Factors associated with media use among adolescents: a multilevel approach.

BACKGROUND: During the last few years, several studies have reported a high screen time use among adolescents that can be related to negative health effects. The aims of this study were to describe screen time use among secondary school students and to identify individual- and school-level factors associated with media use. METHODS: A cross-sectional study based on a self-reported questionnaire was performed among a representative sample of 2675 secondary school students (13-19 years old). Adolescents reported the amount of time spent viewing television, playing videogames and using the computer as well as other health-related behaviours and attitudes. Multilevel analysis was carried out and prevalence ratios were calculated to determine the association between media use and related factors. RESULTS: Around 50% of the students reported watching television for ≥2 h/day during weekdays. Boys reported playing videogames for ≥2 h/weekday much more often than girls (14.6 and 1.5%, respectively). 68.2% of boys and 61.7% of girls reported using the computer for ≥2 h/weekday. In the multilevel analysis, the main factors associated with screen-related sedentary behaviours were attending schools from a low socio-economic status neighbourhood, eating unhealthy food and not reading books frequently. CONCLUSION: The prevalence of adolescents reporting an excessive use of media devices is high, especially among students attending schools from deprived areas. Interventions to reduce screen time among adolescents may be necessary to reduce the risk of some metabolic and cardiovascular diseases such as being overweight and obesity in late adolescence or early adulthood.

Adoption of preventive measures during and after the 2009 influenza A (H1N1) virus pandemic peak in Spain.

OBJECTIVE: This study describes the preventive measures adopted by the Spanish population towards 2009 influenza A (H1N1) virus and their associated factors. METHOD: An anonymous computer-assisted telephone interview survey was conducted in Spain in December 2009 and February 2010. Respondents were asked about their perceptions of influenza A (H1N1) virus and the preventive measures adopted. Factors associated with the adoption of preventive measures were assessed by logistic regression analyses. RESULTS: Out of 4892 households approached, 1627 valid responses were obtained (response rate of 33.3%). The most commonly adopted preventive measures were respiratory hygiene and hand washing. Factors independently associated with the adoption of the preventive measures recommended by the Spanish Ministry of Health were female gender, higher educational level, size of municipality of residence >50,000 inhabitants, high perceived susceptibility to infection, high perceived effectiveness of the measures and high perceived usefulness of the information provided by the government. The presence of school-aged children in household was associated with purchasing masks and hand sanitizer. CONCLUSION: In addition to demographic factors, modifiable factors such as personal beliefs and expectations play a role in the adoption of preventive measures.

[Process evaluation of the school-based cannabis use prevention program "xkpts.com" in adolescents from Barcelona in 2006]. / Evaluación de proceso del programa escolar de prevención del consumo de cánnabis xkpts.com en adolescentes de Barcelona en 2006.

BACKGROUND: The observed positive effects of school-based prevention programs are frequently lower than what was expected, usually due to inadequate implementation. AIMS: To describe the process evaluation of a cannabis use school-based prevention program (xkpts.com), to measure teachers' satisfaction with the program and to define quantitative and qualitative parameters for assessing the exhaustiveness of the intervention. METHODS: Cross-sectional descriptive study. SAMPLE: 117 9th-grade classes in 39 schools (2812 students). The information was gathered by means of a self-report questionnaire for teachers and families. A descriptive analysis was made of the implementation of the intervention in the classrooms and of the families' participation. RESULTS: Teachers' response rate was 65%. Discussion was the method most widely applied (100% of the classrooms) and DVD was the most widely used material (93.4%). Skills training was applied in 72.4% of the classrooms. In 59.2% of the classrooms there was an acceptable intervention (at least 8 of the 16 preventive activities), while in 38.2% there was a qualified intervention (at least 1 activity for each general lesson and 2 for each specific one). Mean score given to the program by teachers was 7.4, and 81.6% of them reported their intention to apply it again. Participation rate of the students' families was 28.3% (796). CONCLUSIONS: The intervention was acceptable in two out of three classrooms, while in four out of ten the protocol was applied strictly. Greater participation of the students' families corresponded to those schools in which the intervention was better implemented.

ICOVIR-5 shows E2F1 addiction and potent antiglioma effect in vivo.

During 2007, approximately 200,000 people in the United States will be diagnosed with brain tumors. Gliomas account for 77% of primary malignant brain tumors, and the prognosis has hardly changed in the past 20 years, with only 30% of patients with malignant glioma surviving 5 years after diagnosis. Oncolytic adenoviruses are promising therapies for the treatment of gliomas. Here, report the antiglioma activity of the tumor-selective ICOVIR-5 adenovirus, which encompasses an early 1A adenoviral (E1A) deletion in the retinoblastoma (Rb) protein-binding region, substitution of the E1A promoter for E2F-responsive elements, and an RGD-4C peptide motif inserted into the adenoviral fiber to enhance adenoviral tropism. Mechanistic studies showed a dramatic addiction of ICOVIR-5 to the E2F1 oncogene in vitro and in vivo. This addiction was mediated by the occupancy of the ectopic adenoviral E2F1-responsive elements by the endogenous E2F1 protein resulting in high level of E1A expression in cancer cells and potent antiglioma effect. Importantly, we showed for the first time the ability of oncolytic adenoviruses to enhance E2F transcriptional activity in vivo, and we provided direct evidence of the interaction of the E2F1 protein with native and ectopic adenovirus promoters. Restoration of Rb function led to the association of Rb/E2F1 repressor complexes with ICOVIR-5 ectopic E2F1 promoter and subsequent down-modulation of E1A, dramatically impairing adenoviral replication. In xenografted mice, intratumoral injection of ICOVIR-5 resulted in a significant improvement of the median survival (P < 0.0001), and furthermore, led to 37% of long-term survivors free of disease. The antitumor activity of ICOVIR-5 suggests that it has the potential to be an effective agent in the treatment of gliomas.

Food consumption frequency and excess body weight in adolescents in the context of financial crisis in Barcelona (Spain).

OBJECTIVES: To describe food consumption frequency in adolescents in the context of the financial crisis in 2012, and to analyse potential fluctuations in excess body weight between 2008 and 2012. METHOD: A cross-sectional study of eating habits and excess body weight was conducted in adolescents aged 13 to 19 years old from public, subsidised and private secondary schools in Barcelona, Spain. The FRESC lifestyle risk factors survey was used, and food frequency consumption, food recommendations and body mass index were analysed according to gender, year of education and socioeconomic status. RESULTS: Girls ate vegetables and fruits more frequently than boys, while the prevalence of junk food consumption was higher in boys. The prevalence of compliance with food recommendations was lower than 50% for all foods, and gender and socioeconomic differences were found for eggs, red meat and soft drinks. Regarding excess body weight, boys had a higher prevalence than girls in the 2 years analysed. Furthermore, a reduction in excess body weight was observed among girls in secondary education in the highest socioeconomic groups (28.7% [95% CI: 24.8-32.6%] in 2008 to 20.5% [95% CI: 17.1-23.8%] in 2012). CONCLUSIONS: The prevalence of adolescents following food recommendations is low, and gender differences were found in terms of food consumption frequency, even in the context of financial crisis. There is a need to promote programmes and policies to reduce inequalities related to eating habits and excess body weight in adolescents.

[Potential selection bias in telephone surveys: landline and mobile phones]. / Potencial sesgo de selección en las encuestas telefónicas: teléfonos fijos y móviles.

The increasing use of mobile phones in the last decade has decreased landline telephone coverage in Spanish households. This study aimed to analyze sociodemographic characteristics and health indicators by type of telephone service (mobile phone vs. landline or landline and mobile phone). Two telephone surveys were conducted in Spanish samples (February 2010 and February 2011). Multivariate logistic regression analyses were performed to analyze differences in the main sociodemographic characteristics and health indicators according to the type of telephone service available in Spanish households. We obtained 2027 valid responses (1627 landline telephones and 400 mobile phones). Persons contacted through a mobile phone were more likely to be a foreigner, to belong to the manual social class, to have a lower educational level, and to be a smoker than those contacted through a landline telephone. The profile of the population that has only a mobile phone differs from that with a landline telephone. Therefore, telephone surveys that exclude mobile phones could show a selection bias.

Bullying among schoolchildren: differences between victims and aggressors.

OBJECTIVE: To identify the factors associated with bullying behaviors among adolescents by analyzing victims, aggressors and victims/aggressors separately. METHODS: A cross-sectional study was performed in a representative sample of 3,089 secondary school students (13-18 years old) in Barcelona (Spain). To define bullying behaviors, we used three questions about different types of mistreatment (jeering, attacking, marginalizing). RESULTS: Compared with secondary school students not involved in bullying, victims, aggressors and victims/aggressors were more likely to be boys and to report negative mood states. Victims were younger, were more overweight or obese and were lighter cannabis users, while aggressors were also younger but reported more antisocial behaviors and more cannabis and alcohol use. Victims/aggressors reported more antisocial behaviors and were overweight. CONCLUSIONS: Being involved in bullying, independently of the role adopted, was associated with health-related problems, which can lead to psychological disorders in adulthood.

[Evaluative designs in public health: methodological considerations]. / Diseños evaluativos en salud pública: aspectos metodológicos.

Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided.

[Factors related to bullying in adolescents in Barcelona (Spain)]. / Factores relacionados con el acoso escolar (bullying) en los adolescentes de Barcelona.

OBJECTIVES: Violence and bullying in the school setting are a serious social and health problem that have created great alarm in the last few years. We aimed to describe bullying and factors related to this phenomenon in students in the city of Barcelona. METHODS: We performed a cross-sectional study of a representative sample of 2,727 students from 66 secondary schools in Barcelona. Bullying was defined as having been laughed at, hit or marginalized four or more times, or as having been the target of all three of these behaviors at least once, in the last 12 months. To analyze the associations among bullying and related factors including sociodemographic variables, attitudes and behaviors, we used bivariate and multivariate logistic regression. RESULTS: The prevalence of bullying was 18.2%, 10.9% and 4.3% in boys and 14.4%, 8.5% and 4.5% in girls in the 8th, 10th and 12th grades, respectively. Factors associated with an increased likelihood of being bullied were negative mood states and violent behavior, while being older, alcohol consumption, cannabis use and going to bars and discos were negatively associated with being bullied. CONCLUSIONS: This study confirms that bullying is a serious problem in our context and identifies certain factors, such as negative mood states and other risk behaviors. These factors should be further analyzed in longitudinal studies in order to design and implement appropriate prevention programs.

Systemic toxicity-efficacy profile of ICOVIR-5, a potent and selective oncolytic adenovirus based on the pRB pathway.

E2F acts as a transcriptional repressor when bound to unphosphorylated RB during the G(1) or G(0) phase. Upon phosphorylation, E2F is released from the E2F-RB complexes to activate transcription. Tumor cells are characterized by an increase in the level of "free" E2F as a consequence of the absence or hyperphosphorylation of RB. The E2F-1 promoter is a well-characterized E2F-responsive promoter, and it can be used to control adenovirus E1a gene expression as a strategy to achieve tumor-selective expression and replication of an adenovirus. ICOVIR-5 (Ad-DM-E2F-K-Delta24RGD) is an optimized oncolytic adenovirus that combines E1a transcriptional control by an insulated form of the E2F promoter with the Delta24 mutation of E1a to improve the therapeutic index of AdDelta24RGD. ICOVIR-5 also contains the Kozak sequence at the E1a start codon, which is important to restore E1a expression and viral replication to AdwtRGD levels in tumor cells. The unique combination of genetic elements in ICOVIR-5 allows the selectivity for cells with a deregulated E2F-RB pathway to be increased and potent anti-tumoral activity to be maintained. Dose-response toxicological and efficacy studies after a single systemic administration in pre-clinical models in mice are presented to demonstrate that this virus holds promise for treatment of disseminated cancer.