ABSTRACT
This pilot study was an approach to determine the health outcomes (nutritional status, cognitive status, mental health and educational status), and the presence of health risk behaviors (aggressive behavior/ delinquency, hazardous/harmful drinking, substance use/abuse and tobacco use) of adolescents who have been exposed all their lives to lead. Besides, we could identify individual, familial and social factors, such as lead exposure, that were related to them. The sample included 40 adolescents (25 females and 15 males), aged 12-19 years, who participated as children in the Childhood Lead Exposure Surveillance Program (CLESP), conducted in a metallurgical area of Mexico. The 100% of the participants were reported neurologically healthy by medical clinical examination. The 15% were below 70 points of the Full Scale Intelligence Quotient, higher than the expected percentage in the general Mexican population. Moreover, we detected the presence of health risk behaviors. The protective factors identified were mean cell volume, adolescent education, father education and living in an apartment. Risk factors identified were: sleep hours, mono-parental family, positive family history of substance use/abuse, residents by household, having social security, tibia bone lead, and childhood blood lead (p<0.05). The gender and exercise variables were accounted for both risk and protection. The health problems that we found were mostly related to individual factors, followed by familial and social factors. The lead exposure explained, in minor proportions, the multivariate models; however, for every 1 pg lead/g bone mineral increased in the tibia and 1 pg/dL increase in blood lead during childhood; the Perceptual Organization/Perceptual Reasoning Index and Processing Speed Index are decreased by 1.21 and 1.11~points, respectively. The detection of protective and risk factors enable the design of an intervention program as an extension of CLESP. The health of these adolescents can be improved by avoiding some risk factors and fostering protective factors at individual, family and community levels.
Este estudio piloto fue una aproximación para determinar el estado de salud (nutricional, cognitivo, salud mental y educacional) y las conductas de riesgo para la salud (agresión/delincuencia, consumo riesgoso/ dañino de alcohol, uso/ abuso de sustancias y consumo de tabaco) de adolescentes que han estado expuestos toda su vida al plomo. Se identificaron factores individuales, familiares y sociales; así como la exposición al plomo, que estuvieran relacionados con ellos. Se incluyeron 40 adolescentes (25 mujeres y 15 hombres) de 12 a 19 años de edad, quienes participaron siendo niños en el Programa de Vigilancia Infantil de Exposición a Plomo (PVIEP), conducido en un área metalúrgica de México. El 100% estaba neurológicamente sano por examen médico. El 15% obtuvo menos de 70 puntos en la Escala Total del Coeficiente Intelectual, porcentaje mayor al esperado en la población general mexicana. Además se detectó la presencia de conductas de riesgo. Los factores protectores identificados fueron volumen corpuscular medio, educación del adolescente, educación del padre y vivir en departamento. Los factores de riesgo fueron horas de sueño, familia monoparental, familia con antecedentes de uso/abuso de sustancias, número de residentes en la vivienda, tener seguridad social, plomo en tibia y plomo en sangre durante la infancia (p<0.05). El género y el ejercicio fueron variables tanto de riesgo como de protección. Los problemas de salud encontrados estuvieron mayormente asociados a factores individuales, seguidos por factores familiares y sociales. La exposición a plomo explicó en menor proporción los modelos multivariados, sin embargo, por cada 1 ug plomo/g de hueso mineral incrementado en tibia y 1 ug/dL de plomo incrementado en sangre durante la infancia, el Indice de Organización Perceptual/Razonamiento Perceptual e Indice de Velocidad de Procesamiento, disminuyeron 1.21 y 1.11 ~puntos, respectivamente. La detección de factores de riesgo y protección permitirá el diseño de un programa de intervención como parte del PVIEP. La salud de estos adolescentes puede ser mejorada aminorando algunos factores de riesgo y fomentando factores de protección, desde el nivel individual, familiar y/o comunitario.
ABSTRACT
O presente artigo teve como foco a exploração sexual percebida como trabalho, com delineamento de estudo de caso único. O objetivo foi investigar o caso de uma menina de 14 anos, em situação de exploração sexual comercial, que informava em uma entrevista semi-estruturada, ser esta a sua atividade laboral. Foram levantadas categorias relacionadas aos fatores de risco e de proteção na vida da jovem, especialmente relacionados ao trabalho. Constatou-se que a jovem percebia a atividade como um trabalho que lhe proporcionava autonomia, subsistência e sobrevivência. No entanto, os efeitos negativos da exploração sexual e de sua percepção desta como atividade laboral eram evidentes sobre sua saúde e seu desenvolvimento. O trabalho juvenil pode ser considerado um fator de risco, como no presente estudo de caso, principalmente quando as condições laborais não se dão de forma adequada e protegida.
The present article focused on the perception of sexual exploitation as a job, using a single case study design. The aim of the study was to investigate the case of a 14 year-old girl, involved in commercial sexual exploitation, who considered this situation as her labor activity. A content analysis showed protective and risk factors as categories, especially related to her labor activities. The girl perceived the sexual exploitation activity as a job that provided autonomy, subsistence, and survival. The study revealed that the negative effects of working during adolescence may bring consequences to health and development. Youth work may be defined as a risk factor, especially when the labour conditions are not adequate and protected.
ABSTRACT
In the course of the last three years, a wide range of epidemiological studies related to drug use has been conducted, both at a national and international level. Talking about national studies in the field of school population, surveys have been conducted in the states of Colima, Nuevo León and Jalisco, as well as surveys in university population, among others. Regarding tobacco use, several studies were made and they covered many cities of the country. About household surveys, the fifth National Addictions Survey (ENA) was carried out in 2008 and it provided data at a national and state level. The Global Survey of Smoking in Adults (GATS) was also made having nationwide coverage. In relation to tobacco use, the trend shows a decrease in the prevalence of consumption. This is shown in ENA 2008 and GATS, as well as school population studies in different states. For alcohol consumption, the situation is different; both for the prevalence and for the proportion of people who start its early consumption, significant increases have been reported throughout the country. Alcohol abuse remains constant and is similar between men and women. When considering the use of illegal drugs, there is an overall increase. As for marijuana, data indicates that its consumption has increased and that it remains as the primary drug of use. However, the main increase is for inhalants, particularly among school population and especially in women. For cocaine, data from United Nations shows a significant decrease in the supply of this substance due to the increase of seizures. Data from ENA 2008 shows that the use of this drug has doubled between 2002 and 2008. The United Nations report indicates that the increase in our country is apparent until 2005 and since then it has been decreasing. Methamphetamine use remains low and it does not increase. Only in the case of the population that goes to service centers for drug users, a high rate of consumption is found. Finally, the consumption of heroin and hallucinogens is low. Chihuahua remains as the state with the most problems in the use of heroine. Most recent surveys have allowed us to see, in general, some of the trajectories in adolescent mental health, where sexual abuse is presented first in women, followed by ADDH, then the consumption of legal drugs, antisocial behavior, use of inhalants and suicide attempt. Then drug consumption, marijuana and cocaine. In men, the sequence is similar, although they face ADDH first and then sexual abuse. In this context, the objective of this study is to assess the prevalence of drug, alcohol and tobacco use, as well as consumption trends in school population from 7th to 12th grade from Mexico City and its political delegations. Method To ensure the comparability with similar studies carried out in Mexico in school population, the methodology used in this study maintains the basic aspects of the previous measurements that have been made in students from 7th to 1 2th grade from Mexico City and other states. The project had the approval of the ethics committee from the National Institute of Psychiatry Ramón de la Fuente Muñiz, and was approved by the educational authorities of Mexico City to be applied in school population. The unit of analysis from which the information was obtained were the students enrolled in 7th to 12th grade in 2008-2009 from public and private schools in Mexico City. The sampling frame was developed based on the official records of the 2008-2009 school year. A non-response rate of 20%, a confidence level of 95% and an average absolute error of 0.004 were considered. The sample design was stratified by level of education (7th to 9th grades and 10th to 12th grades) and political delegations, which gave 32 different strata. It was also clustered by scholar group which was the primary unit of selection. The sample of groups and students were weighted considering the group, educational level and the delegation. A final sample of 22 980 subjects was obtained: 49.8% were female and 50.2% were men. 56.3% of the sample attended to 7th to 9th grades and 43.7% attended to 10th to 12th grades. In addition, most of the male and female adolescents were full-time students during the year prior to the study and only 7% of men and 5.1% of women were not students. 23.3% of men and 11.9% of women worked part or full time, and additionally, most of them had both parents. The information was obtained through a standardized questionnaire, which has been applied in previous surveys and has been previously validated. Due to the extension of the instrument, four forms were used to include various sections, the main part of questionnaire was administered to all subjects and the last two pages corresponded to forms, so each form was applied to one quarter of the sample. Alcohol consumption indicators used are comparable with WHO indicators, international observatories from Europe and the ones used in <
Introducción En los últimos tres años, se ha realizado una amplia gama de estudios epidemiológicos, a nivel nacional e internacional, sobre el consumo de drogas. En cuanto a tabaco, la Encuesta Nacional de Adicciones 2008, la encuesta de GATS y los estudios estatales en población escolar muestran una tendencia importante a la disminución del consumo de la sustancia. Para el consumo de alcohol, tanto en la prevalencia como en la proporción de personas que inicia su consumo temprano, se han reportado incrementos. El abuso de alcohol se mantiene constante y similar entre hombres y mujeres. Al considerar el uso de drogas ilegales hay incrementos importantes. El incremento más pronunciado es el de los inhalables, especialmente en mujeres. En cuanto a la cocaína, la ENA 2008 señala que se ha duplicado el consumo y el informe de la ONU indica que al parecer el incremento se da hasta 2005 y a partir de ahí ha disminuido. Las metanfetaminas mantienen una prevalencia baja. Sólo entre quienes acuden a los centros de servicio para usuarios de drogas se encuentra un alto consumo. En este contexto, el objetivo de este trabajo es evaluar las prevalencias del uso de drogas, alcohol y tabaco, así como las tendencias de consumo en la población de estudiantes de enseñanza media y media superior de la Ciudad de México. Método El marco muestral se elaboró con base en los registros oficiales del ciclo escolar 2008-2009 de la Secretaría de Educación Pública (SEP). Se consideró una tasa de no respuesta de 20%, un nivel de confianza de 95%, con un error absoluto promedio de 0.004. El diseño de la muestra fue estratificado y por conglomerados; la unidad de selección fue el grupo escolar. Se obtuvo una muestra final de 22 980 sujetos y quedó conformada por 49.8% de mujeres y 50.2% de hombres. La información se obtuvo mediante un cuestionario estandarizado, que ha sido aplicado y validado en las anteriores encuestas. Los indicadores de consumo de alcohol, drogas y tabaco empleados son comparables con los indicadores de la OMS, de los observatorios internacionales de Europa y de los usados en <
ABSTRACT
El objetivo del presente estudio es identificar y comparar los factores protectores y de riesgo en alumnos de sexto grado en una institución pública y otra privada. La muestra fue no probabilística por conveniencia; ya que se trabajó con los alumnos que asistieron a clases en el día de la administración. Se utilizó un cuestionario con preguntas abiertas y cerradas. Fue aplicado a 85 alumnos y 48 adultos, de nivel socio económico bajo y a 60 alumnos y 53 adultos, de nivel socio económico medio-alto. El análisis de los datos revela similitud de resultados para ambas muestras ya que, tanto los alumnos como sus familias poseen factores protectores y de riesgos semejantes.
The aim of this study is to identify and compare risk and protective factors in students from sixth grade in a public and a private school. The sample was not probabilistic by convenience, as the authors worked with students attending classes on the day of administration. A questionnaire with open and closed questions was used. It was applied to 85 students and 48 adults of low socioeconomic level and to, 60 students and 53 adults, belonging to medium-high socioeconomic level. The data analysis showed similar results for both samples and that both students and their families have protective and risk factors in a similar way.
ABSTRACT
El abuso de drogas legales e ilegales entre los jóvenes es un serio problema de salud pública, tanto en el ámbito internacional como en México. Ante este fenómeno se ha recomendado fortalecer las acciones preventivas que promuevan estilos de vida saludables en los jóvenes. Sin embargo, en México existen pocas iniciativas encaminadas a la prevención del consumo de drogas en jóvenes, en particular dirigidas a los universitarios, quienes constituyen uno de los segmentos de la población que se encuentra en mayor riesgo de consumir sustancias nocivas para la salud. El propósito de esta investigación fue desarrollar un taller y evaluar sus efectos preventivos sobre el consumo de alcohol y otras drogas en estudiantes universitarios, a través de proveer herramientas que aumentaran los factores protectores y disminuyeran los factores de riesgo. Dentro de los cambios más significativos producto de la intervención se encontró que el 92.5% de los estudiantes participantes presenta un cambio en todos aquellos aspectos que se relacionan con un cuidado en su salud de manera integral; el 100% de los estudiantes sugiere la presencia o significado de sufrimiento, y el 96.29% sugiere la presencia de metas y sentido de vida. Hubo una disminución de 74.07% en los factores de riesgo, y un aumento en los factores protectores de un 70.37% en los estudiantes después de haber concluido el taller preventivo. La investigación muestra la factibilidad de prevenir el consumo de drogas en estudiantes universitarios a través de inducir el cambio en la apreciación del cuidado de su salud, el sufrimiento y del sentido de vida mediante talleres que aumentan los factores protectores. De esta forma, queda patente que talleres como el ensayado en nuestro estudio ofrecen un apoyo empírico a los programas de intervención primaria.
The abuse of both legal and illegal drugs among young people has become a serious public health problem, both in the international arena as well as in Mexico. To face this phenomenon, the strengthening of preventive measures that promote healthful life styles among our youth has been recommended. In Mexico, however, few initiatives exist aimed at preventing drug consumption by young people, particularly college students, who make up one of the high-risk segments of the population regarding the use of health-endangering substances. The purpose of this research was to deliver a workshop and evaluate its preventive effects on the abuse of alcohol and other drugs on the part of college students, by means of providing them with tools for increasing protective factors and reducing risk factors. Among the most significant changes product of this intervention it was found that 92.5% of the participants modified aspects related to holistic health care; 100% of the students reported finding a meaning to suffering, whereas 96.29% confirmed having developed goals and a purpose in life upon conclusion of the workshop. Risk factors diminished by 74%, whereas protective factors increased by 70% at the end of the intervention. This research shows the feasibility of preventing drug abuse among college students by inducing a change in their appraisal of health care, suffering and purpose of life by means of workshops that increase protective factors. Thus, it becomes evident that workshops like the ones tested in our study offer empirical support to primary intervention programs.
O abuso de drogas lícitas e ilícitas entre os jovens é um grave problema de saúde pública internacional no México. Para afrontar este fenômeno tem sido recomendado reforçar as medidas preventivas destinadas a promover estilos de vida saudáveis nos jovens. No entanto, no México há poucas iniciativas destinadas a prevenir uso de drogas pelos jovens, sobretudo dirigidas a estudantes universitários, que constituem um dos segmentos da população com maior risco de consumir substâncias nocivas para a saúde. O objetivo deste trabalho foi realizar uma oficina e avaliar seus efeitos de prevenção ao consumo de álcool e outras drogas entre estudantes universitários, fornecendo ferramentas para aumentar os fatores de proteção e diminuir os de risco. Entre os resultados mais significativos da intervenção constatou-se que 92,5% dos alunos participantes apresentam uma mudança nos aspectos relacionados com o cuidado total da saúde, 100% sugerem a presença ou o sentido do sofrimento, e 96,29% sugerem a presença de metas e propósito de vida. Nos alunos, os fatores de risco diminuíram 74,07% e os de proteção aumentaram 70,37% dos alunos após a conclusão da oficina de prevenção. A pesquisa mostra a viabilidade de prevenção ao uso de drogas entre estudantes universitários induzindo mudanças na avaliação dos cuidados de sua saúde, seu sofrimento e sentido da vida através de oficinas que aumentem os fatores de proteção. Assim, é evidente que as oficinas, como no nosso estudo, fornecem suporte empírico para programas de intervenção primários.