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A Schiaffino

Publications and source records attributed to A Schiaffino.

At least 19 recordsLinked to original sources
PubMed2001

Smoking initiation and cessation by gender and educational level in Catalonia, Spain.

BACKGROUND: The role of gender and socioeconomic status in smoking has been characterized in the United States and Northern European countries. However, there is scarce information of the dynamic of the tobacco epidemic in Southern European countries. The aim of this study was to analyze smoking initiation and cessation according to level of education and gender in Catalonia, Spain. METHODS: Data from the Catalan Health Survey (1994), a cross-sectional study based in a representative sample of the noninstitutionalized population of Catalonia, was used. The relative risks and 95% confidence interval of smoking initiation were computed by means of Cox's regression. The odds ratios and 95% confidence intervals of quitting smoking were derived from logistic regression models. Direct responses from 4,370 men and 5,213 women ages 25 years or over were included for analysis. RESULTS: Ever smoking was inversely related to level of education in men. Males with the highest educational level tended to have a lower probability of being a smoker at a given age than those with less than primary school (relative risk = 0.6; 95% confidence interval: 0.5-0.7). This pattern appeared with small variation across age groups. In women, a reverse trend was present: the higher the level of education the higher the relative risk of starting smoking (relative risk = 4.6; 95% confidence interval: 3.1-6.7). Quitting smoking was more likely among men and women with higher education as compared to men and women with less than primary school (men: odds ratio = 1.5; 95% confidence interval 1.1-2.1; women: odds ratio = 4.6; 95% confidence interval: 2.1-10.4). CONCLUSIONS: The differential effect of education according to gender may reflect different phases of the smoking epidemic. In Catalonia, the transition of smoking from upper and lower socioeconomic groups occurred recently among men, and women have currently begun to experience this transition.

Adolescent↗
PubMed2001

Social class inequalities in the use of and access to health services in Catalonia, Spain: what is the influence of supplemental private health insurance?

OBJECTIVE: To analyse social class inequalities in the access to and utilization of health services in Catalonia (Spain), and the influence of having private health insurance supplementing the National Health System (NHS) coverage. DESIGN: 1994 Catalan Health Interview Survey, a cross-sectional survey conducted in 1994. SETTING: Catalonia (Spain). STUDY PARTICIPANTS: The participants were a representative sample of people aged over 14 years from the non-institutionalized population of Catalonia (n = 12,245). MAIN OUTCOME MEASURES: Health services utilization, perceived health, having only NHS or NHS plus a private health insurance, and social class. RESULTS: Although one-quarter of the population of Catalonia had a supplemental private health insurance, percentages were very different according to social class, ranging from almost 50% for classes I and II to 16% for classes IV and V in both sexes. No inequalities by social class were observed for the utilization of non-preventive health care services (consultation with a health professional in the last 2 weeks and hospitalization in the last year) among persons with poor self-perceived health status, i.e. those in most need. However, social inequalities still remain in the use of health services provided only partially by the NHS, and when characteristics of last consultation are taken into account. Subjects who paid for a private service waited an average of 18.8 minutes less than those attending the NHS. Within the NHS, social classes IV and V waited longer (35.5 minutes) than social classes I and II (28.4 minutes). CONCLUSION: The NHS in Catalonia, Spain, has reduced inequalities in the use of health services. Social inequalities remain in the use of those health services provided only partially by the NHS.

Adolescent↗
PubMed2000

[Inequalities in health according to social class in Catalonia, 1994].

OBJECTIVE: To study social inequalities in health in Catalonia. DESIGN: Cross-sectional survey of a representative sample of the population of Catalonia, Spain (Catalan Health Interview Survey, 1994). PARTICIPANTS: Responses from 5641 males and 6604 women aged 15 years or over were included for analysis. MEASUREMENTS AND MAIN RESULTS: We analysed the information about self-perceived health, restriction of activity, and presence of chronic conditions according to social class by means of logistic regression models. The proportion of subjects that rated their health as fair or poor was higher in social classes IV-V than in classes I-II (men: 25.0% vs. 14.5%; OR, 1.8, 95% CI, 1.5-2.3; women: 34.4% vs. 21.5%; OR, 1.7, 95% CI, 1.4-2.1). There were differences by social class in respect to restriction of activity and presence of chronic conditions. CONCLUSIONS: Despite the decrease of social inequalities in accesibility and use of health services due to the universalisation of health coverage, differences by social class remain in the perception of health status. These inequalities should be addressed by the health system within the framework of broad public and social policies.

Adolescent↗
PubMed2000

[Cancer mortality in Spain, 1955-1994].

BACKGROUND: To analyze the mortality from the eight main cancer sites in men and women from Spain between 1955-1994. MATERIAL AND METHODS: Age-standardized mortality rates were computed. RESULTS: In men, an increase in lung cancer mortality as well as in the other 8 sites was registered, except for stomach cancer. In women, breast, ovary, and pancreas cancer mortality continue to increase. CONCLUSIONS: Cancer mortality in Spain has dismal trends. This fact implies the need of strong interventions.

Adult↗
PubMed2000

The quality of care and influence of double health care coverage in Catalonia (Spain).

AIMS: To analyse inequalities by social class in children's access to and utilisation of health services in Catalonia (Spain), private health insurance coverage, and certain aspects of the quality of care received. DESIGN: Cross sectional study using data from the 1994 Catalan Health Interview Survey. SETTING: Child population of Catalonia. PARTICIPANTS: A representative sample of non-institutionalised children younger than 15 years (n = 2433). MAIN OUTCOME MEASURES: Health services utilisation, perceived health, type of health insurance (only National Health System (NHS) or both NHS and private health insurance), and social class. RESULTS: No inequalities by social class were found for the utilisation of health care services provided by the NHS among children in most need. Double health care coverage does not influence the social pattern of visits. Nevertheless, social inequalities still remain in the use of those health services provided only partially by the NHS (dentist) and when characteristics of the last consultation are taken into account. That is, subjects who paid for a private service waited an average of 14.8 minutes less than those whose visit was paid for by the NHS only. CONCLUSION: Equitable access and use of medical care services in relation to need, regardless of the type of insurance and social class of their children and families, has been achieved in this region of Spain; differences by social class remain for those services incompletely covered by national health insurance and aspects of the quality of care provided.

Adolescent↗
PubMed2000

Pattern of smoking initiation in Catalonia, Spain, from 1948 to 1992.

OBJECTIVES: This study analyzed the pattern of smoking initiation by sex and educational level in Catalonia, Spain. METHODS: Data from the 1994 Catalan Health Interview Survey were used (n = 12,245). The age and smoking status of each subject were reconstructed for each calendar period. Age-specific smoking initiation rates were calculated. RESULTS: Smoking initiation among females was rare until the 1960s, but from the period 1968-1972 onward a converging pattern was observed between the genders. Women with higher levels of education started smoking before other women, but the gradient of educational level has changed in recent years, with higher initiation rates among less-educated women. CONCLUSIONS: These results are consistent with diffusion-of-innovations theory and could be related to social and economic changes from the 1960s onward in Spain.

Adolescent↗
PubMed1999

Age at starting smoking and number of cigarettes smoked in Catalonia, Spain.

BACKGROUND: Few studies have investigated the association between age at starting smoking and the average number of cigarettes smoked per day in adulthood. To provide further evidence on this issue, we analyzed data from the Catalan Health Interview Survey (CHIS). METHODS: The CHIS was conducted in 1994 on a randomly selected sample (N = 15,000) of the population of Catalonia, Spain. A total of 4,897 current or exsmokers (3,276 males and 1,621 females) were included for analysis. Age-standardized proportions of subjects smoking <15, 15-24, and >/=25 cigarettes/day, age-standardized mean number of cigarettes smoked per day, and multivariate odds ratios (OR) of being a heavy smoker (>/=25 cigarettes/day) according to age at starting smoking (<15, 15-17, 18-19, >/=20 years) were computed. RESULTS: Men who started smoking before the age of 15 smoked on average 5.5 cigarettes more than those who started at age 19 or over. Women who started smoking early in life smoked, on average, 6.8 cigarettes/day more than women who started later. The proportion of smokers of <15 cigarettes/day was higher among subjects who started smoking later. Both for males and for females, the OR of being a heavy smoker significantly increased with decreasing age at starting smoking (OR = 2.4 for males and 4.5 for females who started at age <15 versus >/=20 years). The level of education did not modify the relationship in males, whereas the association with age at starting was only apparent for more educated women. CONCLUSIONS: This study confirms that age at starting smoking is inversely and strongly associated to the number of cigarettes smoked per day. Thus, actions aimed at the prevention or delay of smoking onset among adolescents would have an important beneficial effect.

Adolescent↗
PubMed1999

Determining correspondence between scores on the EQ-5D "thermometer" and a 5-point categorical rating scale.

BACKGROUND: "Feeling thermometers" and category rating scales (CRS) can be used to measure self-rated health, though the interpretation of scores on the feeling thermometer may be problematic. OBJECTIVES: To analyze correspondence between scores of self-rated health on the EuroQol-5D "feeling thermometer" and a five-Point CRS. To determine the influence of sociodemographic variables on correspondence. RESEARCH DESIGN: Correspondence between EQ-5D "thermometer" scores and CRS categories was determined in a within-subjects design using data from a large-scale health survey. SUBJECTS: Twelve thousand, two hundred and forty-five members of the Spanish general population interviewed in the Catalan Health Interview Survey. MEASURES: Instruments used were the EQ-5D "feeling thermometer" and a five-Point CRS with categories from "excellent" to "poor." RESULTS: Median scores on the thermometer corresponding to CRS categories were as follows: poor = 40; fair = 53; good = 76; and very good = 80; excellent = 90; differences were statistically significant (P < 0.05). Ranges in thermometer scores covered by CRS categories varied from 23.5 points for the category "poor" to 13 points for the category "very good" (range, 25-75 percentiles), with considerable overlap between categories at the upper end of the scale. Median thermometer scores corresponding to the categories "good,""fair," and "poor" were lower in older respondents and in those with a lower educational level. CONCLUSIONS: Determining correspondence between CRS and thermometer scores is useful in interpreting and categorizing thermometer scores. The age and level of education in particular affect the interpretation of CRS categories, and should be taken into account when analyzing results obtained with such instruments.

Adolescent↗
PubMed1999

Gender inequalities in health and health care services use in Catalonia (Spain).

BACKGROUND AND OBJECTIVES: While socio-economically derived differences in health and health services use have long been a subject of study, differences based on gender, considered as the explicative variable, have scarcely been quantified from population-based data. The aim of this investigation was to analyse inequalities in health and health care services utilisation between men and women in Catalonia (Spain). DESIGN, SETTING, PARTICIPANTS, AND MEASURES: Data from the Catalan Health Interview Survey, a cross sectional survey conducted in 1994, were used. A total of 6604 women and 5641 men aged 15 years or over were included for analysis. Health related variables studied were self perceived health, restriction of activity (past two weeks), and presence of chronic conditions; health services use variables analysed were having visited a health professional (past two weeks), an optometrist (12 months), or a dentist (12 months); and hospitalisation (past 12 months). Age standardised proportions were computed according to gender, and prevalence odds ratios (OR) were derived from logistic regression equations. MAIN RESULTS: Women more frequently rated their health as fair or poor than men (29.8% v 21.4%; OR = 1.22; 95% CI: 1.10, 1.34). More women than men reported having restricted activity days (OR = 1.86; 95% CI: 1.59, 2.18) and chronic conditions (OR = 1.74; 95% CI: 1.60, 1.89). The proportion of women visiting a health professional was slightly greater than that for men (OR = 1.20; 95% CI: 1.09, 1.31), as was the proportion of women visiting an optometrist (OR = 1.21; 95% CI: 1.11, 1.33), and a dentist (OR = 1.43; 95% CI: 1.31, 1.55). The proportion of hospitalisation was lower in women (6.6%) than in men (7.7%; OR = 0.73; 95% CI: 0.63, 0.85). When health services use was analysed according to self perceived health, women declaring good health reported a greater probability of consulting a health professional (OR = 1.35; 95% CI: 1.20, 1.52). There were no differences in respect to hospitalisation, visits to the optometrist and to the dentist. CONCLUSIONS: These results indicate a pattern close to the inverse care law, as women, who express a lower level of health and thus would need more health care, are not, however, using health services more frequently than men.

Adolescent↗
PubMed1998

IS200 fingerprint of Salmonella enterica serotype Typhimurium human strains isolated in Sardinia.

A collection of Salmonella enterica serotype Typhimurium human strains isolated in Northern Sardinia (Italy) was examined for the insertion sequence IS200, phage type, antibiotic profile, ribotyping polymorphisms and plasmid profile. All clinical isolates studied contained from 4 to 10 copies of the IS200 element. IS200 permitted to discriminate Typhimurium strains and to identify five IS200 types, some of them circulating in Sardinia at least since 1900. Strains belonging to phage DT104 predominated and correlated with a specific IS200 pattern.

Bacteriophage Typing↗
PubMed1998

Using the EuroQoI 5-D in the Catalan general population: feasibility and construct validity.

Spanish and Catalan versions of the EuroQoi 5-D (EQ-5D) were included in the Catalan Health Interview Survey (CHIS) and administered to a randomly selected cross-section of 12,245 individuals from the Catalan general population. This paper analyses the feasibility, convergent validity and construct validity of three parts of the EQ-5D (the descriptive system, the visual analogue scale (VAS) and the Spanish tariff) using the results obtained in the CHIS. The feasibility was assessed by the number of missing responses. The convergent validity was based on the correlations between the EQ-5D scores and the scores on the General Health Questionnaire (GHQ) and on an index of self-perceived overall health. The construct validity was assessed by analysing the degree to which lower scores on the EQ-5D correlated positively with increasing age, being female, being in a lower social class or having a lower level of education and with increasing levels of disability, co-morbidity, restricted activity, mental health problems and poor self-perceived health. A low number of missing responses on the descriptive system and the VAS (1.5%) indicated a high level of acceptance. A marked ceiling effect was found, with 67% of the sample reporting no problem in any EQ dimension. The convergent validity with the GHQ was generally low, though moderate on the mood dimension. Self-perceived overall health correlated moderately to strongly with the mean VAS and tariff values. The positive correlations between lower scores on all three elements of the EQ-5D and increasing age, increasing levels of disability, comorbidity, restricted activity, mental health problems and poor self-perceived health provide some evidence of the instrument's construct validity, as does the fact that women reported more problems than men. Multivariate analyses using the VAS and tariff values as dependent variables and all of the sociodemographic and health variables as independent variables reached R2 values of 0.45 and 0.81, respectively. The Spanish and Catalan versions of the EQ-5D have proved to be feasible and valid for use in health interview surveys.

Adolescent↗
PubMed1997

Identification of Salmonella abortusovis by PCR amplification of a serovar-specific IS200 element.

Field and collection isolates of Salmonella abortusovis carry one IS200 element in a distinct chromosome location. IS200 is not found in the corresponding region of the chromosome of other Salmonella serovars. Sequencing of the boundaries of the S. abortusovis-specific IS200 insertion permitted the design of primers for the amplification of this IS200 element by PCR. Isolates of S. abortusovis are identified by the amplification of a DNA fragment of about 900 bp or larger. PCR amplification of DNA from salmonellae other than S. abortusovis yields either a fragment of about 200 bp or no product. The high specificity of the assay is confirmed by the absence of cross-reactivity with the following templates: (i) sheep DNA, (ii) DNAs from abortion-causing agents other than S. abortusovis, and (iii) DNAs from microorganisms that do not cause abortion but are common in flocks.

Animals↗
PubMed1996

Strain typing with IS200 fingerprints in Salmonella abortusovis.

A collection of Salmonella abortusovis isolates was examined for the presence of insertion element IS200. All proved to contain three or four copies of the element. One IS200 hybridization band of approximately 9 kb was found in all isolates, indicating that all S. abortusovis strains carry an IS200 element in similar or identical locations; this band can be potentially useful for serovar identification. S. abortusovis collection isolates from distinct geographic areas were highly polymorphic, suggesting that IS200 fingerprints might provide information on the geographic origin of S. abortusovis strains. Isolates obtained from the same geographic area (the island of Sardinia, Italy) were less polymorphic: all shared three constant IS200 hybridization bands, indicating that they derive from a single ancestor. Most strains analyzed contained an additional copy of IS200 in the variable region of the virulence plasmid. Certain Sardinian flocks proved to be infected by only one S. abortusovis strain, while others harbored two strains. Strain typing with IS200 fingerprints proved to be more reliable than plasmid analysis, because the latter yielded a high degree of polymorphism, even among isolates from the same flock.

Abortion, Veterinary↗
PubMed1978

[Not Available].

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Demography↗