[Psychoactive drug use in nursing homes]. / Utilización de fármacos para el sistema nervioso central en residencias geriátricas.

BACKGROUND: Our purpose was to know the use of psychoactive drugs including neuroleptics (NL), benzodiazepines (BNZ) and antidepressants (AD) in nursing homes (NH) in the city of Barcelona. METHOD: Cross-sectional descriptive study of 384 clinical records of people living in 19 NH. The correct use of drugs was estimated by Garrad's and Beers et al criteria. RESULTS: Average age (SD) of residents was 83 years (2.0). The average consumption of drugs was 5 (2.7); 248 individuals (64.6%) were taking at least one psychoactive drug: 81 (21%) consumed NL, 179 (46.6%) BNZ and 73 (19%) AD. 48 (12.5%) NH residents consumed long-acting BNZ and 26 (6.7%) had surpassed the recommended time of consumption for short-acting BNZ. In 21 (26%) NH residents who consumed NL, its use would not be justified. CONCLUSIONS: It is necessary to reduce the use of long-acting BNZ, to encourage a correct use of NL and to achieve a correct identification of depressive disorders in NH.

[Inequalities in maternal-child health: impact of an intervention]. / Desigualdades en salud materno-infantil: impacto de una intervención.

We present the evaluation of the population impact of a social and health maternal and child intervention, implemented in a low income urban area (Ciutat Vella) in Barcelona, Spain. Intervention was based on increasing access to health and social services for pregnant women and for the children. A quasiexperimental design with a nonequivalent control group and multiple measurements was used. We compared infant and perinatal cumulative mortality rates between Ciutat Vella District and the rest of the city, before (1983-86) and after the intervention (1987-89, 1990-92). Results showed that the significant differences found previously to the program between the mortality rates disappeared with the development of the program. Infant mortality in Ciutat Vella was 17.7/.000 births in 1983-86, and became 13.1/1.000 births in 1987-89, and 13.4 in 1990-92; in the rest of the city, infant mortality was 9.5/1.000 births in 1983-86, and became 8.8/ and 7.7/1000 births respectively. A comprehensive social and health care program implemented in small low income areas may contribute to reduce inequalities in maternal and child health.

[Maternity in adolescents in the districts and neighborhoods of Barcelona: its association with the socioeconomic level and the prevalence of low weight at birth. The Working Group of Maternal-Child Health of the Municipal Institute of Health of Barcelona]. / Maternidad en adolescentes en los distritos y barrios de Barcelona: asociación con el nivel socioeconómico y prevalencia de bajo peso al nacer. Grupo de Trabajo de Salud Materno-Infantil del Instituto Municipal de la Salud de Barcelona.

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