ObjectivesTo describe the development and test–retest reliability of OHCITIES, an instrument characterising alcohol urban environment in terms of availability, promotion and signs of consumption.DesignThis study involved: (1) developing the conceptual framework for alcohol urban environment by means of literature reviewing and previous alcohol environment research experience; (2) pilot testing and redesigning the instrument; (3) instrument digitalisation; (4) instrument evaluation using test–retest reliability.SettingData for testing the reliability of the instrument were collected in seven census sections in Madrid in 2016 by two observers.Primary and secondary outcome measuresWe computed per cent agreement and Cohen’s kappa coefficients to estimate inter-rater and test–retest reliability for alcohol outlet environment measures. We calculated interclass coefficients and their 95% CIs to provide a measure of inter-rater reliability for signs of alcohol consumption measures.ResultsWe collected information on 92 on-premise and 24 off-premise alcohol outlets identified in the studied areas about availability, accessibility and promotion of alcohol. Most per cent-agreement values for alcohol measures in on-premise and off-premise alcohol outlets were greater than 80%, and inter-rater and test–retest reliability values were generally above 0.80. Observers identified 26 streets and 3 public squares with signs of alcohol consumption. Intraclass correlation coefficient between observers for any type of signs of alcohol consumption was 0.50 (95% CI −0.09 to 0.77). Few items promoting alcohol unrelated to alcohol outlets were found on public spaces.ConclusionsThe OHCITIES instrument is a reliable instrument to characterise alcohol urban environment. This instrument might be used to understand how alcohol environment associates with alcohol behaviours and its related health outcomes, and can help in the design and evaluation of policies to reduce the harm caused by alcohol.
Background: Little is known about lifestyle choices and preventive healthcare-seeking behaviors during the transition from medical school graduation to residency training, a period characterized by increased rates of stress and lack of free time due to demanding working conditions. All of these issues are likely to affect physical activity (PA) level. This study explored the evolution of PA and other lifestyle behaviors during this transition. Methods: A cross-sectional study and a cohort study were conducted with medical students (2010) and physicians before and after the first year of residency (2013 and 2014). A self-administered questionnaire assessed PA, health and lifestyle behaviors. Results: From a sample of 420 medical students and 478 residents, 74% comply with current PA guidelines. PA decreased by 16% during residency. Low levels of PA were found among (i) females, and in respondents who reported (ii) poor self-perceived health and (iii) unhealthy body weight (p < 0.05). Low PA level was also significantly associated with poor mental health in first-year residents. Conclusions: The transition has a negative effect on physicians' PA level that may affect physicians' own health and patient care.Medical programs should encourage residents to engage in PA to assure physicians' personal and mental health.Keywords: physical activity; medical students; residents' health; lifestyle behaviors; mental healthThe transition of medical students to residency 2 IntroductionIn medical training the transition from medical school to residency training is characterized by higher rates of stress and a lack of free time. The demands of the working conditions can also lead to limited sleep, dealing with patients' suffering and the death and/or the responsibility of starting to make decisions regarding patients' health.1, 2 Further, with increasing demands within medical education, it is important that new studies build on existing research to show the effects that the different stages of training may have on physicians' personal health and lifestyle-related behaviors.In both patients and doctors, sedentary behaviors, physical inactivity, obesity levels, smoking rates, alcohol consumption and substance use are powerful behavioral risk factors for numerous chronic diseases.3, 4 For patients, physicians are both an important source of health-related information and role models. This puts them in a powerful position to influence their patients' behaviors. 5 The TorontoCharter links this influence to the key initiators of prevention actions for non-communicable diseases within healthcare systems and their capacity to influence large portions of the population. Studies show the importance of both including PA prescriptions in the medical curricula and promoting healthy lifestyle choices such as PA during medical school first. Increasing the proportion of students who adopt and maintain regular PA habits is essential for increasing the rate and quality of the future PA counseling delivered by doctors. 5,6 Yet little is...
Up to 75.4% of all premises allow smoking freely. These results show the limitations of the law.
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