Showing papers in "Salud Publica De Mexico in 2010"

Metabolic syndrome in Mexican adults. Results from the National Health and Nutrition Survey 2006

Abstract: Objective. To examine the prevalence of metabolic syndrome (MS) and its associated risk factors in Mexican adults aged 20 years or older, using data derived from the National Health and Nutrition Survey 2006 (ENSANUT 2006). Material and Methods. The ENSANUT 2006 was conducted between October 2005 and May 2006. Questionnaires were administered to 45 446 adult subjects aged 20 years or older who were residents from urban and rural areas. Anthropometric and blood pressure measurements were obtained from all subjects and fasting blood specimens were provided by 30% of participants. We randomly selected a sub-sample of 6 613 from which laboratory measurements were carried out for glucose, insulin, triglycerides, total cholesterol and HDL-cholesterol. For this analysis, we included only results from eight or more hours of fasting samples (n=6 021). We used individual weighted factors in the statistical analysis and considered the survey’s complex sampling design to obtain variances and confidence intervals. All analyses were done using SPSS 15.0. Results. In accordance with definitions by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), the American Heart Association/ National Heart, Lung and Blood Institute (AHA/NHLBI), and the International Diabetes Federation (IDF), the prevalence of MS in Mexican adults aged 20 years or older was 36.8, 41.6 and 49.8%, respectively. Women were more affected than men due to the higher prevalence of central obesity

Prevalence and distribution of type 2 diabetes mellitus in Mexican adult population. A probabilistic survey

Abstract: Objective. To describe the prevalence, distribution and degree of control of type 2 diabetes (T2D) in Mexican population. Material and Methods. Subjects were classified as previously diagnosed T2D (PD); or as “finding of the survey” (FS) (glucose ≥126 mg/dL). Hemoglobin A1c was measured in PD-subjects. Results. The prevalence for PD-T2D was 7.34% (95%CI 6.3, 8.5) and for FS 7.07% (95%CI 6.1, 8.1), summing 14.42%; (7.3 million diabetics). 5.3% of PD-T2D were in good, 38.4% in poor and 56.2% very poor control. Older age (OR=0.96, 95%CI 0.94, 0.97), lower BMI (OR=0.95, 95%CI 0.91, 1.0), were protective for poor control. Affiliation to private services (OR=1.77, 95%CI 0.98, 3.13), larger T2D duration (OR=1.05, 95%CI 1.01, 1.08), and combining oral medication and insulin (OR=16.1, 95%CI 1.61, 161) were riskier. Conclusions. We found an alarming prevalence of T2D in Mexican population; the majority of PD diabetics are in poor control. Research on the latter is warranted.

Factors affecting acceptance of complete immunization coverage of children under five years in rural Bangladesh

Abstract: Objective. This article establishes the hypothesis that predisposing, enabling and household needs influence the complete vaccination status of children. Material and Methods. Data from the 2004 Bangladesh Demographic and Health Survey (N= 3530) was used. The data was analyzed using descriptive and multiple logistic regression methods. Results. Approximately 60% of the children in rural Bangladesh were fully immunized. The full vaccination rate increased with an increase in the previous birth interval and the education level of the mother. Women with the highest wealth index were significantly more likely to fully immunize their children. Distance from health facility, parity, mother’s age, mass media, children’s sex and tetanus toxoid injection were also significantly positively associated with full vaccina tion. Conclusions. Findings reflect that, irrespective of need, only children from higher economic or educational groups can afford to be fully vaccinated in rural Bangladesh. In other words, predisposing, enabling and need factors appear to have a strong association with full immunization coverage

Suicidio y conductas suicidas en México: retrospectiva y situación actual

Abstract: Objective. To summarize the epidemiology of completed suicide and suicidal behavior in Mexico. Material and Methods. National data registries on mortality from the year 1970 to 2007 and cross-sectional surveys were used to analyze suicide mortality and suicidal behavior. Results. The suicide rate grew 275% from 1970 to 2007. Suicide has been increasing among Mexicans 15-29 years old since 1970. In adults aged 18-29 years the lifetime prevalence of ideation was 9.7%, and attempt 3.8%. About 6,601,210 Mexicans had suicidal thoughts, 593,600 attempted suicide and 99,731 used some sort of medical service as a direct consequence of the latter in the year prior to the survey. Conclusions. Suicide and suicide-related behaviors are significant public health problems and, as such, actions are urgently required to identify and treat persons with suicidal thoughts, assess suicidal risk in patients with psychiatric disorders and implement population interventions.

Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006 Prevalencia de las dislipidemias en la Encuesta Nacional de Salud y Nutrición 2006

Abstract: OBJECTIVE To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. RESULTS Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5% (95%CI 58.2-62.8%). Hypercholesterolemia (> 200 mg/dl) had a frequency of abnormality of 43.6% (95%CI 41.4-46.0%). Only 8.6% of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (>or= 150 mg/dl) was observed in 31.5% (IC 95% 29.3-33.9%) of the population. CONCLUSIONS The ENSANUT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.

Hypertension in Mexican adults: results from the National Health and Nutrition Survey 2006

Abstract: OBJECTIVE: To describe the prevalence of hypertension among Mexican adults, and to compare to that observed among Mexican-Americans living in the US. MATERIAL AND METHOD: The primary data source came from adults (>20 years) sampled (n=33366) in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006). Hypertension was defined when systolic blood pressure was >140 and/or diastolic was >90 or patients previously diagnosed. RESULTS: A total of 43.2% of participants were classified as having hypertension. We found a positive statistically significant association (p<0.05) between hypertension and BMI, abdominal obesity, previous diagnosis of diabetes and hypercholesterolemia. Subjects with hypertension had a significantly higher odd of having a history of diabetes or hypercholesterolemia. Hypertension had a higher prevalence in Mexico than among Mexican-Americans living in the US. CONCLUSIONS: Hypertension is one of the most prevalent chronic diseases in Mexico. In the last six years in Mexico, a substantial increase (25%) has been observed in contrast to the reduction seen among Mexican-Americans (-15%).

Trends for type 2 diabetes and other cardiovascular risk factors in Mexico from 1993-2006

Abstract: Objective. To describe the trends in the prevalence of type 2 diabetes (T2D), and other cardiovascular risk factors in three national health surveys (1993, 2000 and 2006). Materials and Methods. The databases of three surveys: ENEC 1993, ENSA 2000 and ENSANUT 2006 were gathered. Calculations of published data were reprocessed to do appropriate adjustments to assure comparability among surveys. Results. From 1993 to 2006 the prevalence of type 2 diabetes (6.7-14.4%), metabolic syndrome (26.6-36.8%), hypertension (23.8-30.7%), hypercholesterolemia (27-43.6%), and high LDL-cholesterol (31.6-46%) increased rapidly. The prevalence of low HDL cholesterol was very high (60.5-63%) in all surveys and remained remarkably unchanged among surveys. Conclusions. This increasing trends for the prevalence of T2D and cardiovascular risk factors predicts larger increments in the near future for T2D and cardiovascular morbidity and mortality. Intensification of the preventive and remedy strategies is mandatory in order curve the foreseen dramatic increment in the disease burden.

Assessing the impact of cigarette package health warning labels: a cross-country comparison in Brazil, Uruguay and Mexico

Abstract: Objetivo Evaluar el impacto de diferentes advertencias sanitarias (AS) Material y metodos Se analizaron datos de la Encuesta Internacional para el Control del Tabaco (ITC Survey), un estudio de fumadores adultos en Brasil, Uruguay y Mexico, tres paises con distintas AS (con imagenes de sufrimiento humano y organos enfermos; con imagenes abstractas del riesgo; mensajes de solo texto, respectivamente) Se analizo prominencia e impacto cognitivo de las AS Resultados Las AS de Uruguay (que era el unico pais con AS en la parte frontal del paquete) tuvieron una mayor prominencia que en Brasil o Mexico En Mexico, la gente que tenia un nivel de educacion mayor eran mas propensos a leer mensajes de advertencia, mientras que educacion no se asocio con prominencia en Brasil o Uruguay Las AS de Brasil tuvieron un mayor impacto cognitivo y conductual que las AS de Uruguay o Mexico Las AS de Uruguay generaron un menor impacto cognitivo y conductual que las AS de solo texto en Mexico En Brasil, los impactos cognitivos fueron los mas fuertes entre fumadores con un bajo nivel educacional Conclusiones Este estudio sugiere que las AS tienen el mayor impacto cuando son prominentes (por ej en el frente y la parte trasera del paquete) e incluyen imagenes emocionalmente llamativas que muestran impactos negativos en el cuerpo o sufrimiento humano debido al fumar

Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006

Abstract: Objective. To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANuT 2006). Material and Methods. Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. Results. Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5% (95%CI 58.2-62.8%). Hypercholesterolemia (≥ 200 mg/dl) had a frequency of abnormality of 43.6% (95%CI 41.4-46.0%). Only 8.6% of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (≥ 150 mg/dl) was observed in 31.5% (IC 95% 29.3-33.9%) of the population. Conclusions. The ENSANuT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.

Nuevos paradigmas y desafíos en la prevención y control del cáncer de cuello uterino en América Latina

Abstract: El cancer de cuello uterino sigue siendo un problema de salud publica en Latinoamerica. El uso de la citologia para la deteccion de lesiones pre-cancerosas no ha tenido mayor impacto en las tasas de incidencia y mortalidad, que aun se mantienen altas en la region. La disponibilidad de nuevas tecnicas de tamizaje para la deteccion de lesiones pre-cancerosas y de vacunas altamente eficaces que previenen casi todas las lesiones relacionadas con VPH-16 y VPH-18 en mujeres no expuestas previamente al virus representan una gran oportunidad para la prevencion del cancer de cuello uterino en la region. En este manuscrito resumimos la evidencia cientifica y la experiencia de la region en i) el uso de pruebas de VPH y de la inspeccion visual despues del acido acetico (IVAA) en tamizaje primario, y ii) la implementacion de programas de vacunacion en adolescentes. Finalmente enumeramos una serie de recomendaciones adecuadas para distintos escenarios. La factibilidad de implementar un programa nacional de prevencion de cancer de cuello uterino exitoso y sostenible en paises latinoamericanos dependera de las prioridades de salud, la infraestructura y personal de salud disponible, determinadas luego de un riguroso analisis situacional local.

Prevalencia y factores asociados a la ideación e intento suicida en adolescentes de educación media superior de la República Mexicana

Abstract: Objective. To identify the prevalence of and factors associated with suicidal ideation and intent in adolescent students in Mexico. Material and Methods. A cross-sectional study was conducted with a sample of 12 424 students from public schools in 2007. We used logistic regression to obtain odds ratios (OR) with 95% confidence intervals. Results. A total of 47% of the students reported at least one suicidal ideation symptom and 9% reported an antecedent of suicidal intent. Factors associated with suicide ideation and intent include low confidence in communication with parents (OR=1.30; OR=1.54), sexual abuse (OR=1.92; OR=1.57), depressive symptoms (OR=5.36; OR=1.51), tobacco use (OR=1.30; OR=2.57), alcohol use (OR=1.60; OR=1.31) and, for women, having had sexual relations (OR=1.28; OR=1.65). Conclusions. Roughly 50% of high school students had at least one symptom of suicidal ideation. To lessen this problem, associated factors should be considered, including consumption of addictive substances, gender, history of sexual abuse and depression.

"Plain packaging" regulations for tobacco products: the impact of standardizing the color and design of cigarette packs Regulaciones de “empaquetado sencillo” para productos de tabaco: el impacto de la estandarizacion en diseño y color en los paquetes de cigarrillos

Abstract: Tobacco packaging and labeling policies have emerged as prominent and cost-effective tobacco control measures. Although packaging policies have primarily focused on health warnings, there is growing recognition of the importance of packaging as a marketing tool for the tobacco industry. The current paper reviews evidence on the potential impact of standardizing the color and design of tobacco packages -so called \"plain\" packaging. The evidence indicates three primary benefits of plain packaging: increasing the effectiveness of health warnings, reducing false health beliefs about cigarettes, and reducing brand appeal especially among youth and young adults. Overall, the research to date suggests that \"plain\" packaging regulations would be an effective tobacco control measure, particularly in jurisdictions with comprehensive restrictions on other forms of marketing.

Publicidad de alimentos en la programación de la televisión mexicana: ¿los niños están más expuestos?

Abstract: Objective. To evaluate food advertisements on broadcast television channels in Mexico City. Material and Methods. Between July and October, 2007 programming by the 11 broadcast channels (N=11) in Mexico City was recorded during one weekday and one weekend day. The length of advertisements (N = 9178), types of products, and nutritional content of foods advertised were analyzed. Results. The time devoted to food products advertising was greater during children’s television than during programming targeted to the general audience (25.8 vs. 15.4%). The foods more frequently advertised were sweetened beverages, sweets and cereals with added sugar. Calorie, carbohydrate and fat contents were higher in foods advertised during children’s shows. The two most common marketing strategies were to offer some kind of gift and to link the item to positive emotions. Conclusion. The findings of this research indicate the need for an effective system to regulate advertising directed towards children and adolescents.

"Plain packaging" regulations for tobacco products: the impact of standardizing the color and design of cigarette packs

Abstract: Tobacco packaging and labeling policies have emerged as prominent and cost-effective tobacco control measures. Although packaging policies have primarily focused on health warnings, there is growing recognition of the importance of packaging as a marketing tool for the tobacco industry. The current paper reviews evidence on the potential impact of standardizing the color and design of tobacco packages -so called "plain" packaging. The evidence indicates three primary benefits of plain packaging: increasing the effectiveness of health warnings, reducing false health beliefs about cigarettes, and reducing brand appeal especially among youth and young adults. Overall, the research to date suggests that "plain" packaging regulations would be an effective tobacco control measure, particularly in jurisdictions with comprehensive restrictions on other forms of marketing.

Violencia doméstica y riesgo de conducta suicida en universitarios adolescentes

Abstract: OBJECTIVE: To estimate the degree of association between domestic violence -physical, verbal or sexual- with suicidal behavior among university students. MATERIAL AND METHODS: A matched case-control study was done with students attending the University of Colima, Mexico. The cases were 235 teenagers who presented both suicidal ideation and suicide attempt; the controls were 470 individuals of the same age and sex. RESULTS: Sexual abuse showed the highest degree of association with suicidal behavior (OR= 27.4), followed by verbal violence (OR= 9.28), drug use (OR= 8.6), physical violence (OR= 5.5) and smoking (OR= 3.6). Multivariate logistic regression showed that verbal violence was associated with suicidal behavior independently of the other variables, while physical violence, sexual abuse, smoking and drug use seem to depend on verbal violence. CONCLUSIONS: Domestic violence, particularly verbal or sexual, is strongly associated with suicidal behavior in adolescents and should be considered in suicide prevention programs.

Efecto de la ganancia de peso gestacional en la madre y el neonato

Abstract: OBJETIVO: Evaluar el efecto de la ganancia de peso gestacional (GPG) en la madre y el neonato. MATERIAL Y METODOS: Se incluyeron 1 000 mujeres en puerperio inmediato atendidas en el Hospital de Ginecologia del Instituto Mexicano del Seguro Social, en Tijuana, Baja California, Mexico. Se considero una GPG optima si en las mujeres con bajo peso, peso normal, sobrepeso u obesidad previo al embarazo, la GPG fue < 18 kg, < 16 kg, < 11.5 kg y < 9 kg, respectivamente. RESULTADOS: Treinta y ocho por ciento de las mujeres tuvieron una GPG mayor a la recomendada, lo cual se asocio con oligo/ polihidramnios (RM 2.1, IC 95% 1.04-4.2) y cesareas (RM 1.8, IC 95% 1.1-3.0) en las mujeres con peso normal previo al embarazo; con preeclampsia (RM 2.2 IC 95% I.I-4.6) y macrosomia (RM 2.5, IC 95% I.I-5.6) en las mujeres con sobrepeso, y con macrosomia (RM 6.6 IC 95% I.8-23) en las mujeres con obesidad. El peso previo al embarazo, mas que la ganancia de peso gestacional, se asocio con diabetes gestacional. CONCLUSIONES: Un aumento de riesgo de complicaciones obstetricas y del neonato fue asociado con una GPG mayor a la recomendada.

Propiedades nutraceúticas del licopeno

Abstract: In recent years, dietary recommendations have suggested an increase in the consumption of foods that contain phytochemicals that provide benefits to human health and play an important role in preventing chronic diseases. Lycopene –the carotenoid responsible for the red color of tomatoes– has attracted attention because of its physicochemical and biological properties in the prevention of chronic diseases in which oxidative stress is a major etiological factor, such as cancer, cardiovascular and neurodegenerative diseases, and hypertension, among others. Antioxidants, including lycopene, interact with reactive oxygen species, can mitigate their damaging effects and play a significant role in preventing these diseases. This article presents a review of some epidemiological studies published in recent years on beneficial effects of lycopene in human health.

[Suicide and suicidal behaviors in Mexico: Retrospective and current status].

Abstract: Objective To summarize the epidemiology of completed suicide and suicidal behavior in Mexico. Material and methods National data registries on mortality from the year 1970 to 2007 and cross-sectional surveys were used to analyze suicide mortality and suicidal behavior. Results The suicide rate grew 275% from 1970 to 2007. Suicide has been increasing among Mexicans 15-29 years old since 1970. In adults aged 18-29 years the lifetime prevalence of ideation was 9.7%, and attempt 3.8%. About 6,601,210 Mexicans had suicidal thoughts, 593,600 attempted suicide and 99,731 used some sort of medical service as a direct consequence of the latter in the year prior to the survey. Conclusions Suicide and suicide-related behaviors are significant public health problems and, as such, actions are urgently required to identify and treat persons with suicidal thoughts, assess suicidal risk in patients with psychiatric disorders and implement population interventions.

Correlatos psicosociales del consumo de sustancias psicoactivas en adolescentes españoles

Abstract: Objective. To offer an analysis of the factors that determine the consumption of psychoactive substances by youth and to evaluate the predictive capacity of variables related to attitude, affect, the family and groups, as well as academics, among others. Materials and Methods. A sample of 750 adolescents was selected at the Principado de Asturias (Spain) (mode 15 years of age, mean=14.69) enrolled during the 2008-2009 academic year. Results. It was confirmed that the teenagers who consumed alcohol and other drugs present a differential profile as compared to non-consumers with respect to greater attitudinal permissiveness, effect of paternal modelling and peer groups, institutional dissatisfaction, emotional instability, and manifestation of more disruptive conducts with problems relating to others and attention-seeking. Conclusions. From our ethiological model we conclude that the consumption of drugs by youth is determined by an interrelation of personal, familiar, school and psychosocial variables.

Acciones gubernamentales para la detección temprana del cáncer de mama en América Latina: Retos a futuro

Abstract: Documentary research carried out in 2009 aims to document the regulatory framework and existing programs for the early detection of breast cancer in Latin America and the Caribbean in order to establish the most important challenges for the containment of the epidemic in the region. The governments of the region have developed diverse efforts and initiatives to confront the rise in mortality due to said cause, including early detection, treatment and research strategies. Despite advances in the early detection of breast cancer, the challenge remains to link efforts to ensure continuity of care (diagnostic confirmation, treatment and monitoring) in order to achieve higher efficiency, effectiveness and benefits for women with this disease.

Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006

Abstract: OBJECTIVE: To describe the characteristics of patients with type 2 diabetes diagnosed before age 40 (early-onset type 2 diabetes) identified in a nation-wide, population-based study. MATERIALS AND METHODS: The survey was done in Mexico during 2006. Medical history, anthropometric and biochemical measurements were obtained in every subject. RESULTS: Cases diagnosed before (n=181) and after age 40 (n=659) were included. Early-onset type 2 diabetes was present in 13.1% of the previously diagnosed, 30.3% of the cases identified during the survey and 21.5% of the whole population with diabetes. These individuals had a greater prevalence of obesity and hypertriglyceridemia compared to the cases diagnosed after age 40. CONCLUSIONS: Early-onset type 2 diabetes was present in 21.5 % of patients with type 2 diabetes in Mexico. Close to 70% of them were obese or overweight and had the clinical profile of the metabolic syndrome.

Cigarette labeling policies in Latin America and the Caribbean: progress and obstacles

Abstract: Objetive. To describe cigarette labeling policies in Latin America and the Caribbean as of August 2010. Material and Methods. Review of tobacco control legislation of all 33 countries of the region; analysis of British American Tobacco (BAT)’s corporate social reports; analysis of information from cigarette packages collected in 27 countries. Results. In 2002, Brazil became the first country in the region to implement pictorial health warning labels on cigarette packages. Since then, six more countries adopted pictorial labels. The message content and the picture style vary across countries. Thirteen countries have banned brand descriptors and nine require a qualitative label with information on constituents and emissions. Tobacco companies are using strategies commonly used around the world to block the effective implementation of WHO Framework Convention on Tobacco Control (FCTC)’s Article 11. Conclusions. Since 2002, important progress has been achieved in the region. However, countries that have ratified the FCTC have not yet implemented all the recom mendations of Article 11 Guidelines.

Differential impact of local and federal smoke-free legislation in Mexico: a longitudinal study among adult smokers

Abstract: Objective To assess the impact of Mexico City and federal smoke-free legislation on secondhand tobacco smoke (SHS) exposure and support for smoke-free laws Material and Methods Pre- and post-law data were analyzed from a cohort of adult smokers who participated in the International Tobacco Control (ITC) Policy Evaluation Suvey in four Mexican cities For each indicator, we estimated prevalence, changes in prevalence, and between-city differences in rates of change Results Self-reported exposure to smoke-free media campaigns generally increased more dramatically in Mexico City Support for prohibiting smoking in regulated venues increased overall, but at a greater rate in Mexico City than in other cities In bars and restaurants/cafes, self-reported SHS exposure had significantly greater decreases in Mexico City than in other cities; however, workplace exposure decreased in Tijuana and Guadalajara, but not in Mexico City or Ciudad Juarez Conclusions Although federal smoke-free legislation was associated with important changes smoke-free policy impact, the comprehensive smoke-free law in Mexico City was generally accompanied by a greater rate of change

Formative research to shape HPV vaccine introduction strategies in Peru

Abstract: Objective. To understand the sociocultural environment, health systems’ capacities, and policy processes related to cervical cancer and HPV vaccines in order to inform HPV vaccine introduction. Material and Methods. Mixedmethod formative research using qualitative and quantitative data collection techniques. Participants included girls, parents, community leaders, health and education officials, and policymakers. Results. Respondents, including policymakers, generally supported HPV vaccine introduction, due partly to appreciation for the benefits of vaccination and the desire to prevent cancer. Community-level concerns regarding safety and quality of services will need to be addressed. The immunization system in Peru is strong and has capacity for including the HPV vaccine. Conclusion. Formative research provides key insights to help shape an effective program for HPV vaccine introduction.

Motivos de uso y no uso de puentes peatonales en la Ciudad de México: la perspectiva de los peatones

Abstract: OBJETIVO. Analizar los motivos de uso y no uso de puentes peatonales (PP). MATERIAL Y METODOS. Se empleo un diseno transversal, a partir de una muestra de peatones usuarios y no usuarios de PP; se utilizo regresion logistica para identificar los factores que influyen en el uso y no uso de PP. RESULTADOS. La prevalencia de no uso fue 50.5% en 813 peatones entrevistados; la principal razon para usar PP fue "seguridad", del no uso fue "flojera". Hubo diferencias significativas al analizar motivos de no uso de PP en las edades de 19 a 36 anos, ajustando por escolaridad y caracteristicas fisicas del PP, con RMa. 1.7 (IC95% 1.06-2.86) y RMa. 1.9 (IC95% 1.14-3.33), respectivamente. CONCLUSIONES. Los resultados de este estudio permiten identificar aspectos importantes a considerar desde la perspectiva de los peatones, antes de construir nuevos PP, asi como aquellos que deben mejorarse para incrementar su uso en zonas de alto riesgo de lesiones por atropellamiento.

The role of organized civil society in tobacco control in Latin America and the Caribbean

Abstract: Civil society has been the engine that has permitted many of the accomplishments seen in tobacco control in Latin America and the Caribbean. However, the role of civil society is not clearly understood. Civil society plays five main roles: advocate, coalition builder, provider of evidence-based information, watchdog and service provider. Some of these roles are played weakly by civil society in the region and should be encouraged to support beneficial societal change. Civil society working in tobacco control has evolved over the years to now become more professionalized. The WHO Framework Convention on Tobacco Control and the Bloomberg Initiative to Reduce Tobacco Use have brought about significant change with positive and negative consequences. Strengthening civil society not only supports the tobacco control movement but it provides competencies that may be used in many ways to promote change in democratic societies.

Acceso a la información de mujeres con VPH, displasia y cáncer cervical in situ

Abstract: OBJETIVO: Presentar un analisis relacional de como mujeres diagnosticadas con el virus del papiloma humano (VPH), displasia del cuello del utero o neoplasias del cuello uterino, reciben y/o acceden a la informacion y como la viven en sus relaciones cercanas. MATERIAL Y METODOS: En 2008 se realizaron 34 entrevistas cualitativas a mujeres en dos clinicas de colposcopia de la Secretaria de Salud, en Hermosillo, Sonora. El analisis se baso en la teoria fundamentada. RESULTADOS: Existe una franca analogia entre cancer cervicouterino (CaCu) y muerte, una amplia desinformacion sobre VPH y displasias y una practica persistente entre los medicos de no ofrecer informacion oportuna y clara a las pacientes. Existe una apreciacion estigmatizante hacia la infeccion por VPH que afecta las relaciones cercanas de las mujeres. CONCLUSION: A pesar de la necesidad de las pacientes de obtener informacion, no la exigen al medico, lo que contribuye a su desconfianza y angustia.

Formative research to shape HPV vaccine introduction strategies in Peru [Investigación formativa relacionada con el diseño deestrategias para introducir la vacuna contra el VPH en Perú.]

Abstract: Objective. To understand the sociocultural environment, health systems’ capacities, and policy processes related to cervical cancer and HPV vaccines in order to inform HPV vaccine introduction. Material and Methods. Mixed-method formative research using qualitative and quantitative data collection techniques. Participants included girls, parents, community leaders, health and education officials, and policymakers. Results. Respondents, including policymakers, generally supported HPV vaccine introduction, due partly to appreciation for the benefits of vaccination and the desire to prevent cancer. Community-level concerns regarding safety and quality of services will need to be addressed. The immunization system in Peru is strong and has capacity for including the HPV vaccine. Conclusion. Formative research provides key insights to help shape an effective program for HPV vaccine introduction.

The status of diabetes care in Mexican population: are we making a difference? Results of the National Health and Nutrition Survey 2006

Abstract: OBJECTIVE: Examine clinical indicators to evaluate diabetes care in Mexico. MATERIAL AND METHODS: Diabetics (self reported, with therapy) were examined with standardized questionnaires, anthropometry, glucose, lipids and glycohemoglobin. Data were analyzed statistically. RESULTS: There were 2 644 patients, 677 cases without access to medical care (73% women), most lived in rural communities and spoke aboriginal dialect. Prevalence of obesity for private access group was 21.2%, for other or non access group was between 31 and 65%. The group without or basic education was most common, 76% of the cases had HDL <40 mg/dl and 36% had hypertriglyceridemia. Only 6.6% of patients had HbA1c <7%. There was no significant difference between HbA1c values observed in the group with or without access. Most patients were treated with oral agents. A significant group was without therapy. Assessments for complications was infrequent. CONCLUSIONS: Current model for diabetes care in Mexico is inefficacious and a paradigm change is necessary.