Bibliometric analysis in paediatric dental journals listed in journal citation reports. Current trends.

AIM: The aim of this study was to analyse articles published in paediatric dental journals included in Journal Citation Reports (JCR), to determine current trends in paediatric publishing. METHODS: Articles included in paediatric dentistry journals in 2020 JCR were selected, published during the period 2008-2020. After applying inclusion criteria, author-based parameters (article title, first author's name, institution, sex and number of authors, number of affiliations, first/last author's origin and geographic origin), and article-based parameters (article type, main topic, research design) were registered for each article. CONCLUSION: International Journal of Paediatric Dentistry, Journal of Clinical Pediatric Dentistry, European Journal of Paediatric Dentistry and Pediatric Dentistry were the four main journals in terms of production volume, USA being the most productive country. The most recurrent topic was dental surgery, and the most common design was observational studies. Study design, geographic origin of the articles, article type and main subject of the article might predict citation.

[Perception of healthcare professionals on the Breast Cancer Screening Programme in Barcelona]. / Percepción de los profesionales de salud sobre el Programa de Detección Precoz del Cáncer de Mama en Barcelona.

OBJECTIVE: A good communication plan is vital for optimal results in any screening programme. The objective of this study was to assess the knowledge, involvement and opinion of health professionals regarding the Breast Cancer Screening Programme in Barcelona in 2008. MATERIAL AND METHODS: A cross-sectional study using an anonymous and self-administered questionnaire. The study population (N = 960) were health professionals from Primary Health-care (PH), Programs for Sexual and Reproductive Health (PSRH), and Community Pharmacies (CP). The dependent variables were: knowledge of the Programme, professional involvement and opinion of the Programme. The independent variables were: sex, age, qualifications, employment status, and health team. A descriptive and bivariate analysis was performed. Using multivariate logistic regression models adjusted for age, an Odds Ratios (OR) were obtained along with the 95% confidence intervals (CI 95%). RESULTS: PSRH professionals know the target population better; 80.2% versus 26.1% PH, and 14.0% CP, respectively. Professional involvement was related to the health care team (ORCP/PH: 0.32, CI 95%: 0.22-0.43) being observed more in PH. The opinion on the Programme in reducing breast cancer mortality was similar in the three teams (61.6% PH, 59.3% PSRH, and 56.5% CP). CONCLUSIONS: Healthcare professionals are unaware of some aspects of Programme, such as age range or periodicity. There is great professional involvement and belief that the Programme has helped disseminate information and knowledge on the early detection of breast cancer.

Socioeconomic inequalities in lung cancer mortality in 16 European populations.

OBJECTIVES: This paper aims to describe socioeconomic inequalities in lung cancer mortality in Europe and to get further insight into socioeconomic inequalities in lung cancer mortality in different European populations by relating these to socioeconomic inequalities in overall mortality and smoking within the same or reference populations. Particular attention is paid to inequalities in Eastern European and Baltic countries. METHODS: Data were obtained from mortality registers, population censuses and health interview surveys in 16 European populations. Educational inequalities in lung cancer and total mortality were assessed by direct standardization and calculation of two indices of inequality: the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). SIIs were used to calculate the contribution of inequalities in lung cancer mortality to inequalities in total mortality. Indices of inequality in lung cancer mortality in the age group 40-59 years were compared with indices of inequalities in smoking taking into account a time lag of 20 years. RESULTS: The pattern of inequalities in Eastern European and Baltic countries is more or less similar as the one observed in the Northern countries. Among men educational inequalities are largest in the Eastern European and Baltic countries. Among women they are largest in Northern European countries. Whereas among Southern European women lung cancer mortality rates are still higher among the high educated, we observe a negative association between smoking and education among young female adults. The contribution of lung cancer mortality inequalities to total mortality inequalities is in most male populations more than 10%. Important smoking inequalities are observed among young adults in all populations. In Sweden, Hungary and the Czech Republic smoking inequalities among young adult women are larger than lung cancer mortality inequalities among women aged 20 years older. CONCLUSIONS: Important socioeconomic inequalities exist in lung cancer mortality in Europe. They are consistent with the geographical spread of the smoking epidemic. In the next decades socioeconomic inequalities in lung cancer mortality are likely to persist and even increase among women. In Southern European countries we may expect a reversal from a positive to a negative association between socioeconomic status and lung cancer mortality. Continuous efforts are necessary to tackle socioeconomic inequalities in lung cancer mortality in all European countries.

Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe.

We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in total cancer mortality between women and men aged 30-74 in 12 different European populations (Madrid, Basque region, Barcelona, Slovenia, Turin, Switzerland, France, Belgium, Denmark, Norway, Sweden, Finland) and to investigate which cancer sites explain the differences found. We measured socioeconomic status using educational level and computed relative indices of inequality (RII). We observed large variations within Europe for educational differences in total cancer mortality among men and women. Three patterns were observed: Denmark, Norway and Sweden (significant RII around 1.3-1.4 among both men and women); France, Switzerland, Belgium and Finland (significant RII around 1.7-1.8 among men and around 1.2 among women); Spanish populations, Slovenia and Turin (significant RII from 1.29 to 1.88 among men; no differences among women except in the Basque region, where RII is significantly lower than 1). Lung, upper aerodigestive tract and breast cancers explained most of the variations between gender and populations in the magnitude of inequalities in total cancer mortality. Given time trends in cancer mortality, the gap in the magnitude of socioeconomic inequalities in cancer mortality between gender and between European populations will probably decrease in the future.

Trends in socioeconomic mortality inequalities in a southern European urban setting at the turn of the 21st century.

OBJECTIVE: To analyse trends in mortality inequalities by educational level for main causes of death among men and women in Barcelona, Spain, at the turn of the 21st century (1992-2003). METHODS: The population of reference was all Barcelona residents older than 19 years. All deaths between 1992-2003 were included. Educational level was obtained through record linkage between the mortality register and the municipal census of Barcelona city. Variables studied were age, sex, educational level, period of death (four periods of 3 years) and cause of death. Age-standardised mortality rates for each educational level, sex and period were calculated. Poisson regression models were fitted to obtain relative index of inequality (RII) for educational level, adjusted for age for the time-periods. RESULTS: RII for all causes of death was constant (around 1.5), but rate differences were higher in 1995-7 (715.6 per 100,000 in men and 352.8 in women) than in other periods and tended to decrease in men over the periods. Analysis of inequality trends by specific causes of death shows a stable trend for the majority of causes, with higher mortality among those with less education for all causes of death except lung cancer and breast cancer among women having RII below 1. CONCLUSIONS: Relative inequalities in total mortality by sex in Barcelona did not change during the 12 years studied, whereas absolute inequalities tended to decrease in men. Our study fills an important gap in southern Europe and Spanish literature on trends during this period.

Applying an equity lens to tobacco-control policies and their uptake in six Western-European countries.

We identified policies that may be effective in reducing smoking among socioeconomically disadvantaged groups, and examined trends in their level of application between 1985 and 2000 in six western-European countries (Sweden, Finland, the United Kingdom, the Netherlands, Germany, and Spain). We located studies from literature searches in major databases, and acquired policy data from international data banks and questionnaires distributed to tobacco policy organisations/researchers. Advertising bans, smoking bans in workplaces, removing barriers to smoking cessation therapies, and increasing the cost of cigarettes have the potential to reduce socioeconomic inequalities in smoking. Between 1985 and 2000, tobacco control policies in most countries have become more targeted to decrease the smoking behaviour of low-socioeconomic groups. Despite this, many national tobacco-control strategies in western-European countries still fall short of a comprehensive policy approach to addressing smoking inequalities.

Trends in smoking behaviour between 1985 and 2000 in nine European countries by education.

OBJECTIVE: To examine whether trends in smoking behaviour in Western Europe between 1985 and 2000 differed by education group. DESIGN: Data of smoking behaviour and education level were obtained from national cross sectional surveys conducted between 1985 and 2000 (a period characterised by intense tobacco control policies) and analysed for countries combined and each country separately. Annual trends in smoking prevalence and the quantity of cigarettes consumed by smokers were summarised for each education level. Education inequalities in smoking were examined at four time points. SETTING: Data were obtained from nine European countries: Norway, Sweden, Denmark, Finland, the United Kingdom, the Netherlands, Germany, Italy, and Spain. PARTICIPANTS: 451 386 non-institutionalised men and women 25-79 years old. MAIN OUTCOME MEASURES: Smoking status, daily quantity of cigarettes consumed by smokers. RESULTS: Combined country analyses showed greater declines in smoking and tobacco consumption among tertiary educated men and women compared with their less educated counterparts. In country specific analyses, elementary educated British men and women, and elementary educated Italian men showed greater declines in smoking than their more educated counterparts. Among Swedish, Finnish, Danish, German, Italian, and Spanish women, greater declines were seen among more educated groups. CONCLUSIONS: Widening education inequalities in smoking related diseases may be seen in several European countries in the future. More insight into effective strategies specifically targeting the smoking behaviour of low educated groups may be gained from examining the tobacco control policies of the UK and Italy over this period.

Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries.

BACKGROUND: Few studies have compared socioeconomic inequalities in the prevalence of both fatal and non-fatal diseases. This paper aims to give the first international overview for several common chronic diseases. METHODS: Micro-level data were pooled from non-standardized national health surveys conducted in eight European countries in the 1990s. Surveys ranged in size from 3700 to 41 200 participants. The prevalence of 17 chronic disease groups were analysed in relation to education. Standardized prevalence rates and age-adjusted odds ratios (ORs) were calculated. RESULTS: Most diseases showed higher prevalence among the lower education group. Stroke, diseases of the nervous system, diabetes, and arthritis displayed relatively large inequalities (OR > 1.50). No socioeconomic differences were evident for cancer, kidney diseases, and skin diseases. Allergy was more common in the higher education group. Relative socioeconomic differences were often smaller among the 60-79 age group as compared with the 25-59 age group. Cancer was more prevalent among the lower educated in the 25-59 age group, but among the higher educated in the 60-79 age group. For diabetes, hypertension, and heart disease, socioeconomic differences were larger among women as compared with men. Inequalities in heart disease were larger in northern European countries as compared with southern European countries. CONCLUSION: There are large variations between chronic diseases in the size and pattern of socioeconomic differences in their prevalence. The large inequalities that are found for some specific fatal diseases (e.g. stroke) and non-fatal diseases (e.g. arthritis) require special attention in equity-oriented research and policies.

[Changes in tobacco use in the general population of Barcelona, 1983-2000]. / Cambios en el consumo de tabaco en la población general en Barcelona, 1983-2000.

OBJECTIVES: To analyze the prevalence trends for smoking and its determinants in the general population of Barcelona from 1983 to 2000. DESIGN: Time series study. SETTING: Health survey based on home interviews of a representative sample of the general population of Barcelona. PARTICIPANTS: In the years 1983, 1992, and 2000 we interviewed 3134, 5004, and 10,000 persons, respectively. MAIN OUTCOME MEASURES AND RESULTS: Between 1983 and 2000 daily tobacco use showed a steady tendency to decrease among men, with a prevalence that decreased from 54.6% to 38.3%, while in women, smoking increased between 1983 and 1992 (from 20.9% to 25.4%) but remained stable in 2000 (24.5%). The proportion of smokers who said they wanted to quit increased in both sexes from 1992 (54.2%) to 2000 (65.7%). During this period the proportion of smokers who said their doctor had advised them to quit increased from 36.1% to 48.1%. The trends for both sexes showed that consumption of tobacco products was greater among less privileged socioeconomic groups. CONCLUSIONS: The results of this study confirm the decrease in the prevalence of daily consumption of tobacco products and the increase in smokers who would like to quit, in parallel with the increase in advice from physicians to quit. However, the trends among younger groups remained stable, a finding that makes it necessary to intensify efforts aimed at this population group.

[Smoking cessation in a population-based cohort study]. / Abandono del consumo de tabaco en una cohorte de base poblacional.

OBJECTIVE: To study the incidence rates and the determinants of smoking cessation in a population-based cohort. MATERIAL AND METHODS: We used data from the Cornellà Health Interview Survey Follow-up Study. Subjects who declared they were daily smokers at baseline (1994) and had complete follow-up, with information on smoking status in 2002, entered into analysis. We calculated incidence rates and the relative risks of cessation (with 95% confidence intervals) using the Cox model. RESULTS: Out of 353 daily smokers, 100 quit smoking during the follow-up period (cumulative incidence of 28.3%). The incidence rate of cessation was higher among men (42.34 per 1000 person-years) than among women (24.97 per 1000 person-years), with a relative risk of cessation of 1.69 (95% confidence interval, 1.02-2.79) for men. Age and level of education were associated with a higher relative risk of quitting in men. CONCLUSIONS: The main determinants for smoking cessation are sociodemographic (sex, age, and level of education).

[Exposure to smoking during pregnancy: Barcelona (Spain) 1994-2001]. / Tendencias en la exposición al tabaquismo durante la gestación: Barcelona, 1994-2001.

BACKGROUND: Exposure to smoking during pregnancy is an important risk factor for child health. In the last few decades, the prevalence of smoking among fertile women has increased in Spain. OBJECTIVES: To assess fetal exposure to smoking in a representative sample of pregnant women and its trends. METHODS: The prevalence of smoking and smoking cessation were analyzed in a representative sample of women who gave birth in the city of Barcelona, extracted from a population-based registry of birth defects. The sample consisted of 1,801 women and covered the period 1994 to 2001. RESULTS: Among pregnant women, 43.4 % smoked before pregnancy, and 42.2 % of these quit. At the time of giving birth, 25.2 % of the women were smokers. Over the period studied the prevalence of smoking among pregnant women clearly decreased. Although the proportion of cessations showed no significant changes, fetal exposure to tobacco decreased. CONCLUSIONS: The prevalence of smoking among pregnant women was high, although many quit during pregnancy. Over the period studied, fetal exposure to smoking decreased. There is a need for more systematic interventions.

[Impact of smoking and alcohol consumption on mortality in the population of Barcelona [Spain]: 1983-1998]. / Impacto del tabaquismo y del consumo excesivo de alcohol en la mortalidad de la población de la ciudad de Barcelona: 1983-1998.

OBJECTIVES: To analyze the mortality attributable to smoking and alcohol consumption in the city of Barcelona from 1983 to 1998. METHODS: All deaths among residents of the city of Barcelona from 1983 to 1998 were included. Population data were obtained from the city inhabitants register. The mortality attributable to smoking and alcohol consumption was calculated by population attributable fractions using relative risks from previous studies in the US population. RESULTS: In 1998, 2,205 deaths were attributable to smoking, representing 13.8% of all deaths among the population aged 35 years or older and a decrease of 9.6% compared with deaths in 1983. From 1983 to 1998 there was an increase in smoking-attributable adjusted mortality rates for lung cancer (155.84/100,000 inhabitants in men and 9.39/100,000 in women in 1998) and chronic obstructive pulmonary disease (COPD) (95.89/100,000 in men and 11.29/ 100,000 in women in 1998). In 1998, deaths attributed to alcohol consumption accounted for 4.3% of total mortality, representing a reduction of 26% since 1983. Among men, the primary cause of alcohol-attributable mortality was liver cirrhosis (17.1%), although its relative importance decreased (accounting for 17.1% of alcohol-attributable mortality in 1998 compared with 24.3% in 1983). CONCLUSIONS: The mortality attributable to smoking and alcohol consumption decreased in the city of Barcelona during the study period. Smoking-attributable mortality from lung cancer and COPD increased in both sexes. Alcohol consumption-attributable mortality from liver cirrhosis decreased in men.

[Comparability between the ninth and tenth revisions of the International Classification of Diseases applied to coding causes of death in Spain]. / Comparabilidad entre la novena y la décima revisión de la Clasificación Internacional de Enfermedades aplicada a la codificación de la causa de muerte en España.

OBJECTIVE: To analyze comparability between the ninth and tenth revisions of the International Classification of Diseases (ICD) applied to coding causes of death in Spain. METHODS: According to the ninth and tenth revisions of the ICD, 80,084 statistical bulletins of mortality registered in 1999 were assigned the Basic Cause of Death. The statistical bulletins corresponded to the Autonomous Communities of Andalusia, Cantabria, Murcia, Navarre and the Basque Country, and the city of Barcelona. The underlying causes of death were classified into 17 groups. Simple correspondence, the Kappa index and the comparability ratio for major causes were calculated. RESULTS: A total of 3.6% of deaths changed group due to an increase (36.4%) in infectious and parasitic diseases, mainly because of the inclusion of AIDS, and a corresponding decrease due to the exclusion of endocrine, nutritional and metabolic disorders. Furthermore, myelodysplastic syndrome was moved to the category of neoplasm. The group including nervous system diseases, eye and related diseases, and ear and mastoid apophysis diseases increased (14.7%) at the expense of mental and behavior disorders, due to the inclusion of senile and presenile organic psychosis. Poorly-defined entities increased (14.1%) due to the inclusion of cardiac arrest and its synonyms, together with heart failure, to the detriment of diseases of the vascular system. Diseases of the respiratory system increased (4.8%) due to the inclusion of respiratory failure, previously considered as a poorly defined cause. The correspondence for all causes was 96.4% and kappa's index was 94.9% CONCLUSIONS: The introduction of ICD-10 affects the comparability of statistical series of mortality according to cause. The results of this study allow us to identify the main modifications and to quantify the changes in the major causes of mortality in Spain.

[Lung cancer mortality in Barcelona: evidence for an initial decline in men]. / Mortalidad por cáncer de pulmón: inicio de declive en los varones de Barcelona.

BACKGROUND: Tobacco use in Spain is still high, with many smoking related deaths. However, a decrease in smoking prevalence in men has been observed in recent years, with a stabilisation or an increase among women. This paper studies the evolution of cancer mortality in Barcelona city (Catalonia, Spain) according to age and sex over the period 1984-1998. SUBJECTS AND METHOD: The evolution of annual mortality by age and sex was calculated. Specific mortality rates were estimated by age and sex strata; crude and standardized death rates for each year were also determined. Finally, for the 35-64 years population, specific mortality rates were estimated for each 5-year period (1984-1988, 1989-1993, and 1994-1998). RESULTS: Mortality rates do not change for men aged 35-39, 50-54 and 55-59 years. There was a decrease in lung cancer mortality rates in the 1994-1998 period compared to the first period for those men in the 60-64 years group. In men in the 40-44 and 45-49 years groups, rates increased in the second and stabilize in the last period. Global rates in men in the 35-64 years group, both crude and adjusted, were in the first and last 5-year periods. Among women, rates are much lower, although there was a significant increase in the 35-39 and 45-49 years groups. Crude and adjusted rates in all women aged 35 to 64 years displayed an increase in the last 5-year period. CONCLUSIONS: These results show that in Barcelona the decrease in smoking prevalence among males is now leading to an initial decrease in lung cancer mortality. The turning point seems to be in the period 1989-1993. On the contrary, there is a clear increase among young women, although the rates are still much lower.

Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance?

OBJECTIVE: To analyse social class inequalities in the access to and utilization of health services in Catalonia (Spain), and the influence of having private health insurance supplementing the National Health System (NHS) coverage. DESIGN: 1994 Catalan Health Interview Survey, a cross-sectional survey conducted in 1994. SETTING: Catalonia (Spain). STUDY PARTICIPANTS: The participants were a representative sample of people aged over 14 years from the non-institutionalized population of Catalonia (n = 12,245). MAIN OUTCOME MEASURES: Health services utilization, perceived health, having only NHS or NHS plus a private health insurance, and social class. RESULTS: Although one-quarter of the population of Catalonia had a supplemental private health insurance, percentages were very different according to social class, ranging from almost 50% for classes I and II to 16% for classes IV and V in both sexes. No inequalities by social class were observed for the utilization of non-preventive health care services (consultation with a health professional in the last 2 weeks and hospitalization in the last year) among persons with poor self-perceived health status, i.e. those in most need. However, social inequalities still remain in the use of health services provided only partially by the NHS, and when characteristics of last consultation are taken into account. Subjects who paid for a private service waited an average of 18.8 minutes less than those attending the NHS. Within the NHS, social classes IV and V waited longer (35.5 minutes) than social classes I and II (28.4 minutes). CONCLUSION: The NHS in Catalonia, Spain, has reduced inequalities in the use of health services. Social inequalities remain in the use of those health services provided only partially by the NHS.

Material deprivation and leading causes of death by gender: evidence from a nationwide small area study.

STUDY OBJECTIVE: To investigate the association between material deprivation and 10 leading causes of death by gender. DESIGN: Small area cross sectional ecological study using two dimensions of material deprivation (Index 1 and Index 2) drawn from 1991 census and cause specific mortality data aggregated for 1987-1995. SETTING: 2218 small areas in Spain. MAIN RESULTS: Strong detrimental associations of two deprivation indices were found with top six leading causes of death for men and top seven leading causes of death for women, except breast cancer. For men, the highest percentages of excess mortality (between 40% and 60%) were found for smoking and alcohol related causes of death such as lung cancer, chronic obstructive pulmonary diseases, and cirrhosis while for women the highest percentages of excess mortality (between 40% and 60%) were found for diet related causes such as diabetes and ischaemic heart disease. CONCLUSIONS: Health inequality is a widespread phenomenon in the majority of the top leading causes of deaths of the nation. Increasing levels of deprivation indices are associated with mortality risk differently by both cause and gender. Results suggest that deprivation effects mainly captured by Index 2 may manifest largely as unfavourable health behaviours leading to gender specific sets of causes of deaths. Findings of this study are consistent with the idea that material deprivation determines health inequality through both an increase of general susceptibility to ill health, leading to excess mortality in a wide range of causes, and a set of specific factors, resulting in an increased risk of death from a specific set of causes in each gender.

Pattern of smoking initiation in Catalonia, Spain, from 1948 to 1992.

OBJECTIVES: This study analyzed the pattern of smoking initiation by sex and educational level in Catalonia, Spain. METHODS: Data from the 1994 Catalan Health Interview Survey were used (n = 12,245). The age and smoking status of each subject were reconstructed for each calendar period. Age-specific smoking initiation rates were calculated. RESULTS: Smoking initiation among females was rare until the 1960s, but from the period 1968-1972 onward a converging pattern was observed between the genders. Women with higher levels of education started smoking before other women, but the gradient of educational level has changed in recent years, with higher initiation rates among less-educated women. CONCLUSIONS: These results are consistent with diffusion-of-innovations theory and could be related to social and economic changes from the 1960s onward in Spain.

The quality of care and influence of double health care coverage in Catalonia (Spain).

AIMS: To analyse inequalities by social class in children's access to and utilisation of health services in Catalonia (Spain), private health insurance coverage, and certain aspects of the quality of care received. DESIGN: Cross sectional study using data from the 1994 Catalan Health Interview Survey. SETTING: Child population of Catalonia. PARTICIPANTS: A representative sample of non-institutionalised children younger than 15 years (n = 2433). MAIN OUTCOME MEASURES: Health services utilisation, perceived health, type of health insurance (only National Health System (NHS) or both NHS and private health insurance), and social class. RESULTS: No inequalities by social class were found for the utilisation of health care services provided by the NHS among children in most need. Double health care coverage does not influence the social pattern of visits. Nevertheless, social inequalities still remain in the use of those health services provided only partially by the NHS (dentist) and when characteristics of the last consultation are taken into account. That is, subjects who paid for a private service waited an average of 14.8 minutes less than those whose visit was paid for by the NHS only. CONCLUSION: Equitable access and use of medical care services in relation to need, regardless of the type of insurance and social class of their children and families, has been achieved in this region of Spain; differences by social class remain for those services incompletely covered by national health insurance and aspects of the quality of care provided.