Compassion fatigue and anxiety in critical care emergency nurses: In between efficiency and humanity.

OBJECTIVES: To determine the emotional impact of permanent proximity to trauma and death in the Emergency and ICU's nurses establishing prevalence of Compassionate Fatigue (burnout and Secondary Traumatic Stress) and anxiety. Analyze its relationship with sociodemographic, training, workplace and psychological variables. METHODS: Descriptive, cross-sectional and multicentre study. The validated ProQOL v. IV and STAI scales and an ad-hoc questionnaire with the variables of the second objective were used in 710 nurses from nine highly complex hospitals in Catalonia (Spain). RESULTS: In both units, the prevalence of professionals affected with high scores of burnout was higher than 20%, on Secondary Traumatic Stress was 30% and, 12% on anxiety. Each subscale was significantly associated with the intention to leave units and the career. 97% of participants stated that they needed to be trained in emotional management. CONCLUSION: The prevalence of burnout and Secondary Traumatic Stress were higher in our study than those offered in the reference literature in emergency and ICU nurses. The prevalence of each construct was individually related to the desire to leave work units and career. This fact, together with the participants' desire to be better trained in emotional management exposes the need to establish educational plans, as well as institutional measures to prevent and support nurses for Compassion Fatigue.

Fatiga por compasión y ansiedad en enfermeras de cuidados críticos y emergencias. Entre eficiencia y humanidad / Compassion fatigue and anxiety in critical care emergency nurses: In between efficiency and humanity

Objetivos: Determinar el impacto emocional de la proximidad al trauma y la muerte en enfermeras de urgencias y de UCI mediante las prevalencias de fatiga de compasión (burnout y estrés traumático secundario) y ansiedad. Analizar su relación con variables de tipo sociodemográfico, formativas, laborales y psicológicas. Método: Estudio descriptivo, transversal y multicéntrico. Se utilizaron las escalas validadas ProQOL v.IV y STAI y un cuestionario ad-hoc con las variables del segundo objetivo, en 710 enfermeras de nueve hospitales de alta complejidad de Cataluña (España). Resultados: En ambas unidades, la proporción de profesionales afectados en alto grado de burnout fue superior al 20%, al 30% en estrés traumático secundario y al 12% en ansiedad. Cada subescala se asoció con la intención de abandonar la unidad y la profesión. El 97% de participantes manifestaron que era necesario recibir formación en gestión emocional. Conclusiones: Las prevalencias de burnout y de estrés traumático secundario fueron superiores en nuestro estudio respecto a la literatura de referencia en las enfermeras de urgencias y en las de UCI. La prevalencia de cada constructo se relacionó individualmente con el deseo de abandono de las enfermeras de sus unidades y de su profesión. Este hecho, junto al deseo de recibir formación de los participantes, expone la necesidad de establecer planes formativos, así como medidas institucionales de prevención y apoyo para la fatiga por compasión.(AU)

Objectives: To determine the emotional impact of permanent proximity to trauma and death in the Emergency and ICU's nurses establishing prevalence of Compassionate Fatigue (burnout and secondary traumatic stress) and anxiety. Analyze its relationship with sociodemographic, training, workplace and psychological variables. Methods: Descriptive, cross-sectional and multicentre study. The validated ProQOL v.IV and STAI scales and an ad-hoc questionnaire with the variables of the second objective were used in 710 nurses from nine highly complex hospitals in Catalonia (Spain). Results: In both units, the prevalence of professionals affected with high scores of burnout was higher than 20%, on secondary traumatic stress was 30%, and 12% on anxiety. Each subscale was significantly associated with the intention to leave units and the career. 97% of participants stated that they needed to be trained in emotional management. Conclusion: The prevalence of burnout and secondary traumatic stress were higher in our study than those offered in the reference literature in emergency and ICU nurses. The prevalence of each construct was individually related to the desire to leave work units and career. This fact, together with the participants’ desire to be better trained in emotional management exposes the need to establish educational plans, as well as institutional measures to prevent and support nurses for Compassion Fatigue.(AU)

Epidemiology of tuberculosis in the Americas: the Stop TB strategy and the millennium development goals.

BACKGROUND: Tuberculosis (TB), a preventable and curable disease, remains a major public health threat in the poorest regions of the Americas. The DOTS strategy was implemented to control TB in the region in 1993, and the new Stop TB strategy, emphasizing high-quality DOTS expansion, in 2006. OBJECTIVES: To describe TB epidemiology in the region of the Americas from 1994 to 2005 and to analyze the progress made towards and prospects for achieving Goal 6 of the Millennium Development Goals (MDGs) by 2015. METHODS: TB incidence, mortality and prevalence rates as well as DOTS coverage and DOTS treatment success rates were collated from the World Health Organization (WHO) databases from 1994 to 2005. RESULTS: DOTS coverage and DOTS treatment success rates rose steadily from 1994 to 2005, with 88% of the population covered under DOTS by 2005, and an 80% success rate by the end of 2004. The TB incidence, prevalence and mortality rates have also decreased steadily from 1994 to date, but differ with respect to the various scenarios. CONCLUSIONS: With the exception of some countries, further reduction in TB incidence, prevalence and deaths by 2015 is possible. Widespread implementation of DOTS should continue in order to meet WHO targets and attain the MDGs.

[The opinion of the users as opportunity for improvement in primary health care]. / La opinión de los usuarios como oportunidad de mejora en atención primaria.

OBJECTIVES: To determine those aspects of Primary Care Center (PCC) that displeases more the clients/users, to investigate its determinants, and to apply the intervention or corresponding interventions. DESIGN: Results evaluation oriented. Detection of dissatisfaction reasons through cross observational study from survey self-fulfilled on 200 individuals selected through random cluster sampling. A continuous improvement group was implemented in order to the factors causing detected problems and their possible solutions were analyzed. LOCATION: Rambla PCC, Sant Feliu de Llobregat. Catalonian Health Institute. PARTICIPANTS AND CONTEXT: Users/clients of the PCC who were in the waiting room. Improvement Group: Professionals of Sant Feliu Primary Care Team and Baix Llobregat Nord Primary Care Service. INTERVENTIONS: Reorganization of the family doctors' agendas and reduction of bureaucratic tasks in the physicians' offices. PRINCIPAL MEASUREMENTS: Respondents socio-demographic data, and reasons for their dissatisfaction. Determinants of the problem were analyzed. The principal cause of discomfort was the delay of previous appointment. RESULTS: Among reasons for discomfort expressed by the users, the most frequent was lag time with 16% (95% CI, 10.9-21.1). This complaint referred both to wait for obtaining visit and to be in the waiting room before being visited. As determinants of delay there were identified a high number of patients, visits duplicity, bureaucratic visits, high number of urgent visits and an insufficient previous appointment visits. CONCLUSIONS: Patient's opinions help us to know how public health services are accomplishing their expectations. Process improvement is indispensable in order to provide a quality product, but it must be endowed with resources adequacy to population needs.

La opinión de los usuarios como oportunidad de mejora en atención primaria / The opinion of the users as opportunity for improvement in primary health care

Objetivos. Determinar los aspectos del centro de atención primaria (CAP) que desagradan más a los clientes/usuarios, investigar sus determinantes y aplicar la intervención o intervenciones correspondientes. Diseño. Evaluación orientada hacia los resultados. Detección de los motivos de insatisfacción a través de un estudio observacional transversal a partir de una encuesta autocumplimentada en 200 individuos seleccionados mediante muestreo aleatorio por conglomerados. Constitución de un grupo de mejora continua para investigar los factores determinantes de los problemas detectados y sus posibles soluciones. Emplazamiento. CAP Rambla, Sant Feliu de Llobregat, del Instituto Catalán de la Salud. Participantes y contexto. Usuarios/clientes de la sala de espera del CAP. Grupo de mejora: profesionales del Equipo de Atención Primaria Sant Feliu y del Servicio de Atención Primaria Baix Llobregat Nord. Intervenciones. Reorganización de las agendas de los médicos de cabecera y disminución de las tareas burocráticas en las consultas. Mediciones principales. Variables sociodemográficas de los encuestados y motivos de insatisfacción de éstos. Se procedió a analizar los determinantes del problema. La variable principal fue la demora de la cita previa. Resultados. Entre los motivos de insatisfacción expresados por los usuarios, el más frecuente fue el tiempo de demora, con un 16% (intervalo de confianza [IC] del 95%, 10,9-21,1). Esta queja se refería tanto a la espera para obtener un visita como al tiempo en la sala de espera. Como determinantes de la demora se identificaron el número elevado de pacientes, la duplicación de visitas, las visitas burocráticas, el número elevado de visitas urgentes y la cita previa insuficiente. Conclusiones. La opinión de los usuarios nos ayuda a conocer en qué medida los servicios públicos de salud están cumpliendo sus expectativas. La mejora de los procesos es un paso fundamental para la mejora continua, pero debe ir acompañada de recursos adecuados a las necesidades de la población

Objectives. To determine those aspects of Primary Care Center (PCC) that displeases more the clients/users, to investigate its determinants, and to apply the intervention or corresponding interventions. Design. Results evaluation oriented. Detection of dissatisfaction reasons through cross observational study from survey self-fulfilled on 200 individuals selected through random cluster sampling. A continuous improvement group was implemented in order to the factors causing detected problems and their possible solutions were analyzed. Location. Rambla PCC, Sant Feliu de Llobregat. Catalonian Health Institute. Participants and context. Users/clients of the PCC who were in the waiting room. Improvement Group: Professionals of Sant Feliu Primary Care Team and Baix Llobregat Nord Primary Care Service. Interventions. Reorganization of the family doctors' agendas and reduction of bureaucratic tasks in the physicians' offices. Principal measurements. Respondents socio-demographic data, and reasons for their dissatisfaction. Determinants of the problem were analyzed. The principal cause of discomfort was the delay of previous appointment. Results. Among reasons for discomfort expressed by the users, the most frequent was lag time with 16% (95% CI, 10.9-21.1). This complaint referred both to wait for obtaining visit and to be in the waiting room before being visited. As determinants of delay there were identified a high number of patients, visits duplicity, bureaucratic visits, high number of urgent visits and an insufficient previous appointment visits. Conclusions. Patient's opinions help us to know how public health services are accomplishing their expectations. Process improvement is indispensable in order to provide a quality product, but it must be endowed with resources adequacy to population needs

Estudio de la infección tuberculosa en adultos / A study of the tuberculous infection in adults

La infección tuberculosa en adultos no es muy conocida en nuestro país a pesar del interés epidemiológico que tiene. Se diseñó un estudio observacional en un grupo homogéneo de adultos funcionarios de Cataluña (n = 8.202) de 20 a 54 años de edad que se sometieron a un examen de salud, en el que se incluyó una prueba de tuberculina, con objeto de estudiar la infección tuberculosa en ellos y evaluar los factores relacionados con la misma. Resultados. La prevalencia global a la reactividad de la prueba de la tuberculina es del 22,36 por ciento y la prevalencia de la infección tuberculosa del 14,76 por ciento. Los factores relacionados con la infección tuberculosa son: edad, sexo masculino, antecedentes de exposición a fuentes de contagio y vacunación antituberculosa (BCG) previa. Conclusiones. La prevalencia de la infección tuberculosa en adultos ha descendido, siendo mayor en hombres que en mujeres, entre los que reconocen haber tenido contacto con un enfermo tuberculoso y entre los que fueron vacunados con BCG (AU)

[A study of the tuberculous infection in adults]. / Estudio de la infección tuberculosa en adultos.

UNLABELLED: Tuberculous infection in adults is not a well known entity in our country, despite its epidemiological importance. We have designed an observational study in a homogeneous group of adult civil servants of Catalonia (n = 8,202) from 20 to 54 years old that were submitted to a health examination which included a tuberculin test, in order to study the tuberculous infection in these people and to evaluate the factors associated with this infection. RESULTS: The global prevalence of reactivity in tuberculin test was 22.36% and the prevalence of the tuberculous infection was 14.76%. The factors related to the tuberculous infection were the following: age, male sex, background of exposure to sources of contagion, and previous BCG vaccination. CONCLUSIONS: The prevalence of tuberculous infection in adults has declined, and is currently greater in men than women, among patients who recognize previous contact with a tuberculous patient, and among patients with previous BCG vaccination.

[Pulmonary symptomatic tuberculosis' diagnostic delay study]. / Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática.

OBJECTIVE: To study symptomatic pulmonary tuberculosis (PTB) diagnostic delay. PATIENTS AND METHODS: Prospective study of new symptomatic PTB cases (aged > or = 15 years) by structured interview with the patients and their families. The main variables analyzed were patient's delay (PD), doctor's delay (DD), diagnostic process delay (DPD), health care system delay (HCSD) and total delay between the onset of symptoms and start of treatment (TD). Univariate and multivariate statistical analyses were performed for each component of delay. RESULTS: Two hundred eighty-seven patients were studied. The mean delays in days standard deviations were TD 81.8 77.3; PD 43.3 55.7; DD 28.4 59.6; DPD 10.0 17.7, and HCSD 38.5 62.5. CONCLUSIONS: Patients are responsible for 50% of excess delay in diagnosing symptomatic PTB. Patients in the health care system experienced diagnostic delays over 60 days in 18.5% of cases, doctors being responsible for 75% of the diagnostic delay attributable to the system.

Estudio del retraso diagnóstico de la tuberculosis pulmonar sintomática / Pulmonary symptomatic tuberculosis' diagnostic delay study

OBJETIVO: Estudiar el retraso diagnóstico de la tuberculosis pulmonar (TBP) sintomática. PACIENTES Y MÉTODOS: Estudio prospectivo de casos nuevos sintomáticos de TBP (edad 15 años) mediante entrevista estructurada al paciente y su familia. Las variables fundamentales analizadas fueron: retraso del enfermo (RE), retraso atribuible al médico (RM), retraso durante el proceso diagnóstico (RPD), retraso en el sistema sanitario (RSS) y retraso total (RT), esto es, el tiempo transcurrido desde el comienzo de los síntomas hasta el inicio del tratamiento de la TBP. Se realizó un análisis estadístico univariante, así como análisis multivariante para cada uno de los componentes del retraso diagnóstico. RESULTADOS: Se estudió a 287 enfermos. La media en días ñ desviación estándar (DE) fue para el RT y sus distintos componentes de 81,8 ñ 77,3 en el RT, 43,3 ñ 55,7 días en el RE, de 28,4 ñ 59,6 días en el RM; para el RD, de 10,0 ñ 17,7 días y en el RSS de 38,5 ñ 62,5 días. CONCLUSIONES: Dentro del elevado retraso diagnóstico de la TBP los enfermos son responsables del 50 por ciento. En el sistema sanitario el 18,5 por ciento de los enfermos sufrió un retraso diagnóstico mayor de 60 días, siendo los médicos responsables del 75 por ciento de la demora atribuible al sistema (AU)

Population-based study of cutaneous malignant melanoma in the Granada province (Spain), 1985-1992.

Cutaneous melanoma has received substantial attention during the last years because of the increase in its incidence which has been registered in many countries. This paper aims at describing the incidence and characteristics of all new cutaneous malignant melanoma cases during 1985-1992 reported to the Granada Cancer Registry (Spain) in the context of Mediterranean populations. A population-based study with 247 cutaneous melanoma cases was carried out. The variables used were: sex, age, anatomic site, hystological type, level of invasion and tumour thickness. The Age-Standardised incidence Rate per World population (ASRW) was 2.9 for males and 3.7 for females in the whole period. An increasing incidence trend for both males and females was found. The ASRW in 1985-1987, 1988-1990 and 1991-1992 was respectively 2.2, 2.9 and 3.2 for males and 3, 3.4, 4.7 for females. The most frequent location was trunk for males (36%) and lower extremities for females (44%). The most frequent hystological type for both males and females was superficial spreading melanoma. Seventy-six percent of males and 60% of females were diagnosed Clark's level III or over. Average tumour thickness was 3.3 mm for males and 2.4 mm for females. The results of this study can be a guidance for the setting up of health policies which would contribute to the prevention of the disease and to an improvement in care. Because of the increase in incidence rates and the high percentage of cases which were diagnosed at advanced stages, it is advised that prevention campaigns are addressed to the Granada population.

[Analysis of the claims in a specialist primary care center]. / Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades.

OBJECTIVE: To analyze the written claims attended at a specialists unit of a Primary Health Care Center in Nou Barris, Barcelona. DESIGN: Evaluative observational study. SETTING: Health Care District of Nou Barris, with a population of 170,849. Period of study covers claims attended between 1-6-1996 to 31-12-1998. PARTICIPANTS: 220 claims registered at a specialist unit of a primary health care center. MEASUREMENTS: Claimer's age and gender, heath care net of origin, claim's motive, claimed person or service and health care activity. Statistical analyses performed included descriptive techniques and Khi-square (chi 2) tests (alpha = 0.05). RESULTS: Cumulative incidence of claims was 4.03 per 10,000 person-year in 1996, 4.70 in 1997 and 5.88 in 1998 (p = 0.0128). 220 claims were analyzed, 53.1% of them came from women. Mean age was 51.12 +/- 15.8 years. 60% of claims came from people using the traditional health care net, and 40% from reformed health care net. Mean time of response was 12.3 +/- 12.7 days. Ophthalmology was the most claimed service (18.64%), followed by "the system" (13.64%), and "the center" (13.64%). 64% of claims pointed to specialists, and don't adjusted with their health care activity (p = 0.0001). Relative risk of being claimed at the specialists unit was 2.91, compared to the rest of the primary health care centers of Nou Barris in 1998. CONCLUSIONS: Health care user's claims become useful to detect some difficult aspects. However, improvements in the methodology of their evaluation are needed.

Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades / Analysis of claims to specialists in a primary health care center

Objetivo. Analizar las reclamaciones presentadas en la Unidad de Atención al Usuario del Centro de Atención Especializada de la Dirección de Atención Primaria (DAP) Nou Barris de Barcelona ciudad. Diseño. Investigación evaluativa observacional. Emplazamiento. DAP de Nou Barris que atiende una población de 170.849 personas, según datos censales de 1996. El período de estudio comprende las reclamaciones presentadas entre el 1 de junio de 1996 y el 31 de diciembre de 1998. Participantes. Cada una de las 220 reclamaciones registradas en el centro de atención especializada. Mediciones. Edad y género del demandante, modelo asistencial de procedencia, motivo de la reclamación, persona o servicio reclamado y actividad de la consulta. Se ha utilizado la descripción estadística y las pruebas de ji-cuadrado (*2) pertinentes. El riesgo * ha sido del 5 por ciento. Resultados. La incidencia acumulada del número de reclamaciones ha sido de 4,03 por 10.000 personas-año en 1996, de 4,70 en 1997 y de 5,88 en 1998 (p = 0,0128). De las 220 reclamaciones registradas, un 53,1 por ciento corresponde a mujeres. La edad media es de 51,12 ñ 15,80 años. El 60 por ciento de las reclamaciones proviene de la asistencia no reformada y el 40 por ciento de la reformada. El tiempo medio de demora en la respuesta es de 12,3 ñ 12,7 días. Las reclamaciones más frecuentes van dirigidas a oftalmología (18,64 por ciento), al sistema (13,64 por ciento) y al centro (13,64 por ciento). El 64 por ciento de las reclamaciones van dirigidas a médicos especialistas y no se ajustan a la actividad asistencial desarrollada (p = 0,0001). El riesgo relativo de presentar reclamaciones en el centro de atención especializada fue de 2,91 respecto del resto de centros de la DAP Nou Barris en 1998. Conclusiones. Las reclamaciones de los usuarios de la atención primaria de salud son un instrumento útil para detectar algunos aspectos conflictivos. Sin embargo, hay que mejorar la metodología de evaluación de las mismas (AU)

[Diagnosis of maternal and infant health in Palestine]. / Diagnóstico de salud maternoinfantil en Palestina.

OBJECTIVE: To describe the health situation of the target population (women between 15 and 45 and children from 0 to 3), living in the towns on the West Bank in which the 12 dispensaries of the Palestine NGO Health Services Council were located, in order to plan a programme of support activities for that NGO. DESIGN: Crossover survey. Descriptive analysis of the data. SETTING: 12 towns in the 5 districts of the West Bank (Palestine) between May and July 1994. PARTICIPANTS: Women of a fertile age (15 to 45) and children between 0 and 3 living in the towns where the 12 dispensaries of the NGO Health Services Council were located. MEASUREMENTS AND MAIN RESULTS: Social, demographic and health variables of the population group involved, the availability of primary care services and the pattern of health service use were studied. Worthy of mention were the average fertility of fertile women of 4.55 deliveries (CI 95%, 4.30-4.80), the use of family planning methods by 61% of the women surveyed, the low indices of mother and infant malnutrition, and the frequency of episodes of acute respiratory infections and diarrhoea in the under-3s. The availability of health services in these communities is wide. The non-governmental and private Palestinian services were preferred for antenatal control, whereas the Israeli government services were preferred for deliveries, as these services had more resources. CONCLUSIONS: The findings were typical of an intermediately developed society, similar to neighbouring countries. The multiplicity of health services available and their lack of coordination could make the application of a unitary health policy in the area difficult.

[Assessment of an interventional study on iodine deficiency in Burkina Faso, 1990-1993. Direction de la Santé de la Famille (Burkina Faso)]. / Valoración de un estudio de intervención sobre el déficit de yodo en Burkina Faso, 1990-1993. Direction de la Santé de la Famille (Burkina Faso).

OBJECTIVES: To find how the urinary parameters of iodine excretion evolved in a community with deficiencies, after administering iodine orally and IM in two provinces in Burkina Faso; to recommend a national strategy to tackle iodine deficits. Design. A longitudinal survey before and after the iodine was given (12 months). Descriptive analysis of the data. SETTING: Provinces of Namentenga and Passoré in Burkina Faso. PARTICIPANTS: The general population of the two provinces who satisfied age-sex criteria: males from 0 to 25, females from 0-45. Randomised two-stage sampling. 423 people in all took part (210 in Namentenga and 213 in Passoré). INTERVENTIONS: The administration of 1 ml of iodised oil (Lipiodol) orally in Namentenga and IM in Passoré. MEASUREMENTS AND MAIN RESULTS: The urinary parameters of micrograms of iodine per gr. of Creatinine, and micrograms of iodine per dl of urine, were used. Figures for normalisation of the urinary parameters 12 months after iodisation was significantly higher in Passoré province, where iodine was administered IM. CONCLUSIONS: The intramuscular pathway has more longlasting effects, but the characteristics of Burkina Faso's health system and the feasibility of a medium or long-term intervention make it advisable that iodine supplements be administered orally.

[Factors conditioning absenteeism among primary care physicians]. / Factores condicionantes del absentismo laboral entre los médicos de atención primaria.

OBJECTIVES: To find whether the variables age, gender, speciality, training and type of contract of primary care doctors, as well as the size of their patient lists and the sort of centre where they work, affect their absenteeism, as measured by time off work sick. DESIGN: An observational, crossover study. SETTING: Nou Barris, sub-division of Barcelona City, primary care (PC) district during 1994. PARTICIPANTS: Doctors. MEASUREMENTS AND MAIN RESULTS: In the PC district there were 121 doctors, counting PC teams (PC), traditional system (TS) and specialists. Bivariant epidemiological and statistical techniques were used to verify the relationships between variables. Alpha risk was 5%. 40% of the District's doctors had some time off sick during the year. There were 79 occasions of time off (74 were for short-term sickness and 5 for maternity). Total days lost were 2,477, an average of 31.35. Time off work was related to the age of the doctors and the number of patients attending. Centres where the reform had been implemented had very few cases of time off. CONCLUSIONS: Cases of time off work for sickness among primary care doctors are mainly concentrated in the non-reformed network. It would be useful to study ways of increasing these doctors' motivation.

[Epidemiology of tobacco use in health-science students]. / Epidemiología del tabaquismo en los estudiantes de ciencias de la salud.

The characteristics of tobacco use by students of the Division of Health Sciences of the University of Barcelona have been studied. During the 1988-1989 school year, 382 students were individually interviewed about their use of tobacco by means of a questionnaire routinely used by the Department of Health and Social Security of the Generalitat of Catolonia (Spain), with pertinent modifications for this specific group. These interviews were performed by appropriately trained personnel. Information was also gathered on the influence of university-level studies on smoking habits, the effect of advertising and the efficacy of antitobacco programs and campaigns carried out by the government. The study sample was drawn from lists supplied by the registrars' offices, by means of a random sampling by school (Medicine, Pharmacy, Psychology, Odontology and Nursing). The prevalence of tobacco use was 40.8% (29.8% daily smokers and 11% occasional smokers). These results are similar to those described in the literature, although these values are somewhat higher than those in more developed countries with a longer tradition of resistance to the use of tobacco. It is important to note that studying health sciences does not appear to be a major influence on the student's habits, but that the social and cultural environment is the factor which weighs the most in this respect. In conclusion, to reduce the prevalence of tobacco use in this important group, educational programs must be begun at the pre-university level (secondary school) and changes should be made in the curricula of the health professional so that areas related to tobacco use are more motivational for students.

Epidemiología del tabaquismo en los estudiantes de ciencias de la salud / Tobacco use in health-science students

Foram estudadas as características do hábito de fumar nos estudantes de ciências da saúde da Universidade de Barcelona. Durante o ano letivo 1988-89 foram entrevistados 382 aluno em relaçäo ao uso do fumo, por meio de questionário rotinamente utilizado por um Departamento daquela Universidade, no qual foram efetuadas modificaçöes pertinentes ao grupo estudado. Foram obtidas informaçöes relacionadas com a influência dos estudos universitários no hábito de fumar, com os efeitos da publicidade e com a eficácia dos programas e das campanhas da luta anti-fumo desenvolvidos pelas administraçöes públicas. A amostra foi obtida a partir das listagens fornecidas pelas diferentes secretarias administrativas, por meio de uma amostragem aleatória estratificada por Faculdades (Medicina, Farmácia, Psicologia, Odontologia e Enfermagem). A prevalência do tabagismo foi de 40,8 por cento (29,8 por cento de fumantes habituais e 11 por cento ocasionais). Os estudos relacionados com a saúde näo parecem influir, de uma forma destacada, no hábito dos estudantes, sendo o meio cultural e social o fator que exerce papel mais determinante nesse sentido. Assinala-se que, para poder diminuir a prevalência do fumo nesse importante grupo, devem-se iniciar programas educativos ao nível de escolarizaçäo pré-universitária (bacharelato unificado polivalente e curso de orientaçäo universitária) e introduzir modificaçöes nos futuros planos de estudo das profissöes sanitárias, de forma a que os conteúdos relacionados com o fumo sejam canais motivadores para os alunos

[An approach to the study of excess weight in health professionals using observational data]. / Aproximación al estudio del exceso de peso en profesionales sanitarios mediante datos observacionales.

BASIS: Overweight is a public health problem in Catalonia as well. Quetelet's body mass index (BMI) is the most commonly used measurement in epidemiology for obesity quantification. This study was designed to assess its prevalence among the Catalonian health professionals. MATERIAL AND METHODS: We used a self-evaluated anonymous questionnaire which was filled up by 176 health professionals (75 men, 101 women) attending several training programmes in public health. More than 90% of the were between 25 and 38 years of age. RESULTS: Overweight prevalence (BMI > or = ) was of 15% (10% - 10% - 20%), significantly greatest among men (29%) than among women (5%). In both cases, it was mainly mild overweight. CONCLUSIONS: Overweight prevalence is highest among male health professionals, although globally, it is lower than in the general adult population of Catalonia for similar age groups.