Influencia de la formación impartida en las Facultades de Medicina en las aptitudes y actitudes de sus alumnos en tabaquismo / Influence of training given in the medical schools in the appitudes and attitudes of their students regarding the smoking habit

Objetivo. Conocer aptitudes y actitudes sobre el tabaquismo en alumnos de Medicina y valorar la formación adquirida. Métodos. Estudio transversal realizado a estudiantes de medicina durante el curso 2010-2011 utilizando un cuestionario validado, anónimo y autoaplicado. Resultados. El 36% fuman: el 18,7% los fines de semana y el 17,3% a diario, con un consumo medio de 2,08 cigarrillos/día. Han intentado dejar de fumar el 29,3% de los fumadores y desean hacerlo el 28,3% de los alumnos fumadores. Existen diferencias significativas entre los alumnos de primero y sexto en la valoración del tabaquismo como drogodependencia y enfermedad crónica y también en el conocimiento de las enfermedades relacionadas con el tabaco (p< 0,005). El análisis bivariante y multivariante indican que la mayor formación de los alumnos de sexto se relaciona significativamente con un mayor conocimiento de las enfermedades asociadas al tabaco. En relación con el diagnóstico y tratamiento, existen diferencias significativas entre los alumnos de primero y sexto en todos los ítems (p< 0,005). Las tres variables asociadas con los conocimientos adquiridos son la capacidad de recoger en la historia el consumo de tabaco, el conocimiento de los métodos de diagnóstico y del tratamiento multicomponente. Conclusiones. Los resultados muestran que a mayor conocimiento, se asocia mayor competencia profesional en la cumplimentación de la historia clínica y mayor capacidad de intervención (AU)

Objective. To study aptitudes and attitudes with regard to smoking in medical students and evaluate the education received throughout the course of the academic studies. Methods. A cross-sectional study of medical students during the academic year of 2010-2011 using a validated questionnaire, anonymous and completed individually. Results. 36% smoke: 18.7% on weekends and 17.3% daily, with an average consumption of 2.08 cigarettes/ day. 29.3% of smokers have tried to quit smoking and 28.3% of students wish to quit smoking. There are significant differences between students ofthe first and the sixth year in the valuation of smoking and the related drug dependence and also in the knowledge of diseases related to tobacco (p <0.005). The bivariate and multivariate analyses indicate that the higher level of professional education of the 6th year students is significantly related to greater knowledge of the diseases associated with smoking. With regard to diagnosis and treatment there are significant differences between students of the first and the sixth year on all items (p <0.005). The three variables associated with the acquired knowledge consist of the ability to collect data related to smoking in the anamnesis, knowledge of methods of diagnosis and tobacco treatment. Conclusions. The results show that the greater knowledge is associated with greater professional expertise in the completion of the clinical history and greater knowledge of medical intervention (AU)

[Lung cancer and smoking in Asturias, Spain. A case-control study]. / Cáncer de pulmón y tabaco en Asturias. Un estudio de casos y controles.

OBJECTIVE: Lung cancer in Asturias is 1.4-fold greater than the Spanish average, while the proportion of smokers is similar. The objective of this study was to examine the relationship between lung cancer and smoking in Asturias. MATERIAL AND METHODS: We performed a hospital-based, incident case control study. The cases were newly diagnosed lung cancer patients and controls were patients from the surgical wards. Information was sought on smoking, occupational exposures, and demographic variables. The analysis was performed by means of odds ratios (OR). RESULTS: One hundred ninety-seven cases and 196 controls were included in the analysis. The adjusted OR of cigarette smoking was 5.77 (95% CI, 2.96-11.22). The risk increased with the number of cigarettes smoked per day (chi 2 = 56.3), the number of packs/year (chi 2 = 48.4), and the age at which smoking started (chi 2 = 76.5). The OR diminished with the number of years of cessation (chi 2 = 39.9). CONCLUSIONS: The relationship between smoking and lung cancer in Asturias is similar to that found in other studies carried out in other parts of the western world. The magnitude of the OR may explain the frequency of lung cancer in Asturias. Greater efforts should be devoted to controlling this problem.

Cáncer de pulmón y tabaco en Asturias.Un estudio de casos y controles / Lung cancer and smoking in Asturias, Spain. A case-control study

Objetivo: Examinar la relación entre el consumo de tabaco y cáncer de pulmón en Asturias. Material y métodos: Se realizó un estudio de casos y controles de base hospitalaria. Los casos fueron pacientes con diagnóstico nuevo de cáncer de pulmón (casos incidentes) y los controles procedían de los servicios quirúrgicos. La información obtenida incluyó el consumo de tabaco, las exposiciones ocupacionales y las variables demográficas. Resultados: Se incluyeron en el análisis 197 casos y 196 controles. La odds ratio (OR) ajustada de cáncer de pulmón fue de 5,77 (intervalo de confianza [IC] del 95 por ciento, 2,96-11,22) para el consumo de cigarrillos. El riesgo aumentaba con la cantidad de cigarrillos fumados por día, el número de paquetes/día, la edad de inicio del hábito, y disminuía con el número de años desde el abandono. Conclusiones: La relación entre el tabaco y el cáncer de pulmón en Asturias es similar a la encontrada en otros estudios llevados a cabo en el mundo occidental. La magnitud de la asociación puede explicar la frecuencia de cáncer de pulmón en Asturias (AU)

The effects of temperature on human fertility.

Monthly birth and temperature data for a variety of states and countries are used to estimate the effect of short-run temperature fluctuations on fertility. Regressions of monthly births on a flexible specification of lagged monthly temperature show that temperature has quantitatively important effects on both seasonal and nonseasonal variation in births. Summer temperature extremes reduce conceptions in the southern United States, explaining a substantial part of the observed seasonal birth pattern. Extreme cold shows no evidence of affecting conceptions. The results also show significant seasonality in births even after accounting for temperature. Controls for monthly temperature do not explain the persistent spring peak in births in northern Europe. This finding suggests that other factors play an important role.

Modeling seasonality in fecundability, conceptions, and births.

This paper develops a model of seasonal fluctuations in fecundability, conceptions, and births. We begin with a model of individual fecundability that combines behavioral and biological components, with particular attention to the roles of coital frequency, sperm concentration, fetal loss, and contraception. The individual-level model is then expanded into a model of seasonal fluctuations in births at the population level, which accounts explicitly for seasonal fluctuations in the size of the susceptible population. We illustrate the use of the model by analyzing proposed explanations of birth seasonality that rely on extreme summer heat.

Global patterns of seasonal variation in human fertility.

Pronounced and persistent seasonal patterns in fertility are observed in virtually all human populations. This paper presents evidence on these seasonal patterns. We note that the most pronounced seasonal patterns are in the southern United States, where births decline substantially in April and May, and in northern Europe, where births increase substantially in March and April. Although seasonal variations in fertility were more pronounced in earlier agricultural populations, we show that seasonality has increased in this century in some high income, low fertility populations such as Sweden. We use data on monthly temperature to analyze the potential role of temperature in explaining seasonal patterns. We find strong evidence that summer heat plays an important role in explaining the July-August trough in conceptions in the southern United States. We find little evidence, however, that temperature plays any role in explaining the pronounced June-July peak in conceptions in Sweden. Temperature also appears to be relatively unimportant in several other populations with substantial seasonal variations in births, suggesting that other factors play an important role in birth seasonality.

Seasonality of births in human populations.

Seasonal fluctuations in births have been observed in virtually all human populations. In this paper we re-examine the seasonality of births with two main objectives in mind. The first is to provide an overview of the basic facts about the seasonality of births, presenting new estimates of the seasonal patterns. Seasonality is an important if not dominant source of nontrend variation in births in virtually all populations, but there are dramatic and puzzling differences across countries and time periods in the pattern of seasonal variation observed in particular populations. The second purpose of the paper is to survey the leading hypotheses about birth seasonality that have appeared in the literature and to discuss the consistency of these hypotheses with observed seasonal patterns. Using our estimates of seasonal patterns along with other evidence in the literature, we conclude that no single explanation receives strong, consistent support from the data.

PIP: Reviewing leading hypotheses on the seasonality of births in human populations, the authors find no 1 explanation to be supported by existing data. Births are highly seasonal in all human populations, with great variation in the timing of seasonal patterns across populations. Available literature estimates birth seasonality for many countries and time periods, but differing methodologies and the frequent use of small populations pose obstacles to comparing patterns across populations. This paper's estimates of seasonal patterns document major regularities and unify existing estimates to come to the above conclusions about the ubiquity of birth seasonality. This conclusion and basic facts about births seasonality are presented in the paper. No simple rule exists to describe and/or predict which seasonal patterns of births particular populations will exhibit. Dramatic and puzzling differences exist between countries and time periods in the pattern of seasonal variation, making much of the determinants of birth seasonality an unresolved mystery of empirical demography. Questions abound for both the biological and behavioral research of fertility. 2 effects noted as most consistent with seasonal patterns, however, are weather and leisure time due to holidays. To better understand the determinants of birth seasonality, the authors advise the use of variables other than births, employing more disaggregated data sets, and explicitly accounting for multivariate explanations.

Temperature and the seasonality of births.

PIP: The relationship between temperature and seasonal fluctuations in births is presented cross nationally. Previous literature which give some credence to this relationship is reviewed, but the authors caution that there is no singular reason for birth seasonality. The summary conclusion is that the evidence is inconclusive; the most consistent hypothesis is that summer heat depresses conceptions. The next section is concerned with a selected set of estimates for birth seasonality. The data description and methods are published elsewhere. Tests of statistical significance at the 1% level reject the null hypothesis of no seasonality. In the US birth seasonality if reflected in a September peak and an April/May trough with variation between states in amplitude. The southern state's pattern is compared to 3 regions in India and Israel, and found to be similar. A European pattern is discerned with a spring peak, a local September peak, and a trough during late fall and early winter. The September peak is the only similarity to the US The explanation for variations is difficult, particularly when the birth seasonality between Sweden and the US is different and the seasonal temperature patterns are the same. 2 explanations are posited and discussed: 1) temperature operates in a more complicated manner than by simply depressing conceptions during the period of summer heat; and 2) 1 other factor, in addition to temperature explains the observed seasonal patterns. An estimation strategy is outlined which utilizes a variety of temperature effects, such as the effect of temperature on coital frequency. The equations also allow for the possibility that temperature has no effect at moderature temperature, a negative effect an high temperatures, or that hot or cold temperatures suppress fecundity. The results strongly reject the null hypothesis, but are mixed in the monthly temperature explanation with significance at the 5% level for Georgia, New York, Kerala, Maharashtra, England, and France, at the 10% level in California, Israel, and New Zealand, and insignificant for the Punjab, Canada, Sweden and Australia. The trends show that there is a spring trough in births in warm climate populations (hot summers reduce conceptions); that there is a pattern without temperature explanation for a persistent September peak in births and a spring peak in births in northern populations. High temperatures reduce conceptions in a wide variety of populations, but the explanation is not apparent.^ieng