Comparative Study of Lifestyle: Eating Habits, Sedentary Lifestyle and Anthropometric Development in Spanish 5- To 15-yr-Olds

Background: The infant-juvenile period is one of high vulnerability during the lifestyles chosen become determining factors for future health status. This study aimed to evaluate lifestyle, specifically eating habits and physical activity, in 5-15-year-olds in Spain and their health status (anthropometry). Methods: This cross-sectional population study with two time points (2006 and 2013) was conducted by compiling data from the Spanish National Health Survey. We used the minor survey, specifically the data from the Health De-terminants module, which included 5-15-year-olds. Compiled information was obtained from parents or guardians. Results: The overall overweight and obesity prevalence in Spain (2013) in 5- to 15-year-olds is 24.3%. A drop of 8.2% in meat consumption was found, while overall intake was high. Daily intake of plant-based food (fruit, vegetables, pulses) was low, especially vegetables (32.9%). Increased sedentary lifestyle was observed, probably because the use of communication technologies has increased in recent years (P<0.001). Moreover, watching TV rose to 19.3% for 1 hour/day watching TV on weekdays and to 23.5% at weekends. Conclusion: When comparing the two time points (2006 and 2013), we observed that lifestyle, eating habits and phys-ical activity strongly associated with the Spanish infant-juvenile population¿s anthropometry. Mediterranean diet pat-terns seem to be abandoned and physical activity is practiced less, which will have a negative impact on future quality of life

Assessment of the microbiological quality of groundwater in three regions of the Valencian community (Spain)

Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water and agricultural activities are high. Groundwater bodies (GWBs) are regarded as management areas within each territory, and were used to establish protection policies. This study analyzed eleven GWBs. We used two databases with microbiological measurements from 154 wells over a 7-year period (2004-2011), risk factors and groundwater information. Wells were grouped according to frequency of microbiological contamination using E. coli measurements, category <1, or wells with low-frequency microbiological contamination and high-frequency wells or category 1-100, according to World Health Organization (WHO) quality criteria of drinking water. Of all wells, 18.12% showed high-frequency microbiological contamination with a majority distribution in the Ribera Alta region (26.98%, p < 0.001). No significant differences were found between the two risk categories for flow, static level, well depth and distance from population centres. This paper reveals that the vulnerability classes established by the Geological and Mining Institute of Spain (IGME) do not match the microbiological results, and that only eight wells with high-frequency contamination coincide with the high vulnerability areas

Actigraphic Sleep and Dietary Macronutrient Intake in Children Aged 6-9 Years Old: A Pilot Study

The objective of this study was to examine the relationship between different sleep parameters and energy and macronutrient intake in school-aged children. A total of 203 children 6 to 9 years of age participated in this cross-sectional study. Anthropometric measurements were taken first. Diet was assessed with 3-day food logs and sleep was measured with a questionnaire on sleep quality and a wrist actigraph worn for at least 7 days. A decrease of 165.45 kcal was observed per each additional hour of sleep during the week (β (95% CI) = −165.45 (−274.01, −56.88); p = 0.003). This relationship was also observed for fat (β (95% CI) = −11.14 (−18.44, −3.84); p = 0.003) and protein (β (95% CI) = −13.27 (−22.52, −4.02); p = 0.005). An increase in weekend sleep efficiencies for those under the recommended threshold of 85% also had a similar association with energy (β (95% CI) = −847.43 (−1566.77, 128.09); p = 0.021) and carbohydrate (β (95% CI) = −83.96 (−161.76, −6.15); p = 0.035)) intake. An increase in habitual sleep variability was related with a slight increase in protein intake (β (95% CI) = 0.32 (0.031, 0.62); p = 0.031). Children who slept less had a higher energy intake, especially from fat and protein and those who presented inefficient sleep had a higher carbohydrate intake. Strategies to enhance sleep quality and quantity combined with dietary recommendations could help to improve energy and macronutrient intake levels in children

Efectos de la alteración endocrina durante la gestación: una revisión sistemática

Los alteradores endocrinos son contaminantes ambientales, naturales y sintéticos, ubicuos, que pueden mimetizar, bloquear o alterar funciones hormonales. La exposición ambiental a estos contaminantes es prácticamente imposible de evitar debido a que están presentes en el aire, en el agua, en los suelos, en los alimentos, y en muchos de los materiales con los que estamos en contacto diariamente, como los plásticos. La gestación supone una etapa de vulnerabilidad para el feto porque su organismo está en proceso de desarrollo y cualquier alteración puede afectar su salud a corto o largo plazo. Hay cierta evidencia de que estas sustancias alteran procesos de crecimiento y diferenciación de tejidos, producen malformaciones y afectan la duración del embarazo. Hasta el momento se conoce algo de sus efectos en la etiología de la criptorquidia, hipospadias y micropene, abortos espontáneos, partos prematuros y el bajo peso al nacimiento, efectos que serán revisados en este documento que quiere aportar una actualización del conocimiento, concentrándose en la epidemiología ambiental y la literatura relacionada. La dificultad para estudiar este tema por la cantidad de factores que intervienen hace que los resultados existentes no sean concluyentes o incluso contradictorios, por lo que es necesario que se siga investigando Abstract.Endocrine disruptors are ubiquitous natural and synthetic environmental pollutants that can mimic, block or disturb normal hormonal function. Environmental exposure to these pollutants is almost impossible to prevent due to their presence in the air,water, soil, food and in many other materials with which we come in contact daily, such as plastics. Foetuses are vulnerable during pregnancy because their organism is in a developmental stage, and any disruption may affect their health in the short and/or long term. There is some evidence that these substances disrupt tissue differentiation and growth processes, cause birth defects and affect the length of pregnancy. In this review we will focus on environmental epidemiology and related literature in order to update current knowledge based on the actual evidence of the effects of these substances on the aetiology of preterm delivery, miscarriages, low birth weight, malformations, cryptorchidism, hypospadias and micropenis. The difficulty in studying this topic is due to the high number of involved factors, which makes the available results inconclusive or even contradictory. Consequently,further research is necessary

Exposición a factores ambientales y riesgo de tumores en el sistema nervioso central en niños: revisión sistemática y metaanálisis

Se analiza el riesgo de tumores en el sistema nervioso central en niños en relación con la exposición a factores ambientales como radiaciones (ionizantes, no ionizantes), sustancias químicas (pesticidas, productos de belleza, contaminantes atmosféricos) y alimentos. Se realizó una revisión sistemática y un metaanálisis con estudios identificados en la búsqueda de PubMed (1987-2013). Los resultados obtenidos a partir de los valores de OR muestran que el riesgo de tumores en el sistema nervioso central en niños se asocia significativamente con la exposición de los padres y que el periodo prenatal es una ventana crítica para varios de los factores ambientales considerados. Aunque la fracción de riesgo atribuible a cada factor aún se desconoce, el análisis estadístico permitió determinar asociaciones significativas para factores químicos como pesticidas (OR: 1,93; IC 95 % 1,51-2,47), contaminantes atmosféricos (OR: 1,45; IC 95 % 1,17-1,80) y alimentos con compuestos N-nitroso (OR: 1,96; IC 95 % 1,40-2,73) especialmente durante la exposición prenatal. Abstract. We analyzed the risk of tumors in the central nervous system of children in relation to exposure to environmental factors such as radiation (ionizing, non-ionizing), chemicals (pesticides, cosmetics, air pollutants) and foods. We performed a systematic review and meta-analysis of studies identified through a PubMed search (1987-2013). The results obtained from OR values show that the risk of tumors in the central nervous system of children is significantly associated with parental exposure and that the prenatal period is a critical window for several of the environmental factors considered. Although the risk fraction attributable to each factor is still unknown, a statistical analysis allowed to determine significant relations for chemical factors such as pesticides (OR:1.93; 95% IC 1.51-2.47), air pollutants (OR: 1.45; 95% IC 1.17-1.80) and foods with N-nitrous compounds (OR: 1.96; 95% IC 1.40-2.73) especially for prenatal exposur

Influencia de los trihalometanos según la clasificación climatológica de Koppën y el índice de Lang, sobre la mortalidad asociada al cáncer de estómago y vejiga por áreas geográficas en España

The present study aims to determine the levels of trihalomethanes (THMs) in drinking water from different Spanish cities, and assess whether the temperature and rainfall influence them. Also assess the possible association of THM to mortality from stomach cancer and bladder. For this we took water samples from 49 cities in 2002, 2005 and 2006, which were analyzed by gas chromatography coupled with mass spectrometry obtaining THM levels. Climatic classifications were made according Koppën Lang and index the data of temperature and precipitation, and finally death rates from cancer of the stomach and bladder were standardized by sex and age. We found a decrease in the levels of THMs in Spain over time, managing to be below the limits established by Royal Decree 140/2003, but three cities studied. The results indicate that climatic classifications most of the Spanish territory has a temperate climate type - Wet. However it was found that different climatic zones exhibit an influence on the levels of THMs. Nor was significant correlation of the levels of THM with cancer of stomach and bladder, but is significant between stomach cancer and Köppen climate classification. It should continue with studies that include other variables allow clarifying and / or strengthening these results.El presente trabajo tiene como objetivo conocer los niveles de trihalometanos (THM) en el agua potable de diferentes ciudades españolas y evaluar si la temperatura y las precipitaciones influyen sobre ellos. También, valorar la posible asociación de los THM con la mortalidad por cáncer de estómago y vejiga. Para esto, se tomaron muestras de agua de 49 ciudades en el 2002, 2005 y 2006, las cuales se analizaron por cromatografía de gases acoplada a espectrometría de masas, obteniendo los niveles de THM. Se realizaron las clasificaciones climáticas según Koppën y el índice de Lang con los datos de temperatura y precipitación y, por último, las tasas de mortalidad por cáncer de estómago y vejiga fueron estandarizadas por sexo y edad. Se evidencia un descenso de los niveles de THM en España con el paso del tiempo, logrando estar por debajo de los límites establecidos por el R. D. 140/2003, excepto en tres ciudades estudiadas. Los resultados de las clasificaciones climáticas nos indican que la mayor parte del territorio español presenta un tipo de clima templado-húmedo. Sin embargo, no se encontró que las diferentes zonas climáticas presenten alguna influencia sobre los niveles de THM. Tampoco se encontró relación significativa de los niveles de THM con el cáncer de estomago y de vejiga, pero sí es significativa entre el cáncer de estómago y clasificación climática de Koppën. Es preciso continuar con estudios que incluyan otras variables permitirán esclarecer y/o reforzar estos resultados

Implementação de sistemas de gestão ambiental voluntários na rede hospitalar espanhola: situação atual (2015)

Hospitals produce vast amounts of waste and are large consumers of energy and natural resources. However, do they worry about environmental health? With this question in mind, and in order to approach hospital environmental practices, the introduction into the Spanish hospital network of the most accepted certified environmental management systems (CEMS), such as ISO 14001 and EMAS, was evaluated so as to obtain a point of reference for environmental practices in our National Health System as no up-to-date, specific official register exists. To this end, a list of hospitals by Spanish Autonomous Community having CEMS in force in 2015 was drawn up using official databases, evaluating information and conducting fieldwork. We found that 18.9 % of hospitals had CEMS (ISO 14001 in all cases): 149 out of 787 hospitals, in the National Hospitals Catalogue, especially in Madrid (40) and Andalusia (37). Eighty-one of the certified hospitals are private. Only 23 had EMAS: 12 are public and 11 private. The resulting “map” shows the main references in order for the need to offer citizens a balance between healthcare and environmental friendliness, to be compared and envisaged based on hospital activity, considering hospitals socially responsible, environmentally friendly organisations, that seek leadership in the field of environmental sustainability together with other sectors (environmental, engineering, industrial).Los hospitales son grandes productores de residuos y consumidores de recursos energéticos y naturales, pero ¿se preocupan por la salud ambiental? Partiendo de esta cuestión con el objetivo de poder aproximarnos a las prácticas ambientales hospitalarias, se evalúa la implantación en la red hospitalaria española de los sistemas de gestión medioambiental certi cados (SGMA) más reconocidos, ISO 14001 y EMAS, para disponer de un referente de experiencias ambientales en nuestro sistema nacional de salud y dado que no existe un registro oficial específico y actualizado. Para ello se ha elaborado un listado de hospitales por comunidad autónoma con SGMA certificado en vigor en 2015, partiendo de bases de datos oficiales, evaluación de información y trabajo de campo. Nos encontramos con un 18,9 % de los hospitales que cuenta con un SGMA (ISO 14001 en todos los casos): 149 de 787, en el Catálogo Nacional de Hospitales, especialmente en Madrid (40) y Andalucía (37). 81 de los centros certificados son de ámbito privado. Solo 23 tienen EMAS: 12 son hospitales públicos y 11, privados. El “mapa” resultante muestra las principales referencias para compararse y plantearse desde la actividad hospitalaria la necesidad de ofrecer a la ciudadanía el equilibrio entre la atención sanitaria y el respeto al medio ambiente, situando a los hospitales como organizaciones socialmente responsables y respetuosas con el medio ambiente, buscando el liderazgo en el campo de la sostenibilidad ambiental compartido con otros sectores (medio ambiental, ingeniería, industrial).Os hospitais são grandes produtores de resíduos e consumidores de recursos energéticos e naturais, mas preocupam-se com a saúde ambiental? Partindo desta questão com o objetivo de realizar uma abordagem às práticas ambientais hospitalares, avalia-se a implementação na rede hospital espanhola dos sistemas de gestão ambiental certificados (SGMA) mais reconhecidos, ISO 14001 e EMAS, para obter um referencial de experiências ambientais no nosso sistema nacional de saúde dado que não existe um registo oficial específico e atualizado. Para isso elaborou-se uma listagem de hospitais por comunidade autónoma com SGMA certificado em vigor em 2015, partindo de bases de dados oficiais, avaliação de informação e trabalho de campo. Encontramo-nos com 18,9 % dos hospitais com um SGMA implementado (ISO 14001 em todos os casos): 149 de 787, no Catálogo Nacional de Hospitais, especialmente em Madrid (40) e Andaluzia (37). Cifram-se em 81 os centros certificados de âmbito privado. Apenas 23 têm EMAS: 12 são hospitais públicos e 11 privados. O “mapa” resultante mostra as principais referências a serem comparadas e, com base na atividade hospital, considera a necessidade de encontrar e oferecer aos cidadãos o equilíbrio entre os cuidados de saúde e o respeito pelo ambiente, situando os hospitais como organizações socialmente responsáveis e respeitadoras do ambiente, procurando a liderança no campo da sustentabilidade ambiental compartilhada com outros sectores (ambiental, engenharia, industrial)

Estudio de la obesidad y del sobrepeso como factores de riesgo de la prevalencia y severidad del asma en niños de Valencia

[email protected]; [email protected]; [email protected]: La obesidad y el sobrepeso se han descrito como factores de riesgo asociados a la prevalencia y severidad del asma en niños y adolescentes. El objetivo del estudio ha sido el valorar el papel de la obesidad en el asma infantil. Ámbito de estudio y sujetos:Estudio realizado en niños y adolescentes entre 8 y 15 años, elegidos por un muestreo aleatorio tipo cluster entre los niños que estudiaban en 80 colegios, el cual representa el 30% de los colegios de la ciudad de Valencia. Material y métodos:El análisis de los datos se organizó en dos grupos, obesos (aquellos niños en un percentil superior al 85 del Índice de Masa Corporal (kg/m2), tomando como referencia la población española) y no obesos, cuando no cumplian esta condición. Se calcularon la prevalencia de los diferentes parámetros con un intervalo de confianza al 95%, y el riesgo relativo (RR) de los síntomas compatibles con asma entre niños obesos comparándolos con los no obesos. Resultados: No se obtuvo un riesgo relativo significativo para la obesidad con respecto al asma en aquellos niños por encima del percentil 85. Por otra parte, un incremento en el riesgo en relación con la severidad del asma se observó con la obesidad, principalmente en el percentil 85 (RR = 1,51 de sufrir entre 4-12 ataques de pitos y RR = 1,86 de sufrir más de 12 ataques en niños obesos frente a los no obesos) Conclusiónes: En este estudio, no identificamos un riesgo más alto de asma entre niños obesos frente a los no obesos, aunque encontramos que hubiera un riesgo más alto de severidad de síntomas asmáticos. En relación con la severidad del asma, observamos un riesgo más alto de ataques de pitos y sibilancias entre los niños obesos en los percentiles 85 y 95 del Indice de Masa Corporal.Background: Obesity and overweight have been described as factors associated with asthma. Our aim was to evaluate the role obesity plays on asthma in children. Scope and subjects: A study carried out on children and teenagers between 8 and 15 years of age, chosen for a cluster-type random sampling from children who studied in 80 schools, which represents 30% of the schools in the city of Valencia. Material and Methods: The analysed data was organized into two groups, obese (from the Body Mass Index (Kg/m2)), showing children with a percentile over 85% of the measuring reference for the Spanish population) and non obese, when they did not fulfil this condition. The prevalence of the different parameters studied was calculated by an Interval of Confidence of 95%. The risk was calculated (Relative Risk) from those symptoms compatible with asthma among obese children compared to non obese children. Results: No significant relative risk (RR) was seen for obesity with regards to asthma in those percentiles of obesity over 85. Otherwise, an increase in the relative risk (RR) regarding the severity of asthma was seen in relation to obesity, mainly in the 85th percentile (RR = 1.51 of suffering between 4-12 wheezing attacks and RR = 1.86 of suffering more than 12 attacks in obese children as opposed to non obese children). Conclusions: In this study, we did not identify a higher risk of asthma among obese children than among non obese children, although we did find there was a higher risk of severity of asthmatic symptoms. As far as the severity of the asthma is concerned, we saw a higher risk of wheezing and whistling attacks among obese children with the 85th and the 95th percentiles according to the Body Mass [email protected]; [email protected]; [email protected]

Current situation of sepsis care in Spanish emergency departments

Objective. To describe the approach to the patients with suspected sepsis in the Spanish emergency department hospitals (ED) and analyze whether there are differences according to the size of the hospital and the number of visits to the emergency room. Method. Structured survey of those responsible for the 282 public EDs that serve adults 24 hours a day, 365 days a year. It was asked about assistance and management in the emergency room in the care of patients with suspected sepsis. The results are compared according to hospital size (large = 500 beds vs medium-small <500) and influx to the emergency room (discharge = 200 visits / day vs medium-low <200). Results. A total of 250 Spanish EDs responded (89%). Sepsis protocols are available in 163 (65%) EDs median weekly sepsis treated ranged from 0-5 per week in 39 (71%) ED, 6-10 per week in 10 (18%), 11-15 per week in 4 (7%), and more than 15 activations per week in 3 centers (3.6%). The criteria used for sepsis diagnosis were the qSOFA/SOFA in 105 (63.6%) of the hospitals, SIRS in 6 (3.6%), while in 49 (29.7%) they used both criteria simultaneously. In 79 centers, the sepsis diagnosis was computerized, and in 56 there were tools to help decision-making. 48% (79 of 163) of the EDs had data on bundles compliance. In 61% (99 of 163) of EDs there was training in sepsis and in 56% (55 of 99) it was periodic. Considering the size of the hospital, large hospitals participated more frequently as recipients of patients with sepsis and had an infectious, sepsis and short-stay unit, a microbiologist and infectious disease specialist on duty. Conclusion. Most EDs have sepsis protocols, but there is room for improvement. The computerization and development of alerts for diagnosis and treatment still have a long way to go in EDs

Vitamin d and psoriasis pathology in the mediterranean region, valencia (Spain)

Vitamin D has important immunomodulatory effects on psoriasis in the Mediterranean region. To measure vitamin D intake in subjects with and without psoriasis, and to find an association with relevant clinical features, a case-control study was performed using cases (n = 50, 50% participation rate) clinically diagnosed with psoriasis and 200 healthy subjects (39.5% participation rate), leaving a final sample of 104 people. A survey was conducted using a food frequency questionnaire and clinical histories. Cases and controls were compared using univariate and multivariate analyses. We observed insufficient intake of cholecalciferol (vitamin D3) or ergocalciferol (vitamin D2) for both cases and controls. Patients with psoriasis were at greater risk of associated pathologies: dyslipidaemia (OR: 3.6, 95% CI: 0.8-15.2); metabolic syndrome (OR: 3.3, 95% CI: 0.2-53.9); hypertension (OR: 1.7, 95% CI: 0.4-7.2). Insufficient vitamin D intake in both psoriasis patients and controls in the Mediterranean population, and cardiovascular comorbility is more frequent in patients with psoriasis