Obesity is one of the main determinants of avoidable disease burden.To implement a program by university students acting as "health promoting agents" (HPAs) and to evaluate the effects on obesity ...prevalence of the primary-school-based program that promotes healthy lifestyle, including dietary and physical activity recommendations over 28 months.
Two school clusters were randomly assigned to intervention (24 schools, 1,222 pupils) or control (14 schools, 717 pupils); 78% of pupils were Western European. Mean age (±SD) was 8.4±0.6 years (49.9% females) at baseline. Generalized linear mixed models were used to analyze differences in primary outcome between both groups. Data collected included body mass index (BMI) every year. Dietary habits and lifestyle questionnaires were filled in by the parents at baseline and at the end of the study. The interventions focused on eight lifestyle topics covered in 12 activities (1 hour/activity/session) implemented by HPAs over 3 school academic years.
At 28 months, obesity prevalence in boys was decreased -2.36% in the intervention group (from 9.59% to 7.23%) and increased 2.03% (from 7.40% to 9.43%) in the control group; the difference was 4.39% (95% CI 3.48 to 5.30; P=0.01). The boys in the intervention group had an effective reduction of -0.24 units in the change of BMI z-score (from 0.01 to -0.04), compared to control (from -0.10 to 0.09); 5.1% more intervention pupils undertook physical activity>5 hours/week than control pupils (P=0.02).Fish consumption was a protector (odds ratio 0.39; 95% CI 0.23 to 0.67) while "fast-food" consumption was a risk factor for childhood obesity (odds ratio: 2.27; 95% CI 1.08 to 4.77).
Our school-based program, conducted by HPA students, successfully reduced childhood obesity prevalence in boys.
International Standard Randomized Controlled Trial Number: ISRCTN29247645.
•Work organization plays a prominent role on the workers' health.•In Spain, there are no systematic sources of information specifically designed for recording the work organization or health status ...of the working population.•OTS Panel represents a valuable information source to explore the relationship between work organization and health in Spain.•OTS Panel can contribute to generate solid evidence for research and for decision-making to improve the living and health conditions of the working population.
It is well known that work has a great influence on the well-being of workers. In the aftermath of the COVID-19 pandemic, it seems evident that work organization, in particular, plays a key role to face and control a pandemic. Consequently, it is essential to establish specific and sustainable tools to further study the relationship between work organization and workers' health. The aim of this paper is to describe the study design and baseline data of the OTS PANEL (“OTS” stands for “Work Organization and Health” in Spanish).
Panel-type cohort study to be carried out annually applying an online self-administered questionnaire. Work organization and health indicators and their corresponding questions were selected through a multistep process carried out by a team composed by professionals of different disciplines. The sample is composed of n = 1824 salaried workers, aged 25–64, residing in Spain.
Mean response time was 17.4 ± 7 min (median 15.8). 84.6 % of the indicators had percentages of missing values lower than 3 %, with labor market insecurity being the highest (5.8 %). We compute 39 indicators in which, except for a few cases, women and manual workers show consistently worse results.
OTS PANEL can represent a valuable information source in Spain to contribute to generate solid evidence for research and for decision-making to improve the living and health conditions of the working population.
Abstract Objective Researchers in public health are often interested in examining the effect of several exposures on the incidence of a recurrent event. The aim of the present study is to assess how ...well the common-baseline hazard models perform to estimate the effect of multiple exposures on the hazard of presenting an episode of a recurrent event, in presence of event dependence and when the history of prior-episodes is unknown or is not taken into account. Methods Through a comprehensive simulation study, using specific-baseline hazard models as the reference, we evaluate the performance of common-baseline hazard models by means of several criteria: bias, mean squared error, coverage, confidence intervals mean length and compliance with the assumption of proportional hazards. Results Results indicate that the bias worsen as event dependence increases, leading to a considerable overestimation of the exposure effect; coverage levels and compliance with the proportional hazards assumption are low or extremely low, worsening with increasing event dependence, effects to be estimated, and sample sizes. Conclusions Common-baseline hazard models cannot be recommended when we analyse recurrent events in the presence of event dependence. It is important to have access to the history of prior-episodes per subject, it can permit to obtain better estimations of the effects of the exposures
Individuals experiencing neuropathic pain (NP) after spinal cord injury (SCI) present with a variety of pain descriptors in different combinations and at different intensities. These sensory features ...form distinct patterns, known as sensory symptom profiles.
In the present cross-sectional study, we have used a multivariate statistical method (multiple correspondence analysis) to categorize the sensory symptom profiles of a cohort of 338 patients with at-level or below-level NP after SCI. We also investigated possible associations between positive neuropathic symptoms and features of the neurological lesion.
The majority of participants had a combination of pain descriptors, with 59% presenting with 3 or 4 pain subtypes. No significant associations were found between specific pain profiles and etiology or clinical degree of the neurological lesion. Furthermore, similar symptom profiles were seen in patients with at-level and below-level NP. The most frequent pattern observed in patients with cervical SCI consisted predominantly of electric shocks and tingling, without burning, pressure pain, or allodynia.
Classification of SCI-NP patients into the 5 groups identified in the present study based on their distinct sensory symptom profiles may allow identification of those most likely to respond to a specific analgesic approach.
HPV screening has been shown to be more cost-effective than cytology screening under most scenarios. Furthermore, it should be offered only in organized programmes with good quality assurance ...mechanisms. This study analyses the comparative cost of the current policy of opportunistic cytology screening vs. a hypothetical organized programme based on primary HPV screening.
Total cervical cancer expenditure was defined as the sum of three cost elements: (i) direct (medical and non-medical) costs, obtained from a calibrated Markov model of the natural history of HPV and cervical cancer; (ii) programmatic costs, estimated based on other organized screening programmes; and (iii) indirect costs, extrapolated from previously published data.
Organized HPV screening at 5-year intervals costs consistently less across all coverage levels than opportunistic cytology screening at 3-year intervals. The current annual direct medical cost to the public health system of the opportunistic cytology at 40% coverage is estimated at €33.2 per woman screened aged 25-64. Under an organized programme of primary HPV screening at 70% coverage, the cost is estimated to be €18.4 per woman screened aged 25-64.
Our study concludes that the economic resources currently devoted to providing opportunistic cytology screening to 40% of the target population at 3-year intervals could be more effectively used to screen 70% of the target population at 5-year intervals by switching to an organized programme based on primary HPV screening. This finding is of relevance to other European countries or regions with similar screening policies and health infrastructures.
Resumen Que haya valores ausentes en variables registradas en encuestas de salud es habitual, pero no lo es imputarlos posteriormente cuando se realiza el análisis. Trabajar con datos imputados puede ...tener ventajas en términos de precisión de los estimadores y de identificación sin sesgos de la asociación entre variables. Probablemente, el proceso de imputación sigue siendo desconocido para muchos profesionales no estadísticos, que le atribuyen una alta complejidad y quizás un objetivo que no es exactamente el que persigue. Para aclarar estas cuestiones, esta nota pretende ofrecer una visión amena, no exhaustiva, del proceso de imputación, que permita conocer sus bondades para el trabajo de un salubrista. Todo ello en el marco de variables dicotómicas, habituales en salud pública. Para ilustrar los conceptos se usa un ejemplo en el cual se trabaja con datos con valores ausentes, imputados de forma simple y múltiple.
The presence of missing data in collected variables is common in health surveys, but the subsequent imputation thereof at the time of analysis is not. Working with imputed data may have certain ...benefits regarding the precision of the estimators and the unbiased identification of associations between variables. The imputation process is probably still little understood by many non-statisticians, who view this process as highly complex and with an uncertain goal. To clarify these questions, this note aims to provide a straightforward, non-exhaustive overview of the imputation process to enable public health researchers ascertain its strengths. All this in the context of dichotomous variables which are commonplace in public health. To illustrate these concepts, an example in which missing data is handled by means of simple and multiple imputation is introduced.
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