Objective: To estimate the association strength of dietary behaviour and sedentary habits in relation to childhood obesity in Spain. Design: A matched case-control study was carried out using data collected by sentinel network paediatricians in general practices. Setting: Five Spanish autonomous communities. Subjects: Cases were 437 children (2-14 years old) with BMI .95th percentile according to Spanish reference tables. Controls were 751 children (2-14 years old; two paired per case) with BMI ,84th percentile. Data were collected in two phases: individual (questionnaires filled in by sentinel paediatricians) and family (self-administered questionnaires filled in a family environment). Crude OR and adjusted OR (ORc and adj OR) for the given variables were calculated using a simple and multiple conditional logistic regression analysis. Results: The factors with the greatest effect on obesity were family history of obesity: both parents (adj OR 5 11?2), mother but not father (adj OR 5 9?1), father but not mother (adj OR 5 6?1), siblings (adj OR 5 2?7); and eating between meals (adj OR 5 2?5) and consumption of sweets and soft drinks .2 times/week (adj OR 5 2?0). The highest protection effect was found for five meals per day (adj OR 5 0?5), the regular consumption of breakfast (adj OR 5 0?5) and for eating fruit for dessert (adj OR 5 0?6). Factors related to sedentary habits did not appear as noteworthy. Conclusions: We have determined the association between certain dietary behaviour and family history with childhood obesity in several Spanish regions.

Cognitive impairment is a frequent reason for consultations in primary care. Its prevalence is higher in women and increases exponentially with age. A number of sensitive, validated tools have been proven useful in screening for and confirming cognitive impairment. Using these tools in primary care settings enables early treatment of these patients.

From the social standpoint, administering chicken pox vaccine in conjunction with the mumps, measles, rubella vaccines show itself to be profitable. The profitability is modified both if a second dose of vaccine is added as well as if only the direct healthcare costs are analyzed.

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Resumen Objetivos: conocer la prevalencia de inicio de lactancia materna exclusiva en la comunidad de Castilla y León y los factores que influyen en su inicio y duración.Métodos Situación actual y factores que condicionan la lactancia materna en Castilla y León

Health sentinel networks are being increasingly used in the study of health-related problems. The present article aims to provide a methodological guide - designed by regional sentinel network managers and based on the results of a Delphi study - that can be used to set up and develop a health sentinel network. The main topics in the guide are the following: definition of a health sentinel network; network description: aims and structure; methods for the selection of sentinel participants; description of health processes suitable for study through this methodology: incidence, case definition, exclusion and inclusion criteria; description of the target population: the denominator for incidence rates estimates; quality indicators; periodicity of data collection; dissemination of the information: periodicity and methods, and incorporation of the participants in the decision-making process through multidisciplinary commissions. This guide aims to contribute to the development of sentinel networks in the autonomous communities by providing a common methodology, which could be highly useful when introducing new networks in Spain. Finally, we conclude that it is important to raise awareness of the concept of health sentinel networks, disseminate the information generated, and promote its use by public health administration.

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In order to establish a sentinel physicians network in Castilla y León to collect systematically population-based morbidity data, a random sample of general practitioners (GP's) whose covered population was representative of the regional population was obtained. A cluster analysis with the ZBS (Zonas Básicas de Salud) was performed according to a list of variables considered important in the diseases incidence. Five clusters were obtained in the urban areas and twenty in the rural areas, where, after stratification, the GP's random sample was selected. The outcome of the distribution, within each cluster, between all Castilla y León GP's and the sentinel GP's did not show statistically significant differences. The statistically significant difference found between the age of all GP's and the 127 sentinel GP's, due to the voluntary participation, was not found in the comparison of the two populations covered by them, confirming the efficacy of this method in the selection of a representative population from a random sampling of population groups.