ABSTRACT
Abstract Introduction Child obesity is a growing phenomenon and marginalized communities in Mexico City are not exempt from it. The results achieved by frequent preventive and remedial interventions are still unacceptable. Objective To contribute to the understanding of the growing problem of child obesity and overweight through a community health approach capable of transcending the biological perspective in order to improve interventions. Method We observed and interviewed a sample of school children, some overweight, some obese, and some with a normal BMI. All observations and interviews were carried out in the children's daily environment. We also interviewed some of their mothers. Together with our field notes, we analyzed these testimonies to construct the Grounded Theory that is the output of the present study. Results We found the children and their families immersed in a toxic environment that, through several mechanisms, fosters the consumption of high-density foods and discourages physical activity. We also found that the resources and competencies that families could use to fend off this environment are, at present, very limited. Discussion and conclusion We concluded that the energy imbalance in overweight and obese children's bodies corresponds to an abysmal psychosocial imbalance between the forces that foster obesity and the resources of the families affected by it. Any intervention aimed at preventing obesity must take this psychosocial imbalance into account.
Resumen Introducción La obesidad infantil es un fenómeno creciente del cual no quedan exentas las comunidades marginales de la Ciudad de México. Las intervenciones preventivas y remediales son frecuentes, pero sus impactos todavía no son aceptables. Objetivo Contribuir a la comprensión del fenómeno creciente de la obesidad y el sobrepeso infantil con una visión de salud comunitaria, que trascienda la visión biológica del problema y mejore las intervenciones. Método En su entorno escolar y comunitario observamos y entrevistamos a escolares, unos con obesidad o sobrepeso y otros con índice de masa corporal normal. También entrevistamos a las madres de algunos de ellos. Analizamos estos testimonios y nuestras notas de campo para construir la Teoría Fundamentada producto de este estudio. Resultados Encontramos a los niños y sus familias inmersos en un ambiente tóxico que, por múltiples mecanismos, promueve el consumo de alimentos de alta densidad e inhibe la actividad física. Encontramos también que los recursos y habilidades con que las familias podrían resistir a este ambiente son, por lo pronto, muy reducidos. Discusión y conclusión Concluimos que el desbalance energético en el cuerpo de los niños con sobrepeso corresponde a un enorme desbalance psicosocial entre las fuerzas que promueven la obesidad y los recursos de las familias que la sufren. Toda intervención preventiva debe tomar en cuenta este desequilibrio psicosocial.
ABSTRACT
Addictive disorders and behaviors have increased in the past years in Mexico. These behaviors and disorders are considered a public health issue because of the social and economic strains they generate. However, the state is unprepared to attend such high demands. Non government organizations have arisen in order to fulfill this demand, but it is known that many of them do not regard federal health regulations and often they have infringed the basic human rights. The present study has for objective to analyze the experience of men who have been atended in self-help residential substance abuse attention centers. Fifteen focalized interviews were carried out with men of different characteristics, all of them having been attended in at least two centers. The results help to understand the consumption dynamic, usually linked to family abandonment and anger. It further analyzes the unhealthy and inhuman services offered in many of these centers such as poor feeding and hygiene services; many of the men are admitted violently and against their will. It is concluded that even though these centers respond to the demand that addictive disorders have, they do not professionally and skillfully support a rehabilitation process. It is thus of utter importance to guarantee the training and proffessionalization of these centers' staff through an observation and regulation process.
Los trastornos y conductas adictivas se han incrementado en México en los últimos años. Estas conductas y trastornos son considerados un problema de salud pública debido a los estragos sociales y económicos que implican. Sin embargo, la demanda de atención ha rebasado las capacidades del Estado, por lo que han surgido organizaciones civiles que buscan responder a dicha problemática, aunque en muchas ocasiones esto suele hacerse sin atender a la reglamentación federal para la atención de la salud y las adicciones, por lo que existen casos en los que se han violentado los derechos humanos básicos. El presente estudio tuvo por objetivo analizar la experiencia de hombres atendidos en centros residenciales de ayuda mutua para la atención de las adicciones. Se llevaron a cabo 15 entrevistas focalizadas con hombres de diferentes características, que habían sido internados en al menos dos de estos centros. Los resultados ayudan a comprender la dinámica de consumo, que usualmente está ligada al abandono familiar y al enojo. Además, se analiza el uso de servicios de estos centros, como alimentación e higiene. Se encontró que muchos de estos hombres fueron ingresados de manera involuntaria y se vieron expuestos a diversas formas de abuso. Se concluye que a pesar de que estos centros responden a una necesidad de la sociedad para atender los problemas de salud que generan las adicciones, es imprescindible garantizar el respeto a los derechos humanos, asegurando la regulación y reglamentación de los centros.
ABSTRACT
OBJECTIVE: To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. MATERIAL AND METHODS: A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. RESULTS: The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. CONCLUSIONS: The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding.