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1.
Front Public Health ; 11: 1069294, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37206875

RESUMO

Introduction: Cigarette smoking is a significant public health problem, and it is essential to work actively with young people to limit the incorporation of this addiction. This study aimed to identify characteristics associated with tobacco use in adolescents in a real setting. Methods: Epidemiologic, cross-sectional study including secondary school students aged 12-17 years in the 1st, 2nd, and 3rd grades of "Joan Fuster High School" in the city of Sueca, Valencia (Spain). An anonymous, self-administered questionnaire was used to collect data on demographics, cigarette smoking history, alcohol consumption, nicotine dependence, and exposure to parental cigarette smoking. Results: The final sample of individuals surveyed included 306 students (50.6% females) with a median age of 13 years. The prevalence of cigarette smoking was 11.8% (13.5% in females and 9.9% in males). The mean age of cigarette smoking onset was 12.7 ± 1.6 years. Ninety-three students (30.4%) were repeaters, and 114 (37.3%) reported alcohol consumption. Significant factors associated with tobacco use were being a repeater (odds ratio [OR] 4.19, 95% confidence interval [CI] 1.75-10.55, p = 0.002), alcohol consumption (OR 4.06, 95% CI 1.75-10.15, p = 0.002) and parental cigarette smoking (OR 3.76, 95% CI 1.52-10.74, p = 0.007). Discussion: An operational profile of features associated with tobacco consumption was identified in the presence of parental cigarette smoking, alcohol consumption, and poor academic performance. Consideration of these factors could be useful in the operational design of cigarette smoking cessation interventions for young people in a context where there is a great need for better prevention and control of cigarette smoking.


Assuntos
Instituições Acadêmicas , Estudantes , Masculino , Adolescente , Feminino , Humanos , Criança , Estudos Transversais , Espanha/epidemiologia , Uso de Tabaco/epidemiologia
2.
Aten Primaria ; 54 Suppl 1: 102442, 2022 10.
Artigo em Espanhol | MEDLINE | ID: mdl-36435590

RESUMO

We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.


Assuntos
Promoção da Saúde , Estilo de Vida , Criança , Humanos , Medicina Comunitária , Estilo de Vida Saudável , Exercício Físico
3.
Artigo em Inglês | MEDLINE | ID: mdl-36231564

RESUMO

AIMS: To identify principal components of free-living patterns of sedentary behaviour in office employees with type 2 diabetes (T2D) compared to normal glucose metabolism (NGM) office employees, using principal component analysis (PCA). METHODS: 213 office employees (n = 81 with T2D; n = 132 with NGM) wore an activPAL inclinometer 24 h a day for 7 consecutive days. Comparions of sedentary behaviour patterns between adults with T2D and NGM determined the dimensions that best characterise the sedentary behaviour patterns of office employees with T2D at work, outside work and at weekends. RESULTS: The multivariate PCA technique identified two components that explained 60% of the variability present in the data of sedentary behaviour patterns in the population with diabetes. This was characterised by a fewer number of daily breaks and breaks in time intervals of less than 20 min both at work, outside work and at weekends. On average, adults with T2D took fewer 31 breaks/day than adults without diabetes. CONCLUSION: Effective interventions from clinical practice to tackle prolonged sedentary behaviour in office employees with T2D should focus on increasing the number of daily sedentary breaks.


Assuntos
Diabetes Mellitus Tipo 2 , Comportamento Sedentário , Adulto , Glucose , Hábitos , Humanos , Análise de Componente Principal , Local de Trabalho
4.
BMC Public Health ; 22(1): 1269, 2022 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-35768818

RESUMO

BACKGROUND: Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months. METHODS: Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18-65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour. VARIABLES: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed. DISCUSSION: If the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT04092738. Registered September 17, 2019.


Assuntos
Diabetes Mellitus Tipo 2 , Local de Trabalho , Atenção à Saúde , Diabetes Mellitus Tipo 2/terapia , Exercício Físico , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Sedentário
5.
Arch Bronconeumol ; 57(8): 521-527, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35699029

RESUMO

INTRODUCTION: Lung cancer screening with low-dose computed tomography (LDCT) has been proposed as a strategy to reduce lung cancer mortality. Since LDCT has side effects there is a need to carefully select the target population for screening programmes. Because in Spain health competences are transferred to the seventeen Autonomous Communities (ACs), the present paper aims to identify individuals at high risk of developing lung cancer in the different ACs. METHODS: We used the 2011-2012 data of the Spanish National Interview Health Survey (n=21,006) to estimate the proportion of individuals at high risk of developing lung cancer using a 6-year prediction model (PLCOm2012). This proportion was then extrapolated into absolute figures for the Spanish population, using the population census data of 2018 from the National Institute of Statistics. RESULTS: The proportion of individuals aged 50-74 with a risk of lung cancer ≥2% was 9.5% (15.9% in men, 3.5% in women). This proportion ranged from 6.6% in Región de Murcia to 12.7% in Andalucía and 13.0% in Extremadura. When extrapolated to the Spanish population, it was estimated that a total of 1,341,483 individuals may have a 6-year risk of lung cancer ≥2%. CONCLUSIONS: The present study is the first one that evaluated the number of individuals at high risk of developing lung cancer in the different Spanish ACs using a prediction model and selecting people with a 6-year risk ≥2%. Further studies should assess the cost and effectiveness associated to the implementation of a lung cancer screening programme to such population.


Assuntos
Neoplasias Pulmonares , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/epidemiologia , Masculino , Programas de Rastreamento/métodos , Espanha/epidemiologia , Tomografia Computadorizada por Raios X/métodos
6.
Tob Prev Cessat ; 6: 55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33083683

RESUMO

INTRODUCTION: We analyze the activities carried out by primary care (PC) physicians and nurses with respect to smoking cessation and evaluate their self-reported training, knowledge, and behavior. METHODS: A cross-sectional study was conducted including 1514 PC physicians and nurses from June 2016 to March 2017, in Spain. The main variable was Good Practice (GP) in attention to smokers. To identify associated factors, a multilevel logistic regression model was used adjusted for sex, age, type of center, contract, years of employment, tobacco consumption, and self-reported training/knowledge. RESULTS: Of the 792 physicians and 722 nurses, 48.6% referred to GP in smoking cessation management. The finding related to: being a non-smoker (OR=1.8; 95% CI: 1.2-2.5) or ex-smoker (OR=1.4; 95% CI: 1.02-2.1), having a good level of knowledge (OR=1.8; 95% CI: 1.3-2.4) and training (OR=2.4; 95% CI: 1.8-3.2), and, to a lesser extent, being female (OR=1.3; 95% CI: 1.03-1.7), and work experience >10 years (OR=1.4; 95% CI: 1.03-1.9). The main GP barriers were: lack of time (45.5%), organizational problems (48.4%), and 35.4% lack of training. CONCLUSIONS: The GP of PC physicians and nurses regarding smoking cessation management is related to being non-smokers or ex-smokers, and having sufficient training and knowledge. Lack of time and organizational problems were considered to be the main barriers. The promotion of training activities in the Spanish National Health Service with the support of scientific societies is required.

7.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32402549

RESUMO

INTRODUCTION: Lung cancer screening with low-dose computed tomography (LDCT) has been proposed as a strategy to reduce lung cancer mortality. Since LDCT has side effects there is a need to carefully select the target population for screening programmes. Because in Spain health competences are transferred to the seventeen Autonomous Communities (ACs), the present paper aims to identify individuals at high risk of developing lung cancer in the different ACs. METHODS: We used the 2011-2012 data of the Spanish National Interview Health Survey (n=21,006) to estimate the proportion of individuals at high risk of developing lung cancer using a 6-year prediction model (PLCOm2012). This proportion was then extrapolated into absolute figures for the Spanish population, using the population census data of 2018 from the National Institute of Statistics. RESULTS: The proportion of individuals aged 50-74 with a risk of lung cancer ≥2% was 9.5% (15.9% in men, 3.5% in women). This proportion ranged from 6.6% in Región de Murcia to 12.7% in Andalucía and 13.0% in Extremadura. When extrapolated to the Spanish population, it was estimated that a total of 1,341,483 individuals may have a 6-year risk of lung cancer ≥2%. CONCLUSIONS: The present study is the first one that evaluated the number of individuals at high risk of developing lung cancer in the different Spanish ACs using a prediction model and selecting people with a 6-year risk ≥2%. Further studies should assess the cost and effectiveness associated to the implementation of a lung cancer screening programme to such population.

8.
Aten Primaria ; 52 Suppl 2: 32-43, 2020 11.
Artigo em Espanhol | MEDLINE | ID: mdl-33388116

RESUMO

Primary and secondary health determinants explain a large part of the morbidity and mortality observed in primary care. The recommendations of the Program of Preventive Activities and Health Promotion (PAPPS) of the semFyC are presented, for the promotion of a healthy lifestyle through intervention methodology and preventive actions in tobacco consumption, alcohol consumption, healthy eating, physical activity in free time and prevention of traffic accidents and child restraint systems. The most common clinical prevention guidelines are outlined. The recommendations are updated, new aspects are pointed out, such as the definition of low-risk alcohol consumption, and the bibliography is updated. For the main recommendations, specific tables are included that show the quality of the evidence and the strength of the recommendation.


Assuntos
Promoção da Saúde , Estilo de Vida , Criança , Exercício Físico , Estilo de Vida Saudável , Humanos , Atenção Primária à Saúde
9.
Aten Primaria ; 52(3): 151-158, 2020 03.
Artigo em Espanhol | MEDLINE | ID: mdl-30638697

RESUMO

OBJECTIVE: To evaluate the validity, acceptability, and impact on the level of knowledge and skills of Primary Care health professionals of a training model aimed at improving the care of critical patients. DESIGN: A quasi-experimental interventional, multicentre study. LOCATION: Eight health care teams in Barcelona. PARTICIPANTS: A total of 272 professionals. INTERVENTIONS: A training program consisting of 48 simulations of acute myocardial infarction and stroke. MAIN MEASUREMENTS: A checklist was used to evaluate critical patient skills, effect of training on the knowledge of the participants, and a satisfaction survey. The training was carried out after 2 series of simulations (AMI+Stroke). In the second series, 3evaluations were made: in situ, one week after, and at 3weeks. Concordance and reliability were measured. The differences in means were analysed using the Student t test for paired data. RESULTS: A total of 449 knowledge tests were answered, with a higher score being obtained at the end of each simulation (3.89 -SD 1.01 vs. 3.21 -SD 1.09). Doctors obtained better medical scores than nurses (3.81 - SD 0.87 vs. 3.32 - SD 1.15), and professionals with a specialty completed scored more than those in training (MIR) (3.6 - SD 1.08 vs. 3.4 - SD 1.18). The mean score was 7.7 points (SD 1.56) in the first evaluation, and improved to 9.1 points (SD 0.78). The kappa index was greater than 0.40 in all cases. CONCLUSIONS: A training methodology in the management of emergencies in Primary Care based on simulations is valid, reliable and well accepted, achieving an improvement in the level of knowledge and skills of the participating professionals.


Assuntos
Competência Clínica , Cuidados Críticos , Pessoal de Saúde/educação , Atenção Primária à Saúde , Treinamento por Simulação/métodos , Lista de Checagem , Emergências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Médicos/estatística & dados numéricos , Reprodutibilidade dos Testes , Espanha , Acidente Vascular Cerebral/terapia
10.
Hypertens Res ; 42(6): 852-862, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30587857

RESUMO

Our aim was to investigate the effects of an intervention that comprised a brief counseling session on lifestyle habits together with the use of the EVIDENT (Lifestyles and arterial aging) application on the modification of markers that indicated different hemodynamic functions, such as arterial stiffness, blood pressure or wave reflections. The EVIDENT II study (Lifestyles and arterial aging) is a randomized clinical trial with two parallel groups. Each participant had an initial visit and two follow-up visits at 3 and 12 months where the peripheral augmentation index-PAIx75 was measured by tonometry, while an oscillometric method was used for the cardio-ankle vascular index-CAVI and brachial-ankle pulse wave velocity-baPWV. Both groups (intervention-IG and control-CG) were briefly counseled on diet and exercise. The IG also received instructions on the use of the EVIDENT II application during the 3 months. The sample (N = 597; 52 ± 11 years; 64% women) was randomized into IG = 291 and CG = 306. Comparing groups, there was a decrease in the PAIx75 favorable to the IG at 3 months (-4.9%, 95% CI: -7.7 to -2.1) and 12 months (-3.9%, 95% CI: -6.8 to -1.0). There was also a nonsignificant reduction of the CAVI at 3 months in the IG. A group effect was observed in the measurement of the PAIx75 over the 12-month follow-up (p = 0.003). This interaction was only observed in women (p = 0.017). In conclusion, the use of the EVIDENT II application achieved a modification of the PAIx75, a marker of wave reflection and vascular tone, in women through lifestyle improvements (physical activity and adherence to the Mediterranean diet). No significant results were found regarding blood pressure or arterial stiffness markers.


Assuntos
Pressão Sanguínea , Aconselhamento/métodos , Estilo de Vida , Aplicativos Móveis , Atenção Primária à Saúde/métodos , Smartphone , Rigidez Vascular , Adulto , Idoso , Dieta Mediterrânea , Exercício Físico , Feminino , Seguimentos , Humanos , Manometria , Pessoa de Meia-Idade , Análise de Onda de Pulso , Resultado do Tratamento
11.
Tob Prev Cessat ; 5: 9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32411874

RESUMO

INTRODUCTION: Our aim was to ascertain how the anti-smoking legislation of 2005/2010 has affected the behavior of primary healthcare center (PHC) personnel (medical and nonmedical) with respect to their attitudes towards tobacco, its consumption and the legislative changes. METHODS: We conducted a multi-center descriptive study of a randomized conglomerate sample of PHC personnel from each Autonomous Community in Spain. The questionnaire covered tobacco consumption, and knowledge/attitudes towards smoking and legislation. The statistical analysis used SPSS software. RESULTS: The sample consisted of 2040 PHC employees (1578 women, 77.4%). Never smokers, ex-smokers, and smokers represented 46.7%, 37.8%, and 15.5% of the sample, respectively. Tobacco prevalence amongst physicians and nurses was 12.3%. Following the introduction of the antismoking legislation, a decrease in consumption was observed. Most of the participants considered that tobacco consumption affected health, was an addictive illness, and passive smoking had an impact on the health of non-smokers. Whilst 91.6% agreed with the current legislation, only 25% felt that it encouraged cessation. CONCLUSIONS: Spanish primary healthcare professionals have a relatively low prevalence of smoking compared to the general population. It is necessary to implement more legislative measures to improve and maintain this outcome.

12.
Eur Respir J ; 52(4)2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30166322

RESUMO

There is a need to increase and maintain physical activity in patients with chronic obstructive pulmonary disease (COPD). We assessed 12-month efficacy and effectiveness of the Urban Training intervention on physical activity in COPD patients.This randomised controlled trial (NCT01897298) allocated 407 COPD patients from primary and hospital settings 1:1 to usual care (n=205) or Urban Training (n=202). Urban Training consisted of a baseline motivational interview, advice to walk on urban trails designed for COPD patients in outdoor public spaces and other optional components for feedback, motivation, information and support (pedometer, calendar, physical activity brochure, website, phone text messages, walking groups and a phone number). The primary outcome was 12-month change in steps·day-1 measured by accelerometer.Efficacy analysis (with per-protocol analysis set, n=233 classified as adherent to the assigned intervention) showed adjusted (95% CI) 12-month difference +957 (184-1731) steps·day-1 between Urban Training and usual care. Effectiveness analysis (with intention-to-treat analysis set, n=280 patients completing the study at 12 months including unwilling and self-reported non-adherent patients) showed no differences between groups. Leg muscle pain during walks was more frequently reported in Urban Training than usual care, without differences in any of the other adverse events.Urban Training, combining behavioural strategies with unsupervised outdoor walking, was efficacious in increasing physical activity after 12 months in COPD patients, with few safety concerns. However, it was ineffective in the full population including unwilling and self-reported non-adherent patients.


Assuntos
Terapia por Exercício , Doença Pulmonar Obstrutiva Crônica/reabilitação , Caminhada , Actigrafia , Idoso , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Autorrelato , Espanha , Fatores de Tempo
14.
BMC Public Health ; 18(1): 874, 2018 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-30005705

RESUMO

BACKGROUND: Health promotion is a key process of current health systems. Primary Health Care (PHC) is the ideal setting for health promotion but multifaceted barriers make its integration difficult in the usual care. The majority of the adult population engages two or more risk behaviours, that is why a multiple intervention might be more effective and efficient. The primary objectives are to evaluate the effectiveness, the cost-effectiveness and an implementation strategy of a complex multiple risk intervention to promote healthy behaviours in people between 45 to 75 years attended in PHC. METHODS: This study is a cluster randomised controlled hybrid type 2 trial with two parallel groups comparing a complex multiple risk behaviour intervention with usual care. It will be carried out in 26 PHC centres in Spain. The study focuses on people between 45 and 75 years who carry out two or more of the following unhealthy behaviours: tobacco use, low adherence to the Mediterranean dietary pattern or insufficient physical activity level. The intervention is based on the Transtheoretical Model and it will be made by physicians and nurses in the routine care of PHC practices according to the conceptual framework of the "5A's". It will have a maximum duration of 12 months and it will be carried out to three different levels (individual, group and community). Incremental cost per quality-adjusted life year gained measured by the tariffs of the EuroQol-5D questionnaire will be estimated. The implementation strategy is based on the "Consolidated Framework for Implementation Research", a set of discrete implementation strategies and an evaluation framework. DISCUSSION: EIRA study will determine the effectiveness and cost-effectiveness of a complex multiple risk intervention and will provide a better understanding of implementation processes of health promotion interventions in PHC setting. It may contribute to increase knowledge about the individual and structural barriers that affect implementation of these interventions and to quantify the contextual factors that moderate the effectiveness of implementation. TRIAL REGISTRATION: ClinicalTrials.gov , NCT03136211 .Retrospectively registered on May 2, 2017.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Atenção Primária à Saúde , Idoso , Análise Custo-Benefício , Feminino , Promoção da Saúde/economia , Comportamentos de Risco à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Espanha , Inquéritos e Questionários
17.
PLoS One ; 13(1): e0190750, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29370176

RESUMO

BACKGROUND AND OBJECTIVES: Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals. METHODS: A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was 'sitting time' (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered. RESULTS: 464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ≥6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting. CONCLUSIONS: In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.


Assuntos
Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Atenção Primária à Saúde/organização & administração , Comportamento Sedentário , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha
18.
PLoS One ; 12(7): e0181035, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28759596

RESUMO

AIMS: The aim of this systematic review and meta-analysis is to synthesize the available evidence in scientific papers of smokefree legislation effects on respiratory diseases and sensory and respiratory symptoms (cough, phlegm, red eyes, runny nose) among all populations. MATERIALS AND METHODS: Systematic review and meta-analysis were carried out. A search between January 1995 and February 2015 was performed in PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, and Google Scholar databases. Inclusion criteria were: 1) original scientific studies about smokefree legislation, 2) Data before and after legislation were collected, and 3) Impact on respiratory and sensory outcomes were assessed. Paired reviewers independently carried out the screening of titles and abstracts, data extraction from full-text articles, and methodological quality assessment. RESULTS: A total number of 1606 papers were identified. 50 papers were selected, 26 were related to symptoms (23 concerned workers). Most outcomes presented significant decreases in the percentage of people suffering from them, especially in locations with comprehensive measures and during the immediate post-ban period (within the first six months). Four (50%) of the papers concerning pulmonary function reported some significant improvement in expiratory parameters. Significant decreases were described in 13 of the 17 papers evaluating asthma hospital admissions, and there were fewer significant reductions in chronic obstructive pulmonary disease admissions (range 1-36%) than for asthma (5-31%). Six studies regarding different respiratory diseases showed discrepant results, and four papers about mortality reported significant declines in subgroups. Low bias risk was present in 23 (46%) of the studies. CONCLUSIONS: Smokefree legislation appears to improve respiratory and sensory symptoms at short term in workers (the overall effect being greater in comprehensive smokefree legislation in sensory symptoms) and, to a lesser degree, rates of hospitalization for asthma.


Assuntos
Doença Pulmonar Obstrutiva Crônica/prevenção & controle , Transtornos Respiratórios/prevenção & controle , Transtornos de Sensação/prevenção & controle , Fumar/legislação & jurisprudência , Asma/prevenção & controle , Tosse , Expiração , Promoção da Saúde/legislação & jurisprudência , Hospitalização , Humanos , Admissão do Paciente , Espirometria
19.
BMC Public Health ; 17(1): 305, 2017 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-28390406

RESUMO

BACKGROUND: We aimed to simplify information from food frequency questionnaires (FFQs) in a single parameter that allows for rapid identification of quality of patient diet and its relationship to cardiovascular risk and pulse wave velocity (PWV). METHODS: The sample from the EVIDENT study, consisting of 1553 subjects (aged 20-80 years) with no cardiovascular disease selected by random sampling among those attending primary care clinics, was used. The EVIDENT diet index (range 0-100) was calculated based on the results of a FFQ. Evaluation of dietary habits also included adherence to the Mediterranean diet (MD). Cardiovascular risk was estimated, and carotid-femoral pulse wave velocity was measured. RESULTS: Mean subject age was 54.9 ± 13.8 years, and 60.3% of subjects were female. The mean value of the EVIDENT diet index was 52.1 ± 3.2 points. Subjects in the third tertile (the highest score) had the greatest adherence to MD and the highest energy intake, with greater amounts of carbohydrates, protein, and fiber. The best cut-off point of the EVIDENT diet index for predicting good adherence to the MD is 52.3 (0.71 sensitivity, 0.61 specificity). In a multiple regression analysis, after a complete adjustment, it was estimated that for each one-point increase in the EVIDENT diet index, cardiovascular risk (CVR), blood-pressure, waist circumference, and PWV decreased by 0.14, 0.43, 0.24, and 0.09 respectively (p < 0.05, all). CONCLUSIONS: The diet quality index developed is associated to CVR and its components, and also with arterial stiffness, as measured with PWV. This index is also a good predictor of adherence to MD.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Registros de Dieta , Dieta , Adulto , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/fisiopatologia , Artérias Carótidas/fisiologia , Feminino , Artéria Femoral/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Análise de Regressão , Fatores de Risco , Sensibilidade e Especificidade , Rigidez Vascular/fisiologia , Adulto Jovem
20.
J Aging Phys Act ; 25(2): 254-260, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27705093

RESUMO

This study determined the relationship between self-reported and objective measurements of physical activity with adiposity markers in a random sample of community-dwelling older adults. The sample included 439 individuals over 65 years (age 71.1 ± 7.8; 54.2% women). Regular physical activity information was collected using self-reported (questionnaire, 7-day-PAR) and objective measurements (accelerometer ActiGraph GT3X) over 7 days. Anthropometric parameters included body mass index, body fat percentage, and waist circumference. The number of patients considered active was 28% according to the results of 7-day PAR, and 69% according to objective measures of accelerometry. With every daily increase of 10 min of sedentary activity, the BMI, body fat percentage, and waist circumference values increased by 0.04 units, 0.14%, and 0.14 cm, respectively. According to the accelerometry data, being active was a protective factor for presenting obesity criteria (OR = 0.34, CI 95% 0.19-0.59). Objective but non self-reported physical activity was associated with adiposity markers in older adults.


Assuntos
Adiposidade , Exercício Físico , Acelerometria , Idoso , Antropometria , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Vida Independente , Masculino , Autorrelato , Espanha , Inquéritos e Questionários
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