Agencia de Salut Publica de Barcelona ASPB

Barcelona, Spain

Agencia de Salut Publica de Barcelona ASPB

Barcelona, Spain
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Pernambuco Ld.eA.,Federal University of Rio Grande do Norte | Espelt A.,Agencia de Salut Publica de Barcelona ASPB | Magalhaes Junior H.V.,Federal University of Rio Grande do Norte | Cavalcanti R.V.,Federal University of Rio Grande do Norte | de Lima K.C.,Federal University of Rio Grande do Norte
Journal of voice : official journal of the Voice Foundation | Year: 2016

PURPOSE: To identify the validity evidence based on the content and response processes of the Rastreamento de Alterações Vocais em Idosos (RAVI; "Screening for Voice Disorders in Older Adults"), an epidemiologic screening for voice disorders in older adults.STUDY DESIGN: This is a prospective, nonrandomized, cross-sectional, validation study.METHODS: Criteria for defining the domains and elaborating the questions were established to confirm the validity evidence based on the content. A multidisciplinary committee of 19 experts evaluated the questions, and the relevance and representation of the domains were analyzed using the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI), respectively. For validity evidence based on the response processes, 40 individuals of both sexes, aged ≥60 years, were stratified by demographic and socioeconomic condition. They responded to the RAVI, made suggestions, and their verbal and nonverbal reactions were observed.RESULTS: The first version of the RAVI consisted of 20 questions related to sensations and perceptions associated with the voice. Although the CVI value of 0.80 was satisfactory, the CVI-I and the suggestions of the expert committee indicated that the scale needed to be reformulated. Consultation with older adults indicated a need for further adjustment. The preliminary version of the RAVI consisted of 16 questions.CONCLUSIONS: The two aspects of validity evidence described in the present study were essential for adapting the questions to better fit the construct of the questionnaire. Other aspects of validity evidence and reliability analysis will be described in part II of this study. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.


Rocha K.B.,Grande Rio University | Muntaner C.,University of Toronto | Gonzalez Rodriguez M.J.,Major University | Baksai P.B.,Major University | And 3 more authors.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2013

Objective. To analyze links between social class and health-related indicators and behaviors in Chilean workers, from a neo-Marxian perspective. Methods. A cross-sectional study based on the First National Survey on Employment, Work, Health, and Quality of Life of Workers in Chile, done in 2009-2010 (n = 9 503). Dependent variables were self-perceived health status and mental health, examined using the General Health Questionnaire (GHQ-12). Health-related behavior variables included tobacco use and physical activity. The independent variable was neo- Marxian social class. Descriptive analyses of prevalence were performed and odds ratio (OR) models and 95% confidence intervals (95%CI) were estimated. Results. Medium employers (between 2 and 10 employees) reported a lower prevalence of poor health (21.6% [OR 0.68; 95%CI 0.46-0.99]). Unskilled managers had the lowest mental health risk (OR 0.43; 95%CI 0.21-0.88), with differences between men and women. Large employers (more than 10 employees) reported smoking the least, while large employers, expert supervisors, and semi-skilled workers engaged in significantly more physical activity. Conclusions. Large employers and expert managers have the best health-related indicators and behaviors. Formal proletarians, informal proletarians, and unskilled supervisors, however, have the worst general health indicators, confirming that social class is a key determinant in the generation of population health inequalities.


PubMed | Agencia de Salut Publica de Barcelona ASPB, University of Barcelona, Autonomous University of Barcelona and CIBER ISCIII
Type: Journal Article | Journal: Gaceta sanitaria | Year: 2015

Among men who have sex with men (MSM), the association between searching for sexual partners on the Internet and increased risk of sexually transmitted infections (STIs)/HIV infection, together with current low levels of partner notification (PN), justifies a study to explore the intention to use new communication technologies for PN in Spain.Two cross-sectional surveys were performed: the first was administered online to visitors to web pages where the survey was advertised; the second was administered on paper to patients attending an STI Unit and centres similar to Community-Based Voluntary Counselling and Testing centres.The study population comprised 1578 Spanish residents (median age, 34 years [range: 18 to 74]); 84% lived in urban areas, and 69% reported searching for sexual partners on the Internet. Thirty-seven per cent would be willing to use a website for PN, 26% did not know if they would use one, and 37% would not want to use one. The main reasons for not intending to notify STI/HIV were shame or fear (stable partner) and not knowing how to contact them (casual partner). The preferred method of notification was face to face (73%) for both stable and casual partners, although using new technologies (Short Messaging System, e-mail, web page, phone applications) was widely accepted for notifying casual partners.Fighting stigma and promoting alternative methods of PN among MSM and health professionals through new technologies could increase the frequency of PN. This approach will improve early detection and reduce transmission in Spain.


Pernambuco L.,Federal University of Paraiba | Espelt A.,Agencia de Salut Publica de Barcelona ASPB | Espelt A.,Autonomous University of Barcelona | Espelt A.,CIBER ISCIII | Costa de Lima K.,Federal University of Rio Grande do Norte
Journal of Voice | Year: 2016

Aim: The aim of the study was to determine the cutoff score and clinical consistency of "Screening for Voice Disorders in Older Adults" (RAVI-Rastreamento de Alterações Vocais em Idosos). Study Design: This is a prospective, nonrandomized, cross-sectional diagnostic study. Methods: A sample of 301 subjects, including both sexes, aged 60 and more, and all of whom were living in either a community or an institution, was studied. To determine which subjects had or did not have voice problems, we used a composite reference standard (auditory-perceptual analysis of sustained vowel phonation, auditory-perceptual analysis of connected speech, and vocal self-assessment). The best cutoff score was identified using the receiver operating characteristic (ROC) curve analysis. The clinical consistency indicators were co-positivity, co-negativity, positive and negative predictive values, positive and negative likelihood ratio, and test efficiency. The significance level was 5%. Results: The area under the ROC curve was 0.763 (95% confidence interval: 0.706-0.821), and the best cutoff score for determining which older adults had or did not have a voice disorder was 2. All clinical consistency indicators were satisfactory: co-positivity (79%), co-negativity (60%), predictive positive value (51%), negative predictive value (84%), positive likelihood ratio (2.01), negative likelihood ratio (0.34), and test efficiency (69%). Conclusions: RAVI has satisfactory indicators of clinical consistency and is able to determine which older adults have voice disorders by a cutoff score of 2. The use of RAVI as a screening tool is recommended to help determine the prevalence of voice disorders in older adults. © 2016 The Voice Foundation.


Rocha K.,Agencia de Salut Publica de Barcelona ASPB | Rocha K.,Autonomous University of Barcelona | Rocha K.,Biomedical Research Institute Sant Pau | Perez K.,Agencia de Salut Publica de Barcelona ASPB | And 9 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2012

Background: In the past few years, there has been increasing interest in studying the association between problems in the neighbourhood environment and health indicators. The Objective: of this study is to examine the relationship between the perception of environmental problems by individuals and the prevalence of common mental disorders (CMD) in Spain. Methods: A cross-sectional study using data from a large scale national representative survey of households (the 2006 Spanish National Health Survey). Participants included in the study were aged between 16 and 64 years (n = 23,760). The dependent variable was common mental disorders assessed with the General Health Questionnaire (GHQ-12). The independent variable was the individual's perception of environmental problems. Raw and adjusted Odds Ratios and their confidence intervals (95%) were calculated by fitting logistic regression models adjusting for age, marital status, work situation, social class, rural or urban area, country of origin, restrictions in carrying out activities of daily life due to a health problem and social support. Results: The individuals who reported environmental problems had a higher prevalence of CMD. There was a clear increasing gradient in CMD prevalence with the increase in the number of environmental problems mentioned. Among the subjects who reported to have 1 or no environmental problem the prevalence of CMD was 11.8% (men) and 18.7% (women), and among those who mentioned 6 or more problems, the prevalence increased to 20.8% (men) and 35.4% (women). After adjusting for all the covariables, there is an association between environmental problems and CMD (men OR 1.44, 95% CI 1.08-1.66; women OR 1.46, 95% CI 1.27-1.67). The environmental problems most strongly associated with the prevalence of CMD are noise, bad smell, air pollution, and lack of green areas. Conclusion:s: Our findings show that individuals who perceive environmental problems in their neighbourhood have a higher prevalence of CMD, even after adjusting for all co-variables. In addition, there is a clear increasing gradient in the prevalence of CMD with the increase in the number of environmental problems. Efforts to reduce the prevalence of CMD must be directed to improve individual and contextual risks. © Springer-Verlag 2011.


Santamarina-Rubio E.,Agencia de Salut Publica de Barcelona ASPB | Santamarina-Rubio E.,CIBER ISCIII | Santamarina-Rubio E.,Biomedical Research Institute Sant Pau | Santamarina-Rubio E.,University Pompeu Fabra | And 9 more authors.
Accident Analysis and Prevention | Year: 2014

There is no consensus on whether the risk of road traffic injury is higher among men or among women. Comparison between studies is difficult mainly due to the different exposure measures used to estimate the risk. The measures of exposure to the risk of road traffic injury should be people's mobility measures, but frequently authors use other measures such population or vehicles mobility. We compare road traffic injury risk in men and women, by age, mode of transport and severity, using the time people spend travelling as the exposure measure, in Catalonia for the period 2004-2008. This is a cross-sectional study including all residents aged over 3 years. The road traffic injury rate was calculated using the number of people injured, from the Register of Accidents and Victims of the National Traffic Authority as numerator, and the person-hours travelled, from the 2006 Daily Mobility Survey carried out by the Catalan regional government, as denominator. Sex and age specific rates by mode of transport and severity were calculated, and Poisson regression models were fitted. Among child pedestrians and young drivers, males present higher risk of slight and severe injury, and in the oldest groups women present higher risk. The death rate is always higher in men. There exists interaction between sex and age in road traffic injury risk. Therefore, injury risk is higher among men in some age groups, and among women in other groups, but these age groups vary depending on mode of transport and severity. © 2013 Elsevier Ltd.


Tobias A.,CSIC - Institute of Environmental Assessment And Water Research | de Olalla P.G.,Agencia de Salut Publica de Barcelona ASPB | Linares C.,Institute Salud Carlos III ISCIII | Bleda M.J.,Research Center y Desarrollo Josep Pascual Vila | And 2 more authors.
International Journal of Biometeorology | Year: 2010

The summer of 2003 was exceptionally hot, leading to an excess of mortality in Europe. Here, we assess the short-term effects of extreme hot summer temperatures on total daily mortality in Barcelona (Spain). Daily mortality from burial records, maximum temperature, relative humidity and photochemical pollutants, were collected for the period 1999-2003. Data was analysed using Poisson regression with generalised additive models. Mortality shows a considerable increase when maximum temperatures are over a threshold temperature of 30.5°C. The risk of death associated with an increase of 1°C above the threshold was 6%, 7% and 5% after 1, 2 and 3 days, respectively. Exposure to extreme hot temperatures leads to an significant increase in mortality. © 2009 ISB.


Muntaner C.,University of Toronto | Rocha K.B.,Agencia de Salut Publica de Barcelona ASPB | Borrell C.,Agencia de Salut Publica de Barcelona ASPB | Vallebuona C.,Ministerio de Salud de Chile | And 3 more authors.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2012

This paper reviews the principal concepts of social class, occupation, and social stratification, and their contribution to the analysis of the social determinants of health (SDH), and reviews empirical studies conducted in Latin America that use employment relations as an SDH. The review focuses on studies of the relationship between health and social class based on neo-Weberian or neo-Marxist perspectives. A search of the BIREME Virtual Health Library and the SciELO database found 28 articles meeting these characteristics. This relative dearth contrasts with the profusion of papers that use these approaches written in Europe and in the United States, with a long tradition in the analysis of SDH. In this regard, the political and programmatic implications of research on social class and employment relations are different from and complementary to studies of health gradients associated with income and education. Globalization of employment relations requires the development of new concepts to explain and measure the mechanisms of action of the SDH going beyond what is strictly labor related; in particular, the importance in the current Latin American reality of the impact of informal work on health.


Bosque-Prous M.,Agencia de Salut Publica de Barcelona ASPB | Espelt A.,Agencia de Salut Publica de Barcelona ASPB | Guitart A.M.,Agencia de Salut Publica de Barcelona ASPB | Bartroli M.,Agencia de Salut Publica de Barcelona ASPB | And 2 more authors.
Addiction (Abingdon, England) | Year: 2014

AIMS: To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50-64 years in 16 European countries, taking into account both individual and contextual-level factors (alcohol taxation, availability, etc.).DESIGN: Cross-sectional study based on SHARE project surveys.SETTING AND PARTICIPANTS: A total of 27 773 subjects, aged 50-64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project.MEASUREMENTS: We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi-level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained.FINDINGS: The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI = 29.3-31.8) in countries with no restrictions, 20.3% (95% CI = 19.3-21.2) in countries with some restrictions and 14.4% (95% CI = 11.9-16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI = 0.90-2.06) for countries with some restrictions and 1.95 (95% CI = 1.31-2.91) for those with no advertising restrictions.CONCLUSIONS: The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50-64 years. © 2014 Society for the Study of Addiction.


PubMed | Agencia de Salut Publica de Barcelona ASPB and Agencia de Salut Publica de Catalonia ASPCAT
Type: Journal Article | Journal: Alcoholism, clinical and experimental research | Year: 2015

The goal of this study was to estimate excess death due to external causes among 18- to 64-year-olds with alcohol use disorder (AUD) who were treated at public outpatient treatment centers, and the time elapsed from treatment initiation to death.We conducted a retrospective longitudinal study among 7,012 outpatients aged 18 to 64years who began treatment for AUD between 1997 and 2007. Deaths due to external causes (intentional and unintentional injuries) were monitored until the end of 2008. Person-years (PY) of follow-up and crude mortality rates (CMRs) were calculated for all study variables, for each sex, and for 2 age groups (18 to 34 and 35 to 64years). Standardized mortality ratios (SMRs) were estimated by age group and sex. Survival was analyzed using the Kaplan-Meier method and Cox regression.We recorded 114 deaths due to external causes. The CMR was 2.7 per 1,000 PY (95% confidence interval [CI]: 2.2 to 3.2), with significant gender differences only among younger individuals (CMR for males=3.9 per 1,000 PY [95% CI: 2.2 to 5.5] and CMR for females=2.8 per 1,000 PY [95% CI: 0.1 to 5.6]). Unintentional injury was the most common cause of death (n=65), of which acute poisoning (n=25; 38.5%) and traffic accidents (n=15; 23.1%) were the most prevalent. Suicide accounted for 91.8% (n=49) of deaths from intentional injuries. The excess of mortality between the AUD group and the general population (SMR) was 9.5 higher than in the general population (95% CI: 7.9 to 11.4), with significant differences between genders (SMR=6.1 [95% CI: 4.9 to 7.5] in males and SMR=20.4 [95% CI: 13.9 to 29.9] in females). Approximately 35% of deaths among individuals aged <35years and 60% among women occurred within a year of initiating treatment.This study highlights the importance of excess of mortality among people with AUD and patients vulnerability during the initial years of treatment. Preventing premature deaths due to external causes among women and younger patients with AUD is a priority.

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