BackgroundResidence at high altitude has been associated with lower obesity rates probably due to hypoxia conditions. However, there is no evidence of this association in a free-living population.ObjectivesWe assessed the association between the altitude where each participant of a Spanish cohort (the SUN Project) was living and the incidence of overweight/obesity.MethodsThe SUN Project is a dynamic, prospective, multipurpose cohort of Spanish university graduates with a retention rate of 89%. We included in the analysis 9 365 participants free of overweight/obesity at baseline. At the baseline questionnaire, participants reported their postal code and the time they had been living in their city/village. We imputed the altitude of each postal code according to the data of the Spanish National Cartographic Institute and categorized participants in tertiles. We used Cox regression models to adjust for potential confounding variables.ResultsDuring a median follow-up of 10 years, we identified 2 156 incident cases of overweight/obesity. After adjusting for sex, age, time of residence at current city, baseline body mass index, physical activity, sedentarism and years of education (≤ 3 years, ≥ 4 years, Master/PhD), those participants in the third tertile (>456 m) exhibited a statistically significant 14% reduction in the risk of developing overweight/obesity in comparison to those in the first tertile (<124 m) (adjusted HR = 0.86; 95% CI: 0.77, 0.96).ConclusionsLiving in cities of higher altitude was inversely associated with the risk of developing overweight/obesity in a cohort of Spanish university graduates.

Background: Palliative care is a priority for health systems worldwide, yet equity in access remains unknown. To shed light on this issue, this study compares populations’ driving time to specialized palliative care services in three countries: Ireland, Spain, and Switzerland. Methods: Network analysis of the population’s driving time to services according to geolocated palliative care services using Geographical Information System (GIS). Percentage of the population living within a 30-min driving time, between 30 and 60 minutes, and over 60 min were calculated. Results: The percentage of the population living less than thirty minutes away from the nearest palliative care provider varies among Ireland (84%), Spain (79%), and Switzerland (95%). Percentages of the population over an hour away from services were 1.87% in Spain, 0.58% in Ireland, and 0.51% in Switzerland. Conclusion: Inequities in access to specialized palliative care are noticeable amongst countries, with implications also at the sub-national level.

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A pesar de que las publicaciones en torno a ríos urbanos son abundantes, no hay investigaciones que se centren en su definición y, por esa misma razón, tampoco procedimientos oficiales para delimitarlos. El presente trabajo tiene como objetivos (1) definir qué es un río urbano y (2) delimitar los tramos fluviales urbanos para el territorio español. Las principales motivaciones para realizar este estudio son de diversa índole. En primer lugar, el interés científico-geográfico que entraña analizar una cuestión compleja como esta; en segundo lugar, la evidencia de que existen conflictos entre ayuntamientos y administraciones hidráulicas por la asunción de competencias y; por último, la idea, cada vez más extendida entre la comunidad científica, de promover una gestión diferenciada del espacio fluvial urbano y rural. A través del análisis del escenario de planificación y gestión de los cursos de agua en las zonas urbanas y la reflexión en torno al concepto "río urbano", se concluye que un tramo de un río debe considerarse como urbano cuando se encuentren usos urbanos en su Dominio Público Hidráulico o sus Zonas de Protección y/o cuando dicho tramo se encuentre inmerso en una matriz urbana. En base a esta definición, se elabora una metodología de delimitación a escala nacional que indica que un 6 % de la red fluvial del territorio español tiene carácter urbano.