diabetes, hypertension, obesity, and smoking. We estimated the relative risk of inequality using Poisson regression models. Analyses were stratified by men and women and by region (autonomous communities). RESULTS Overall, the relative risk of inequality was 1.02, 1.13, 1.06, 1.17 and 1.09 for high cholesterol, diabetes, hypertension, obesity, and current smoking, respectively. Ocuupational social class inequities in diabetes, hypertension, and obesity was stronger for women. Results showed a large regional heterogeneity in these inequities; some regions (e.g. Asturias and Balearic Islands) presented wider social inequities in cardiovascular risk factors than others (e.g. Galicia, Navarra or Murcia). CONCLUSION In Spain, we found marked social inequities in the prevalence of cardiovascular risk factors, with wide regional and women/men heterogeneity in these inequities. Education, social, economic and health policies at the regional level could reduce health inequities in cardiovascular risk factors and, thus, prevent cardiovascular disease.
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Affiliation(s)
- Pedro Gullón
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Usama Bilal
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health Drexel University, Philadelphia, PA, USA
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Molina-de la Fuente I, Pastor A, Conde P, Sandín Vázquez M, Ramos C, Bosque-Prous M, Franco M, Sureda X. Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city. Health Place 2021; 69:102566. [PMID: 33873132 DOI: 10.1016/j.healthplace.2021.102566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status. A total of 26 people participated, who took and discussed photographs about their alcohol environment. They grouped them into 33 final categories, such as the socialising role of alcohol or the alcohol advertising. Co-authors further grouped participants final categories into seven general areas. The participants in the Photovoice project have helped to deepen the understanding of the alcohol urban environment. These results may help to design more effective policies to prevent hazardous alcohol consumption.
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Affiliation(s)
- Irene Molina-de la Fuente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, 28029, Spain
| | - Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - Paloma Conde
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - María Sandín Vázquez
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Carmen Ramos
- Public Health Institute of Madrid, Madrid City Council, 28007, Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. 615 North Wolfe Street, Baltimore, 21205, Maryland, USA
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA; Tobacco Control Research Group, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.
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Zhang Y, Ke W, Vyas D, Adesogan A, Franco M, Li F, Bai J, Guo X. Antioxidant status, chemical composition and fermentation profile of alfalfa silage ensiled at two dry matter contents with a novel Lactobacillus plantarum strain with high-antioxidant activity. Anim Feed Sci Technol 2021. [DOI: 10.1016/j.anifeedsci.2020.114751] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Vernooij-Dassen M, Moniz-Cook E, Verhey F, Chattat R, Woods B, Meiland F, Franco M, Holmerova I, Orrell M, de Vugt M. Bridging the divide between biomedical and psychosocial approaches in dementia research: the 2019 INTERDEM manifesto. Aging Ment Health 2021; 25:206-212. [PMID: 31771338 DOI: 10.1080/13607863.2019.1693968] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To provide a new perspective on integrated biomedical and psychosocial dementia research. BACKGROUND Dementia is being recognized as a multifactorial syndrome, but there is little interaction between biomedical and psychosocial approaches. A way to improve scientific knowledge is to seek better understanding of the mechanisms underlying the interaction between biomedical and psychosocial paradigms. One rationale for integrating biomedical and psychosocial research is the discordance between neuropathology and cognitive functioning. The concept of social health might bridge the two paradigms. It relates to how social resources influence the dynamic balance between capacities and limitations. HYPOTHESES Social health can act as the driver for accessing cognitive reserve, in people with dementia through active facilitation and utilization of social and environmental resources. Thereby we link lifestyle social and opportunities to the brain reserve hypothesis. MANIFESTO We provide a Manifesto on how to significantly move forward the dementia research agenda.
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Affiliation(s)
- Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esme Moniz-Cook
- Faculty of Health Sciences, School of Health & Social Work, University of Hull, Hull, UK
| | - Frans Verhey
- Alzheimer Centrum Limburg, School of Mental Health & Neurosciences/Psychiatry and Psychology/MUMC, Maastricht, The Netherlands
| | - Rabih Chattat
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Bob Woods
- Dementia Services Development Centre, DSDC Wales, Bangor University, Ardudwy, Bangor, UK
| | - Franka Meiland
- Department of Psychiatry, Amsterdam University Medical Centers, Location VUmc, APH Research Institute, Amsterdam, the Netherlands
| | - Manuel Franco
- Department Psychiatry, University Rio Hortega Hospital (Valladolid) and Zamora Hospital (Zamora), Spain.,Psychiatric and Mental Health Department, University Rio Hortega Hospital and Zamora Hospital, Zamora, Spain
| | - Iva Holmerova
- Charles University FHS CELLO and Gerontologicke Centrum, Kobylisy, Czechia
| | - Martin Orrell
- The Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
| | - Marjolein de Vugt
- Alzheimer Center Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
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