Habitus tabaci. Un análisis estructural de los discursos sobre el tabaco cuando su introducción en España (1500-1700)

This article uses the concept of habitus in order to study the social construction that during the sixteenth and seventeenth centuries was made of an unknown commodity in Europe: tobacco. A sample of Spanish documents of this period are analyzed from an structural viewpoint, uncovering associations with medical uses, witchcraft ceremonies, psychotropic plants, wine, food, vicious behavior and dirt. On this basis it is proposed that tobacco was perceived in terms of local schemas of the habitus which were applied to the act of ingesting, orienting this action through the categories of food, medicine and poison. This classification is closely linked as well to the distinction between the profane, the holy and the demoniac. The initial ambiguity of tobacco regarding to this schemes, ended with its drift into the realm of the profane, at the same time that its consumption was generalized.Este artículo utiliza el concepto de habitus para estudiar la construcción que durante los siglos XVI y XVII se hizo de un producto desconocido en Europa: el tabaco. Una muestra dedocumentos españoles de la época se analiza desde el punto de vista estructural, encontrándose asociaciones con usos medicinales, ceremonias de hechicería, plantas psicotrópicas, vino, comida, conductas viciosas y suciedad. Sobre esta base se propone que el tabaco fue percibido en función de  locales del habitus que se aplicaban a la acción de ingerir, orientándola mediante las categorías de alimento, medicina y veneno. Esta clasificación aparece estrechamente vinculada a su vez a la distinción entre lo profano, lo santo y lo demoníaco. La ambigüedad inicial del tabaco en relación a estos esquemas terminó en una deriva hacia el ámbito de lo profano, paralela a la generalización de su uso

Key epidemiological indicators and spatial autocorrelation patterns across five waves of COVID-19 in Catalonia

Epidemiology; StatisticsEpidemiología; EstadísticasEpidemiologia; EstadístiquesThis research studies the evolution of COVID-19 crude incident rates, effective reproduction number R(t) and their relationship with incidence spatial autocorrelation patterns in the 19 months following the disease outbreak in Catalonia (Spain). A cross-sectional ecological panel design based on n = 371 health-care geographical units is used. Five general outbreaks are described, systematically preceded by generalized values of R(t) > 1 in the two previous weeks. No clear regularities concerning possible initial focus appear when comparing waves. As for autocorrelation, we identify a wave’s baseline pattern in which global Moran’s I increases rapidly in the first weeks of the outbreak to descend later. However, some waves significantly depart from the baseline. In the simulations, both baseline pattern and departures can be reproduced when measures aimed at reducing mobility and virus transmissibility are introduced. Spatial autocorrelation is inherently contingent on the outbreak phase and is also substantially modified by external interventions affecting human behavior.All the authors acknowledge funding from the Social Observatory of the “la Caixa” Foundation as part of the project LCF/PR/SR20/52550011. Partial funding was also received from the Spanish Ministry of Science and Innovation (PID2020-117029RB-I00). Joan Benach gratefully acknowledges the financial support by ICREA under the ICREA Academia programme. J. Fernández-Gracia was supported by Direcció General de Política Universitària i Recerca from the government of the Balearic Islands through the postdoctoral program Vicenç Mut. J. P. Rodríguez is supported by Juan de la Cierva Formacion program (Ref. FJC2019-040622-I) funded by MCIN/AEI/ https://doi.org/10.13039/501100011033

Precarious Employment and Stress : The Biomedical Embodiment of Social Factors. PRESSED Project Study Protocol

Juan de la Cierva Incorporación fellowship (IJCI-2017-33999) ; ICREA Academia programThe PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N = 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N = 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects

The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

Spatial visualization of HIV surveillance data could improve the planning of programs to address the HIV epidemic. The objectives of the study were to describe the characteristics and the spatial distribution of newly diagnosed HIV infection in Catalonia and to identify factors associated with HIV infection rates. Surveillance data from the national registry were presented in the form of descriptive and ring maps and used to study the spatial distribution of new HIV diagnoses in Catalonia (2012-2016) and associated risk factors at the small area level (ABS, acronym for "basic health area" in Catalan). Incident cases were modeled using the following as predictors: type of municipality, prevalence of young men and migrant groups, GBMSM activity indicators, and other variables at the aggregated level. New HIV diagnoses are heterogeneously distributed across Catalonia. The predictors that proved to be significantly associated with a higher rate of new HIV diagnoses were ABS located in the city of Barcelona (IRR, 2.520; P < 0.001), a higher proportion of men aged 15-44 years (IRR, 1.193; P = 0.003), a higher proportion of GBMSM (IRR, 1.230; P = 0.030), a higher proportion of men from Western Europe (IRR, 1.281; P = 0.003), a higher proportion of men from Latin America (IRR, 1.260; P = 0.003), and a higher number of gay locations (IRR, 2.665; P < 0.001). No association was observed between the HIV diagnosis rate and economic deprivation. Ring maps revealed substantial spatial associations for the rate of new HIV diagnoses. New HIV diagnoses are concentrated in ABS located in urban areas. Our results show that, in the case of HIV infection, the socioeconomic deprivation index on which the Catalan government bases its budget allocation policies among the ABS should not be the only criterion used

Qualitat de l’ocupació i salut en la població usuària dels serveis socials de la ciutat de Barcelona

Sol·licitant de l’informe: Gerència de Drets SocialsFa referència a l'Enquesta de Condicions de Vida de Barcelona 2016 [http://hdl.handle.net/11703/102248]Les mencions de responsabilitat s'han basat en els crèdits facilitats per l'àrea responsabl

El peritatge mèdic en processos judicials contra la indústria del tabac. Adulteració i molèsties a Castella i Aragó (1659-1701)

Aquest treball estudia el peritatge de metges i apotecaris en un seguit de processos judicials ocorreguts a la segona meitat del segle XVII, de primer a la Corona de Castella (Sevilla, 1659; Burgos, 1666) i després al regne d'Aragó (Saragossa, 1698-1701). Les acusacions s'adreçaven contra els fabricants de tabac, per suposada adulteració del tabac en pols i, en un cas, contra la pretensió d'instal·lar un molí al centre de Saragossa. Tot indica que aquests judicis utilitzaren de forma inusualment intensa el peritatge de les professions de la salut, i ho feren en àrees on tampoc era gaire freqüent, ja que la qualitat de les mercaderies i la neteja urbana eren gestionades tradicionalment dintre les atribucions de la policia de mercat, per càrrecs i treballadors municipals. El desplaçament de l'expertesa cap a les professions de la medicina hauria estat facilitat en aquest cas per les característiques especials que la mesura mercantilista de l'estanc havia donat al negoci del tabac, en termes de magnitud de l'empresa, règim d'explotació, i rellevància fiscal per a la Corona. A l'anterior caldria afegir la natura suposadament medicinal d'un producte colonial sense tradició local, la vàlua medicinal del qual havia estat construïda al llarg dels cent anys precedents per les mateixes professions a les quals ara es consultava sobre la conveniència de barrejar molsa amb el tabac, o la presència de pols de vidre en un tabac sospitós. El règim d'explotació de l'estanc com a arrendament inestable a particulars estimulava en aquests la possibilitat del frau. Els contractes a la Corona de Castella no contenien clàusules relatives a la qualitat del producte, mentre que els de l'Aragó sí que preveien penes per a la manca de qualitat, però enlloc s'especificava en què consistia aquesta. Aquesta situació abocava, en cas de conflicte, a decidir els estàndards del producte a posteriori, en judicis on els perits deposen sobre una qüestió absolutament clau per a la resolució d'aquest. Potencialment, per tant, la cessió de funció judicial en el perit és molt gran. En els processos judicials de la Corona de Castella, l'atribució d'expertesa recau gairebé de forma exclusiva en els practicants de la medicina més legitimats per les autoritats: físics, apotecaris i cirurgians, amb una particular preeminència dels primers. No consta que es recorri a altres figures, com podrien ser de forma raonable p. ex. els mercaders de tabac, o consumidors de la planta. En contrast, en el cas de l'adulteració a Saragossa l'atribució d'expertesa pateix un canvi entre el principi i la fi del procés. Inicialment es manifesten els "vells" procediments locals i forals associats a la policia de mercat, els quals apliquen al cas del tabac el marc conceptual del "frau en la mercaderia". La investigació, per altra banda, és duta a terme per perits mal descrits però aparentment sense formació erudita, lligats a les institucions locals. L'evolució del procés els desacredita com a perits, tot donant preferència a la doctrina sobre l'adulteració continguda en un imprès mèdic per establir un criteri sobre la qualitat del tabac. De fet, el mateix imprès s'utilitza també per justificar la innocuïtat de la fàbrica de tabac citada al principi. Sembla tanmateix que la utilització de l'expertesa mèdica en aquesta àrea tingué poca continuïtat a causa del canvi en el règim d'explotació de l'estanc, el qual passà a estar directament gestionat per la Corona que en garantia la qualitat mitjançant el control burocràtic del procés de fabricació. La consideració d'aquest cas convida a la reflexió sobre les causes que estimulen el recurs a l'expertesa mèdica i per extensió el procés de medicalització.Este trabajo estudia la peritación de médicos y boticarios en una serie de pleitos ocurridos en la segunda mitad del siglo XVII, primero en la Corona de Castilla (Sevilla, 1659; Burgos, 1666) y en el reino de Aragón después (Zaragoza, 1698-1701). Las acusaciones se dirigían contra los fabricantes de tabaco, por adulteración del tabaco en polvo y, en un caso, contra la instalación de un molino en el centro de Zaragoza. Todo indica que estos juicios utilizaron de forma inusualmente intensa la peritación de las profesiones de la salud, y lo hicieron en áreas donde tampoco era muy frecuente, puesto que la calidad de las mercancías y la limpieza urbana eran gestionadas tradicionalmente dentro las atribuciones de la policía de mercado, por cargos y trabajadores municipales. El desplazamiento de la pericia hacia las profesiones de la medicina habría sido facilitado en este caso por las características especiales que la medida mercantilista del estanco había otorgado al negocio del tabaco, en términos de magnitud de la empresa, régimen de explotación, y relevancia fiscal para la Corona. A lo anterior habría que añadir la naturaleza supuestamente medicinal de un producto colonial sin tradición local, la valía medicinal del cual había sido construida a lo largo de la centuria precedente por las mismas profesiones a las que ahora se consultaba sobre la conveniencia de mezclar musgo con el tabaco, o la presencia de polvo de vidrio en un tabaco sospechoso. El régimen de explotación del estanco como arrendamiento inestable a particulares estimulaba en estos la posibilidad del fraude. Los contratos en la Corona de Castilla no contenían cláusulas relativas a la calidad del producto, mientras que los del Aragón sí preveían penas para la mala calidad, pero en ninguna parte se especificaba en que consistía esta. Esta situación abocaba, en caso de conflicto, a decidir los estándares del producto a posteriori, en juicios donde los peritos deponían sobre una cuestión absolutamente clave para la resolución de los mismos. Potencialmente, por tanto, la cesión de función judicial en el perito era muy grande. En los procesos de la Corona de Castilla, la atribución de pericia recae casi de forma exclusiva en los practicantes de la medicina más legitimados por las autoridades: físicos, boticarios y cirujanos, con una particular preeminencia de los primeros. No consta que se recorra a otros figuras, como podrían ser de forma razonable p.e. los mercaderes de tabaco, o consumidores de la planta. En contraste, en el caso de adulteración en Zaragoza, la atribución de pericia sufre un cambio entre el principio y el fin del proceso. Inicialmente se manifiestan los "viejos" procedimientos locales y forales asociados a la policía de mercado, los cuales aplican al caso del tabaco el marco conceptual del "fraude en la mercancía". La investigación, por otro lado, es llevada a cabo por peritos mal descritos pero aparentemente sin formación erudita, ligados a las instituciones locales. La evolución del proceso los desacredita como peritos, dando preferencia a la doctrina sobre la adulteración contenida en un impreso médico, para establecer un criterio sobre la calidad del tabaco. De hecho, el mismo impreso se utiliza también para justificar la inocuidad de la fábrica de tabaco citada al principio. De todos modos, parece que la utilización de la pericia médica en este área tuvo poca continuidad a causa del cambio en el régimen de explotación del estanco, el cual pasó a estar directamente gestionado por la Corona, la cual garantizaba la calidad mediante el control burocrático de la producción. La consideración de este caso invita a la reflexión sobre las causas que estimulan el recurso a la pericia médica, y por extensión el proceso de medicalización.This work studies medical and farmacist expertise in a set of lawsuits that occurred in the second half of the seventeenth century, first in the Crown of Castile (Seville, 1659; Burgos, 1666) and later in the kingdom of Aragon (Zaragoza, 1698 -1701). The accusations were directed against the tobacco manufacturers, for alleged adulteration of the tobacco snuff and, in one case, against the projected construction of a mill in the center of Zaragoza. Everything suggests that these trials used the expertise of the health professions in an unusually intense way, and they did so in areas where it was not very frequent, since the quality of goods and urban environment were traditionally managed by the municipalities. The shift of expertise to the medical professions would have been facilitated in this case by the special characteristics that the tobacco tax monopoly had given to the tobacco business, in terms of the size of the company, exploitation regime, and fiscal relevance for the crown. To this should be added the presumed medical value of a colonial plant without local tradition, whose value had been built throughout the preceding century by the same professions that were now consulted about the convenience of mixing moss with snuff, or the suspected presence of ground glass in the snuff. The regime of exploitation of the tobacconist as an unstable lease to individuals encouraged in them the temptation to cheat. Contracts in the Crown of Castile did not contain clauses relating to product quality, while those of Aragon did provide penalties for poor quality, but nowhere was it specified what this consisted of. This situation led, in case of conflict, to deciding the standards of the product a posteriori, in lawsuits where the experts testified on an absolutely key issue for their resolution. Potentially, therefore, the transfer of judicial function to the expert was very large. In the processes of the Crown of Castile, the attribution of expertise falls almost exclusively on the practitioners of medicine most legitimized by the authorities: physicists, apothecaries and surgeons, with a particular preeminence of the former. There is no evidence that other figures such as tobacco mercants or tobacconists were consulted. In contrast, in the case of adulteration in Zaragoza, the attribution of expertise changes throughout the process. Initially, local officials intervene, applying the conceptual framework of "commodity fraud" to the tobacco case. The evolution of the process discredits them as experts, the authorities giving preference to the doctrine on tobacco adulteration contained in a medical brochure, which is used to establish a criterion on the quality of tobacco. In fact, the same brochure is also used to justify the harmlessness of the tobacco factory mentioned above. In any case, it seems that the use of medical expertise in this area had little continuity due to the change in the exploitation regime of the tobacco tax monopoly, which began to be directly managed by the Crown. Consideration of these trials points to the causes stimulate the use of medical expertise, and by extension the process of medicalization.Universitat Autònoma de Barcelona. Programa de Doctorat en Història de la Ciènci

Precarious employment and chronic stress: do social support networks matter?

Precarious employment has been identified as a potentially damaging stressor. Conversely, social support networks have a well-known protective effect on health and well-being. The ways in which precariousness and social support may interact have scarcely been studied with respect to either perceived stress or objective stress biomarkers. This research aims to fill this gap by means of a cross-sectional study based on a non-probability quota sample of 250 workers aged 25–60 in Barcelona, Spain. Fieldwork was carried out between May 2019 and January 2020. Employment precariousness, perceived social support and stress levels were measured by means of scales, while individual steroid profiles capturing the chronic stress suffered over a period of a month were obtained from hair samples using a liquid chromatography-tandem mass spectrometry methodology. As for perceived stress, analysis indicates that a reverse buffering effect exists (interaction B = 0.22, p = 0.014). Steroid biomarkers are unrelated to social support, while association with precariousness is weak and only reaches significance at p < 0.05 in the case of women and 20ß dihydrocortisone metabolites. These results suggest that social support can have negative effects on the relationship between perceived health and an emerging stressful condition like precariousness, while its association with physiological measures of stress remains uncertain.This work was supported by the Spanish Ministry of Science, Innovation and Universities under the research grant “Precariedad laboral y estrés: factores sociales con impacto biomédico”, ref. CSO2017-89719-R funded by the Agencia Estatal de Investigación (AEI) and the European Regional Development Fund (ERDF), EU

Hospital costs of nosocomial multi-drug resistant <it>Pseudomonas aeruginosa</it> acquisition

Abstract Background We aimed to assess the hospital economic costs of nosocomial multi-drug resistant Pseudomonas aeruginosa acquisition. Methods A retrospective study of all hospital admissions between January 1, 2005, and December 31, 2006 was carried out in a 420-bed, urban, tertiary-care teaching hospital in Barcelona (Spain). All patients with a first positive clinical culture for P. aeruginosa more than 48 h after admission were included. Patient and hospitalization characteristics were collected from hospital and microbiology laboratory computerized records. According to antibiotic susceptibility, isolates were classified as non-resistant, resistant and multi-drug resistant. Cost estimation was based on a full-costing cost accounting system and on the criteria of clinical Activity-Based Costing methods. Multivariate analyses were performed using generalized linear models of log-transformed costs. Results Cost estimations were available for 402 nosocomial incident P. aeruginosa positive cultures. Their distribution by antibiotic susceptibility pattern was 37.1% non-resistant, 29.6% resistant and 33.3% multi-drug resistant. The total mean economic cost per admission of patients with multi-drug resistant P. aeruginosa strains was higher than that for non-resistant strains (15,265 vs. 4,933 Euros). In multivariate analysis, resistant and multi-drug resistant strains were independently predictive of an increased hospital total cost in compared with non-resistant strains (the incremental increase in total hospital cost was more than 1.37-fold and 1.77-fold that for non-resistant strains, respectively). Conclusions P. aeruginosa multi-drug resistance independently predicted higher hospital costs with a more than 70% increase per admission compared with non-resistant strains. Prevention of the nosocomial emergence and spread of antimicrobial resistant microorganisms is essential to limit the strong economic impact.</p

The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

Background: Spatial visualization of HIV surveillance data could improve the planning of programs to address the HIV epidemic. The objectives of the study were to describe the characteristics and the spatial distribution of newly diagnosed HIV infection in Catalonia and to identify factors associated with HIV infection rates. Methods: Surveillance data from the national registry were presented in the form of descriptive and ring maps and used to study the spatial distribution of new HIV diagnoses in Catalonia (2012–2016) and associated risk factors at the small area level (ABS, acronym for “basic health area” in Catalan). Incident cases were modeled using the following as predictors: type of municipality, prevalence of young men and migrant groups, GBMSM activity indicators, and other variables at the aggregated level. Results: New HIV diagnoses are heterogeneously distributed across Catalonia. The predictors that proved to be significantly associated with a higher rate of new HIV diagnoses were ABS located in the city of Barcelona (IRR, 2.520; P < 0.001), a higher proportion of men aged 15–44 years (IRR, 1.193; P = 0.003), a higher proportion of GBMSM (IRR, 1.230; P = 0.030), a higher proportion of men from Western Europe (IRR, 1.281; P = 0.003), a higher proportion of men from Latin America (IRR, 1.260; P = 0.003), and a higher number of gay locations (IRR, 2.665; P < 0.001). No association was observed between the HIV diagnosis rate and economic deprivation. Conclusions: Ring maps revealed substantial spatial associations for the rate of new HIV diagnoses. New HIV diagnoses are concentrated in ABS located in urban areas. Our results show that, in the case of HIV infection, the socioeconomic deprivation index on which the Catalan government bases its budget allocation policies among the ABS should not be the only criterion used

Precarious employment and stress: the biomedical embodiment of social factors. PRESSED Project Study Protocol

The PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N = 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N = 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects