Open Access
Relationship between perceived body weight and body mass index based on self- reported height and weight among university students: a cross-sectional study in seven European countries
(BioMed Central, 2010) Mikolajczyk, Rafael T.; Maxwell, Annette E.; El Ansari, Walid; Stock, Christiane; Petkeviciene, Janina; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Background: Despite low rates of obesity, many university students perceive themselves as overweight, especially women. This is of concern, because inappropriate weight perceptions can lead to unhealthy behaviours including eating disorders. Methods: We used the database from the Cross National Student Health Survey (CNSHS), consisting of 5, 900 records of university students from Bulgaria, Denmark, Germany, Lithuania, Poland, Spain and Turkey to analyse differences in perceived weight status based on the question: "Do you consider yourself much too thin, a little too thin, just right, a little too fat or much too fat?". The association between perceived weight and body mass index (BMI) calculated from self-reported weight and height was assessed with generalized non-parametric regression in R library gam. Results: Although the majority of students reported a normal BMI (72-84% of males, 65-83% of females), only 32% to 68% of students considered their weight "just right". Around 20% of females with BMI of 20 kg/m(2) considered themselves "a little too fat" or "too fat", and the percentages increased to 60% for a BMI of 22.5 kg/m(2). Male students rarely felt "a little too fat" or "too fat" below BMI of 22.5 kg/m(2), but most felt too thin with a BMI of 20 kg/m(2). Conclusions: Weight ideals are rather uniform across the European countries, with female students being more likely to perceive themselves as "too fat" at a normal BMI, while male students being more likely to perceive themselves as "too thin". Programs to prevent unhealthy behaviours to achieve ill-advised weight ideals may benefit students.
Open Access
The impact of COVID-19 on DTP3 vaccination coverage in Europe (2012-2023)
(MDPI, 2025-12-24) Aguinaga Ontoso, Inés; Guillén Aguinaga, Sara; Guillén Aguinaga, Laura; Alas Brun, Rosa María; Guillén-Aguinaga, Miriam; Onambele, Luc; Aguinaga Ontoso, Enrique; Rayón Valpuesta, Esperanza; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Background: The COVID-19 pandemic disrupted routine child immunization efforts, threatening to reverse progress in controlling vaccine-preventable diseases. Materials and Methods: We analyzed the impact of COVID-19 on DTP3 vaccination in Europe by comparing trends before and after the pandemic using time series data from 2000 to 2023. Employing joinpoint regression, chi-square tests, and segmented regression analysis, we assessed DTP3 vaccination trends and coverage changes. Results: The findings revealed significant regional disparities across Europe. Statistical models indicated reductions in DTP3 coverage in countries such as Ireland, Sweden, and Switzerland, whereas Ukraine and San Marino showed improvements. Conclusions: There are variations in the effect of COVID-19 on DTP3 coverage rates, indicating the need for targeted public health strategies to address vaccine hesitancy, logistical barriers, and systemic inequities.
Open Access
Perfil de la demanda urgente e influencia del fútbol televisado en un servicio extrahospitalario en la Zona Básica de Salud de Tafalla, Navarra
(Ministerio de Sanidad y Consumo, 2003) Pérez Ciordia, Ignacio; Catalán Fabo, Francisca; Zalacain Nicolay, Fernando; Barriendo Antoñanzas, Maite; Solaegui Díaz de Guereñu, Ramón; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Fundamento: la demanda a los servicios de urgencias, tanto hospitalarios como extrahospitalarios, mantiene un ritmo creciente. El objetivo del presente trabajo es doble: cuantificación y estudio de las características personales de los usuarios demandantes de atención urgente y valorar si el fútbol televisado influye en la utilización del servicio de urgencias. Métodos: Estudio descriptivo longitudinal (9.723 usuarios demandantes) y estudio de casos y controles (1.284 usuarios demandantes) según presencia o no de fútbol televisado mediante modelo de regresión logística. Las asociaciones se han cuantificado mediante la odds ratio (OR). Se excluyen del estudio las consultas telefónicas y las de enfermería. Resultados: El 10,6% de la demanda ha correspondido a consultas en domicilio y se han remitido al hospital el 4,8% del total. El 13,3% de la demanda corresponde a personas desplazadas de otras zonas de salud y son 65 los usuarios hiperfrecuentadores con 8 o más consultas. El mes de agosto (32,3%), el domingo (44,56%) y el grupo horario de 12 a 14 horas (8,38%) son los momento de mayor demanda de atención, siendo las diferencias estadísticamente significativas. El fútbol televisado se asoció a un aumento de la demanda del 19,8% (p<0,001) respecto al periodo control. Conclusiones: Se observa una alta frecuentación a los servicios de urgencia extrahospitalaria, con una importante concentración de la demanda en momentos muy concretos. Es muy importante la atención prestada a personas desplazadas. La retransmisión de fútbol televisado se asocia con una mayor utilización del servicio de urgencias.
Open Access
Influence of the Mediterranean diet during pregnancy in the development of wheezing and eczema in infants in Pamplona, Spain
(Codon Publications, 2017-06-17) Álvarez Zallo, Noelia; Aguinaga Ontoso, Inés; Álvarez Álvarez, Ismael; Marín Fernández, Blanca; Guillén Grima, Francisco; Azcona San Julián, María Cristina; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: this study examined the relationship between different food groups and the adherence to a Mediterranean diet during pregnancy and the risk of wheezing and eczema in children aged 12-15 months. Methods: the study involves 1087 Spanish infants from the International Study of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). The study of the association of the different food consumption and Mediterranean diet with wheezing, recurrent wheezing and eczema was performed using different models of unconditional logistic regression to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals (95% CI). Results: no association was found between a good adherence to the Mediterranean diet during pregnancy and the development of wheezing (p=0.372), recurrent wheezing (p=0.118) and eczema (p=0.315). The consumption once or twice a week of white fish (OR: 1.95[1.01-3.75]), cooked potatoes (OR: 1.75[1.22-2.51]) and industrial pastry (OR: 1.59[1.13-2.24]), and the consumption more than three times a week of industrial pastry (OR: 1.47 [1.01-2.13]) during pregnancy increases the risk of "wheezing" at 12 months. Instead, high fruit consumption during the pregnancy has a protective effect against "wheezing" in 12-month-old infants (OR: 0.44 [0.20-0.99]). No statistically significant differences were observed between food intake during pregnancy and "recurrent wheezing". No statistically significant differences were observed between the consumption of any food during pregnancy and the presence of eczema at 12 months. Conclusions: the present study showed that the consumption of Mediterranean diet during pregnancy did not have a protective effect for wheezing, recurrent wheezing or eczema.
Open Access
Validation study of a Spanish version of the modified Telephone Interview for Cognitive Status (STICS-m)
(Elsevier, 2018) Muñoz-García, Mariana; Cervantes, Sebastián; Razquin, Cristina; Guillén Grima, Francisco; Toledo, Juan B.; Martínez González, Miguel Ángel; Toledo, Estefanía; Ciencias de la Salud; Osasun Zientziak
Objetivo: Estudiar la correlación de la Telephone Interview for Cognitive Status modificada en español(STICS-m) con el Mini-Mental State Examination (MMSE) y predecir la capacidad de la primera para detectar el desarrollo de demencia. Método: Ciento seis sujetos de un estudio de intervención dietética fueron evaluados personalmente con el MMSE y por teléfono con la STICS-m. La correlación entre ambos se midió con el coeficiente de correlación intraclase (CCI) de consistencia. Además, 932 participantes mayores de 55 años de la cohorte 'Seguimiento Universidad de Navarra' fueron evaluados con la STICS-m. Durante una mediana de seguimiento de 6,5 años, se recogió información sobre el desarrollo de demencia. Mediante regresión logística se estudió la asociación entre la puntuación de la STICS-m o el cambio a 2 años en la puntuación y el riesgo de desarrollar demencia, ajustando por apolipoproteína E, edad y años de educación universitaria. Resultados: El CCI entre el MMSE y la STICS-m fue de 0,31 (intervalo de confianza del 95% [IC95%]:0,13-0,48). La odds ratio (OR) ajustada para el desarrollo de demencia para cada punto adicional en la puntuación basal de la STICS-m fue de 0,85 (IC95%: 0,72-1,02; p = 0,084). Al considerar el cambio en la puntuación a los 2 años como variable independiente, la OR fue de 0,79 (IC95%: 0,67-0,93; p = 0,006).
Open Access
Atopic dermatitis and indoor use of energy sources in cooking and heating appliances
(BioMed Central, 2012) Vicedo Cabrera, Ana M.; García Marcos, Luís; Llopis González, Agustín; López Silvarrey Varela, Ángel; Miner Canflanca, Izaskun; Batlles Garrido, José; Blanco Quirós, Alfredo; Busquets Monge, Rosa María; Díaz Vazquez, Carlos; González Díaz, Carlos; Martínez Gimeno, Antonio; Guillén Grima, Francisco; Arnedo Pena, Alberto; Morales Suárez Varela, María; Ciencias de la Salud; Osasun Zientziak
Background: Atopic dermatitis (AD) prevalence has considerably increased worldwide in recent years. Studying indoor environments is particularly relevant, especially in industrialised countries where many people spend 80% of their time at home, particularly children. This study is aimed to identify the potential association between AD and the energy source (biomass, gas and electricity) used for cooking and domestic heating in a Spanish schoolchildren population. Methods: As part of the ISAAC (International Study of Asthma and Allergies in Childhood) phase III study, a cross-sectional population-based survey was conducted with 21,355 6-to-7-year-old children from 8 Spanish ISAAC centres. AD prevalence, environmental risk factors and the use of domestic heating/cooking devices were assessed using the validated ISAAC questionnaire. Crude and adjusted odds ratios (cOR, aOR) and 95% confidence intervals (CIs) were obtained. A logistic regression analysis was performed (Chi-square test, p-value < 0.05). Results: It was found that the use of biomass systems gave the highest cORs, but only electric cookers showed a significant cOR of 1.14 (95% CI: 1.01-1.27). When the geographical area and the mother’s educational level were included in the logistic model, the obtained aOR values differed moderately from the initial cORs. Electric heating was the only type which obtained a significant aOR (1.13; 95% CI: 1.00-1.27). Finally, the model with all selected confounding variables (sex, BMI, number of siblings, mother’s educational level, smoking habits of parents, truck traffic and geographical area), showed aOR values which were very similar to those obtained in the previous adjusted logistic analysis. None of the results was statistically significant, but the use of electric heating showed an aOR close to significance (1.14; 95% CI: 0.99-1.31). Conclusion: In our study population, no statistically significant associations were found between the type of indoor energy sources used and the presence of AD.
Open Access
Factores asociados al asma en los niños y adolescentes de la zona rural de Navarra (España)
(Elsevier, 2018) Elizalde Beiras, Itsaso; Guillén Grima, Francisco; Aguinaga Ontoso, Inés; Ciencias de la Salud; Osasun Zientziak
Objetivos: Conocer los factores asociados al asma y síntomas relacionados con asma en la población infantil y adolescente en la zona rural de Navarra (España) a través de la validación del cuestionario ISAAC. Participantes y métodos: Estudio transversal mediante la realización del cuestionario ISAAC y variables adicionales por 797 niños y adolescentes, a través del cual se obtuvieron datos de prevalencia sobre síntomas de asma y factores asociados sin realizar ninguna prueba diagnóstica adicional. Emplazamiento: Marco de atención primaria. A través de las zonas básicas de salud se hizo la selección de la muestra y en los centros educativos de dichas zonas se realizó el cuestionario. Mediciones y resultados: El análisis estadístico se hizo a través de regresión logística, chi cuadrado e intervalo de confianza al 95%. La prevalencia asma referida es del 11,7% en niños y del 13,4% en adolescentes. En cuanto a los factores relacionados, según los valores de OR destacan: OR = 9,5 entre sibilancias y asma, y OR = 3,5 entre rinitis recientes y asma. Respecto a las sibilancias recientes, hallamos un OR = 11,5 entre despertares y sibilancias recientes, y un OR = 3,4 entre rinitis recientes y sibilancias recientes. Conclusiones: El asma referida es una enfermedad prevalente ligeramente superior en la adolescencia y la población femenina de los escolares de la zona rural. Rinitis y otros síntomas de asma están relacionados con el asma y con las sibilancias, así como la utilización de los servicios de urgencias en el caso del asma y la bronquitis con las sibilancias.
Open Access
Personal and perceived peer use and attitudes towards the use of nonmedical prescription stimulants to improve academic performance among university students in seven European countries
(Elsevier, 2016) Helmer, Stefanie M.; Pischke, Claudia R.; Hal, Guido van; Vriesacker, Bart; Guillén Grima, Francisco; Ciencias de la Salud; Osasun Zientziak
Background: Overestimations of non-prescribed stimulant use of peers are well documented in the USA and have also been identified as predictive of personal stimulant consumption. This study aimed to examine whether overestimations of peer use and approval of the use are associated with personal use and attitude towards the use of non-prescribed stimulants among European university students. Method: The EU funded 'Social Norms Intervention for the prevention of Polydrug usE (SNIPE)' study was conducted in seven European countries. In a web-based questionnaire, 4482 students were asked about their personal use and their attitude towards non-prescribed stimulant use, as well as the perceived peer use and peer attitude. Results: 59% of students thought that the majority of their peers used non-prescribed stimulants more frequently than themselves, and only 4% thought that the use of the majority was lower than their personal use. The perception that the majority of peers had used non-prescribed stimulants at least once was significantly associated with higher odds for personal use of non-prescribed stimulants (OR: 3.30, 95% CI: 2.32–4.71). In addition, the perception that the majority of peers approved of the non-prescribed use of stimulants was associated with a 4.03 (95% CI: 3.35–4.84) times higher likelihood for personal approval. Discussion: European university students generally perceived the non-prescribed use of stimulants of peers to be higher than their personal use. This perception, as well as a perception of higher approval in the peer group, was associated with a higher likelihood of personal non-prescribed stimulant medication use and approval.
Open Access
The influence of gender and atopy in the relationship between obesity and asthma in childhood
(Elsevier, 2017-01-24) Álvarez Zallo, Noelia; Aguinaga Ontoso, Inés; Álvarez Álvarez, Ismael; Guillén Grima, Francisco; Azcona San Julián, María Cristina; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background: the objective of the study was to examine the relationship between asthma and overweight¿obesity in Spanish children and adolescents and to determine whether this relationship was affected by gender and atopy. Methods: the study involves 8607 Spanish children and adolescents from the International Study of Asthma and Allergies in Childhood phase III. Unconditional logistic regression was used to obtain adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the association between asthma symptoms and overweight-obesity in the two groups. Afterwards, it was stratified by sex and rhinoconjunctivitis. Results: the prevalence of overweight and obesity in 6-7-year-old children was 18.6% and 5.2% respectively and in 13-14 year-old teenagers was 11.4% and 1.1% respectively. Only the obese children, not the overweight children, of the 6-7 year old group had a higher risk of any asthma symptoms (wheezing ever: OR 1.68 [1.15-2.47], asthma ever: OR 2.29 [1.43-3.68], current asthma 2.56 [1.54-4.28], severe asthma 3.18 [1.50-6.73], exercise-induced asthma 2.71 [1.45-5.05]). The obese girls had an increased risk of suffering any asthma symptoms (wheezing ever: OR 1.73 [1.05-2.91], asthma ever: OR 3.12 [1.67-5.82], current asthma 3.20 [1.65-6.19], severe asthma 4.83[1.94-12.04], exercise-induced asthma 3.68 [1.67-8.08]). The obese children without rhinoconjunctivitis had a higher risk of asthma symptoms. Conclusions: obesity and asthma symptoms were associated in 6-7 year-old children but not in 13-14 year-old teenagers. The association was stronger in non-atopic children and obese girls.
Open Access
Individual- and community-level determinants of maternal health service utilization in southern Ethiopia: a multilevel analysis
(SAGE, 2023) Yoseph, Amanuel; Teklesilasie, Wondwosen; Guillén Grima, Francisco; Astatkie, Ayalew; Ciencias de la Salud; Osasun Zientziak
Background: Maternal health service utilization decreases maternal morbidity and mortality. However, the existing evidence is inadequate to design effective intervention strategies in Ethiopia. Objectives: This study aimed to examine the utilization of maternal health service and identify its determinants among women of reproductive age in southern Ethiopia. Design: A community-based cross-sectional study was conducted from October 21 to November 11, 2022 on a sample of 1140 women selected randomly from the Northern Zone of the Sidama region. Methods: Data were collected using the Open Data Kit mobile application and exported to Stata version 15 for analysis. We used a multilevel mixed-effects modified Poisson regression with robust standard error to identify determinants of maternal health service utilization. Results: Utilization of antenatal care, health facility delivery, and postnatal care was 52.0% (95% confidence interval: 49.0%, 55.0%), 48.5% (95% confidence interval: 45.6%, 51.4%), and 26.0% (95% confidence interval: 23.0%, 29.0%), respectively. Antenatal care use was associated with receiving model family training (adjusted prevalence ratio: 1.19; 95% confidence interval: 1.06, 1.35), knowledge of antenatal care (adjusted prevalence ratio: 1.54; 95% confidence interval: 1.31, 1.81), perceived quality of antenatal care (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), and having birth preparedness plan (adjusted prevalence ratio: 1.13; 95% confidence interval: 1.02, 1.25). The identified determinants of health facility delivery use were middle wealth rank (adjusted prevalence ratio: 1.35; 95% confidence interval: 1.03, 1.77), perceived quality of health facility delivery (adjusted prevalence ratio: 1.02; 95% confidence interval: 1.01, 1.03), antenatal care (adjusted prevalence ratio: 1.76; 95% confidence interval: 1.36, 2.26), and high community-level women literacy (adjusted prevalence ratio: 1.55; 95% confidence interval: 1.10, 2.19). Postnatal care use was associated with facing health problems during postpartum period (adjusted prevalence ratio: 1.79; 95% confidence interval: 1.18, 2.72), urban residence (adjusted prevalence ratio: 3.52; 95% confidence interval: 2.15, 5.78), knowledge of postnatal care (adjusted prevalence ratio: 1.11; 95% confidence interval: 1.04, 1.19), and low community-level poverty (adjusted prevalence ratio: 0.43; 95% confidence interval: 0.25, 0.73). Conclusion: Maternal health service use was low in the study area and was influenced by individual- and community-level determinants. Any intervention strategies must consider multi-sectorial collaboration to address determinants at different levels. The programs should focus on the provision of model family training, the needs of women who have a poor perception, and knowledge of maternal health service at the individual level.