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Background There is considerable evidence demonstrating socioeconomic inequalities in mortality, some of which focuses on intraurban inequalities. However, all the studies assume that the spatial variation of inequalities is stable over the time. We challenge this assumption and propose two hypotheses: (i) have spatial variations in socioeconomic inequalities in mortality at an intraurban level changed over time? and (ii) as a result of the economic crisis, has the gap between such disparities widened? In this paper, our objective is to assess the effect of the economic recession on the spatio-temporal variation of socioeconomic inequalities in mortality in Barcelona (Catalonia, Spain). Methods We used a spatio-temporal ecological design to analyse mortality inequalities at small area level in Barcelona. Mortality data and socioeconomic indicators correspond to the years 2005 and 2008-2011. We specified spatio-temporal ecological mixed regressions for both men and women using two indicators, neighbourhood and year. We allowed the coefficients of the socioeconomic variables to differ according to the levels and explicitly took into account spatio-temporal adjustment. Results For men and women both absolute and, above all, relative risks for mortality have increased since 2009. In relative terms, this means that the risk of dying has increased much more in the most economically deprived neighbourhoods than in the more affluent ones. Conclusions Although the geographical pattern in relative risks for mortality in neighbourhoods in Barcelona remained very stable between 2005 and 2011, socioeconomic inequalities in mortality at an intraurban level have surged since 2009. [ABSTRACT FROM AUTHOR]

Background Studies have shown that immigrants residing in Spain have lower risks of delivering low birthweight (LBW) and preterm babies despite their socioeconomic disadvantages (the healthy migrant paradox). However, less is known about other important perinatal outcomes derived from birth weight and gestational age such as macrosomia and post-term birth. This paper aims to compare the main indicators related to birth weight and gestational age (LBW, macrosomia, preterm and post-term) for immigrants and Spaniards. Methods Cross-sectional study based on the Spanish vital statistics for years 2009–2011. Multinomial regression models were performed to obtain crude and adjusted ORs and their 95% CIs. Results After adjusting for known confounders, compared with Spaniards, most immigrant groups show lower or not significantly different risks of delivering LBW (OR between 0.65 and 0.87) or, more exceptionally, preterm babies (between 0.75 and 0.93). However, most of them also show higher risks of delivering macrosomic (OR between 1.21 and 2.58) and post-term babies (OR between 1.11 and 1.50). Mothers from sub-Saharan Africa show a higher risk in all perinatal outcomes studied. Conclusions The immigrant health paradox should be carefully assessed in comprehensive terms. Together with a predominantly lower risk of LBW, most immigrants have a higher risk of macrosomia, post-term and preterm births. These results have policy-making implications since studying the right tail of the birth weight and gestational age distributions implies considering a different set of risk factors. [ABSTRACT FROM AUTHOR]

Objectives The Spanish government has strengthened tobacco control policies since 2005, including changes in tobacco taxes. Because these changes have targeted cigarettes mainly, the tobacco industry has marketed cheaper alternative tobacco products, offering smokers the possibility to downtrade. This paper traces the evolution of patterns of demand for cigarettes and other tobacco products in Spain over the period 2005-2011 in order to assess the impact of such tax loopholes. Methods The authors use data on tobacco products prices and sales as well as changes in the structure and levels of tobacco taxes to relate tax changes to price changes and subsequent market share changes. Results Tax reforms have lifted the bottom end of the cigarette price distribution, but the industry has been successful in marketing fine-cut tobacco at cheap prices. There have been partial attempts to correct this asymmetric tax treatment, but these have not avoided a remarkable increase in the market share of fine-cut tobacco. The absence of a minimum tax on quantity for the rest of tobacco products allows the industry to place them as potential future downtrading vehicles. Conclusions In order to address public health objectives, tax policies should aim to equalise the cost of smoking across different tobacco products. Otherwise the tobacco industry can exploit tax loopholes to market cheap alternatives to cigarettes. This requires all tobacco products to bear a minimum tax on quantity, whose levels need to be adjusted in order to reflect the equivalence between different forms of smoking. [ABSTRACT FROM AUTHOR]

Background: This study assesses the impact on safety of a system designed to enhance sleep in car passengers. The system holds the head posteriorly and limits its rotation in the sagittal and frontal planes, modifying the occupant's head position. This device may have an influence on the interaction between the occupant and the vehicle restraint systems. Methods: It was a randomised, prospective, single-blind, cross-over controlled study in which 41 volunteers were exposed to using the system while riding as car passengers. Whether the device influenced the posture of the occupants and prevented them from adopting out-of-position (OOP) configurations was also analysed. Occupants were videotaped while they were using both the innovative system (cases) and their normal sleeping device (controls), if any. Results: Controls were exposed to OOP situations in 825 occasions (18.4%; 95% CI 17.3% to 19.6%), while cases were exposed in 416 occasions (9.3%; 95% CI 8.4% to 10.2%). The paper also analysed how many cases and controls were exposed at least once to a particular event and how frequent a single participant incurred in an OOP situation. In both cases, the innovative device showed a reduction in exposition. When OOP situations were grouped into severe, moderate and minor events, the innovative device produced a statistically significant reduction in the occurrence of severe and moderate events. Conclusions: A device originally designed to improve comfort and rest in car passengers has been found to reduce the exposure of the occupants to being OOP while resting in the car. [ABSTRACT FROM AUTHOR]

Background This paper aims at assessing the effectiveness of the package of road safety measures implemented after road safety was included in the political agenda in the year 2004 on the number of road traffic-injured people in Spain. Methods An evaluation study was performed using an interrupted time-series design. The study population was people injured in road traffic crashes in Spain between 1 January 2000 and 31 December 2006. The road traffic crashes database of the General Directorate for Traffic was used. The dependent variable was the monthly number of people injured, stratified by sex, age, severity and type of road user. The explanatory variable (intervention) compared the post-intervention period (2004-6) with the pre-intervention period (2000-3). Quasi-Poisson regression models were adjusted, controlling for time trend and for seasonality. Results Results show a reduction in the risk of being injured for both men (RR 0.91; 95% CI 0.87 to 0.95) and women (RR 0.89; 95% CI 0.85 to 0.94). Risk reductions were observed across all age groups and all road users, except for pedestrians. Conclusions The present study suggests that prioritising road safety reduces the number of people injured in road traffic collisions. [ABSTRACT FROM AUTHOR]

The article focuses on a study with regards to the use of reporting guidelines such as CONSORT and STROBE for the improvement of manuscript quality in biomedical journals. It says that the subject of the study were the research manuscripts acquired by the journal "Medicina Clínica" from May 2008 to April 2009. Results show that 34 papers were rejected from the 126 papers for conventional peer review, wherein the additional review shows an improvement in the quality of the manuscripts.