Carmen Amezcua Prieto

Factors associated with a low adherence to a Mediterranean diet pattern in healthy Spanish women before pregnancy

OBJECTIVE To analyse the factors associated with the level of adherence to a Mediterranean dietary pattern in healthy Spanish women before pregnancy. DESIGN A prospective series of 1175 women. An FFQ validated in Spanish populations served to collect dietary data. The Mediterranean Diet Adherence Index was used to assess the level of adherence to a Mediterranean diet pattern. Polytomic regression was performed to identify the associated factors. SETTING Catchment area of Virgen de las Nieves University Hospital, Andalusia, Spain. SUBJECTS The women were invited to participate in the study at the 20th-22nd gestational week. The selection criteria were: Spanish nationality, 18 years of age or older, singleton pregnancy and absence of health problems that required modifying the diet or physical activity. RESULTS An inverse relationship was found between womens age and level of adherence to a Mediterranean diet pattern, with a clear dose-response association: a younger age entailed worse adherence (P < 0·001). The habit of smoking and sedentary lifestyle had a positive relationship with low adherence, giving OR = 5·36 (95 % 1·91, 15·07) for women who smoked >20 cigarettes/d and OR = 2·07 (95 % CI 1·34, 3·17) for sedentary women. Higher age, higher educational level, and higher social class of the women were associated with a higher level of adherence to the Mediterranean diet (P < 0·001). CONCLUSIONS In our sample population, younger age, lower social class, primary educational level and elements of an unhealthy lifestyle such as smoking and lack of exercise were associated with low adherence to a Mediterranean diet.

DISEÑO Y VALIDACIÓN DE UN CUESTIONARIO SOBRE PATRONES DE CONDUCCIÓN DE RIESGO EN JÓVENES

Fundamentos: Las Lesiones por Trafico continuan siendo un importante problema de Salud Publica en poblacion joven. A pesar de ello, no existen en nuestro pais cuestionarios idoneos para la investigacion epidemiologica de este problema. El objetivo del presente trabajo fue disenar y validar un cuestionario orientado a explorar la frecuencia de implicacion en circunstancias de conduccion teoricamente asociadas con la accidentalidad por trafico en poblacion universitaria. Metodos: Se aplico un cuestionario autoadministrado (MATCA: movilidad, accidentalidad por trafico y circunstancias asociadas) a 1597 jovenes alumnos de grado de la Universidad de Granada, entre los anos 2007 y 2010, que recogia informacion, entre otras variables, sobre la exposicion, la accidentalidad y la implicacion en 28 circunstancias de conduccion. Para su diseno se realizo una extensa revision de la literatura al respecto y se conto con el juicio de un panel de cinco expertos. Aplicando el coeficiente de correlacion tetracorico, se realizo un analisis factorial. La consistencia interna se valoro mediante el coeficiente alfa de Crombach. Finalmente, se valoro la asociacion cruda y ajustada de cada factor identificado con la odds de haber sufrido un accidente. Resultados: Tras descartar 8 circunstancias, las restantes se agruparon en tres factores: el primero incluyo diez circunstancias de elevada prevalencia y explico el 31,9% de la variabilidad total. Los otros dos factores, incluyeron cinco circunstancias cada uno que explicaron respectivamente, el 15,2% y el 12,5% de la variabilidad. Los coeficientes alfa de Crombach oscilaron entre 0,816 y 0,553. Cuando se ajusto por la edad, el sexo, los anos de antiguedad del permiso y la intensidad de exposicion, la puntuacion mas fuertemente asociada a la accidentalidad fue la del primer factor (OR=1,51: IC95% 1,25-1,85). Conclusiones: La version final (20 circunstancias), identifico tres factores asociados a una mayor accidentalidad entre jovenes conductores. El primero integro, entre otras, la velocidad excesiva y conducir con sueno o cansancio, y fue el mas estrechamente asociado a la accidentalidad en el analisis ajustado. El segundo agrupo las circunstancias relacionadas con la comision de infracciones y el tercero incluyo la conduccion bajo los efectos del alcohol, el no uso siempre del cinturon y las distracciones.Background: Traffic Injuries are a major public healh problem, especially among young people. However, we have not found any useful questionnaire designed in our country for the epidemiological research in this field. The objective of this study was to design and validate an easy and quickly-to-fill questionnaire aimed to collect information on how frequently university car drivers report to be involved in driving circumstances theoretically related to traffic crashes. Methods: Between 2007 and 2010, a total of 1597 young undergraduate students at the University of Granada answered a self-administered questionnaire collecting information about exposure, accidents and involvement in 28 different driving circumstances. For designing this questionnaire, an extensive literature review was carried out and the opinions of five experts in a panel were also taken into account. By applying the tetracoric correlation coefficient, we conducted a factor analysis. Internal consistency was assessed using Cronbachs alpha coefficient. Finally, we evaluated the crude and adjusted association of each identified factor with the odds for having suffered an accident. Results: After excluding 8 circumstances, the remaining ones were grouped into three factors: the first one included ten high-prevalence circumstances and explained 31.9% of the total variability. Meanwhile, the other two factors included five circumstances each one which respectively explained 15.2% and 12.5% of the variability. Cronbachs alpha coefficients ranged between 0.816 and 0.553. When adjustments according age, sex, years in possession of the driving license and intensity of exposure were made, the first factor obtained the score more strongly associated with the accident rate (OR = 1.51; CI95%: 1.25-1.85). Conclusions: The final version (20 circumstances) identified three factors related to higher accident rates among the young drivers. The first one integrated, among other circumstances, the excessive speed and driving while sleepy or tired and it was the most closely associated with the accident rate in the adjusted analysis. The second factor included, among others, the commission of driving offences, and the third one included driving under the influence of alcohol, not always wearing the seat belt and distractions. Keywords: Driver distraction; Language: es

Factores asociados al riesgo de provocar una colisión entre un ciclista y un peatón en España, 1993-2011

OBJECTIVE To identify and quantify the factors depending on pedestrians, cyclists and the environment associated with the risk of causing a collision between a cyclist and a pedestrian in Spain from 1993 to 2011. METHODS STUDY DESIGN retrospective case series. POPULATION 1228 pedestrian-cyclist pairs involved in the same number of collisions in an urban area, only one of whom committed an infraction. SOURCE Register of Traffic Accidents with Victims, supported by the Spanish Traffic General Directorate. VARIABLES committing an infraction (yes/no), age, sex, helmet use (cyclist), hour, type of day, year, existence of sidewalks, place of the accident, and priority regulated. ANALYSIS logistic regression model to estimate the strength of the association between the pedestrians responsibility and independent variables. The association with the cyclists responsibility was assessed by reversing the value of the odds ratios obtained. RESULTS In both groups of users, the risk of causing a collision was higher in extreme ages. Female cyclists had a slightly higher risk than male cyclists, while the use of a helmet had a protective effect. The risk of the pedestrian causing an accident was higher in the absence of sidewalks. Cyclists more frequently provoked accidents in crosswalks. CONCLUSION We recommend the implementation of safety campaigns aimed at pedestrians and cyclists, with special attention paid to the youngest and older people. Interventions for correct road use would also be advisable.

Design and Validation of a Questionnaire Exploring Risky-driving Patterns in Young Drivers

Fundamentos: Las Lesiones por Trafico continuan siendo un importante problema de Salud Publica en poblacion joven. A pesar de ello, no existen en nuestro pais cuestionarios idoneos para la investigacion epidemiologica de este problema. El objetivo del presente trabajo fue disenar y validar un cuestionario orientado a explorar la frecuencia de implicacion en circunstancias de conduccion teoricamente asociadas con la accidentalidad por trafico en poblacion universitaria. Metodos: Se aplico un cuestionario autoadministrado (MATCA: movilidad, accidentalidad por trafico y circunstancias asociadas) a 1597 jovenes alumnos de grado de la Universidad de Granada, entre los anos 2007 y 2010, que recogia informacion, entre otras variables, sobre la exposicion, la accidentalidad y la implicacion en 28 circunstancias de conduccion. Para su diseno se realizo una extensa revision de la literatura al respecto y se conto con el juicio de un panel de cinco expertos. Aplicando el coeficiente de correlacion tetracorico, se realizo un analisis factorial. La consistencia interna se valoro mediante el coeficiente alfa de Crombach. Finalmente, se valoro la asociacion cruda y ajustada de cada factor identificado con la odds de haber sufrido un accidente. Resultados: Tras descartar 8 circunstancias, las restantes se agruparon en tres factores: el primero incluyo diez circunstancias de elevada prevalencia y explico el 31,9% de la variabilidad total. Los otros dos factores, incluyeron cinco circunstancias cada uno que explicaron respectivamente, el 15,2% y el 12,5% de la variabilidad. Los coeficientes alfa de Crombach oscilaron entre 0,816 y 0,553. Cuando se ajusto por la edad, el sexo, los anos de antiguedad del permiso y la intensidad de exposicion, la puntuacion mas fuertemente asociada a la accidentalidad fue la del primer factor (OR=1,51: IC95% 1,25-1,85). Conclusiones: La version final (20 circunstancias), identifico tres factores asociados a una mayor accidentalidad entre jovenes conductores. El primero integro, entre otras, la velocidad excesiva y conducir con sueno o cansancio, y fue el mas estrechamente asociado a la accidentalidad en el analisis ajustado. El segundo agrupo las circunstancias relacionadas con la comision de infracciones y el tercero incluyo la conduccion bajo los efectos del alcohol, el no uso siempre del cinturon y las distracciones.Background: Traffic Injuries are a major public healh problem, especially among young people. However, we have not found any useful questionnaire designed in our country for the epidemiological research in this field. The objective of this study was to design and validate an easy and quickly-to-fill questionnaire aimed to collect information on how frequently university car drivers report to be involved in driving circumstances theoretically related to traffic crashes. Methods: Between 2007 and 2010, a total of 1597 young undergraduate students at the University of Granada answered a self-administered questionnaire collecting information about exposure, accidents and involvement in 28 different driving circumstances. For designing this questionnaire, an extensive literature review was carried out and the opinions of five experts in a panel were also taken into account. By applying the tetracoric correlation coefficient, we conducted a factor analysis. Internal consistency was assessed using Cronbachs alpha coefficient. Finally, we evaluated the crude and adjusted association of each identified factor with the odds for having suffered an accident. Results: After excluding 8 circumstances, the remaining ones were grouped into three factors: the first one included ten high-prevalence circumstances and explained 31.9% of the total variability. Meanwhile, the other two factors included five circumstances each one which respectively explained 15.2% and 12.5% of the variability. Cronbachs alpha coefficients ranged between 0.816 and 0.553. When adjustments according age, sex, years in possession of the driving license and intensity of exposure were made, the first factor obtained the score more strongly associated with the accident rate (OR = 1.51; CI95%: 1.25-1.85). Conclusions: The final version (20 circumstances) identified three factors related to higher accident rates among the young drivers. The first one integrated, among other circumstances, the excessive speed and driving while sleepy or tired and it was the most closely associated with the accident rate in the adjusted analysis. The second factor included, among others, the commission of driving offences, and the third one included driving under the influence of alcohol, not always wearing the seat belt and distractions. Keywords: Driver distraction; Language: es