Geographical patterns of childhood cancer incidence in Europe, 1988-1997. Report from the Automated Childhood Cancer Information System project.

Data on more than 50,000 registrations in the Automated Childhood Cancer Information System (ACCIS) database were used to present an overview of regional patterns in childhood cancer incidence in Europe during 1988-1997, and to present additional detail on selected carcinomas whose occurrence in childhood is seldom described because of their rarity. Total age-standardised incidence was 138.5 per million for Europe overall, and varied between regions from 131.1 per million in the British Isles to 160.1 per million in Northern Europe. Incidence varied significantly between regions for nearly all diagnostic groups. The greatest range of regional incidence rates was for central nervous system (CNS) tumours, from 27.0 per million in the West to 43.8 per million in the North. Differences in registration practice for non-malignant tumours account for some of this variation. There was a marked excess of carcinoma in Eastern Europe, which was wholly attributable to the high incidence of thyroid carcinoma in Belarus, though there was also evidence of inter-regional variation attributable to differences in registration practice. The geographical heterogeneity of incidence rates for other diagnostic groups seems more likely to reflect variations in underlying risk.

[Consumption of psychodrugs. Influence of family dysfunction]. / Consumo de psicofármacos. Influencia de la disfunción familiar.

INTRODUCTION: The objective of this study is to know the prevalence of psychodrug consumption in Primary Health Care, related factors and influence of the family factor on this consumption. METHODS: Observational cross sectional study carried out in an urban Health Care Center. A total of 434 patients older than 14 years old, who are health care consumers, were included. They were selected by systematic sampling for 6 consecutives weeks. Psychodrugs consumption and related factors were measured by a questionnaire designed for this purpose. The questionnaire was filled out by personal interview and case history revision. Existence of family dysfunction was determined by self-applied Apgar-family questionnaire. RESULTS: Prevalence of psychodrugs consumption was 26% (95 % CI: 22-30). A total of 53% were benzodiazepines and 27% were antidepressants (73 % are SSRI). There was family dysfunction in 20 % of consumers and 12 % of non-consumers, which is a statistically significant difference (p<0.01). By logistic regression, being between 45-64 years old (OR: 3.18), or more than 65 years old (OR: 3.29), being female (OR: 2.2), being a housewife (OR: 3.07), having psychiatric background (OR: 15.2) and having important family dysfunction in the Apgar-family questionnaire (OR: 7.19) were the variables which appeared as associated with this consumption. CONCLUSIONS: Consumption of psychodrugs in Primary Health Care consumers is 26 %. Being 45 years old or more, female and housewife are possible factors which predict psychodrugs consumption. Psychiatric disease antecedents and having important family dysfunction are also associated independently. These should be kept in mind to improve medical prescription of these drugs in Primary Health Care.

Consumo de psicofármacos. Influencia de la disfunción familiar / Consumption of psycbodrugs Influence of family dysfunction

Introducción. El objetivo de este estudio es conocer la prevalencia del consumo de psicofármacos en Atención Primaria, los factores relacionados y la influencia del factor familiar en dicho consumo. Métodos. Estudio observacional y transversal realizado en un centro de salud urbano. Incluimos 434 pacientes, mayores de 14 años demandantes de consulta, seleccionados durante 6 semanas consecutivas mediante muestreo sistemático. Medimos el consumo de psicofármacos y los factores relacionados mediante cuestionario diseñado al efecto y cumplimentado con entrevista personal y revisión de historias clínicas. La presencia de disfunción familiar se determina con el autocumplimentado del test de Apgar familiar Resultados. Prevalencia del consumo de psicofármacos del 26 por ciento (IC 95 por ciento: 22-30). El 53 por ciento fueron benzodiacepinas y el 27 por ciento antidepresivos (73 por ciento son ISRS). Encontramos disfunción familiar en el 20 por ciento de los consumidores y en el 12 por ciento de los que no consumen, diferencia estadísticamente significativa (p < 0, 01 ). Mediante regresión logística, tener entre 45-64 años (OR. 3,18) o más de 65 años (OR:3,29), ser mujer (OR. 2,2), ser ama de casa (OR: 3,07), tener antecedentes psiquiátricos (OR. 15,2) y presentar un Apgar familiar con disfunción familiar grave (OR: 7,19) son las variables que aparecen asociadas al citado consumo. Conclusiones. El consumo de psicofármacos en población demandante de asistencia en Atención Primaria es del 26 por ciento. Tener 45 o más años, ser mujer y ama de casa constituyen posibles factores predictores del consumo de psicofármacos. Los antecedentes de patología psiquiátrica y presentar disfunción familiar grave se asocian también de forma independiente y deberían ser tenidos en cuenta en la mejora de la calidad y pertinencia de la prescripción de estos fármacos en Atención Primaria (AU)

[Evaluation of the surveillance system of chlorination of public water supply in the province of Albacete]. / Valoración del sistema de vigilancia de cloración de aguas de abastecimiento público en la provincia de Albacete.

OBJECTIVE: The aim was to study the reliability of the available data, stemming from the concordance between two different observers' measurement of the level of free residual chlorine. DESIGN: An observational, crossover study, using measurements of the level of free residual chlorine repeated on the same day by two different observers. SETTING: Health Area of Albacete. PATIENTS AND OTHER PARTICIPANTS: 176 double measurements of chlorine, carried out during the study period in 69 networks distributing different waters. MEASUREMENTS AND MAIN RESULTS: Concordance between observers on the absence or presence of chlorination was low (I.Kappa = 0.261), showing a bias in favour of the presence of chlorination in the measurements made by local technicians (McNemar p < 0.01). Applying a logistic regression model, it was observed that the risk of disagreement was as much as 8.5 times greater when chlorine measurement required the local technician to travel. CONCLUSIONS: We concluded that the data available was of questionable value and that it would be useful to put forward some new proposals to improve the supervision of the network.

[Epidemic outbreaks in the province of Albacete. 1987]. / Brotes epidémicos en la provincia de Albacete. Año 1987.

A descriptive study has been made based on the epidemiologic data obtained from the "Outbreak Reports" during the year 1987 in the Province of Albacete. In this study the need to improve the quality of the data on outbreaks is emphasized. This would allow for programming concrete actions which would permit its future control.