Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol / Monitorización de la salud y los comportamientos de salud entre los adolescentes de la Cataluña Central: Protocolo DESKcohort

El objetivo de este estudio prospectivo de cohortes (proyecto DESKcohort) es describir y monitorizar la salud, los comportamientos de salud y sus factores asociados en los adolescentes de entre 12 y 19 años escolarizados en centros de Educación Secundaria Obligatoria o secundaria posobligatoria de la Cataluña Central, considerando los determinantes sociales de la salud. La encuesta DESKcohort se realiza bianualmente, entre los meses de octubre y junio, y el proyecto lleva 3 años en marcha. Se ha entrevistado a 7319 y 9265 adolescentes en los cursos 2019/20 y 2021/22, respectivamente. Respondieron un cuestionario creado por un comité de expertos, que incluía las siguientes variables: sociodemográficas, salud física y mental, alimentación, actividad física, ocio y movilidad, consumo de sustancias, relaciones interpersonales, sexualidad, uso de pantallas y entretenimiento digital, y juegos de azar. Los resultados son presentados a los centros educativos, las diputaciones, los municipios y las entidades sanitarias y del tercer sector para planificar, implementar y evaluar acciones de prevención y promoción de la salud que aborden las necesidades identificadas.(AU)

The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.(AU)

Monitoring health and health behaviors among adolescents in Central Catalonia: DESKcohort protocol.

The objective of the prospective cohort study (the DESKcohort project) is to describe and monitor health, health behaviors, and their related factors among 12 and 19-year-old adolescents schooled at centers of Compulsory Secondary Education or post-compulsory secondary education in Central Catalonia, considering social determinants of health. The DESKcohort survey is administered biannually between the months of October and June, and the project has been running for three years. We have interviewed 7319 and 9265 adolescents in the academic years 2019/20 and 2021/22, respectively. They responded a questionnaire created by a committee of experts, that included the following variables: sociodemographic factors, physical and mental health, food, physical activity, leisure and mobility, substance use, interpersonal relationships, sexuality, screen use and digital entertainment, and gambling. The results are presented to educational centers, county councils, municipalities, and health and third sector entities to plan, implement, and evaluate prevention and health promotion actions that address the identified needs.

Impact of COVID-19 inequalities on children: An intersectional analysis.

Societal concerns about the effects of the COVID-19 pandemic have largely focussed on the social groups most directly affected, such as the elderly and health workers. However, less focus has been placed on understanding the effects on other collectives, such as children. While children's physical health appears to be less affected than the adult population, their mental health, learning and wellbeing is likely to have been significantly negatively affected during the pandemic due to the varying policy restrictions, such as withdrawal from face to face schooling, limited peer-to-peer interactions and mobility and increased exposure to the digital world amongst other things. Children from vulnerable social backgrounds, and especially girls, will be most negatively affected by the impact of COVID-19, given their different intersecting realities and the power structures already negatively affecting them. To strengthen the understanding of the social determinants of the COVID-19 crisis that unequally influence children's health and wellbeing, this article presents a conceptual framework that considers the multiple axes of inequalities and power relations. This understanding can then be used to inform analyses and impact assessments, and in turn inform the development of effective and equitable mitigation strategies as well as assist to be better prepared for future pandemics.

Influencia del entorno en el consumo de alcohol en jóvenes: Un estudio utilizando concept mapping con estudiantes universitarios / Understanding how alcohol environment influences youth drinking: A concept mapping study among university students

El objetivo del estudio fue identificar los factores del entorno que influyen en el consumo de alcohol según la perspectiva de estudiantes universitarios, y evaluar la importancia y la frecuencia atribuida a cada factor. Se utilizó la metodología del Concept Mapping con una muestra de estudiantes de enfermería, que participaron en dos sesiones de recogida de datos. En la sesión 1, se obtuvo un consenso sobre los aspectos del entorno que influyen en su consumo de alcohol. En la sesión 2, los ítems obtenidos se clasificaron en función de la importancia y la frecuencia de estos factores en el consumo de alcohol (1 = mínimo; 5 = máximo). Todos los datos se analizaron con el RCMAP del paquete estadístico R 3.6.1.Alrededor de 60 estudiantes participaron en cada sesión. La mayoría eran mujeres de 20 a 24 años. En la sesión 1, se obtuvieron un total de 55 ítems que fueron clasificados en 7 grupos: Publicidad (9 ítems); Ambiente familiar (4 ítems); Presión social (12 ítems); Responsabilidades/normas (4 ítems); Vacaciones y tiempo libre (7 ítems); Situaciones emocionales (8 ítems); Accesibilidad (11 ítems). Los factores relacionados con la presión social, las vacaciones y el tiempo libre y la accesibilidad del alcohol, fueron considerados los más importantes y frecuentes en el consumo de alcohol. Contrariamente, la publicidad del alcohol fue considerada el factor menos importante (media 2,6 sobre 5) y frecuente (media 2,1 sobre 5). En conclusión, los factores considerados más relevantes entre los estudiantes coinciden con los que se destinan más recursos para la prevención y la promoción de la salud, a excepción de la publicidad del alcohol, que se percibió como menos importante y frecuente comparado con los otros factores. (AU)

The aim of the study was to identify the environmental factors that influence alcohol consumption, according to university students, and assess the relative importance and the frequency attributed to each factor. A study using Concept Mapping methodology was performed with a sample of nursing students, who participated in two face-to-face data collection sessions. In session 1, a consensus about the environmental aspects that influence their alcohol consumption was obtained. In session 2, the statements obtained were rated according to their relative importance and frequency in alcohol use (1 = minimum; 5 = maximum). Subsequently, all data were analyzed with the RCMAP of the statistical package R 3.6.1.Approximately 60 students participated in each session. Most were women aged 20 to 24. In session 1, a total of 55 statements were obtained and classified into 7 different clusters: Advertising (9 statements); Family environment (4 statements); Social pressure (12 statements); Responsibilities/norms (4 statements); Holidays and leisure time (7 statements); Emotional situations (8 statements); Accessibility (11 statements). Factors related to social pressure, holidays and leisure time, and alcohol accessibility were considered the most important and frequent in alcohol consumption. In contrast, alcohol advertising was considered the least important (mean 2.6 out of 5) and frequent (mean 2.1 out 5) factor. In conclusion, the factors considered most relevant among nursing students match those having more resources allocated for prevention and health promotion, except for alcohol advertising, which was perceived as less important and frequent compared with the other factors. (AU)

[Design and pilot testing of a school-based emotional education program for health promotion and prevention for children from 3 to 5 years of age.] / Diseño y prueba piloto de un programa escolar de educación emocional para la promoción de la salud y la prevención destinado a niños y niñas de 3 a 5 años.

OBJECTIVE: Increasing emotional competence is a health promotion strategy that can be enhanced through school-based emotional education programs. This study aims to describe the participative process to design the emotional education program 1, 2, 3, emoció! aimed at children aged from 3 to 5 years and to analyze the results of the pilot test. METHODS: Existing international emotional education programs were reviewed. A participative process was carried out for its adaptation and a pilot test of the training and materials. Training and activity evaluation questionnaires were used to calculate mean scores for quantitative responses and percentages for categorical responses, and the Emotional Competence Profile Questionnaire for teaching staff was administered before and after the intervention and for which it was calculated whether there were significant differences between the two scores using Wilcoxon test. RESULTS: Eleven school programs were reviewed. The Social and Emotional Aspects of Learning (SEAL) program was selected. Seventeen professionals participated in working groups to carry out the adaptation to the Barcelona context. Eleven schools participated in the pilot test. The teachers increased their emotional competencies. The teachers' average evaluation of the activities was 8.18 out of 10. The result of the whole is the 1, 2, 3, emoció! program. CONCLUSIONS: The 1, 2, 3, emoció! program is well received by the schools participating in the pilot test. Future studies should evaluate its effectiveness.

OBJETIVO: Incrementar la competencia emocional es una estrategia de promoción de la salud que puede potenciarse mediante programas escolares de educación emocional. El objetivo de este estudio fue describir el proceso participativo del diseño del programa de educación emocional 1, 2, 3, emoció!, dirigido a niños y niñas de 3 a 5 años y analizar los resultados de la prueba piloto. METODOS: Se revisaron los programas de educación emocional existentes a nivel internacional. Se llevó a cabo un proceso participativo para su adaptación y una prueba piloto de la formación y materiales del programa. Se utilizaron cuestionarios de evaluación de la formación y de las actividades, de los que se calcularon puntuaciones medias para las respuestas cuantitativas y porcentajes para las categóricas, y el Cuestionario de Perfil de Competencias Emocionales para el personal docente administrado antes y después de la intervención, para el que se calculó si existían diferencias estadísticamente significativas entre ambas puntuaciones mediante la prueba de Wilcoxon. RESULTADOS: Se revisaron once programas escolares. Se seleccionó el programa Social and Emotional Aspects of Learning (SEAL). Diecisiete profesionales colaboraron en grupos de trabajo para realizar la adaptación. En la prueba piloto participaron once centros educativos. Las maestras aumentaron sus competencias emocionales después de la formación. La valoración media de las maestras con respecto a las actividades fue de 8,18 sobre 10. El resultado del proceso es el programa 1, 2, 3, emoció! CONCLUSIONES: El programa 1, 2, 3, emoció! tiene una buena acogida entre las escuelas participantes en la prueba piloto. En futuros estudios debería evaluarse su efectividad.

Diseño y prueba piloto de un programa escolar de educación emocional para la promoción de la salud y la prevención destinado a niños y niñas de 3 a 5 años / Design and pilot testing of a school-based emotional education program for health promotion and prevention for children from 3 to 5 years of age

FUNDAMENTOS: Incrementar la competencia emocional es una estrategia de promoción de la salud que puede potenciarse mediante programas escolares de educación emocional. El objetivo de este estudio fue describir el proceso participativo del diseño del programa de educación emocional 1, 2, 3, emoció!, dirigido a niños y niñas de 3 a 5 años y analizar los resultados de la prueba piloto. MÉTODOS: Se revisaron los programas de educación emocional existentes a nivel internacional. Se llevó a cabo un proceso participativo para su adaptación y una prueba piloto de la formación y materiales del programa. Se utilizaron cuestionarios de evaluación de la formación y de las actividades, de los que se calcularon puntuaciones medias para las respuestas cuantitativas y porcentajes para las categóricas, y el Cuestionario de Perfil de Competencias Emocionales para el personal docente administrado antes y después de la intervención, para el que se calculó si existían diferencias estadísticamente significativas entre ambas puntuaciones mediante la prueba de Wilcoxon. RESULTADOS: Se revisaron once programas escolares. Se seleccionó el programaSocial and Emotional Aspects of Learning (SEAL). Diecisiete profesionales colaboraron en grupos de trabajo para realizar la adaptación. En la prueba piloto participaron once centros educativos. Las maestras aumentaron sus competencias emocionales después de la formación. La valoración media de las maestras con respecto a las actividades fue de 8,18 sobre 10. El resultado del proceso es el programa 1, 2, 3, emoció! CONCLUSIONES: El programa 1, 2, 3, emoció! tiene una buena acogida entre las escuelas participantes en la prueba piloto. En futuros estudios debería evaluarse su efectividad.(AU)

BACKGROUND: Increasing emotional competence is a health promotion strategy that can be enhanced through school-based emotional education programs. This study aims to describe the participative process to design the emotional education program 1, 2, 3, emoció! aimed at children aged from 3 to 5 years and to analyze the results of the pilot test. METHODS: Existing international emotional education programs were reviewed. A participative process was carried out for its adaptation and a pilot test of the training and materials. Training and activity evaluation questionnaires were used to calculate mean scores for quantitative responses and percentages for categorical responses, and the Emotional Competence Profile Questionnaire for teaching staff was administered before and after the intervention and for which it was calculated whether there were significant differences between the two scores using Wilcoxon test. RESULTS: Eleven school programs were reviewed. The Social and Emotional Aspects of Learning (SEAL) program was selected. Seventeen professionals participated in working groups to carry out the adaptation to the Barcelona context. Eleven schools participated in the pilot test. The teachers increased their emotional competencies. The teachers’ average evaluation of the activities was 8.18 out of 10. The result of the whole is the 1, 2, 3, emoció! program. CONCLUSIONS: The 1, 2, 3, emoció! program is well received by the schools participating in the pilot test. Future studies should evaluate its effectiveness.(AU)

Understanding how alcohol environment influences youth drinking: A concept mapping study among university students. / Influencia del entorno en el consumo de alcohol en jóvenes: Un estudio utilizando concept mapping con estudiantes universitarios.

The aim of the study was to identify the environmental factors that influence alcohol consumption, according to university students, and assess the relative importance and the frequency attributed to each factor. A study using Concept Mapping methodology was performed with a sample of nursing students, who participated in two face-to-face data collection sessions. In session 1, a consensus about the environmental aspects that influence their alcohol consumption was obtained. In session 2, the statements obtained were rated according to their relative importance and frequency in alcohol use (1 = minimum; 5 = maximum). Subsequently, all data were analyzed with the RCMAP of the statistical package R 3.6.1.Approximately 60 students participated in each session. Most were women aged 20 to 24. In session 1, a total of 55 statements were obtained and classified into 7 different clusters: Advertising (9 statements); Family environment (4 statements); Social pressure (12 statements); Responsibilities/norms (4 statements); Holidays and leisure time (7 statements); Emotional situations (8 statements); Accessibility (11 statements). Factors related to social pressure, holidays and leisure time, and alcohol accessibility were considered the most important and frequent in alcohol consumption. In contrast, alcohol advertising was considered the least important (mean 2.6 out of 5) and frequent (mean 2.1 out 5) factor. In conclusion, the factors considered most relevant among nursing students match those having more resources allocated for prevention and health promotion, except for alcohol advertising, which was perceived as less important and frequent compared with the other factors.

El objetivo del estudio fue identificar los factores del entorno que influyen en el consumo de alcohol según la perspectiva de estudiantes universitarios, y evaluar la importancia y la frecuencia atribuida a cada factor. Se utilizó la metodología del Concept Mapping con una muestra de estudiantes de enfermería, que participaron en dos sesiones de recogida de datos. En la sesión 1, se obtuvo un consenso sobre los aspectos del entorno que influyen en su consumo de alcohol. En la sesión 2, los ítems obtenidos se clasificaron en función de la importancia y la frecuencia de estos factores en el consumo de alcohol (1 = mínimo; 5 = máximo). Todos los datos se analizaron con el RCMAP del paquete estadístico R 3.6.1.Alrededor de 60 estudiantes participaron en cada sesión. La mayoría eran mujeres de 20 a 24 años. En la sesión 1, se obtuvieron un total de 55 ítems que fueron clasificados en 7 grupos: Publicidad (9 ítems); Ambiente familiar (4 ítems); Presión social (12 ítems); Responsabilidades/normas (4 ítems); Vacaciones y tiempo libre (7 ítems); Situaciones emocionales (8 ítems); Accesibilidad (11 ítems). Los factores relacionados con la presión social, las vacaciones y el tiempo libre y la accesibilidad del alcohol, fueron considerados los más importantes y frecuentes en el consumo de alcohol. Contrariamente, la publicidad del alcohol fue considerada el factor menos importante (media 2,6 sobre 5) y frecuente (media 2,1 sobre 5). En conclusión, los factores considerados más relevantes entre los estudiantes coinciden con los que se destinan más recursos para la prevención y la promoción de la salud, a excepción de la publicidad del alcohol, que se percibió como menos importante y frecuente comparado con los otros factores.

Alcohol and educational inequalities: Hazardous drinking prevalence and all-cause mortality by hazardous drinking group in people aged 50 and older in Europe.

BACKGROUND: We examined educational inequalities in hazardous drinking prevalence among individuals aged 50 or more in 14 European countries, and explored educational inequalities in mortality in hazardous drinkers in European regions.Methods: We analyzed data from waves 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (SHARE). We estimated age-standardized hazardous drinking prevalence, and prevalence ratios (PR) of hazardous drinking by country and educational level using Poisson regression models with robust variance. We estimated the relative index of inequality (RII) for all-cause mortality among hazardous drinkers and non-hazardous drinkers using Cox proportional hazards regression models and for each region (North, South, East and West).Results: In men, educational inequalities in hazardous drinking were not observed (PRmedium = 1.09 [95%CI: 0.98-1.21] and PRhigh = 0.99 [95%CI: 0.88-1.10], ref. low), while in they were observed in women, having the highest hazardous drinking prevalence in the highest educational levels (PRmedium = 1.28 [95%CI: 1.15-1.42] and PRhigh = 1.53 [95%CI: 1.36-1.72]). Overall, the Relative Index of Inequality (RII) in all-cause mortality among hazardous drinkers was 1.12 [95%CI: 1.03-1.22] among men and 1.10 [95%CI: 0.97-1.25] among women. Educational inequalities among hazardous drinkers were observed in Eastern Europe for both men (RIIhazardous = 1.21 [95%CI: 1.01-1.45]) and women (RIIhazardous = 1.46 [95%CI: 1.13-1.87]). Educational inequalities in mortality among non-hazardous drinkers were observed in Southern, Western and Eastern Europe among men, and in Eastern Europe among women.Conclusions: Higher educational attainment is positively associated with hazardous drinking prevalence among women, but not among men in most of the analyzed European countries. Clear educational inequalities in mortality among hazardous drinkers were only observed in Eastern Europe. Further research on the associations between alcohol use and inequalities in all-cause mortality in different regions is needed.

Contextual Determinants in Alcohol, Tobacco and Cannabis Consumption, Mood and Bullying during Adolescence.

The present study aimed to explore the differences in the consumption of alcohol, tobacco and cannabis, mood and bullying between adolescents. A cross-sectional study was carried out in five regions of Northern Spain (one in Galiza and four in central Catalonia) that share similar socioeconomic characteristics and encompass around 10,000 inhabitants each. Students living in Burela, Galiza (N = 71) were compared to those of Central Catalonia (N = 193). The independent variable was the municipality of residence. The dependent variables encompassed: weekly available pocket money, Family Affluence Scale, self-classified academic qualification, place of origin, alcohol consumption, tobacco and cannabis smoking, negative mood and bullying. The mean age and their 95% confidence intervals (95% CI) of participants were similar between the regions (Burela: 15.90 years (15.68-16.13) and Central Catalonia: 15.36 years (15.28-15.44)). More than half of the participants were females (Burela, Galiza (53.5%) and Catalonia (54.9%)). Prevalence ratios (PR) and their 95% CI were estimated using Poisson regression models. In comparison with adolescents from Burela (Galiza), those living in Central Catalonia had higher prevalence of diverse academic levels (adjusted PR = 3.92 (1.78-8.66)), tobacco consumption (adjusted PR = 2.41 (1.47-3.97)) and negative mood (adjusted PR = 5.97 (3.05-11.70)). Even when dealing with regions with similar socioeconomic characteristics and number of inhabitants, differences exist in terms of the socioeconomic level, tobacco consumption, mood and bullying, as reported by adolescents.

Multimorbidity and its associated factors among adults aged 50 and over: A cross-sectional study in 17 European countries.

AIMS: To estimate the prevalence of multimorbidity among European community-dwelling adults, as well as to analyse the association with gender, age, education, self-rated health, loneliness, quality of life, size of social network, Body Mass Index (BMI) and disability. METHODS: A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted, and community-dwelling participants aged 50+ (n = 63,844) from 17 European countries were selected. Multimorbidity was defined as presenting two or more health conditions. The independent variables were gender, age group, educational level, self-rated health, loneliness, size of network, quality of life, BMI and disability (1+ limitations of basic activities of daily living). Poisson regression models with robust variance were fit for bivariate and multivariate analysis. RESULTS: The prevalence of multimorbidity was 28.2% (confidence interval-CI 95%: 27.5.8-29.0) among men and 34.5% (CI95%: 34.1-35.4) among women. The most common health conditions were cardiometabolic and osteoarticular diseases in both genders, and emotional disorders in younger women. A large variability in the prevalence of multimorbidity in European countries was verified, even between countries of the same region. CONCLUSIONS: Multimorbidity was associated with sociodemographic and physical characteristics, self-rated health, quality of life and loneliness.

[Prevalence of binge drinking among high school students and urban contextual factors.] / Prevalencia de los episodios de consumo intensivo de alcohol entre estudiantes de secundaria y factores urbanos contextuales.

OBJECTIVE: Many teenagers experiment with addictive substances such as alcohol. The objective of this study was to estimate the frequency of binge drinking among secondary school students and its relationship with sex, grade, and type of school, as well as with urban contextual factors of the school neighborhood: socioeconomic level, density of alcohol outlet premises, and tourist pressure. METHODS: This was an observational cross-sectional study. The study population were the students of 8th and 10th grade (2nd and 4th year of ESO) in the city of Barcelona in 2016. Alcohol use, sex, grade, type of school and school neighborhood were taken from the FRESC survey. The wealth of the neighborhood and tourist pressure were extracted from municipal statistics. The density of alcohol outlets was obtained by direct observation with the OHCITIES instrument. We estimated the prevalence of binge drinking (consumption of five or more units on one occasion) stratifying by age, sex and ownership of the school. We calculated a robust Poisson regression model with the individual and contextual variables and analyzed the situation of those neighborhoods with the highest prevalence of binge. RESULTS: The self-declared frequency of binge drinking in the last 30 days was 6.1% in this sample of 2,329 students, 2.2% in 8th grade and 10.3% in 10th grade. It was higher in boys (7%) than in girls (5.1%), and slightly higher in private subsidized schools (6.4%) than in public schools (5.5%). In the Poisson regression models, neither the coefficients of the three contextual variables nor the type of school reached statistical significance, contrary to those obtained with the individual variables of sex and year. The adjusted prevalence of binge in the 36 neighborhoods ranged from 0 to 18.2%. Comparing the contextual variables of the 8 neighborhoods with the lowest prevalence of binge with the others, both a greater density of local alcohol sales and higher tourism pressure were associated with a higher prevalence of binge drinking, while for wealth there were no significant differences. CONCLUSIONS: The use of alcohol in early adolescence is related to individual variables such as sex and age. Urban contextual factors such as a higher tourist pressure and the density of premises that sell alcohol may exert also some influence.

OBJETIVO: Muchos adolescentes experimentan con sustancias adictivas como el alcohol. El objetivo de este estudio fue estimar la prevalencia del consumo intensivo episódico de alcohol (binge drinking o atracón de bebida) en estudiantes de secundaria y su relación con el género, el curso y el tipo de escuela, así como con factores urbanos contextuales del barrio de escolarización: nivel socioeconómico, densidad de locales de venta de alcohol y presión turística. METODOS: Se trató de un estudio observacional transversal. La población estudiada fue el alumnado de 2º y 4º de Enseñanza Secundaria Obligatoria (ESO) de la ciudad de Barcelona en 2016. El consumo de alcohol, el sexo, el curso, el tipo de escuela y el barrio de escolarización se extrajeron de la encuesta FRESC. La riqueza del barrio y la presión turística se extrajeron de las estadísticas municipales. La densidad de establecimientos de venta de alcohol se obtuvo por observación directa mediante el instrumento OHCITIES. Se estimó la prevalencia de episodios de consumo intensivo de alcohol (cinco o más unidades en una ocasión), estratificando por edad, sexo y titularidad de la escuela. Se calcularon modelos de regresión de Poisson con varianza robusta para estimar las variables relacionadas con una mayor prevalencia de consumo intensivo. RESULTADOS: La frecuencia autodeclarada de episodios de consumo intensivo en los últimos 30 días fue del 6,1% en esta muestra de 2.329 estudiantes, 2,2% en 2º curso y 10,3% en 4º curso. Fue mayor en los chicos (7%) que en las chicas (5,1%), y ligeramente mayor en las escuelas privadas subvencionadas (6,4%) que en las escuelas públicas (5,5%). En los modelos de regresión de Poisson, ni los coeficientes de las tres variables de contexto ni el tipo de escuela alcanzaron significación estadística, a diferencia de los obtenidos con las variables individuales de sexo y curso. La prevalencia ajustada de episodios de consumo intensivo en los barrios osciló entre 0 y el 18,2%. Al comparar las variables contextuales de los ocho barrios con menor prevalencia de consumo intensivo con los demás, tanto una mayor densidad de locales de venta de alcohol como una mayor presión turística se asociaron a una mayor prevalencia de episodios de consumo intensivo, mientras que para la riqueza no hubo diferencias estadísticamente significativas. CONCLUSIONES: El consumo de alcohol en la adolescencia temprana está asociado con variables individuales como el sexo y la edad. Factores urbanos contextuales como una mayor presión turística y la densidad de los locales que venden alcohol podrían ejercer también cierta influencia.

Assessing the association between tourism and the alcohol urban environment in Barcelona: a cross-sectional study.

OBJECTIVES: Alcohol availability and promotion are not distributed equally in the urban context. Evidence shows that the socioeconomic level seems to influence the amount of alcohol-related elements in an area. Some studies suggest that tourism could also affect the distribution of these elements. We explore with a valid instrument in a large city whether there is an association between high tourism pressure and a greater presence of alcohol-related elements in the urban environment. DESIGN: Observational ecological study. SETTING: The study was conducted in Barcelona during 2017-2018. PARTICIPANTS: We assessed urban exposure to alcohol by performing social systematic observation using the OHCITIES Instrument in a stratified random sample of 170 census tracts within the city's 73 neighbourhoods. PRIMARY AND SECONDARY OUTCOME MEASURES: For each census tract we calculated the density of alcohol premises, and of promotion in public places per 1000 residents. We estimated tourism pressure using the number of tourist beds per 1000 residents in each neighbourhood and calculated quartiles. To assess the relationship between rate ratios of elements of alcohol urban environment and tourism pressure, we calculated Spearman correlations and fitted Poisson regression models with robust error variance. RESULTS: The median densities obtained were of 8.18 alcohol premises and of 7.59 alcohol advertising and promotion elements visible from the public space per 1000 population. Census tracts with the highest tourism pressure had 2.5 (95% CI: 1.85-3.38) times more outlets and 2.3 (95% CI: 1.64-3.23) times more promotion elements per 1000 residents than those in the lowest tourism pressure quartile. CONCLUSIONS: We observed a strong association between tourism pressure and alcohol exposure in the city of Barcelona.

Association between negative mood states, psychoactive substances consumption and bullying in school-aged adolescents. / Asociación entre los estados de ánimo negativo, el consumo de sustancias psicoactivas y el bullying en adolescentes escolarizados.

OBJECTIVE: mental health problems during adolescence lead to increased morbidity and mortality. We intend to test the hypothesis that bullying and addictive substance use is related to negative mood states. METHODS: We carried out a cross-sectional study among high school students in Burela (Northern Spain) (n=238). "Negative mood state" was defined as experiencing the following: feeling tired, sad, out of place, bored, hopeless, nervous or lacking sleep. Independent variables were binge drinking, having smoked tobacco or cannabis, and the corresponding perceived risk of using them. The variable bullying was also measured. Poisson regression models with robust variance were estimated, and Prevalence Ratios were obtained. RESULTS: 10.5% [CI 95% (7.2-15.2)] of the students reported suffering negative mood states. Students declaring low perceived risk of cannabis use [PR = 2.6 (1.2-5.5)], having tried this addictive substance at some point [PR = 3.1 (1.1-8.9)] and having suffered bullying [PR = 4.8 (2.4-9.6)] increased the risk of experiencing negative mood states. CONCLUSION: It would be advisable to design and implement interventions aimed at improving mental health during adolescence which account for the use of addictive substances and being a victim of bullying.

Antecedentes: los problemas de salud mental durante la adolescencia suponen un aumento de la morbimortalidad y la discapacidad. Se pretende testar la hipótesis de que el bullying y el consumo de sustancias psicoactivas están asociados al estado de ánimo negativo.Métodos: estudio transversal entre estudiantes de Educación Secundaria Obligatoria (ESO) (n=238) de los institutos de Burela (Lugo). El "estado de ánimo negativo" se definió a partir de los siguientes ítems: sentirse cansado/a, triste, desplazado/a, aburrido/a, desesperanzado/a, nervioso/a o insomne. Como variables independientes se consideraron: el binge drinking, el haber fumado alguna vez tabaco o cannabis, así como sus correspondientes percepciones de peligrosidad. Además, se midió la variable bullying. Se estimaron modelos de regresión de Poisson con varianza robusta y se obtuvieron Razones de Prevalencia (RP).Resultados: el 10,5% [IC95% (7,2-15,2)] de la población encuestada presentaba estado de ánimo negativo. La nula o baja percepción de peligrosidad para el cannabis [RP=2,6 (1,2-5,5)], haber probado alguna vez esta sustancia adictiva [RP=3,1 (1,1-8,9)] y haber sufrido bullying [RP=4,8 (2,4-9,6)] se asociaban al estado de ánimo negativo.Conclusiones: sería recomendable crear intervenciones para la mejora de la salud mental durante la adolescencia que tengan en cuenta el consumo de sustancias adictivas y el hecho de haber sufrido bullying.

Asociación entre los estados de ánimo negativo, el consumo de sustancias psicoactivas y el bullying en adolescentes escolarizados / Association between negative mood states, psychoactive substances consumption and bullying in school-aged adolescents

ANTECEDENTES: los problemas de salud mental durante la adolescencia suponen un aumento de la morbimortalidad y la discapacidad. Se pretende testar la hipótesis de que el bullying y el consumo de sustancias psicoactivas están asociados al estado de ánimo negativo. MÉTODOS: estudio transversal entre estudiantes de Educación Secundaria Obligatoria (ESO) (n = 238) de los institutos de Burela (Lugo). El "estado de ánimo negativo" se definió a partir de los siguientes ítems: sentirse cansado/a, triste, desplazado/a, aburrido/a, desesperanzado/a, nervioso/a o insomne.como variables independientes se consideraron: el binge drinking, el haber fumado alguna vez tabaco o cannabis, así como sus correspondientes percepciones de peligrosidad. Además, se midió la variable bullying. Se estimaron modelos de regresión de Poisson con varianza robusta y se obtuvieron Razones de Prevalencia (RP). RESULTADOS: el 10,5% [IC95% (7,2-15,2)] de la población encuestada presentaba estado de ánimo negativo. La nula o baja percepción de peligrosidad para el cannabis [RP = 2,6 (1,2-5,5)], haber probado alguna vez esta sustancia adictiva [RP = 3,1 (1,1-8,9)] y haber sufrido bullying [RP = 4,8 (2,4-9,6)] se asociaban al estado de ánimo negativo. CONCLUSIONES: sería recomendable crear intervenciones para la mejora de la salud mental durante la adolescencia que tengan en cuenta el consumo de sustancias adictivas y el hecho de haber sufrido bullying

OBJECTIVE: mental health problems during adolescence lead to increased morbidity and mortality. We intend to test the hypothesis that bullying and addictive substance use is related to negative mood states. METHODS: We carried out a cross-sectional study among high school students in Burela (Northern Spain) (n=238). "Negative mood state" was defined as experiencing the following: feeling tired, sad, out of place, bored, hopeless, nervous or lacking sleep. Independent variables were binge drinking, having smoked tobacco or cannabis, and the corresponding perceived risk of using them. The variable bullying was also measured. Poisson regression models with robust variance were estimated, and Prevalence Ratios were obtained. RESULTS: 10.5% [CI 95% (7.2-15.2)] of the students reported suffering negative mood states. Students declaring low perceived risk of cannabis use [PR = 2.6 (1.2-5.5)], having tried this addictive substance at some point [PR = 3.1 (1.1-8.9)] and having suffered bullying [PR = 4.8 (2.4-9.6)] increased the risk of experiencing negative mood states. CONCLUSIONS: It would be advisable to design and implement interventions aimed at improving mental health during adolescence which account for the use of addictive substances and being a victim of bullying

Prevalencia de los episodios de consumo intensivo de alcohol entre estudiantes de secundaria y factores urbanos contextuales / Prevalence of binge drinking among high school students and urban contextual factors

OBJETIVO: Muchos adolescentes experimentan con sustancias adictivas como el alcohol. El objetivo de este estudio fue estimar la prevalencia del consumo intensivo episódico de alcohol (binge drinking o atracón de bebida) en estudiantes de secundaria y su relación con el género, el curso y el tipo de escuela, así como con factores urbanos contextuales del barrio de escolarización: nivel socioeconómico, densidad de locales de venta de alcohol y presión turística. MÉTODOS: Se trató de un estudio observacional transversal. La población estudiada fue el alumnado de 2º y 4º de Enseñanza Secundaria Obligatoria (ESO) de la ciudad de Barcelona en 2016. El consumo de alcohol, el sexo, el curso, el tipo de escuela y el barrio de escolarización se extrajeron de la encuesta FRESC. La riqueza del barrio y la presión turística se extrajeron de las estadísticas municipales. La densidad de establecimientos de venta de alcohol se obtuvo por observación directa mediante el instrumento OHCITIES. Se estimó la prevalencia de episodios de consumo intensivo de alcohol (cinco o más unidades en una ocasión), estratificando por edad, sexo y titularidad de la escuela. Se calcularon modelos de regresión de Poisson con varianza robusta para estimar las variables relacionadas con una mayor prevalencia de consumo intensivo. RESULTADOS: La frecuencia autodeclarada de episodios de consumo intensivo en los últimos 30 días fue del 6,1% en esta muestra de 2.329 estudiantes, 2,2% en 2º curso y 10,3% en 4º curso. Fue mayor en los chicos (7%) que en las chicas (5,1%), y ligeramente mayor en las escuelas privadas subvencionadas (6,4%) que en las escuelas públicas (5,5%). En los modelos de regresión de Poisson, ni los coeficientes de las tres variables de contexto ni el tipo de escuela alcanzaron significación estadística, a diferencia de los obtenidos con las variables individuales de sexo y curso. La prevalencia ajustada de episodios de consumo intensivo en los barrios osciló entre 0 y el 18,2%. Al comparar las variables contextuales de los ocho barrios con menor prevalencia de consumo intensivo con los demás, tanto una mayor densidad de locales de venta de alcohol como una mayor presión turística se asociaron a una mayor prevalencia de episodios de consumo intensivo, mientras que para la riqueza no hubo diferencias estadísticamente significativas. CONCLUSIONES: El consumo de alcohol en la adolescencia temprana está asociado con variables individuales como el sexo y la edad. Factores urbanos contextuales como una mayor presión turística y la densidad de los locales que venden alcohol podrían ejercer también cierta influencia

OBJECTIVE: Many teenagers experiment with addictive substances such as alcohol. The objective of this study was to estimate the frequency of binge drinking among secondary school students and its relationship with sex, grade, and type of school, as well as with urban contextual factors of the school neighborhood: socioeconomic level, density of alcohol outlet premises, and tourist pressure. METHODS: This was an observational cross-sectional study. The study population were the students of 8th and 10th grade (2nd and 4th year of ESO) in the city of Barcelona in 2016. Alcohol use, sex, grade, type of school and school neighborhood were taken from the FRESC survey. The wealth of the neighborhood and tourist pressure were extracted from municipal statistics. The density of alcohol outlets was obtained by direct observation with the OHCITIES instrument. We estimated the prevalence of binge drinking (consumption of five or more units on one occasion) stratifying by age, sex and ownership of the school. We calculated a robust Poisson regression model with the individual and contextual variables and analyzed the situation of those neighborhoods with the highest prevalence of binge. RESULTS: The self-declared frequency of binge drinking in the last 30 days was 6.1% in this sample of 2,329 students, 2.2% in 8th grade and 10.3% in 10th grade. It was higher in boys (7%) than in girls (5.1%), and slightly higher in private subsidized schools (6.4%) than in public schools (5.5%). In the Poisson regression models, neither the coefficients of the three contextual variables nor the type of school reached statistical significance, contrary to those obtained with the individual variables of sex and year. The adjusted prevalence of binge in the 36 neighborhoods ranged from 0 to 18.2%. Comparing the contextual variables of the 8 neighborhoods with the lowest prevalence of binge with the others, both a greater density of local alcohol sales and higher tourism pressure were associated with a higher prevalence of binge drinking, while for wealth there were no significant differences. CONCLUSIONS: The use of alcohol in early adolescence is related to individual variables such as sex and age. Urban contextual factors such as a higher tourist pressure and the density of premises that sell alcohol may exert also some influence

The urban environment of alcohol: a study on the availability, promotion and visibility of its use in the neighborhoods of Barcelona. / Entorno urbano de alcohol: un estudio sobre disponibilidad, promoción y visibilidad del consumo en barrios de Barcelona.

INTRODUCTION: This paper describes the presence of alcohol in the public space, assessing establishments that offer it, its advertising, and signs of consumption, as factors that may influence its consumption. METHOD: Descriptive observational study based on cluster sampling with two-step selection. Results are described, and the spatial association between variables is assessed. RESULTS: In the 20 census tracts studied, 306 premises were identified that offered alcoholic beverages: 204 were on-premises and 102 were off-premises, mainly supermarkets and food retail stores. Their spatial distribution was uneven, concentrated in two central districts. We identified 72 publicity items, mostly sponsorship of musical events. There were many promotional items linked to on- premises, especially in their terraces. Five people were detected promoting consumption or selling alcohol in the Old Town. In each time slot, between 39 and 51 signs of consumption on the public space were observed (mostly abandoned beer cans), more frequent at night and in the Old Town. There is an association between the presence of establishments that offer alcohol and advertising. There is no relationship between these variables and signs of consumption in the public space; these are concentrated in the Old Town, which has greater presence of tourism. CONCLUSIONS: The urban environment is characterized by elements that stimulate alcohol use and its distribution is uneven, with a strong influence of tourism-related activities. Further regulation of alcohol promotion, availability and consumption in the public space may change its social image and decrease its use.

Introducción. Se describe la presencia de alcohol en el espacio público, valorando los establecimientos que lo ofrecen, la publicidad, y los indicios de consumo, como factores que pueden inducir el consumo. Método. Estudio observacional descriptivo basado en un muestreo por conglomerados con selección bietápica. Se describen los resultados, y se valora la asociación espacial entre variables. Resultados. En las 20 secciones censales estudiadas se identificaron 306 establecimientos que ofrecían bebidas alcohólicas: 204 de venta y consumo y 102 de venta sin consumo, básicamente supermercados y comercio alimentario. Su distribución territorial fue desigual, concentrada en dos distritos céntricos. Se identificaron 72 elementos de promoción y publicidad destacando el patrocinio de actividades musicales. Se observan elementos promocionales vinculados a los locales de venta y consumo, sobre todo en sus terrazas. Se detectaron cinco personas realizando venta ambulante o promoción del consumo en el casco antiguo. En cada franja horaria se apreciaron entre 39 y 51 indicios de consumo en la vía pública (mayoritariamente envases de cerveza abandonados), más frecuentes de noche y en el casco antiguo. Hay una asociación entre la presencia de establecimientos que ofrecen alcohol y la de elementos de publicidad. No se aprecia relación entre estas variables y los indicios de consumo en el espacio público; éstos se concentran en el casco antiguo, con mayor presencia del turismo. Conclusiones. El medio urbano se caracteriza por elementos que estimulan el consumo de alcohol y su distribución es desigual, muy influida por las actividades orientadas al turismo. Mejorar la regulación de su promoción, disponibilidad y consumo en el espacio público puede contribuir a cambiar su imagen social y disminuir su uso.

Individual and contextual factors related to binge drinking among adolescents in Spain: a multilevel approach. / Factores individuales y contextuales relacionados con el binge drinking en adolescentes españoles: un enfoque multinivel.

The aim of this study was to estimate the prevalence of binge drinking by regions in Spain and assess the effect of individual and contextual factors related to this drinking pattern in adolescents. A cross-sectional study was performed with data from the 2014 Spanish School Survey on Drug Use (ESTUDES) in students aged 14-18 years (N = 34,259). The outcome was binge drinking in adolescents during the last 30 days. Individual independent variables were socioeconomic variables and variables related to access to alcohol and its availability. Contextual variables consisted of adult alcohol consumption, public policies on alcohol, and socioeconomic factors. Multilevel Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR) and their 95% confidence intervals.  The results showed that the prevalence of youth binge drinking by region of residence was similar for both sexes (r = 0.72). At the individual level, binge drinking was mainly associated with the perception of easy access to alcohol (PR: 1.38; 95% CI: 1.23-1.55), consumption in open areas [(PR: 3.82; 95% CI: 3.44-4.24) < once a month and (PR: 6.57; 95% CI: 5.85-7.37) ≥ once a month], at least one parent allowing alcohol consumption (PR: 1.42; 95% CI: 1.37-1.47), and receiving >30 euros weekly (PR :1.51; 95% CI: 1.37-1.67). Contextual variables were not associated with youth binge drinking when individual variables were considered. In conclusion, youth binge drinking was associated with individual variables related to high alcohol accessibility and availability, regardless of contextual variables. These variables explained the variability in binge drinking among Spanish regions.

El objetivo de este estudio era estimar la prevalencia de binge drinking por provincias en España y estimar el efecto de variables individuales y contextuales relacionadas con dicho consumo en adolescentes españoles. Se realizó un estudio transversal con datos de la Encuesta sobre uso de drogas en Enseñanzas Secundarias en España (ESTUDES 2014) a estudiantes de 14 a 18 años (N = 34.259). La variable dependiente fue binge drinking en adolescentes durante los últimos 30 días. Las variables independientes individuales fueron variables socioeconómicas y variables relacionadas con el acceso y la disponibilidad de alcohol. Las variables contextuales fueron el consumo de alcohol en adultos, políticas públicas relacionadas con el alcohol y factores socioeconómicos. Se ajustaron modelos de regresión de Poisson multinivel con variancia robusta, obteniendo razones de prevalencia (RP) y sus intervalos de confianza al 95%. Los resultados muestran que la prevalencia de binge drinking en estudiantes españoles en función de la provincia era similar para ambos sexos (r = 0,72). A nivel individual, el binge drinking se asociaba principalmente a una percepción de acceso fácil al alcohol (RP: 1,38; IC 95%: 1,23-1,55), a su consumo en zonas abiertas [(RP: 3,82; IC 95%: 3,44-4,24) < una vez al mes y (RP: 6,57; IC 95%: 5,85-7,37) ≥ una vez al mes], a tener uno de los dos padres que permite beber (RP: 1,42; IC 95%: 1,37-1,47), y a disponer de más de 30 euros semanales (RP: 1,51; IC 95%: 1,37-1,67). Las variables contextuales no se asociaban al binge drinking cuando se consideraban las variables individuales. En conclusión, el binge drinking se asociaba con variables individuales relacionadas con una alta accesibilidad y disponibilidad de alcohol independientemente de las variables contextuales. Estas variables explicaban la variabilidad de el binge drinking entre las provincias.

Entorno urbano de alcohol: un estudio sobre disponibilidad, promoción y visibilidad del consumo en barrios de Barcelona / The urban environment of alcohol: a study on the availability, promotion and visibility of its use in the neighborhoods of Barcelona

Introducción. Se describe la presencia de alcohol en el espacio público, valorando los establecimientos que lo ofrecen, la publicidad, y los indicios de consumo, como factores que pueden inducir el consumo. Método. Estudio observacional descriptivo basado en un muestreo por conglomerados con selección bietápica. Se describen los resultados, y se valora la asociación espacial entre variables. Resultados. En las 20 secciones censales estudiadas se identificaron 306 establecimientos que ofrecían bebidas alcohólicas: 204 de venta y consumo y 102 de venta sin consumo, básicamente supermercados y comercio alimentario. Su distribución territorial fue desigual, concentrada en dos distritos céntricos. Se identificaron 72 elementos de promoción y publicidad destacando el patrocinio de actividades musicales. Se observan elementos promocionales vinculados a los locales de venta y consumo, sobre todo en sus terrazas. Se detectaron cinco personas realizando venta ambulante o promoción del consumo en el casco antiguo. En cada franja horaria se apreciaron entre 39 y 51 indicios de consumo en la vía pública (mayoritariamente envases de cerveza abandonados), más frecuentes de noche y en el casco antiguo. Hay una asociación entre la presencia de establecimientos que ofrecen alcohol y la de elementos de publicidad. No se aprecia relación entre estas variables y los indicios de consumo en el espacio público; éstos se concentran en el casco antiguo, con mayor presencia del turismo. Conclusiones. El medio urbano se caracteriza por elementos que estimulan el consumo de alcohol y su distribución es desigual, muy influida por las actividades orientadas al turismo. Mejorar la regulación de su promoción, disponibilidad y consumo en el espacio público puede contribuir a cambiar su imagen social y disminuir su uso

Introduction. This paper describes the presence of alcohol in the public space, assessing establishments that offer it, its advertising, and signs of consumption, as factors that may influence its consumption. Method. Descriptive observational study based on cluster sampling with two-step selection. Results are described, and the spatial association between variables is assessed. Results. In the 20 census tracts studied, 306 premises were identified that offered alcoholic beverages: 204 were on-premises and 102 were off-premises, mainly supermarkets and food retail stores. Their spatial distribution was uneven, concentrated in two central districts. We identified 72 publicity items, mostly sponsorship of musical events. There were many promotional items linked to on- premises, especially in their terraces. Five people were detected promoting consumption or selling alcohol in the Old Town. In each time slot, between 39 and 51 signs of consumption on the public space were observed (mostly abandoned beer cans), more frequent at night and in the Old Town. There is an association between the presence of establishments that offer alcohol and advertising. There is no relationship between these variables and signs of consumption in the public space; these are concentrated in the Old Town, which has greater presence of tourism. Conclusions. The urban environment is characterized by elements that stimulate alcohol use and its distribution is uneven, with a strong influence of tourism-related activities. Further regulation of alcohol promotion, availability and consumption in the public space may change its social image and decrease its use

Factores individuales y contextuales relacionados con el binge drinking en adolescentes españoles: un enfoque multinivel / Individual and contextual factors related to binge drinking among adolescents in Spain: a multilevel approach

El objetivo de este estudio era estimar la prevalencia de binge drinking por provincias en España y estimar el efecto de variables individuales y contextuales relacionadas con dicho consumo en adolescentes españoles. Se realizó un estudio transversal con datos de la Encuesta sobre uso de drogas en Enseñanzas Secundarias en España (ESTUDES 2014) a estudiantes de 14 a 18 años (N = 34.259). La variable dependiente fue binge drinking en adolescentes durante los últimos 30 días. Las variables independientes individuales fueron variables socioeconómicas y variables relacionadas con el acceso y la disponibilidad de alcohol. Las variables contextuales fueron el consumo de alcohol en adultos, políticas públicas relacionadas con el alcohol y factores socioeconómicos. Se ajustaron modelos de regresión de Poisson multinivel con variancia robusta, obteniendo razones de prevalencia (RP) y sus intervalos de confianza al 95%. Los resultados muestran que la prevalencia de binge drinking en estudiantes españoles en función de la provincia era similar para ambos sexos (r = 0,72). A nivel individual, el binge drinking se asociaba principalmente a una percepción de acceso fácil al alcohol (RP: 1,38; IC 95%: 1,23-1,55), a su consumo en zonas abiertas [(RP: 3,82; IC 95%: 3,44-4,24) < una vez al mes y (RP: 6,57; IC 95%: 5,85-7,37) ≥ una vez al mes], a tener uno de los dos padres que permite beber (RP: 1,42; IC 95%: 1,37-1,47), y a disponer de más de 30 euros semanales (RP: 1,51; IC 95%: 1,37-1,67). Las variables contextuales no se asociaban al binge drinking cuando se consideraban las variables individuales. En conclusión, el binge drinking se asociaba con variables individuales relacionadas con una alta accesibilidad y disponibilidad de alcohol independientemente de las variables contextuales. Estas variables explicaban la variabilidad de el binge drinking entre las provincias

The aim of this study was to estimate the prevalence of binge drinking by regions in Spain and assess the effect of individual and contextual factors related to this drinking pattern in adolescents. A cross-sectional study was performed with data from the 2014 Spanish School Survey on Drug Use (ESTUDES) in students aged 14-18 years (N = 34,259). The outcome was binge drinking in adolescents during the last 30 days. Individual independent variables were socioeconomic variables and variables related to access to alcohol and its availability. Contextual variables consisted of adult alcohol consumption, public policies on alcohol, and socioeconomic factors. Multilevel Poisson regression models with robust variance were estimated, obtaining prevalence ratios (PR) and their 95% confidence intervals. The results showed that the prevalence of youth binge drinking by region of residence was similar for both sexes (r = 0.72). At the individual level, binge drinking was mainly associated with the perception of easy access to alcohol (PR: 1.38; 95% CI: 1.23-1.55), consumption in open areas [(PR: 3.82; 95% CI: 3.44-4.24) < once a month and (PR: 6.57; 95% CI: 5.85-7.37) ≥ once a month], at least one parent allowing alcohol consumption (PR: 1.42; 95% CI: 1.37- 1.47), and receiving >30 euros weekly (PR :1.51; 95% CI: 1.37-1.67). Contextual variables were not associated with youth binge drinking when individual variables were considered. In conclusion, youth binge drinking was associated with individual variables related to high alcohol accessibility and availability, regardless of contextual variables. These variables explained the variability in binge drinking among Spanish regions

Regional differences in the profile of disabled community-dwelling older adults: A European population-based cross-sectional study.

The main objective of this work was to estimate the prevalence of disability in European community-dwelling older adults, as well as to investigate differences in the profile of disabled older adults between European regions (Northern, Central, Eastern and Southern). A cross-sectional study based on wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. Community-dwelling participants aged 65-84 were selected (n = 33,369). Disability was defined as presenting at least one functional limitation in basic activities of daily living (BADL). Sociodemographic, health services, lifestyle and health-related variables were analyzed. Statistical analysis was carried out through the Chi-square and ANOVA tests for bivariate analysis, and Poisson regression for multivariate analysis. Overall prevalence of disability was 13.8%: 9.4% in the Northern region, 13.1% in the Southern region, 13.6% in the Central region, and 16.6% in the Eastern region. Portugal, Poland, Estonia and Belgium showed the highest prevalence of BADL limitations, while Sweden, Denmark, Greece and Switzerland showed the lowest prevalence. Besides, disabled older adults from East Europe presented the most disadvantaged health profile, followed by the Southern region. On the other hand, disabled older adults living in the Northern region showed the most advantaged characteristics of most variables, except for smoking and polypharmacy.