Gender differences in negative mood states in secondary school students: health survey in Catalonia (Spain)

Objective: To determine the prevalence of negative mood states in adolescents according to gender, toanalyze variability among schools, and to evaluate the associated factors.Methods: A cross-sectional study with a cluster design was carried out. We administered the High-schoolstudents health survey to a sample of 9,340 students (aged 14-16 years) in the third and fourth year ofCompulsory Secondary Education in Catalonia, Spain, during the 2005-6 academic year. The main outcome measure was evidence of a negative mood state. A multilevel logistic regression model stratified bygender was used to identify the factors associated with negative mood states and to determine variabilityamong distinct schools.Results: Approximately 19% of adolescents reported evidence of a negative mood state, with a higherprevalence in girls (25%). The most significant factors associated with negative mood states were “useof tranquilizers” and “having eating disorders” in girls and “not exercising” and “poor self-perception ofhealth status” in boys. In both genders, variability was found among schools in the prevalence of negativemood states (girls: variance = 0.078; p <0.001; boys: variance = 0.079; p = 0.012).Conclusions: The prevalence of negative mood states in adolescent boys and girls was high. Differenceswere observed between genders in the factors related to these health states. The variability observedin the prevalence of negative mood states among distinct schools could not be explained by the studyvariables. Our results emphasize the association between the use of tranquilizers and negative moodstates (AU)

Objetivos: Determinar la prevalencia del estado de ánimo negativo entre alumnos adolescentes segúnsexo, analizar la variabilidad entre escuelas y evaluar los factores asociados.Métodos: Estudio transversal basado en un muestreo por conglomerados bietápico. Administramos unaencuesta de salud a 9340 estudiantes de tercero y cuarto curso de Educación Secundaria Obligatoriade 14 a 16 anos de edad, en Catalu ˜ na, durante el curso escolar 2005-06. La variable principal fue el ˜estado de ánimo negativo. Se usó un modelo de regresión logística multinivel estratificado por sexopara identificar los factores asociados al estado de ánimo negativo y determinar la variabilidad entre lasdiferentes escuelas.Resultados: Aproximadamente el 19% de los adolescentes refirieron un estado de ánimo negativo, siendomás prevalente entre las chicas (25%). En ellas, los factores asociados significativamente con estadosde ánimo negativo fueron «tomar tranquilizantes» y tener trastornos alimentarios, mientras que en loschicos fueron no realizar deporte y tener una mala percepción de su estado de salud. Hay variabilidad enla prevalencia del estado de ánimo negativo según las escuelas en ambos sexos (chicas: varianza = 0,078,p <0,001; chicos: varianza = 0,079, p = 0,012).Conclusiones: La prevalencia del estado de ánimo negativo entre los adolescentes fue alta. Se observarondiferencias entre sexos respecto a los factores relacionados con este estado de salud. Destacó la asociacióndel uso de tranquilizantes con el estado de ánimo negativo. Se observó una variabilidad de la prevalenciadel estado de ánimo negativo entre las diferentes escuelas no explicada por las variables de estudio (AU)

Gender differences in negative mood states in secondary school students: health survey in Catalonia (Spain).

OBJECTIVE: To determine the prevalence of negative mood states in adolescents according to gender, to analyze variability among schools, and to evaluate the associated factors. METHODS: A cross-sectional study with a cluster design was carried out. We administered the High-school students health survey to a sample of 9,340 students (aged 14-16 years) in the third and fourth year of Compulsory Secondary Education in Catalonia, Spain, during the 2005-6 academic year. The main outcome measure was evidence of a negative mood state. A multilevel logistic regression model stratified by gender was used to identify the factors associated with negative mood states and to determine variability among distinct schools. RESULTS: Approximately 19% of adolescents reported evidence of a negative mood state, with a higher prevalence in girls (25%). The most significant factors associated with negative mood states were "use of tranquilizers" and "having eating disorders" in girls and "not exercising" and "poor self-perception of health status" in boys. In both genders, variability was found among schools in the prevalence of negative mood states (girls: variance = 0.078; p <0.001; boys: variance = 0.079; p = 0.012). CONCLUSIONS: The prevalence of negative mood states in adolescent boys and girls was high. Differences were observed between genders in the factors related to these health states. The variability observed in the prevalence of negative mood states among distinct schools could not be explained by the study variables. Our results emphasize the association between the use of tranquilizers and negative mood states.

Risk perception among smokers: a qualitative study.

The aim of this qualitative study is to identify the dimensions people used to assess the risk of smoking and then compare them with those used by health professionals in primary healthcare. Five discussion groups were conducted. The field work was carried out in Barcelona (Spain), from February 2005 to January 2006. Data were analyzed following a semantic-thematic categorical content analysis (ACC-ts). Results showed that people tend to employ stereotypical discourses when evaluating the risk of smoking. Similarly, they reassess the risk in the context of their life experience and incorporate new nuances to the arguments sustaining their behavior. Once this reassessment takes place, the decision to continue smoking emerges, and smokers come up with additional arguments justifying their habit (i.e., age, benefits related to costs). Professionals are aware of this process and its multidimensional nature. Nevertheless, their discourse loses this multidimensional feature when discussing the strategies they use at smoking cessation interventions. This qualitative study increases the understanding of various meanings that people attribute to their life experience. These assumptions may be useful for developing health practices that are closer to people. As a practical utility of these results, it would be interesting to apply a preliminary assessment of the different meanings that people attribute to smoking from their life context in risk communication.

Clinical characteristics of isolated clinic hypertension.

OBJECTIVE: To analyze the clinical characteristics of patients with isolated clinic hypertension (ICH) compared with other hypertensive patients, and to evaluate the capacity of physicians to predict a diagnosis of ICH. METHODS: A cross-sectional, comparative multicenter descriptive study was made of 6176 hypertensive individuals without pharmacological treatment, subjected to ambulatory blood pressure monitoring (ABPM). In 2611 cases, ABPM was prescribed due to suspected ICH. The participants were consecutively selected in primary care centers and hospital hypertension units in all Spanish Autonomous Communities. ICH was defined by clinical blood pressure (BP) >or= 140 mmHg (systolic) or >or= 90 mmHg (diastolic), with diurnal ambulatory BP < 135 and < 85 mmHg (ICH1) or BP < 130 and < 80 mmHg (ICH2) or 24-h BP < 125 and < 80 mmHg (ICH3). RESULTS: ICH1, ICH2 and ICH3 criteria were met by 1807 (29.2%), 960 (15.5%) or 1133 (18.3%) subjects, respectively. Total sample mean age (SD) was 51.8 (14.1) years, and clinical BP 145.7 +/- 17.3/89.3 +/- 11.3 mmHg. Compared with the rest of the hypertensive individuals, the patients with ICH were predominantly female, of older age, with fewer smokers, and increased frequency of obesity. Moreover, they were more frequently nondippers, and with greater systolic BP in the office (P < 0.05), except when we used ICH3 criteria. The sensitivity and specificity of the physician predictions in relation to suspected ICH1, ICH2 and ICH3 were 48.7 and 60.4%, 52.9 and 59.7%, and 52.3 and 60.0%, respectively. CONCLUSIONS: The prevalence of ICH is between 15 and 29%, depending on the defining criterion used. The 24-h ICH criteria are not affected by awake/sleep biases, and should be preferred. Clinical capacity for predicting ICH is low.

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[Ankle-brachial index to detect peripheral arterial disease: concordance and validation study between Doppler and an oscillometric device]. / Indice tobillo-brazo en la detección de arteriopatía periférica: estudio de validez y concordancia entre Doppler y método oscilométrico.

BACKGROUND AND OBJECTIVE: To evaluate the sensitivity and specificity of ankle-brachial index (ABI) determined by oscillometry, using a Doppler ultrasound probe as a gold standard. We also aimed to evaluate the agreement between both methods. PATIENTS AND METHOD: Right and left ABI measurements (ABIr,ABIl) with oscillometric (OMRON-705-CP) and Doppler (DIADOP-50) devices in hypertensive patients without peripheral arterial disease. RESULTS: One hundred patients, 61 women, 66.4 (SD 10.9) year-old, smokers 16%, diabetics 38%. Oscillometric and doppler ABI could be calculated in 83% and 93% of patients, respectively. Oscillometric ABIr and ABIl measurements were <0.9 in 9.6% (CI 95%, 4.2-18.1) and 8.4% (CI 95%, 3.4-16.6), respectively, and Doppler measurements were 10.8% (CI 95%, 5.3-18.9) and 15.4% (CI 95%, 8.7-24.5) respectively. The oscillometric ABIr and ABIl sensitivity was 37.5% (CI 95%, 13.7-69.4) and 20.0% (CI 95%, 5.7-51.0) respectively, and the specificity was 93.0% (CI 95%, 84.6-97.8) and 97.1% (CI 95%, 89.9-99.2), respectively. The intraclass correlation (index Doppler/oscillometric device) was 0.64 (CI 95%, 0.44-0.77) for ABIr and 0.62 (CI 95%, 0.41-0.76) for ABIl. CONCLUSIONS: About 8.4-15.4% of hypertensive patients attended have an abnormal Doppler ABI measurement. There is not a good concordance between Doppler and oscillometric ABI measurements. This oscillometric device does not seem useful as an ABI screening method.

Índice tobillo-brazo en la detección de arteriopatía periférica: estudio de validez y concordancia entre Doppler y método oscilométrico / Ankle-brachial index to detect peripheral arterial disease: concordance and validation study between Doppler and an oscillometric device

Fundamento y objetivo: Estimar la sensibilidad y la especificidad del índice tobillo-brazo (ITB) determinado oscilométricamente respecto al Doppler y la concordancia entre ambas técnicas. Pacientes y método: Cálculo del ITB derecho (ITBd) e izquierdo (ITBi) mediante oscilometría (OMRON 705-CP) y Doppler (DIADOP-50) en pacientes hipertensos sin arteriopatía periférica. Resultados: Se incluyó a 100 pacientes hipertensos, 61 mujeres, con una media (DE) de edad de 66,4 (10,9) años. Un 16% eran fumadores y un 38%, diabéticos. Fue posible calcular el ITB en el 83 y el 93% de los pacientes mediante oscilometría y Doppler, respectivamente. Los ITBd e ITBi calculados oscilométricamente eran < 0,9 en el 9,6% (intervalo de confianza [IC] del 95%, 4,2-18,1) y el 8,4% (IC del 95%, 3,4-16,6), respectivamente, y mediante Doppler en el 10,8% (IC del 95%, 5,3-18,9) y el 15,4% (IC del 95%, 8,7-24,5), respectivamente. Las sensibilidades del ITBd y el ITBi determinados oscilométricamente fueron del 37,5% (IC del 95%, 13,7-69,4) y el 20,0% (IC del 95%, 5,7-51,0) respectivamente, y las especificidades, del 93,0% (IC del 95%, 84,6-97,8) y el 97,1% (IC del 95%, 89,9-99,2), respectivamente. El índice de correlación intraclase Doppler/oscilometría para ITBd e ITBi fue 0,64 (IC del 95%, 0,44-0,77) y 0,62 (IC del 95%, 0,41-0,76), respectivamente. Conclusiones: Entre el 8,4 y el 15,4% de los pacientes hipertensos presentan ITB patológico según Doppler, el cual no tiene buena concordancia con la oscilometría. El equipo oscilométrico evaluado no parece útil para el cribado

Background and objective: To evaluate the sensitivity and specificity of ankle-brachial index (ABI) determined by oscillometry, using a Doppler ultrasound probe as a gold standard. We also aimed to evaluate the agreement between both methods. Patients and method: Right and left ABI measurements (ABIr,ABIl) with oscillometric (OMRON-705-CP) and Doppler (DIADOP-50) devices in hypertensive patients without peripheral arterial disease. Results: One hundred patients, 61 women, 66.4 (SD 10.9) year-old, smokers 16%, diabetics 38%. Oscillometric and doppler ABI could be calculated in 83% and 93% of patients, respectively. Oscillometric ABIr and ABIl measurements were < 0.9 in 9.6% (CI 95%, 4.2-18.1) and 8.4% (CI 95%, 3.4-16.6), respectively, and Doppler measurements were 10.8% (CI 95%, 5.3-18.9) and 15.4% (CI 95%, 8.7-24.5) respectively. The oscillometric ABIr and ABIl sensitivity was 37.5% (CI 95%, 13.7-69.4) and 20.0% (CI 95%, 5.7-51.0) respectively, and the specificity was 93.0% (CI 95%, 84.6-97.8) and 97.1% (CI 95%, 89.9-99.2), respectively. The intraclass correlation (index Doppler/oscillometric device) was 0.64 (CI 95%, 0.44-0.77) for ABIr and 0.62 (CI 95%, 0.41-0.76) for ABIl. Conclusions: About 8.4-15.4% of hypertensive patients attended have an abnormal Doppler ABI measurement. There is not a good concordance between Doppler and oscillometric ABI measurements. This oscillometric device does not seem useful as an ABI screening method

[Measuring blood pressure in the forearm of obese patients: concordance with arm measurement]. / Concordancia de la determinación de la presión arterial en el brazo y en el antebrazo de pacientes obesos.

BACKGROUND AND OBJECTIVE: The occasional forearm blood pressure (BP) measurement has been accepted for some obese patients. However, few studies have compared the concordance between arm and forearm BP measurements. Our aim was to know whether the forearm BP measurement displays a good concordance with the arm BP measurement in obese patients. SUBJECTS AND METHOD: Cross-sectional descriptive study in an ambulatory setting. By means of convenience sampling, a sample of 54 patients with a body mass index > 26 kg/m2 was selected. The study unit was the upper limb (n = 108). BP was measured 3 times in each arm and forearm (12 measurements in each patient using an automated validated device OMRON 705CP) in a randomized order. RESULTS: Women: 77.8%; mean (SD) aged: 60.2 (12.7) years; body mass index: 38.6 (5.5) kg/m2; 79.6% were hypertensive. BP was higher in forearm than in arm: mean (SD) 137.7 (16.9) mmHg versus 132.1 (18) mmHg, for systolic (S) BP (p < 0.001) and 79.8 (11.2) mmHg versus 78.3 (9.9) mmHg for diastolic (D) BP (p = 0.04), respectively. Intraclass correlation coefficients for arm/forearm measurements were 0.83 (95% confidence interval [CI], 0.77-0.88) and 0.74 (95% CI, 0.65-0.82) for SBP and DBP, respectively. Mean differences between arm and forearm measurements were 5.5 mmHg (95% CI, -14.5 to 25.5) mmHg for SBP and 1.53 mmHg [95% CI, -13.5 to 16.5] for DBP. CONCLUSIONS: BP differences between arm/forearm measurements are clinically outstanding. Therefore, forearm BP measurement does not seem advisable in obese patients.

Concordancia de la determinación de la presión arterial en el brazo y en el antebrazo de pacientes obesos / Measuring blood pressure in the forearm of obese patients: concordance with arm measurement

FUNDAMENTO Y OBJETIVO: Se ha admitido la determinación ocasional de la presión arterial (PA) en el antebrazo del paciente obeso. Sin embargo, muy pocos estudios comparan la concordancia entre la PA determinada en el brazo y el antebrazo. Nuestro objetivo fue conocer si la determinación de la PA en el antebrazo de pacientes obesos tiene buena concordancia con la determinación convencional en el brazo. SUJETOS Y MÉTODO: Estudio descriptivo transversal en un centro de salud, con 54 pacientes con índice de masa corporal mayor de 26 kg/m 2 . La unidad de estudio fue la extremidad superior (n = 108). Semidió la PA 3 veces en cada brazo y antebrazo (12determinaciones por paciente) mediante un equipo OMRON 705CP, en orden aleatorio. RESULTADOS: El 77,8% eran mujeres. La media de edad fue de 60,2 (12,7) años; el índice de masa corporal medio de: 38,6 (5,5) kg/m 2 y un 79,6% eran hipertensos. La media de la PA fue superior en el antebrazo que en el brazo: 137,7 (16,9) mmHg frente a 132,1 (18) mmHg (p < 0,001), para la PA sistólica(PAS) y 79,8 (11,2) mmHg frente a 78,3 (9,9) mmHg (p = 0,04) para la PA diastólica (PAD), respectivamente. Los coeficientes de correlación intraclase brazo/antebrazo fueron de 0,83 (intervalo de confianza [IC] del 95%, 0,77-0,88) y de 0,74 (ICdel 95%, 0,65-0,82) para la PAS y la PAD, respectivamente. La media de las diferencias entre brazo y antebrazo fue de 5,5 mmHg (IC del 95%, -14,5 a25,5) para la PAS y de 1,53 mmHg (IC del 95%,-13,5 a 16,5) para la PAD.CONCLUSIONES: En las personas obesas, las diferencias de PA entre brazo y antebrazo son clínicamente relevantes, por lo que no parece conveniente la determinación en este último

BACKGROUND AND OBJECTIVE: The occasional fore armblood pressure (BP) measurement has been accepted for some obese patients. However, few studieshave compared the concordance between armand forearm BP measurements. Our aim was took now whether the forearm BP measurement displaysa good concordance with the arm BP measurement in obese patients. SUBJECTS AND METHOD: Cross-sectional descriptive study in an ambulatory setting. By means of conveniences ampling, a sample of 54 patients with a body mass index > 26 kg/m 2 was selected. The study unit was the upper limb (n = 108). BP was measured 3 times in each arm and forearm (12 measurements in each patient using an automated validated device OMRON 705CP) in a randomized order. RESULTS: Women: 77.8%; mean (SD) aged: 60.2(12.7) years; body mass index: 38.6 (5.5) kg/m 2 ;79.6% were hypertensive. BP was higher in forearm than in arm: mean (SD) 137.7 (16.9) mmHg versus132.1 (18) mmHg, for systolic (S) BP (p < 0.001)and 79.8 (11.2) mmHg versus 78.3 (9.9) mmHg for diastolic (D) BP (p = 0.04), respectively. Intraclass correlation coefficients for arm/forearm measurements were 0.83 (95% confidence interval [CI],0.77-0.88) and 0.74 (95% CI, 0.65-0.82) for SB Pand DBP, respectively. Mean differences between arm and forearm measurements were 5.5 mmHg(95% CI, -14.5 to 25.5) mmHg for SBP and 1.53mmHg [95% CI, -13.5 to 16.5] for DBP.CONCLUSIONS: BP differences between arm/forearm measurements are clinically outstanding. Therefore, forearm BP measurement does not seem advisable in obese patients