María Isolina Santiago-Pérez

Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey

BackgroundThe Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND.MethodsA survey of tobacco use in the general population was carried out in the northern Spanish region of Galicia using both the FTND and the HSI to study a representative sample of 1655 daily smokers. The HSI was compared with the FTND, considered the gold standard. Measures of sensitivity, specificity and predictive values were calculated. Concordance between the tests was also established (Cohens kappa).ResultsCohens kappa showed good agreement between measures (Kappa = 0.7); specificity values were also high (Sp = 96.2%). Sensitivity analysis in females (Se = 62.3%) did not show good agreement.ConclusionsThe HSI can be used as a reasonably good screening test in order to identify daily smokers with high nicotine dependence. Nevertheless, for populations or subpopulations having low nicotine dependence, such as women, the FTND is more reliable.

Impacto de las leyes de control del tabaquismo en la exposición al humo ambiental de tabaco en Galicia (2005-2011)

OBJECTIVE Prevalence of exposure to environmental tobacco smoke is a valuable index to assess the impact of the laws for tobacco control. The objective of this work is to analyse variations in the prevalence of exposure to environmental tobacco smoke in Galicia (Spain) between 2005, before the Law 28/2005, and 2011, after the law 42/2010. METHODS Data were obtained from five population-based independent cross-sectional studies, telephone surveys, developed in Galicia between 2005 and 2011 among population aged 16 to 74 (n=34.419). Self-reported exposure among population aged between 16 and 74 was analysed by setting and tobacco consumption by prevalence with 95% confidence intervals. RESULTS Environmental tobacco smoke exposure decreased dramatically in Galicia between 2005 and 2011. In 2005, before the Law 28/2005, 95% of the population reported exposure to environmental tobacco smoke compared to 28% in 2011, after the Law 42/2010. Decrease was greater in workplaces in 2006 and in leisure time venues in 2011. After an initial decrease in 2006, exposure at home remains unchanged. CONCLUSIONS An important reduction in self-reported exposure to environmental tobacco smoke occurred in Galicia in the period 2005-2011, specially after the introduction of Laws 28/2005 and 42/2010. Nevertheless, one in four of the population aged 16 to 74 remained exposed in 2011.

Distribución geográfica y temporal del suicidio en Galicia (1976–1998)

Objetivo: Estudiar la distribucion geografica y temporal de la mortalidad por suicidio en Galicia desde 1976 a 1998, teniendo en cuenta el sexo, la edad, la estacionalidad y el metodo empleado. Metodos: Para cada sexo se calcularon las tasas provinciales, brutas y ajustadas por edad y las tasas especificas por edad y periodo (1978-1984, 1985-1991, 1992-1998). Para la estimacion del riesgo y la tendencia temporal en el ambito municipal se utilizo un modelo jerarquico bayesiano. Resultados: La mortalidad por suicidio aumento considerablemente en los ultimos anos, pasando de tasas ajustadas en torno al 6 por 105 en los primeros anos de estudio a tasas del 10 por 105 en los ultimos, siendo este aumento mas acentuado en los varones. Las tasas mas elevadas se observan en edades avanzadas, aunque al valorar la tendencia temporal, los mayores incrementos se presentan en adolescentes y adultos jovenes. El principal metodo de suicidio, tanto en varones como en mujeres, ha sido el ahorcamiento, seguido a gran distancia por la caida de lugar elevado y el uso de armas de fuego. Los meses con mayor numero de suicidios corresponden a la primavera y el verano. En cuanto a la distribucion espacial, cabe destacar el elevado numero de suicidios en la provincia de Lugo; en el ambito municipal, se observa un claro patron norte-sur de decrecimiento del riesgo y una tendencia temporal inversa, en ambos sexos, que difieren de los patrones geografico y temporal del suicidio por un metodo distinto al ahorcamiento. Conclusiones: Tanto por su magnitud como por su tendencia al aumento y por el hecho de afectar cada vez mas a personas jovenes, el suicidio es, en Galicia, un importante problema sociosanitario. El analisis geografico y temporal permite diferenciar zonas prioritarias para el establecimiento de politicas preventivas.

High-risk human papillomavirus in Galicia, Spain: prevalence and evaluation of the sample representativeness.

Abstract Background: The prevalence of high-risk genotypes of the human papillomavirus (HR-HPV) in Galicia remained unknown before the introduction of the HPV vaccine. The objective of this study was to estimate this prevalence in non-vaccinated women when vaccination against HR-HPV started. Sample representativeness was also evaluated. Methods: Female volunteers aged 16–64 years, residents in Galicia, Spain, completed a questionnaire and provided biological samples for a virological study and for cytology. The sample was weighted; prevalence rates were estimated and are shown with 95% confidence intervals. Results: Virological results were available for 1703 women. HR-HPV prevalence was 10.1%, decreasing notably at ages above 30 years. HPV-16 was the most frequent genotype and 3.6% of women were infected by more than one genotype. No adjustment was necessary to generalize the results of the study. Conclusions: In Galicia in 2009 there would be 96 400 women aged 16–64 years infected with HR-HPV. It is possible to estimate HR-HPV prevalence in a population starting from a volunteer sample.

Mortalidad y años de esperanza de vida perdidos a causa del tabaquismo en personas mayores de 35 años en Galicia en el período 2001-2006

Fundamento: El tabaquismo es el factor de riesgo susceptible de ser prevenido que mas mortalidad causa en los paises desarrollados. El objetivo de este estudio fue medir el impacto en cifras de mortalidad y anos de esperanza de vida perdidos que el consumo de tabaco tuvo en la poblacion gallega de 35 anos y mas entre 2001 y 2006. Metodos: La mortalidad atribuida se estimo aplicando un metodo dependiente de prevalencia basado en el calculo de fracciones atribuidas poblacionales. La prevalencia de consumo de tabaco en Galicia se estimo para el periodo 2001-2006 a partir de encuestas realizadas en poblacion gallega y los riesgos relativos proceden del Cancer Prevention Study-II. Se calcularon los Anos de Esperanza de Vida Perdidos por causa del tabaco empleando el metodo propuesto por Arriaga. Resultados: Entre 2001 y 2006 en Galicia se atribuyeron 21.588 muertes al consumo de tabaco en la poblacion de 35 anos y mas, lo que supone el 12,5% de la mortalidad sucedida en este periodo. El porcentaje de anos de esperanza de vida perdidos como causa del consumo de tabaco descendio del primer al segundo trienio en hombres (28,1% vs 26,8%) y aumento en mujeres (9,9% vs 10,9%). Conclusiones: La mortalidad atribuida al consumo de tabaco se mantiene estable en Galicia en los anos estudiados. Esta estabilizacion podria suceder a expensas de un aumento ligero de la mortalidad en las mujeres jovenes acompanado de un descenso en los hombres.

Cambios en el consumo de tabaco: auge del tabaco de liar e introducción de los cigarrillos electrónicos

OBJECTIVE To assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015. METHODS Data were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n=8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education. RESULTS Smoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings. CONCLUSION Smoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes.

Backpack weight and back pain reduction: effect of an intervention in adolescents

BackgroundTo assess if an educational intervention is effective to reduce backpack weight and back pain in schoolchildren.MethodsWe designed an intervention study in schoolchildren aged between 12 and 16 years aimed to reduce the weight of backpacks and back pain. The intervention was multifaceted, including an educational intervention with practical examples, advising on performing sports, postural habits, leaflets, stickers, and so on. The comparison group did not receive any intervention.ResultsA total of 1668 schoolchildren took part in the study. We observed a high prevalence of carrying heavy backpacks, with 66–80% of schoolchildren carrying backpacks surpassing 10% of their body weight. Back pain prevalence was 30%. We observed that the intervention was significant in reducing the backpack weight in first-year schoolchildren but not in second-year. The intervention was also significant in reducing back pain in third-year schoolchildren but only in girls.ConclusionThis study shows that an inexpensive intervention directed to reduce the backpack weight and back pain might have a positive effect in schoolchildren.

Direct, indirect and total effectiveness of bivalent HPV vaccine in women in Galicia, Spain

Bivalent human papillomavirus (HPV) vaccine was incorporated into the childhood vaccination calendar in Galicia, Spain in 2008. The objectives of this study were to estimate direct, indirect and total effectiveness of HPV vaccine and to identify sexual habits changes in the post-vaccination period in Galicia, Spain.Endocervical scrapings of 745 women attending 7 Health Areas of the Galician Public Health Service were collected in the post-vaccination period, from 2014–2017. Two groups were studied: women born between 1989 and 1993 (n = 397) and women born in 1994 or later (n = 348). Twelve high-risk human papillomavirus (HR-HPV) genotypes were detected by Cobas® 4800 HPV test (Roche Diagnostics, Mannheim, Germany). The Linear Array® HPV Genotyping Test (Roche Diagnostics) was used for HR-HPV genotype detection other than HPV 16/18. Information about sexual habits was collected by a self-filled questionnaire. Post-vaccination data were compared to previously published pre-vaccination data obtained between 2008 and 2010 in Galicia from women of the same age (18–26 years old, n = 523). The Stata 14.2 software was employed for statistical analyses.Data from 392 unvaccinated and 353 vaccinated women were compared. For unvaccinated and vaccinated women, HPV 16/18 prevalence was 9.2% and 0.8%, respectively, and HPV 31/33/45 prevalence was 8.4% and 1.1%, respectively. Direct, indirect and total effectiveness of the HPV vaccine were (%, 95% CI): 94 (72−99), 30 (-11−56) and 95 (79−99), respectively, for HPV 16/18 and 83 (46−94), -10 (-88−33) and 84 (54−94), respectively, for HPV 31/33/45. The number of women with first intercourse before 17 years old and 3 or more sexual partners along life was higher in the post-vaccination period (p < 0.05). A positive impact of bivalent HPV vaccine was observed, both on direct and cross protection. Sexual habits could have changed in the post-vaccination period.

Exceso ponderal y obesidad abdominal en niños y adolescentes gallegos

INTRODUCTION AND OBJECTIVES The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. MATERIAL AND METHODS Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Coles cut-off criteria) and abdominal obesity (Taylors cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. RESULTS A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. CONCLUSIONS These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration.

Prevalencia de malnutrición en escolares españoles

INTRODUCTION AND AIMS The term malnutrition includes malnutrition due to excess or obesity, underweight as well as stunted growth. Its prevalence in a population can be estimated using anthropometric variables. The aim of this study is to estimate the prevalence of malnutrition in Galician schoolchildren aged 6 to 15years in the school year 2013-2014. METHODS A cross-sectional study was conducted on a representative sample by gender and age of the Galician population of 6 to 15years old. The prevalence of obesity, underweight, and short stature was estimated by age and gender using the reference standards proposed by the World Health Organisation. RESULTS Of the total of 7,438 schoolchildren weighed and measured, 16.4% had malnutrition. The prevalence of obesity was 14.8%, underweight was 0.7%, and short stature for age was estimated at 1%. Obesity was more prevalent among boys. As regards underweight and short stature, when there were differences, prevalence was higher among girls. CONCLUSIONS In Galicia, 16 out of every 100 schoolchildren aged 6 to 15years had malnutrition, with that due to excess or obesity being the most frequent. Prevalence of underweight and short stature did not exceed 1%. This data shows that primary prevention measures should be promoted at an early age to reduce malnutrition due to excess or adiposity, in particular.