Search

Objective: To determine whether the famine experienced during the Spanish civil war and immediate postwar period influenced mortality from coronary heart disease (CHD) in persons born in this period, following the lines of Barker's hypothesis on fetal programming of chronic diseases in adult life., Methods: Using CHD mortality data by age and sex for 1990-2002, annual and age-adjusted rates were calculated by the direct method. Poisson regressions were used to estimate period, age and cohort effects by year of birth (1918-1957)., Results: During the study period, CHD mortality fell by a yearly average of -2.3% in both sexes and in all ages yearly. This trend was influenced by both cohort and period effects (p<0.001); an increased risk was observed for both sexes and in all ages in the deaths corresponding to persons born during the war and postwar years when the famine was most intense (1937, 1940, 1943 and 1945)., Conclusions: The results obtained by studying yearly CHD mortality are compatible with those expected by Barker's hypothesis of the effect of nutritional stress during pregnancy. In addition to its human, economic and political costs, the Spanish civil war could also have had negative consequences for the health of persons born in this period.

The consumption of medicinal herbs is one of the most important topics in alternative and complementary medicine. The widespread use of these substances among the general population gives rise to the possibility of therapeutic or toxic effects in patients seeking conventional medical assistance. To determine the frequency of medicinal herb use, the species consumed and the profile of medicinal herb consumers among patients with gastrointestinal disorders, patients attending the gastroenterology outpatient clinic of the Francesc de Borja district hospital (Gandía, Spain) over a 5-month period were interviewed and 539 valid questionnaires were obtained. A total of 34.7% of the interviewees had taken medicinal herbs at some time and 26.9% had used them in the last year. Self-prescription was reported by 67.1%. Medicinal herbs were mainly obtained in the pharmacy or herbalist's (74.7%). The results of medicinal herb therapy were considered good or excellent by 80.3% of the interviewees, average by 18.6% and poor by 1.1%. In the univariate analysis, medicinal herb consumption was positively associated with female sex (p < 0.001), a university education (p < 0.05), consumption of psychotropic drugs (p < 0.005), use of trencar l'enfit (TE, a common practice of magic medicine in Valencia) (p < 0.001), functional gastrointestinal disorders (p < 0.005) and a diagnosis of lower gastrointestinal disorder (p < 0.01). In the multivariate analysis, the variables that remained statistically significant were female sex (p < 0.005), university education (p < 0.01), use of TE and a diagnosis of lower gastrointestinal disorder. Fifty-seven botanical varieties were used. The most frequent varieties were Santolina chamaecyparissus (18.8%), Tilia platyphyllos (6.5%), Thymus vulgaris (6%), Equisetum ramosissimum (4.7%), Mentha pulegium (4.4%) and Valeriana officinalis (4.4%). The results show that consumption of medicinal herbs is frequent among patients attending the gastroenterology outpatient clinic of a district hospital. The probable profile of those showing maximum consumption is: female sex, university education, lower gastrointestinal disorder, functional gastrointestinal disorder, psychotropic drug consumption and use of TE.

Objective: To determine the incidence of psychiatric morbidity (PM) in the area, and the associated demographic and socio-economic factors., Design: Observational non-longitudinal study., Setting: The population of a Basic Health Area., Participants: Simple random sample of persons over 15 years old, selected from municipal census lists, accurate at 00.4. Initial sample: 697 cases. Excluded: deceased (11) changed address (112) serious mental incapacity (7) and refusal to take part (64). Final sample: 503 cases., Measurements and Main Results: Answering of the General Health Questionnaire of 28 items (GHQ-28) and a questionnaire with study variables, between October 1990 and November 1991. 99 cases answered by post, and 404 via home visit. A GHQ-28 score greater or equal to 7 was considered positive. The incidence of GHQ-28 positive values in the population was found to be 0.35 (IC-0.31-0.39) and that of PM was found to be 0.38 (IC: 0.31-0.44). A link was observed with educational level (OR = 2.0277; p = 0.0174) and with sex (OR = 1.76 40; p = 0.172). There were no differences between those who answered by post or at home (p = 0.21) nor between those answering at different times of the year (p = 0.78)., Conclusions: There was a high incidence of PM in persons older than 15 in our health area. This incidence is associated in a significant way with level of education (higher amongst lower levels) and with sex (higher amongst women). These factors can be considered as risk markers which can help us to detect sufferers from this type of illness.

The study of the determinants of disease-related lifestyles may be relevant for better understanding the potential of health policies. In the present work, results of the analysis of the Elche Healthy Cities Interview Survey prevalence of some disease related lifestyles (physical activity level, cigarette consumption, and alcohol intake) are presented according to economic level as measured by monthly family income, 573 people randomly selected from the town rolls were interviewed at home. No associations were found between economic level and alcohol intake or present smoking status. But, trying to stop smoking and regular exercise were more frequent behaviors in higher economic groups. The ratio of prevalence of regular exercise was 1.73 in favor of the highest economic levels. The gradient found was statistically significant (chi 2 for trend = 17.4, p less than 0.01). The results may be of relevance when implementing health policies to overcome inequalities in health: "unequal interventions" may be more adequate.