Sobrepeso y obesidad infantil según variables socioeconómicas en escolares de tercero de Primaria de la ciudad de Barcelona / Overweight and childhood obesity according to socioeconomic variables in third grade school-age children in the city of Barcelona

Introducción: el sobrepeso y la obesidad infantil han aumentado progresivamente en las últimas décadas, especialmente en países del sur de Europa. Objetivo: analizar la asociación del sobrepeso y la obesidad infantil en la ciudad de Barcelona según variables socioeconómicas en escolares de tercero de Primaria. Métodos: estudio transversal. Población de estudio: alumnos de tercero de Primaria de la ciudad de Barcelona en el año 2011 (n = 3.624). Como variable dependiente se estudió el índice de masa corporal y como independientes: sexo, edad, clase social, situación parental, procedencia, titularidad de la escuela, nivel socioeconómico del barrio de la escuela y distrito. Se realizaron modelos de regresión logística, obteniendo odds ratio (OR) con sus intervalos de confianza al 95% (IC 95%). Resultados: la prevalencia de sobrepeso y obesidad infantil fue del 24,5% y 13,8%, respectivamente. Las variables asociadas a la obesidad fueron: ser niño (OR = 1,26; IC 95% = 1,02-1,57), de nivel socioeconómico bajo (OR = 1,60; IC 95% = 1,16-2,20), en situación familiar monoparental (OR = 1,35; IC 95% = 1,03-1,77), ser inmigrante (OR = 1,68; IC 95% = 1,33-2,13) y residir en uno de los distritos menos favorecidos de Barcelona. Conclusiones: se evidencia que la clase social, la procedencia, la situación familiar y el distrito de residencia juegan un papel importante en la obesidad infantil

Introduction: childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. Objective: to analyze the association of overweight and obesity childhood in the city of Barcelona according to socioeconomic variables in schoolchildren in third grade primary school. Methods: transversal study. Study population: third grade primary school students in the city of Barcelona in year 2011 (n = 3,624). Body mass index was studied as the dependent variable, and sex, age, social class, parental status, origin, ownership school, neighborhood socioeconomic status of the school and district were studied as independent. Logistic regression models were analyzed, obtaining odds ratio (OR) with 95% confidence intervals (95% CI). Results: the prevalence of overweight and obesity in childhood were 24.5% and 13.8%, respectively. The variables associated with obesity were: boy (OR = 1.26; 95% CI = 1.02-1.57), low socioeconomic status (OR = 1.60; 95% CI = 1.16-2.20), single-parent family (OR = 1.35; 95% CI = 1.03-1.77), immigrant (OR = 1.68; 95% CI = 1.33-2.13) and living in one of the less favored districts of Barcelona. Conclusions: it is evident that social class, origin, family status and the district of residence play an important role in childhood obesity

[Overweight and childhood obesity according to socioeconomic variables in third grade school-age children in the city of Barcelona]. / Sobrepeso y obesidad infantil según variables socioeconómicas en escolares de tercero de Primaria de la ciudad de Barcelona.

INTRODUCTION: Introduction: childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. Objective: to analyze the association of overweight and obesity childhood in the city of Barcelona according to socioeconomic variables in schoolchildren in third grade primary school. Methods: transversal study. Study population: third grade primary school students in the city of Barcelona in year 2011 (n = 3,624). Body mass index was studied as the dependent variable, and sex, age, social class, parental status, origin, ownership school, neighborhood socioeconomic status of the school and district were studied as independent. Logistic regression models were analyzed, obtaining odds ratio (OR) with 95% confidence intervals (95% CI). Results: the prevalence of overweight and obesity in childhood were 24.5% and 13.8%, respectively. The variables associated with obesity were: boy (OR = 1.26; 95% CI = 1.02-1.57), low socioeconomic status (OR = 1.60; 95% CI = 1.16-2.20), single-parent family (OR = 1.35; 95% CI = 1.03-1.77), immigrant (OR = 1.68; 95% CI = 1.33-2.13) and living in one of the less favored districts of Barcelona. Conclusions: it is evident that social class, origin, family status and the district of residence play an important role in childhood obesity.

INTRODUCCIÓN: Introducción: el sobrepeso y la obesidad infantil han aumentado progresivamente en las últimas décadas, especialmente en países del sur de Europa. Objetivo: analizar la asociación del sobrepeso y la obesidad infantil en la ciudad de Barcelona según variables socioeconómicas en escolares de tercero de Primaria. Métodos: estudio transversal. Población de estudio: alumnos de tercero de Primaria de la ciudad de Barcelona en el año 2011 (n = 3.624). Como variable dependiente se estudió el índice de masa corporal y como independientes: sexo, edad, clase social, situación parental, procedencia, titularidad de la escuela, nivel socioeconómico del barrio de la escuela y distrito. Se realizaron modelos de regresión logística, obteniendo odds ratio (OR) con sus intervalos de confianza al 95% (IC 95%). Resultados: la prevalencia de sobrepeso y obesidad infantil fue del 24,5% y 13,8%, respectivamente. Las variables asociadas a la obesidad fueron: ser niño (OR = 1,26; IC 95% = 1,02-1,57), de nivel socioeconómico bajo (OR = 1,60; IC 95% = 1,16-2,20), en situación familiar monoparental (OR = 1,35; IC 95% = 1,03-1,77), ser inmigrante (OR = 1,68; IC 95% = 1,33-2,13) y residir en uno de los distritos menos favorecidos de Barcelona. Conclusiones: se evidencia que la clase social, la procedencia, la situación familiar y el distrito de residencia juegan un papel importante en la obesidad infantil.

[Factors Associated with Overweight and Obesity in Schoolchildren from 8 to 9 Years Old. Barcelona, Spain]. / Factores asociados al sobrepeso y la obesidad en escolares de 8 a 9 años de Barcelona.

OBJECTIVE: Childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. The aim of this study was to identify the prevalence of overweight, obesity and its determinants in schoolchildren between 8-9 years old from Barcelona. METHODS: Cross-sectional study of a representative sample of 3,262 schoolchildren in 2011. Body Mass Index (BMI) was calculated following the criteria established by the World Health Organization (z-scores). Variables on eating behaviour, physical activity and use of new technologies were studied through 2 questionnaires. Logistic regression models were adjusted, obtaining adjusted odds ratio and their confidence intervals (95%). RESULTS: The prevalence of overweight was 24.0% and 12.7% for obesity. Obesity was significantly higher in boys than in girls (14.8% vs 10.8%.). No statistically significant differences were observed in the compliance of recommendations of physical activity practice and use of new technologies according to BMI. Factors associated with obesity in boys were to attend a school located in a neighbourhood of disadvantaged socio-economic status [ORa=1.88 (1.35-2.63)], to belong to an immigrant family [ORa=1.57 (1.12-2.20)], to do not eat at school [ORa=1.76 (1.20-2.59)] and to have some meal alone [ORa=1.95 (1.27-3.00)]. In girls associated factors were to belong to a single-parent family [ORa=1.58 (1.06-2.34)] and to an immigrant family [ORa=1.53 (1.07-2.18)]. CONCLUSIONS: The prevalence of childhood obesity in Barcelona is high. It is more common in boys, being the social determinants most relevant associated factors.

Factores asociados al sobrepeso y la obesidad en escolares de 8 a 9 años de Barcelona / Factors associated with overweight and obesity in schoolchildren from to years old. Barcelona, Spain

Fundamentos: El sobrepeso y la obesidad infantil han aumentado progresivamente en las últimas décadas, especialmente en países del sur de Europa. El objetivo del estudio fue identificar la prevalencia de sobrepeso, obesidad y sus determinantes en escolares de 8-9 años de Barcelona. Métodos: Estudio transversal descriptivo de una muestra representativa de 3.262 escolares en 2011. Se calculó el Índice de Masa Corporal (IMC) siguiendo los criterios establecidos por la Organización Mundial de la Salud (z-scores). Se estudiaron variables sobre conducta alimentaria, actividad física y uso de nuevas tecnologías mediante 2 cuestionarios. Se ajustaron modelos de regresión logística, obteniendo odds ratio ajustadas e intervalos de confianza (95%). Resultados: La prevalencia de sobrepeso fue del 24,0% y de obesidad del 12,7%. La obesidad fue significativamente mayor en niños que en niñas (14,8% vs. 10,8%). No se observaron diferencias estadísticamente significativas según IMC en el cumplimiento de las recomendaciones de práctica de actividad física ni uso de nuevas tecnologías. Los factores asociados a la obesidad en niños fueron asistir a escuela situada en barrios de nivel socioeconómico desfavorable [ORa=1,88 (1,35-2,63)], pertenecer a familia inmigrante [ORa=1,57 (1,12- 2,20)], no comer en el colegio [ORa=1,76 (1,20-2,59)] y hacer alguna comida solo [ORa=1,95 (1,27-3,00)]. En niñas fueron pertenecer a familia monoparental [ORa=1,58 (1,06-2,34)] y familia inmigrante [ORa=1,53 (1,07-2,18)]. Conclusiones: La prevalencia de obesidad infantil en Barcelona es alta. Es más frecuente en niños, siendo los determinantes sociales los factores asociados de mayor relevancia (AU)

Background: Childhood overweight and obesity have increased progressively in the last decades, especially in countries of Southern Europe. The aim of this study was to identify the prevalence of overweight, obesity and its determinants in schoolchildren between 8-9 years old from Barcelona. Methods: Cross-sectional study of a representative sample of 3,262 schoolchildren in 2011. Body Mass Index (BMI) was calculated following the criteria established by the World Health Organization (z-scores). Variables on eating behaviour, physical activity and use of new technologies were studied through 2 questionnaires. Logistic regression models were adjusted, obtaining adjusted odds ratio and their confidence intervals (95%). Results: The prevalence of overweight was 24.0% and 12.7% for obesity. Obesity was significantly higher in boys than in girls (14.8% vs 10.8%.). No statistically significant differences were observed in the compliance of recommendations of physical activity practice and use of new technologies according to BMI. Factors associated with obesity in boys were to attend a school located in a neighbourhood of disadvantaged socio-economic status [ORa=1.88 (1.35- 2.63)], to belong to an immigrant family [ORa=1.57 (1.12-2.20)], to do not eat at school [ORa=1.76 (1.20-2.59)] and to have some meal alone [ORa=1.95 (1.27-3.00)]. In girls associated factors were to belong to a single-parent family [ORa=1.58 (1.06-2.34)] and to an immigrant family [ORa=1.53 (1.07-2.18)]. Conclusions: The prevalence of childhood obesity in Barcelona is high. It is more common in boys, being the social determinants most relevant associated factors (AU)

Prospective comparison of whole-body (18)F-FDG PET/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis.

PURPOSE: To prospectively compare (18)F-FDG PET/CT and MRI in the diagnosis of haematogenous spondylodiscitis METHODS: The study included 26 patients (12 women, 14 men; mean age 59 ± 17 years) with clinical symptoms of infection of the spine. Patients who had had prior spinal surgery or any type of antibiotic therapy in the previous 3 months were excluded from the study. Whole-body PET/CT 60 min after injection of 4.07 MBq/kg of (18)F-FDG and an MRI scan of the spine was performed in all patients. SUVmax in an area surrounding the lesions with the suspicion of infection as well as a background SUVmean in a preserved area of the spine were calculated for quantification. Infection was diagnosed by microbiological documentation in cultures of image-guided spinal puncture fluid or blood. Infection was excluded if symptoms were absent without antimicrobial therapy during a follow-up of at least 6 months. RESULTS: Spondylodiscitis was confirmed in 18 of the 26 patients. Staphylococcus aureus was found in 8 patients, Mycobacterium tuberculosis in 4, Escherichia coli in 2 and other pathogens in 4. Of the remaining 8 patients, the diagnoses were degenerative spondyloarthropathy in 5 and vertebral fracture in 3. The sensitivity, specificity, and positive and negative predictive value were 83%, 88%, 94% and 70% for (18)F-FDG PET/CT, and 94%, 38%, 77% and 75% for MRI, respectively. The accuracies of (18)F-FDG PET/CT and MRI were similar (84% and 81%, respectively). The combination of (18)F-FDG PET/CT and MRI detected the infection in 100% of the patients with spondylodiscitis. (18)F-FDG uptake, quantified in terms of SUVmax corrected by the background SUVmean, was significantly higher in patients with spondylodiscitis than in those without infection (p < 0.001). CONCLUSION: Due to its high specificity, (18)F-FDG PET/CT should be considered as a first-line imaging procedure in the diagnosis of spondylodiscitis. Quantification of uptake in terms of SUVmax was able to discriminate infection of the spine from other processes in this series of patients.

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

Introducción: Con frecuencia los efectos positivos observados de las intervenciones preventivas escolares son menores a los esperados, habitualmente por una implementación inadecuada. Objetivos: Describir la evaluación de proceso del programa de prevención del consumo de cánnabis en escolares (xkpts.com), medir la satisfacción de los profesores con el programa y definir los parámetros cuantitativos y cualitativos para valorar la exhaustividad de la intervención. Metodología: Estudio descriptivo transversal. Muestra: 117 aulas de 39 escuelas de 3º ESO (2812 escolares). La información se recogió mediante fichas de evaluación cumplimentadas por el profesorado y las familias. Se realizó un análisis descriptivo de la implementación de la intervención en las aulas y de la participación de las familias. Resultados: Tasa de respuesta de los profesores del 65%. La discusión fue la técnica más aplicada (100% de las aulas) y el DVD el recurso más utilizado (93,4%). El entrenamiento de habilidades se aplicó en el 72,4%de aulas. El 59,2% de aulas realizó una intervención aceptable (mínimo 8 de 16 actividades preventivas) frente al 38,2% de aulas con intervención cualificada (mínimo 1 actividad por cada sesión general y 2 por cada específica). La puntuación media de la valoración del programa fue 7,4 y el 81,6% del profesorado volvería a aplicarlo. La tasa de participación de las familias fue del 28,3% (796). Conclusiones: En dos de cada tres aulas la intervención fue aceptable y cuatro de cada diez cumplieron estrictamente el protocolo. Una mayor participación de las familias se corresponde con las escuelas con una mejor implementación de la intervención (AU)

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-gradeclasses 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 (AU)

[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.

[Predictors of the onset of tobacco consumption among secondary school students of Barcelona and Lleida]. / Predictores de la iniciación al consumo de tabaco en escolares de enseñanza secundaria de Barcelona y Lleida.

BACKGROUND: Knowing the factors predisposing the smoking onset of smoking at school age may help to improve the preventive strategies and make the starting age later. This study is set out to describe the natural history of smoking throughout the teen-age years and the main factors which may predict teenagers developing the smoking habit. METHODS: This is a longitudinal study of a survey type, using the school room as the sampling unit at six schools in Barcelona and Lleida. A total of 1,460 students within the 12-19 age range took part. Two surveys were conducted, an initial survey in the spring of 1992 and a follow-up survey one year later. A total of 1,236 questionnaires (84.3%) were paired by means of a personal code used for the longitudinal study. RESULTS: A total of 25% of the students were regular smokers at the start of the study, 17.1% smoking occasionally or having experimented with smoking, there being no differences between sexes for both of these categories. Among those who were non-smokers at the starting survey, 12.7% stated that they smoked occasionally and 6.2% regularly one year later. The females started smoking at an earlier age, the differences as compared to males being statistically significant at 14 years of age. The predictors of the smoking onset include favorable attitudes toward cigarettes (OR = 3.1; CI5% (1.6-5.6), drinking alcoholic beverages (OR = 2.2; CI95% (1.4-3.3), being younger than age 15 (OR = 2.0; CI95% (1.2-3.4), having friends who smoke (OR = 1.9, CI95% (1.2-3.0) and the stated intention of smoking in the future (OR = 1.6; CI95% (1.0-2.5). CONCLUSIONS: The students showing a higher degree of tolerance toward cigarette smoking, entailing favorable attitudes or friends who smoke or who intend to smoke in the future at the start of the study are at a much higher risk of Smoking onset than their classmates who are not of these characteristics. The cigarette smoking prevention programs must focus special attention on the teenagers most highly vulnerable to these factors.

Predictores de la iniciación al consumo de tabaco en escolares de enseñanza secundaria de Barcelona y Lleida / Predictors for the smoking onset among high school students of Barcelona and Lleida

Fundamento: El conocimiento de los factores que predisponen a la iniciación en el consumo de tabaco en la edad escolar puede ayudar a mejorar las estrategias preventivas y retrasar la edad de inicio. El presente estudio se plantea describir la historia natural del consumo de tabaco a lo largo de la adolescencia y los principales factores que pueden predecir la evolución a fumar. Métodos: Se trata de un estudio longitudinal, de tipo prospectivo, utilizando el aula escolar como unidad muestral, en 6 escuelas de Barcelona y Lleida. Participaron un total de 1.460 escolares con edades comprendidas entre los 12 y los 19 años. Se realizaron dos encuestas, una inicial en la primavera de 1992 y otra de seguimiento un año más tarde. 1.236 cuestionarios (84,7 per cent) se emparejaron a través de un código personal utilizado para el estudio longitudinal. Resultados: El porcentaje de escolares fumadores regulares al inicio del estudio era del 28 per cent, con un 17,1 per cent de fumadores ocasionales o experimentadores, sin diferencias entre sexos para ambas categorías. De los alumnos no-fumadores en la encuesta inicial, un año más tarde se declaraban fumadores ocasionales un 12,7 per cent y un 6,2 per cent fumadores regulares. Existe una mayor precocidad en el inicio del consumo de tabaco en el sexo femenino, siendo las diferencias con el sexo masculino estadísticamente significativas a los 14 años de edad. Los predictores de la iniciación incluyen las actitudes favorables ante el tabaco (OR=3,1; IC95 per cent (1,6-5,6)), el consumo de bebidas alcohólicas (OR=2,2; IC95 per cent (1,4-3,3)), ser menor de 15 años (OR=2,0; IC95 per cent (1,2-3,4)), tener amigos fumadores (OR=1,9; IC95 per cent (1,2-3,0)) y la intención declarada de fumar en el futuro (OR=1,6; IC95 per cent (1,0-2,5)). Conclusiones: Los escolares con una mayor tolerancia hacia el consumo de tabaco, con unas actitudes favorables o con amigos fumadores o con intención de fumar en el futuro al comienzo del estudio, tienen mucho mayor riesgo de iniciarse en el hábito tabáquico que los que no muestran estas características. Los programas de prevención del tabaquismo deberían prestar especial atención a los adolescentes más vulnerables a estos factores (AU)

Factors associated with smoking progression among Spanish adolescents.

Smoking onset takes place in the early years of adolescence, and can be seen as a progression through stages of preparation, trying, experimentation, regular smoking and nicotine dependence or addiction. The objective of this study is to identify 1-year predictors of smoking consolidation among occasional smokers (experimenters) and of cessation among all smokers. A questionnaire developed to monitor trends in smoking and other health-related behaviors was administered in the spring of 1992 and again 1 year later (1993). The survey was carried out in six large, private schools in Barcelona and Raimat, in the Lleida province, in Catalonia (Spain). In total, 1460 schoolchildren aged 12-19 responded to both the baseline and follow-up questionnaires; 1236 questionnaires (84.7%) were matched through a personal code and were used for the longitudinal study. At the baseline survey 28% of the schoolchildren were regular smokers and 17.1 % were occasional smokers, with no differences by gender. At the follow-up survey, progression from occasional to regular smoking was observed in 42% of the girls and 22.7% of the boys. Other predictors of consolidation included drinking alcohol (OR = 3.1; 95% CI = 1.1-10.1) and reporting the intention to smoke in the future (OR = 2.5; 95% CI = 1.3-4.9). Among all the smokers at the baseline, predictors of cessation were smoking occasionally (versus regularly) (OR = 4.9; 95% CI = 2.8-8.6), negative attitudes regarding smoking (OR = 3.3; 95% CI = 1.9-5.4), reporting no intention to smoke in the future (OR = 2.2; 95% CI = 1.3-3.8), gender (OR for boys = 2.1; 95% CI = 1.2-3.6), receiving weekly pocket less than 1000 ptas (OR = 1.7; 95% CI = 1.1-5.3) and age (OR for being 15 and younger = 1.6; 95% CI = 1.1-4.9). We conclude that consolidation of smoking is twice as likely among girls than among boys. Intention to smoke seems to be a good predictor of future behavior, while attitudes may predict cessation, but not consolidation. Available pocket money seems to be a strong risk factor for smoking at this age.