Suicide after and during the COVID-19 pandemic in Mexico City

Objectives: Prior research has indicated that no increase in suicides occurred immediately following the declaration of the COVID-19 emergency in Mexico City. Here we examine longer-term overall suicide trends and trends according to basic demographic groups. Methods: We used interrupted time-series analysis to model trends in monthly suicides before COVID-19 (January 1, 2010 to March 31, 2020), comparing the expected number of suicides both overall and according to age and sex with the observed number of suicides for the remainder of 2020 (April 1, 2020 to December 31, 2020). Results: There was an overall increase in suicides during the first 9 months of the pandemic, with a rate ratio of 2.07 (1.86-2.31). The increase began in the early months of the pandemic and remained stable and high after June 2020. Men and women, younger people (< 45) and older people (≥ 45) were affected. The increase was especially high among older women (RR = 3.33; 2.04-5.15). Conclusions: The increase in suicides in Mexico City is worrying and highlights the need to strengthen economic development, mental health, and well-being programs. Suicides among older women should be closely monitored. There is an urgent need to expand primary health care services to include robust suicide prevention and treatment options.

Barreras para la atención de las conductas suicidas en Ciudad de México: experiencias del personal de salud en el primer nivel de atención / Barriers to Care of Suicidal Behavior in Mexico City: Health Personnel Experiences at the First Level of Care / Barreiras para a atenção das condutas suicidas na Cidade do México: experiências dos profissionais de saúde na atenção básica

Resumen Objetivo: Identificar las barreras que existen para la atención de las conductas suicidas, desde la perspectiva de las/los profesionales de la salud mental del primer nivel de atención de la Ciudad de México. Metodología: Estudio cualitativo exploratorio, basado en 35 entrevistas semiestructuradas, dirigidas a personal de salud de dos unidades de salud mental de referencia nacional. El análisis de la información se hizo mediante el Framework Analysis. Resultados: Las/los participantes consideraron que las conductas suicidas no han sido definidas como una prioridad dentro de los trastornos de salud mental. La ausencia de políticas públicas, la sobrecarga de trabajo, la falta de seguimiento a las/los pacientes, entre otras, fueron identificadas como barreras para una atención adecuada y oportuna. Conclusiones: Los programas de prevención de las conductas suicidas deben tomar en cuenta el contexto socioeconómico de la población y las características de los servicios de salud, así como las necesidades de las personas prestadoras de servicios de salud. Se requiere ampliar el entrenamiento profesional y mejorar el sistema de referencia y contrarreferencia entre los distintos niveles de atención.

Abstract Objective: To identify the existing barriers to the care of suicidal behavior from the perspective of mental health professionals at the first level of care in Mexico City. Methodology: Qualitative exploratory study based on 35 semi-structured interviews conducted on health personnel from two national reference mental health facilities. The data were analyzed with Framework Analysis. Results: The participants considered that suicidal behavior has not been prioritized among mental health disorders. The absence of public policies, work overload, lack of patient follow-up, among others, were identified as barriers to adequate and timely care. Conclusions: Suicidal behavior prevention programs should consider the socioeconomic context of the population, the characteristics of health services, and the needs of health care providers. Professional training should be enhanced, and the referral and counter-referral system across levels of care should be improved.

Resumo Objetivo: Identificar as barreiras existentes para a atenção das condutas suicidas, desde a perspectiva dos profissionais de saúde mental de atenção básica da Cidade do México. Metodologia: Estudo qualitativo exploratório, baseado em 35 entrevistas semiestruturadas, dirigidas a profissionais de saúde de duas unidades de saúde mental de referência nacional. A análise da informação foi feita através do Framework Analysis. Resultados: Os participantes consideraram que as condutas suicidas não têm sido definidas como uma prioridade dentro dos transtornos de saúde mental. A ausência de políticas públicas, a sobrecarga de trabalho, a falta de seguimento aos pacientes, entre outras, foram identificadas como barreiras para uma atenção adequada e oportuna. Conclusões: Os programas de prevenção das condutas suicidas devem considerar o contexto socioeconômico da população e as características dos serviços de saúde, além das necessidades dos profissionais de saúde. É necessário ampliar o treinamento profissional e melhorar o sistema de referência e contrarreferência entre os diferentes níveis de atenção.

Effects of the distribution of product samples to patients and physicians by pharmaceutical companies

Background@#Distribution of product samples is a typical and traditional marketing and promotion strategy used by pharmaceutical companies. However, issues have been raised about their influence on physicians' prescribing behavior and patients' health outcomes. @*Objectives@#This study aimed to determine the effects of the distribution of product samples on physicians' prescribing behavior and adherence to patients' treatment regimens. It also sought to provide policy recommendations on product sample distribution and the administrative order on pharmaceutical promotion. @*Methodology@#The study involved a descriptive design. The study sites were Manila City, Cebu City, and Davao City. Data were collected using focus group discussions, key informant interviews, and surveys among patients and physicians. Content analysis was performed to analyze qualitative data, while descriptive statistics and measures of association were conducted to analyze quantitative data. @*Results@#A total of four FGDs were conducted with one FGD for each stakeholder group, and 846 patients and 286 physicians answered the study questionnaire. About half (48.0%) of the patients received product samples; 75.8% had low medication adherence. Product sample distribution was not significantly associated with patients' adherence (p=0.150). The majority of the physicians (69.2%) received product samples. There was no significant association between product sample distribution and physicians' prescribing behavior (p=0.111). It was found, however, that the distribution of product samples was significantly associated with the other physicians' prescribing behavior (p=0.009). The issues identified included the influence of medical representatives on physicians' prescribing behavior, incapacity of the poor and marginalized population to complete their treatment regimen due to lack of supply of product samples, and mentality of patients that product samples have better quality.@*Conclusion@#This study emphasized that the regulation of product sample distribution was justifiable since this might negatively influence professional behavior affecting rational prescribing and the use of medicines. Furthermore, the distribution of product samples did not directly translate to increased patients' medication adherence. Should the distribution of samples be continuously practiced, the provision of product samples should be strictly followed, and the distribution should be regulated and monitored to prevent the occurrence of violative practices.

Prevención del delito y despliegue territorial de la policía en la Ciudad de México. Evidencia a debate / Crime prevention and territorial deployment of the police in Mexico City. Evidence for debate / Prevenção ao crime e implantação territorial da polícia na Cidade do México. Evidências para debate

Resumen El crimen es un asunto público trascendental. Para hacerle frente se han desarrollado distintas políticas públicas que van desde el despliegue de recursos policiales y castrenses hasta la prevención primaria del delito. En este último caso, y para la Ciudad de México, se han implementado diversas iniciativas; sin embargo, estas no se han estudiado plenamente. Así, el objetivo del texto es mostrar si existe o no correlación entre los módulos de prevención del delito y participación ciudadana y la prevención del delito de la policía de la Ciudad de México con la incidencia delictiva operacionalizada con la variable homicidio. Para ello, se definieron distintos observables empíricos fundamentados en teoría y se ajustaron varios modelos de regresión. Los hallazgos son contraintuitivos, esto es, que en aquellos lugares donde existen módulos se incrementa la probabilidad de ocurrencia de incidentes criminales.

Abstract Crime is a momentous public matter. To address it, different public policies have been developed, ranging from the deployment of police and military resources to the prevention of crime. In the latter case, and for Mexico City, various initiatives have been implemented; however, these have not been fully studied. Thus, the objective of the text is to show whether or not there is a correlation between the Modules of Crime Prevention and Citizen Participation and Crime Prevention of the Mexico City police with the criminal incidence operationalized with the homicide variable. To do this, different empirical observables based on theory were defined and several regression models were adjusted. The findings obtained are counterintuitive, this is that in those places where there are modules, the probability of occurrence of criminal incidents increases.

Resumo O crime é um assunto público importante. Para enfrentá-lo, foram desenvolvidas diferentes políticas públicas, desde a implantação de recursos policiais e militares até a prevenção da criminalidade. Neste último caso, e para a Cidade do México, várias iniciativas foram implementadas; no entanto, estes não foram totalmente estudados. Assim, o objetivo do texto é mostrar se há ou não correlação entre os Módulos de Prevenção ao Crime e Participação Cidadã e Prevenção ao Crime da Polícia da Cidade do México com a incidência criminal operacionalizada com a variável homicídio. Para isso, diferentes observáveis empíricos baseados na teoria foram definidos e vários modelos de regressão foram ajustados. Os achados obtidos são contra-intuitivos, ou seja, nos locais onde há módulos, aumenta a probabilidade de ocorrência de incidentes criminais.

Syphilis infection markers among HIV positive individuals in the Mexico City HIV/AIDS Program / Marcadores de infección por sífilis de individuos VIH positivos en el Programa de VIH/SIDA de la Ciudad de México

Abstract: Objective: The aim of this study is to evaluate the prevalence of T. pallidum infection markers in HIV-positive individuals receiving highly active antiretroviral therapy (ART) in the Mexico City HIV/AIDS Program, as well as predictive characteristics. Materials and methods: The reverse serologic algorithm method was used for the T. pallidum diagnosis, and applied to 2 383 HIV-positive individuals. Sociodemographic characteristics, sexual practices, previous syphilis diagnosis, and length of antiretroviral treatment, were evaluated. Variables significantly associated with syphilis markers were analyzed using a logistic regression model. Results: Prevalence of "active or resolved" and "probable active" infection markers were 44.2 and 28.8%, respectively. Predictive factors were: Clínica Especializada Condesa Iztapalapa (CECI), previous syphilis diagnosis, men in who have sex with men (MSM), and receptive sex practices. Conclusions: The prevalence of T. pallidum infection markers was the highest ever reported in Mexico, and was related to specific sexual practices as well as previous syphilis diagnosis, elements which require preventive measures in the Mexico City HIV/AIDS Program.

Resumen: Objetivo: Evaluar las prevalencias de marcadores de infección por T. pallidum en personas que viven con VIH y reciben tratamiento antirretroviral en el Programa de VIH/SIDA de la Ciudad de México, así como sus características asociadas. Material y métodos: Se siguió el método del algoritmo reverso para el diagnóstico de T. pallidum aplicado a 2 383 individuos VIH positivos, quienes contestaron un cuestionario sobre características sociodemográficas, prácticas sexuales, diagnóstico previo de sífilis y tiempo de tratamiento antirretroviral. Las variables significativamente asociadas con los marcadores de sífilis se analizaron mediante un modelo de regresión logística. Resultados: Las prevalencias de marcadores de infección "activa o resuelta" y "probablemente activa" fueron 44.2 y 28.8%, respectivamente. Las características asociadas con los marcadores fueron Clínica Especializada Condesa Iztapalapa (CECI), diagnóstico previo de infección por sífilis, hombres que tienen sexo con hombres (HSH) y prácticas sexuales receptivas. Conclusiones: Las prevalencias de marcadores de infección por T. pallidum fueron altas y estuvieron relacionadas con prácticas sexuales específicas y con el diagnóstico previo de sífilis, características que requieren medidas preventivas dentro del programa.

El mosquito del dengue en la Ciudad de México. Invasión incipiente de Aedes aegypti y sus potenciales riesgos / Aedes aegypti, the dengue fever mosquito in Mexico City. Early invasion and its potential risks

Resumen Introducción: La Ciudad de México no tiene presencia endémica de Aedes aegypti, por lo que está libre de enfermedades transmitidas por vector como dengue, Zika y chikunguña. Sin embargo, existe evidencia de la presencia de huevecillos en la urbe desde 2015. Objetivo: Reportar la presencia constante y en aumento de huevecillos de Aedes aegypti en la Ciudad de México de 2015 a 2018. Método: Se realizó vigilancia a través de ovitrampas; se contabilizaron y eclosionaron huevecillos para determinar la especie. Resultados: De 2015 a 2018 fueron identificados 378 organismos como Aedes aegypti. En total fueron colectadas 76 ovitrampas positivas a Aedes aegypti en 50 sitios distintos de 11 alcaldías. El noreste de la Ciudad de México fue el área con mayor positividad. Conclusiones: Los resultados pueden estar indicando un periodo de colonización incipiente y la probable la existencia de colonias crípticas del mosquito, por lo que la Ciudad de México podría estar en riesgo de presentar epidemias de enfermedades transmitidas por vector.

Abstract Introduction: Mexico City has no endemic presence of Aedes aegypti, and it is therefore free of vector-borne diseases, such as dengue fever, Zika and chikungunya. However, evidence has shown the presence of Aedes aegypti eggs in the city since 2015. Objective: To report the constant and increasing presence of Aedes aegypti eggs in Mexico City from 2015 to 2018. Methods: Surveillance was carried out using ovitraps. Eggs were counted and hatched in order to determine the species. Results: From 2015 to 2018, 378 organisms were identified as Ae. aegypti. In total, 76 Aedes aegypti-positive ovitraps were collected at 50 different places in 11 boroughs of the city. Northeastern Mexico City was the area with the highest number of positive traps. Conclusions: The results may be indicating a period of early colonization and the probable existence of cryptic colonies of the mosquito, and Mexico City could be therefore at risk of experiencing vector-borne epidemics.

Del "armamento antituberculoso" al Sanatorio para Tuberculosos de Huipulco en la Ciudad de México, 1920-1940 / The road from the "antituberculosis armory" to the Huipulco Tuberculosis Sanatorium in Mexico City, 1920-1940

Resumen Este artículo estudia las diferentes propuestas y estrategias para prevenir los contagios de la tuberculosis pulmonar implementadas en la Ciudad de México a partir de la década de 1920, al comenzar la primera campaña de largo aliento contra esa enfermedad, y analiza las limitaciones y problemas a los que ésta se enfrentó hasta 1940. Se destaca por qué la contención de los contagios de esa enfermedad ocupó un lugar prioritario después de diez años de guerra civil; se presta atención a los modelos y estrategias implementados y se examinan los problemas por lo que atravesó la construcción y el funcionamiento del Sanatorio para Tuberculosos de Huipulco, sustento clave de la lucha antituberculosa desde tiempo atrás a nivel internacional.

Abstract This article discusses the various proposals and strategies to prevent the transmission of pulmonary tuberculosis in the City of Mexico from the 1920s decade onwards, when it was launched the first long-term campaign against the disease, and analyses the limitations and challenges faced until 1940. It looks upon the motives that led the need to contain the transmission of the disease to occupy a dominant role after ten years of civil war; it focuses on the models and strategies implemented, and examines the challenges faced by the construction and operation of the Huipulco Tuberculosis Sanatorium, a key component of the fight against tuberculosis at the international level since long ago.

Activo distribution and paraphernalia among "street children" / Distribución del activo y la parafernalia entre "niños de la calle"

Abstract Introduction The use of solvent inhalants has been documented in Mexico since the 1970s. Nevertheless, very little is known about the distribution and use dynamics among "street children". Few have ventured to study this issue because of the difficulties involved in working with marginalized, relatively inaccessible populations. Objective To analyze the distribution and consumption dynamics of activo, as it is known among street children in downtown Mexico City, and to document the paraphernalia and argot associated with these practices. Method This is a qualitative, descriptive, and interpretative study guided by the "Meeting Place" approach used by Hughes (1977), which has been adapted to Mexican population by Ortiz (1979). We also used ethnographic observation techniques and a social and immersion mapping of street spaces that allowed us to contact and relate to both informants and users. Results We identified activo distributors and storage areas; user groups were made up of men and women in a 7-3 ratio; physical and psycho-social characteristics of sellers and users, and some street argot and paraphernalia that allowed us to understand the dynamics of distribution and consumption. Discussion and conclusion The activo market is both captive and hidden; it is detrimental to the physical and mental health of street children, and is fostered by social exclusion and the lack of legislation.

Resumen Introducción El consumo de solventes inhalables se ha documentado en México desde la década de 1970; sin embargo, poco se sabe sobre la dinámica de distribución y consumo entre los "niños de la calle". Este tema se ha estudiado poco por las dificultades inherentes al trabajo con poblaciones marginales y de difícil acceso. Objetivo Analizar la dinámica de distribución y consumo del "activo" entre los "niños de la calle" de la zona centro de la Ciudad de México, así como documentar la parafernalia y el argot asociados a estas prácticas. Método Es un estudio de tipo cualitativo, de carácter descriptivo-interpretativo, guiado por el enfoque llamado "Lugares de Reunión" empleado por Hughes (1977) y adaptado a población mexicana por Ortiz (1979). También se emplearon técnicas etnográficas de observación, mapeo social e inmersión en los espacios de calle, que sirvieron para contactar y establecer un vínculo con los informantes y consumidores. Resultados Se identifican distribuidores y zonas de almacenamiento del activo; grupos de consumidores formados por hombres y mujeres en una proporción de 7 a 3; signos físicos y características psicosociales de vendedores y usuarios, así como el argot y parafernalia; lo que permite comprender la dinámica de distribución y consumo. Discusión y conclusión El mercado del activo es cautivo y oculto, deteriora la salud física y mental de los "niños de la calle" y es promovido además por la exclusión social y la falta de legislación.

Os Jogos Olímpicos na Cidade do México 1968: discursos oficiais, da mídia e da literatura científica / The Olympic Games in Mexico City 1968: official discourses, the media and the scientific literature

O presente artigo propõe uma análise histórica sobre os principais fatos relacionados à candidatura, eleição e realização dos Jogos Olímpicos de 1968 na Cidade do México, verificando a presença ou ausência desses e de outros debates no jornal Folha de S.Paulo do ano de 1968, nos relatórios oficiais emitidos pelo Comitê Organizador do evento e na literatura científica. Assim, foram identificados e descritos o processo de candidatura e eleição da Cidade do México, assim como os debates acerca da altitude e as manifestações político-sociais durante o processo de preparação e realização do evento - especificamente ao chamado Massacre de Tlatelolco e ao ato de levantar os punhos dos atletas Tommy Smith e John Carlos no pódio olímpico. Sem a pretensão de esgotar a descrição dos acontecimentos daquele evento, tais fatos apontam para relevantes indícios daquela edição dos Jogos Olímpicos. Apesar da especificidade histórica daquele contexto político e esportivo, alguns debates permanecem como desafios para as cidades sedes e para as instituições esportivas mesmo após quase meio século.

This article proposes an historical analysis of the main facts regarding the bid, selection and host of the 1968 Olympic Games in Mexico City. In this process, the presence or absence of these and other facts were verified on the newspaper Folha de S.Paulo of the year of 1968, on the official documents of the 1968 Organizing Committee and at the scientific literature. Then, we have identified and described the bid and selection process of Mexico City, as well as the debates on altitude and the social and political manifestations - specifically, the Tlatelolco Massacre and the raised fists of Tommy Smith and John Carlos at the Olympic podium. The facts were not depleted, but we understand that the description points to relevant evidence on those Games. Even considering the historical specificity of that political and sportive context, some of the debates remain as challenges for host cities and sport organizing bodies after almost fifty years.

Health impact assessment of decreases in PM10 and ozone concentrations in the Mexico City Metropolitan Area: A basis for a new air quality management program / Evaluación de impacto en salud ante reducciones de PM10 y ozono en la Zona Metropolitana del Valle de México: Base para un nuevo programa de calidad del aire

Objective. To conduct a health impact assessment (HIA) to quantify health benefits for several PM and O3 air pollution reduction scenarios in the Mexico City Metropolitan Area (MCMA). Results from this HIA will contribute to the scientific support of the MCMA air quality management plan (PROAIRE) for the period 2011-2020. Materials and methods. The HIA methodology consisted of four steps: 1) selection of the air pollution reduction scenarios, 2) identification of the at-risk population and health outcomes for the 2005 baseline scenario, 3) selection of concentration-response functions and 4) estimation of health impacts. Results. Reductions of PM10 levels to 20 μg/m³ and O3 levels to 0.050ppm (98 µg/m³) would prevent 2300 and 400 annual deaths respectively. The greatest health impact was seen in the over-65 age group and in mortality due to cardiopulmonary and cardiovascular disease. Conclusion. Improved air quality in the MCMA could provide significant health benefits through focusing interventions by exposure zones.

Objetivo. Realizar una evaluación de impacto en salud (EIS) que documente los beneficios en salud ante diversos escenarios de reducción de PM10 y O3 en el aire de la Zona Metropolitana del Valle de México (ZMVM). Los resultados contribuyen al sustento científico del plan de gestión de calidad del aire (PROAIRE 2011-2020). Material y métodos. La metodología de EIS comprende cuatro pasos: 1) selección de los escenarios de reducción, 2) identificación de la población en riesgo y de los eventos en salud para el año basal 2005, 3) selección de las funciones de concentración-respuesta y 4) estimación del impacto en la salud. Resultados. Reducciones de PM10 a 20μg/m³ y de O3 a 0.050ppm (98 µg/m³) evitarían, respectivamente, cerca de 2 300 y 400 muertes por año. El mayor impacto se observa en el grupo de más de 65 años y en la mortalidad por causas cardiopulmonares y cardiovasculares. Conclusiones. Mejorar la calidad del aire en la ZMVM podría reflejar importantes beneficios para la salud focalizados por zonas o áreas de exposición.

Características relacionadas con escaldaduras en menores de 5 años en un Hospital Pediátrico en la Ciudad de México, 2011 / Features related with scalds in children under 5 years old in a pediatric hospital in Mexico City, 2011.

Introducción: Las quemaduras son lesiones de los tejidos producidas por una agresión cutánea de energía térmica cuya clasificación varía de acuerdo a la gravedad. Representan un problema de salud pública especialmente en los niños por su elevada letalidad y los años de vida perdidos por discapacidad. Objetivo: Identificar las características relacionadas con la ocurrencia de escaldaduras en niños menores de 5 años, en un Hospital Pediátrico de la Ciudad de México, 2011. Material y Métodos: Se empleó un diseño de casos-autocontroles en 60 niños menores de 5 años que presentaron escaldadura. La evaluación de algunas variables se obtuvo mediante el diligenciamiento de un cuestionario estructurado por parte de los cuidadores. Se definieron dos periodos de estudio; el primero denominado "periodo de riesgo" que incluyó la evaluación de los eventos ocurridos 15 minutos previos a la escaldadura y el segundo, denominado "periodo de control" que evaluó las 24 horas previas a la ocurrencia del evento. Resultados: La muestra estuvo conformada por 60 menores, 70% (n=42) de los participantes fueron varones. El promedio de edad fue 2.2 años (ds=1.2). El 95% de las escaldaduras ocurrieron en el hogar, 61.4% se presentaron en la cocina y 15.8% en el baño. Cerca del 70% de los participantes tenía bajo nivel socioeconómico, 86.7% vivía en condiciones de hacinamiento. El rango horario en el cual se presentaron con mayor frecuencia fue entre las 12 a 18 horas. La única asociación encontrada se dio cuando el cuidador estaba cocinando (OR 6.8, IC95% 1.9-24.9) Conclusiones: Identificar las características relacionadas con las escaldaduras en menores de cinco años es fundamental para impulsar medidas preventivas que reduzcan el riesgo de vivir con secuelas derivados de estas lesiones. Los cuidadores deben mejorar la supervisión de los niños a su cargo, en especial al interior de las cocinas.

Introduction: Burns are injuries of tissues caused by skin aggression thermal energy. Their classification varies according to gravity. Such injuries are a public health problem especially in children because of its high fatality rate and years of life lost due to disability. Objective: Identify the characteristics associated with the occurrence of scalds in children under 5 years in a Pediatric Hospital in Mexico City, 2011 Methodology: We employed a case crossover design on a sample of 60 children under 5 years old with scalding, to whom we applied a structured questionnaire to their caregivers. We defined two study periods: risk period, 15 minutes pre-scald and control period 24 hours prior to the occurrence of the event. Results: Of the sample of 60 children, 70% (n:42) were male, mean age 2.2 years (sd:1.2); 95% of scalds occurred at home, 61.4% occurred in the kitchen and 15.8% in the bathroom. About 70% of them had low socioeconomic status, 86.7% were living in overcrowded conditions. The times of higher occurrence of events were between 12 to 18 hours. The only association found was when the caregiver was cooking (OR 6.8, CI 95% 1.9 - 24.9). Conclusions: To identify the risk factors and characterize the scald in children under than five years old are fundamentals aspects to promote promotion and preventive program to reduce risk of live with physical and psychological disability from these causes of injuries. The caregiver should to have more attention to the children they supervise, in special within kitchen.

La banda y sus choros: Un grupo de niños de la calle hilando historias de edad, género y liderazgo / La banda and their choros: A group of street children narrating tales about leadership, gender and age

Este artículo narra la historia de los chavos de Bucareli, un grupo de niños de la calle de la Ciudad de México, quienes también eran conocidos como "la banda del metro Juárez". Documentar su vida cotidiana por un periodo de tres años me ha permitido formular tres puntos de análisis relacionados con la diferenciación interna del poder, puntos también válidos para otras 15 bandas de niños de la calle de la Ciudad de México. Primero, es importante poner en una perspectiva de edad las dinámicas sociales de liderazgo y género que se dan al interior de la banda y entre las diferentes bandas. Segundo, los principios que estructuran la vida en las calles, como el liderazgo, el género y la edad, tienen un carácter inherentemente evanescente como consecuencia de la interacción de limitaciones internas y externas a la banda. Tercero, la falta de vivienda genera un mundo de paradojas y contradicciones. La diferenciación de poder entre personas que carecen relativamente de poder es una contradicción; y las dinámicas de liderazgo, género y edad demuestran las paradojas de las relaciones internas de la banda. Dichas paradojas pueden ser particularmente alienantes en las relaciones entre los niños de calle y los adultos que fungen como padres o madres sustitutos. Este análisis etnográfico de la "enloquecedora falta de una vivienda" es relevante para la salud mental. Las historias narradas por los "gamines" en torno al liderazgo, el género y la edad esconden su fragilidad, porque en ellas los niños de la calle se atribuyen un poder del cual carecen en realidad. Más que meramente síntomas de locura o una personalidad manipuladora, estas historias testifican la creatividad y la resiliencia de estos jóvenes. El poder ilusorio de sus "choros" les facilita vivir con aparente armonía en las condiciones en que viven.

This article recounts the story of the Bucareli boys, a group of street children in Mexico City who were also known as the banda of metro Juárez. Documenting the "Buca" boys over a period of three years allowed me to formulate three insights about the internal power differentiation in terms of leadership, gender, and age. These insights are valid as well, I think, for the other 15 bandas where I did fieldwork. First, it is important to place the dynamics of leadership and gender relations in an age perspective. Second, as structuring principles of street life, leadership, gender and age have an inherently evanescent character, due to an interplay of constraints that are both internal and external to the banda. My third suggestion concurs with Liebow in that homelessness creates a world of paradoxes and contradictions. Power differentiation among relatively powerless people is a contradiction in terms; and the dynamics of leadership, gender and age disclose paradoxical social ties within the banda. These can be particularly harrowing in the relations between street kids and the young adults posing as surrogate fathers and mothers. This ethnographic analysis of "crazy-making homelessness" is relevant for mental health. The kids' story-telling about leadership and gender relations veiled their fragility, since in these tales they attributed themselves a power which they did not have in reality. More than mere symptoms of psychopathology or a manipulative personality disorder, these stories testify to the creativity and resilience of these young people. The illusory power of the choros, the bullshit tales about street children, enables them to live in apparent harmony under the conditions in which they live.

#Ladies y #gentlemen del DF: Dominancia social y actitudes hacia la discriminación / #Ladies & #Gentlemen of Mexico City: Social Dominance and Discriminatory Attitudes

La teoría de la dominancia social (SDO) explica el nivel en que las personas aceptan o rechazan las ideologías que le imprimen legitimidad a las jerarquías y la discriminación o a la igualdad y justicia. Este estudio aplica SDO en México y investiga si la dominancia social en abstracto tiene conexión con la aprobación de la discriminación en concreto (usando los casos de Lady de Profeco, Ladies de Polanco y Gentleman de las Lomas). Predecimos (1) que los hombres, los participantes de mayor edad y los que provienen de clases sociales más altas mostrarían niveles más altos de SDO; y (2) que la aprobación de discriminación será determinada por el nivel de SDO (alto > bajo) y por clase social (alta > media > baja). Participantes fueron N=150 miembros del publico en el DF. Llenaron cuestionarios en la calle, midiendo sexo, edad, lugar de residencia, SDO y aprobación de discriminación. Los resultados generalmente aportaron las hipótesis. Hombres tenían puntajes mas altos de SDO que mujeres, pero las clases sociales mas bajas que altas tenían niveles mas altos de SDO. Hubo una correlación positiva entre SDO y aprobación de discriminación. Los resultados se discutieron en términos de diferencias en educación y movilidad social.

Social dominance orientation/theory (SDO) explains the extent to which individuals accept or reject ideologies that legitimize hierarchies and discrimination or equality and social justice. Numerous studies have shown that SDO predicts a wide range of political, ideological, and intergroup phenomena, particularly in relation to negativity towards minorities and outgroups. The aims of the present study were to apply the SDO scale in a Mexican context; examine differences in SDO according to sex, age group, and social class; and investigate whether an orientation towards social dominance would be detectable not only on an abstract level but a concrete level, that of approving inter-class discrimination. We predicted that (1) SDO would be higher in men than women, older than younger participants, and upper rather than lower social classes, (2) that approval of discrimination would be determined by SDO and social class, and (3) that SDO would correlate with approval of discrimination. Participants were N=150 members of the public in Mexico City, with a mean age of 35.3 years (range: 18-74) and from areas of different social classes. Participants completed paper-and-pencil questionnaires on the street. We measured demographics (sex, age, place of residence), a 16-item SDO scale (e.g., "Some people are just more deserving than others") with a Cronbach's alpha of .83, and three instances of discriminatory behavior on the part of upper-class members towards lower-class members, alpha=.90, e.g.: "The behavior of the 'Ladies of Polanco' insulting a police officer is justified". All items were measured on 5-point Likert-type scales, from 1=strongly disagree to 5=strongly agree. Results were generally in line with the hypotheses. A three-way ANOVA on social dominance showed significant effects of sex and place of residence, but not age group nor significant interactions. Men scored significantly higher than women on social dominance, providing evidence for the "invariance hypothesis". Unexpectedly, lower-class participants showed highest levels of SDO, followed by middle-class and upper-class participants. A two-way ANOVA on approval of discrimination showed significant effects of place of residence and SDO and a significant interaction. Middle-class participants showed significantly higher levels of approval of discrimination than the other two classes. SDO correlated with approval of discrimination. Unexpected effects might be due to differential levels of education among social classes and/or to social mobility. The present study is the first investigation of SDO in Mexico and shows the link between an abstract orientation towards social hierarchies and approval of class-based discrimination in everyday life.

Actitudes y percepciones de consumidores en la Ciudad de México, hacia atributos de la producción sustentable de alimentos de origen animal / Consumer attitudes and perceptions towards sustainable animal production attributes in Mexico City

Animal production systems in pursuit of sustainability production, have to integrate several elements such as: environmental protection, food safety, animal welfare, and benefits to local producers. The objectives of the study were: 1) identify the attitudes of consumers in three districts of Mexico City towards sustainable attributes; 2) identify their perceptions regarding the production of animal food products; 3) determine if there is an effect of the social-demographic variables. In this sense, one thousand two hundred consumers were surveyed in markets of three districts of Mexico City with different social-economic levels. Results show that attitudes and perceptions of consumers differ mainly according to the district where they reside. In relation to the sustainable attributes, consumers considered food safety as the most important attribute of an animal product, followed by environmental protection. Regarding animal food production in Mexico, consumers perceived in first place that this benefits local producers, that they are safe products, that it improves animal welfare, and, finally, that it conserves the environment. These results revealed that consumers in Mexico City show positive attitudes towards sustainable animal food production attributes, which could represent new opportunities for the food industry in Mexico.

Los sistemas de producción de alimentos en búsqueda de una producción sustentable, integran diversos elementos como: protección al ambiente, inocuidad de los alimentos, bienestar animal y beneficios para los productores locales. Los objetivos del estudio fueron: 1) identificar actitudes de los consumidores en tres delegaciones de la Ciudad de México hacia atributos de sustentabilidad; 2) identificar sus percepciones con respecto a la producción de alimentos de origen animal en México; 3) determinar si existe un efecto de las variables sociodemográficas. Para este fin se encuestaron a 1200 consumidores de diferentes niveles socioeconómicos, en mercados de tres delegaciones de la Ciudad de México. Los resultados muestran que las actitudes y percepciones de los consumidores difieren principalmente según la delegación donde residen. Respecto a los atributos de sustentabilidad, los consumidores consideraron la inocuidad de los alimentos como el atributo más importante de un producto de origen animal, seguido por la protección al ambiente. En relación con la producción de alimentos de origen animal en México, los consumidores percibieron en primer lugar, que ésta beneficia a los productores locales, que son alimentos seguros, que se mejora el bienestar animal, y finalmente, que se conserva el ambiente. Lo anterior muestra que los consumidores en la Ciudad de México tienen actitudes positivas hacia los atributos de la producción sustentable de alimentos de origen animal, lo cual representa nuevas oportunidades para la industria alimenticia en México.

La investigación de las trayectorias interculturales en las comunidades indígenas migrantes en el Distrito Federal / Researching of intercultural paths in indigenous migrants communities in Distrito Federal

The migrant indigenous population living all over Mexico City is increasing. The settlement of families in a single piece of land has magnified their visibility and political participation in the city based on their kinship and <>* relationships. This family settlement has given the indigenous migrant population the opportunity to maintain its cultural patterns and to speak its mother tongue; but this collective coexistence often creates serious problems and conflicts among its members. However, these communities must concur with institutional criteria and with local social programs' requirements for gaining access to resources (mostly coming from welfare) such as land regulation, medical assistance, grants, groceries, house building, and so on. Those criteria and requirements are usually established from the outside, without a proper knowledge of the communities they attempt to benefit. They do not have enough sensitivity towards the community's social organization, this situation has created conflicts and breaking-offs among the allegedly favored communities, as well as alterations in their traditional forms of organization. Urban resources, for instance, tend to promote group organization among indigenous with a community leader who has to be an agent for getting resources; but he often acts on his own rather than as the traditional guide originally in charge of maintaining the community life inside the limits of the public agreements reached through assemblies. Another troublesome experience that indigenous people face in the city is the frequent inter-ethnic links they have with the academic community, which approaches them to <>. Migrant Triquis, Otomies, Mazahuas, and other groups have a negative opinion of the academic community; they do not see it as an inter-ethnic link but as an inquiring one. Interviewers and pollsters from academic, government, ecclesiastic, news, and school agencies have asked them the same questions for many years: their school history, eating habits, income, occupation, and their reasons for migrating. Apparently researchers tend to believe that this population has an <> for these questions. The use indigenous groups make of the <> underlines their demands before the State about their right to work, to have a house, to medical attention, and to education and constitutes one of the few channels they have to be heard, though a lot remains unheard or in the dark. Even though they have received some attention, many of the places where they live in the city still are in dreadful health and living conditions, lacking the most basic services. After ten years, many of these indigenous camps have nothing but the poorest houses. On the other hand, recent non-indigenous migrants already have much better conditions. Indigenous communities living in the city often think that organizations use them, that they do nothing or very little to understand and benefit them, but that they can make things worse for them (for instance, breaking off their camps and generating more violence and alcohol use among their families). Although in the present there is a paradigm of egalitarian coexistence and multicultural tolerance in the urban centers, being part of an indigenous group still means disadvantage in comparison to a mixed race person. The idea that indigenous people are barbarians or savages still exists in the usual representations of mixed race society and their attention policy is filled with an integration thinking which considers indigenous societies as lower and incapable, as well as prone to be absorbed by the higher culture to finish the civilization process. The fundamental frame for knowing and understanding indigenous communities as well as their experiences in the way they experience them, is through the intercultural paths they are following in the city, their contact with resources, the inter-ethnic relationships they have from the moment they leave their homes until they arrive to the city. Achieving this goal implies that sponsors, researchers, and services providers stop looking at themselves as external observers and the communities as <> and start training informants in professional skills to become collaborators in the researches or in the social programs. Thus members of these <> could be part of the knowledge production in the enclosing culture without sacrificing neither their identity, nor their cultural values but revitalizing them instead. It is also needed that researchers do something more than just tackling indigenous communities' knowledge from the perspective of informants to capture their voice in the final reports, even being cautious not to publish material that could hurt them. The people who get involved in a research as subjects have very little influence on what is published so they do not feel represented. Even though using a classical research model helps to save time and to simplify responsibilities in managing funds and reporting research results, the challenge to access informants and gaining their trust still exists. Generally this approach creates skeptical reactions among participants who do not believe neither in the results nor in the purposes and products of a study because they do not feel part of the planning. It is necessary to practice alternative ways to relate to informants and to make more inclusive participant research projects. That way it would be possible to gradually involve subjects in every step of the research process to found a cooperative model where informants are trained during research to participate in designing, performing, analyzing, and reporting research results. This new team is the one that would present and conduct the research. Such new approach would guarantee that subjects' needs are covered and their experiences recognized. It would also help the researcher to access informants, to gain their trust, and to consider ethical aspects in treating them. This article describes some of the present problems involved in assisting and researching indigenous groups that live in Mexico City. The nature of the socio-cultural organization of indigenous groups living in the city is analyzed, as well as the transformation their communities experience when they contact with urban resources. A brief count of the elements involved in the meeting between indigenous people and the academic staff interested in studying them is presented. The usual failure in setting egalitarian inter-ethnic relationships, which has often resulted in damaging indigenous groups, is exposed. Finally, the need for alternative approaches in assisting and researching cultural minorities is discussed, especially from the perspective that there is an interest in creating equality, renewing their identities and their socio-cultural life, and improving their general living conditions based on the inter-cultural paths these groups follow in the big cities.

Cada vez más frecuentemente, una población indígena migrante reside en todas las unidades territoriales del Distrito Federal. Gracias a sus relaciones de parentesco y compadrazgo -el asentamiento por familias en un solo predio- se ha hecho más notoria su presencia y politización en el área urbana. Sin embargo, estas comunidades deben ajustarse a los criterios institucionales y administrativos de los programas sociales que se ofrecen en la ciudad para hacerse acreedores a recursos (predominantemente asistencialistas) como la regularización de los predios, el otorgamiento de servicios médicos, becas, despensas y construcción de viviendas, etc. Tales criterios son establecidos regularmente de forma externa sin incluir un conocimiento pertinente del funcionamiento de las comunidades a quienes intentan beneficiar. No se es sensible a las formas propias de organización social, lo que ha desencadenado entre los supuestos beneficiados, rupturas y conflictos al interior de las propias comunidades, así como una alteración de sus formas tradicionales de organización. Entre los triquis que migran a la Ciudad de México, al igual que sucede con otomíes, mazahuas y otras comunidades, existe una percepción negativa hacia la comunidad académica, a la que no se le ve como un vínculo interétnico sino como formada por interrogadores. Han sido muchos años en los que encuestadores y entrevistadores de instituciones académicas, de gobierno, eclesiásticas, reporteros y estudiantes, se les han aproximado para preguntarles "siempre lo mismo": su escolaridad, su alimentación, el monto de sus ingresos, su ocupación y las razones de su emigración entre otras cosas. Aun cuando algunos indígenas han conseguido hacerse oír, muchos predios urbanos donde habitan diversas etnias del país presentan aún condiciones deplorables de salud y subsistencia, careciendo de lo más elemental. Actualmente se tiende al paradigma de convivencia igualitaria de la multiplicidad de culturas en los grandes centros urbanos, sin embargo pertenecer a la categoría indígena aún coloca a quienes portan esa identidad en condiciones de desventaja respecto de los mestizos. El imaginario sobre el indígena como bárbaro o salvaje aún prevalece implícito en las representaciones comunes de la sociedad mestiza, y en su política de atención indigenista todavía priva el integracionismo que considera a las sociedades indígenas como incapaces e inferiores, susceptibles de ser asimiladas a la cultura mayoritaria para completar en ellas el proceso de "civilización del bárbaro". Los trayectos interculturales que los indígenas migrantes están recorriendo en la Ciudad, en el contacto con recursos, en las relaciones interétnicas que establecen desde que migran y se instalan en la urbe, es el marco fundamental para conocer y comprender en lo posible a las comunidades indígenas, sus experiencias y significados, tal como son sentidos por sus propios integrantes. En el presente trabajo se describen algunos de los problemas presentes en la atención y la investigación que han merecido grupos indígenas que residen en la Ciudad de México. Se aborda también la naturaleza de la organización social cultural de estos grupos indígenas y la transformación que sufren sus comunidades al vincularse con los recursos citadinos. Posteriormente se hace un breve recuento de los elementos que han caracterizado el encuentro entre indígenas y académicos que intentan aproximárseles para su estudio. Se evidencia el frecuente fracaso para un establecimiento de relaciones interétnicas propicias y equitativas entre ambos sectores, lo que ha resultado en perjuicio de esos grupos étnicos. Finalmente se discute la necesidad y la naturaleza de los abordajes alternativos hacia las minorías culturales, tanto para la prestación de servicios que requieren como cuando son tema de estudio o de conocimiento para los investigadores, reporteros, estudiantes o financiadores, etc., sobre todo si se pretende que las trayectorias interculturales que cursan tales minorías en los grandes centros urbanos de nuestra entidad, nutran y permitan, en igualdad de condiciones, la reelaboración de sus identidades, de su vida cultural social y el potenciamiento de sus condiciones de vida en general.

Assessment of personal exposure to ozone in asthmatic children residing in Mexico City / Evaluación de la exposición personal a ozono en niños asmáticos de la Ciudad de México

OBJECTIVE: A study was conducted to evaluate personal ozone exposure (O3p) among asthmatic children residing in Mexico City. MATERIAL AND METHODS: A total of 158 chil-dren were recruited from December 1998 to April 2000. On average, three O3p measurements were obtained per child using passive badges. Time-activity patterns were recorded in a diary. Daily ambient ozone measurements (O3a) were obtained from the fixed station, according to children’s residence. Levels of O3a and ozone, weighted by time spent in different micro-environments (O3w), were used as independent variables in order to model O3p concentrations using a mixed-effects model. RESULTS: Mean O3p was 7.8 ppb. The main variables in the model were: time spent indoors, distance between residence and fixed station, follow-up group, and two interaction terms (overall R²=0.50, p<0.05). CONCLUSIONS: The O3w concentrations can be used as a proxy for O3p, taking into account time-activity patterns and the place of residence of asthmatic Mexican children.

OBJETIVO: Realizamos este estudio para evaluar la exposición personal a ozono (O3p) en niños asmáticos de la Ciudad de México. MATERIAL Y MÉTODOS: Se incluyeron 158 niños entre diciembre de 1998 y abril de 2000. En promedio se obtuvieron tres mediciones por niño, utilizando filtros pasivos para medir O3p. Se caracterizaron los patrones de actividad y las concentraciones ambientales diarias de ozono (O3a) se obtuvieron de estaciones fijas cercanas a la residencia del niño. Los niveles promedio de O3a y las concentraciones ponderadas por el tiempo en diferentes microambientes (O3w) fueron usados como variables independientes para modelar las concentraciones de O3p, utilizando modelos de efectos mixtos. RESULTADOS: La media de O3p fue 7.8 ppb. Las principales variables en el modelo fueron: tiempo en exteriores, distancia, periodo de seguimiento y dos términos de interacción (R²=0.50, p<0.05). CONCLUSIONES: Las concentraciones de O3w pueden usarse como "proxi" de O3p, tomando en cuenta patrones de actividad y lugar de residencia.

Expectativas relacionadas con el alcohol en la predicción del abuso en el consumo en jóvenes

resumen está disponible en el texto completo

Abstract: In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas: a) Sociodemographic data, b) Questionnaire on Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.

El inicio del manejo del traumatismo en la Ciudad de México (1847-1914) / The beginnings of trauma management in Mexico City. 1847-1914

Describimos el inicio del manejo de las urgencias en la ciudad de México desde las afanadurías de las demarcaciones de policía donde se dejaba morir al paciente bajo un manejo mínimo (por considerársele al paciente objeto del crimen), hasta los procedimientos radicales como el traumatismo de abdomen propuesto desde 1874 y realizado en 1898. También describimos la variedad de técnicas y los principales padecimientos (con estadísticas de la época), de los problemas más relevantes del traumatismo ocurrido en nuestra capital desde 1847 a 1912, que se centraban en las lesiones abdominales, fracturas y heridas por arma cortante, hasta el cambio radical de la patología por las heridas de arma de fuego, y de una actitud más radical que daría surgimiento a los puestos de socorro de la Cruz Verde y a la atención en ferrocarril de los revolucionarios.

We describe how surgical trauma was managed in Mexico City from 1847 to 1912. Management included minimal interventions, generally ending with the patient's death. Other more radical procedures such as abdomen trauma proposed in 1874 and performed in 1898 are also described. A variety of techniques employed and type of trauma cases registered that yielded more radical attitudes that brought about the creation of public emergency rooms (the Cruz Verde) and military surgical rooms in railroad cars that oversaw the care of soldiers during the revolutionary period are discussed.

Serviços de saúde em grandes cidades latinoamericanas: o caso da cidade do México/DF / Health care services in large Latin American cities: the case of Mexico City

Este artigo apresenta a atual política de saúde e a experiência de gestão dos serviços de saúde da Cidade do México, por parte da Secretaria de Saúde do Governo do Distrito Federal. A herança deixada por governos anteriores foi a fragmentação dos serviços de saúde prestados por diferentes instituições, num país onde ainda não foi possível construir um Sistema Único de Saúde e onde a divisão entre os segurados e os não-segurados da Previdência (Seguridade) Social Mexicana traz desigualdades no acesso aos serviços. As condições de saúde determinadas pela segregação da pobreza em territórios definidos fazem com que as estratégias do Governo do DF sejam territorializadas, com adoção de programas sociais integrados, nos quais a saúde ocupa lugar de destaque. Destaca-se o esforço da Secretaria de Saúde em reorganizar e fortalecer os serviços de saúde, optando corajosamente pela gratuidade dos mesmos de modo inédito no país.

This article discusses the current health policy and experience with health services management in Mexico City under the Health Secretariat of the Federal District. The legacy of previous administrations is one of fragmentation of health services provided by different institutions, in a country stin lacking a Unified Health System and where the division between those covered and not covered by the Social Security System leads to unequal access to services. Since health conditions are determined by the segregation of poverty in defined territories, the strategies adopted by the government of the Federal District are territorialized, adopting integrated Social Programs in which Health occupies an outstanding position. The article highlights efforts by the Health Secretariat to reorganize and bolster health services, taking a daring stance in the choice to offer free services, a unique approach in the country.

Estudio de un brote de intoxicacion alimentaria / Study of an outbreak of food poisoning

Se estudia un brote epidemico por probable intoxicacion por alimentos en 41 personas, pertenecientes a la Escuela Secundaria Tecnica No. 21 de Mexico, D.F. Al analizar los datos se encontro correlacion estadistica entre la ingestion de un pastel de nuez con crema chantilly y enfermedad, por incidencia en expuestos de 0.70, en no expuestos de 0.50 y riesgos relativos de 1.4 y desigualdad relativa de 2.37. En los demas alimentos consumidos las cifras no fueron estadisticamente significativas. El Laboratorio Central de la S.S.A. no encontro contaminacion de los alimentos analizados, ni por compuestos organicos fosforados ni por metales pesados. Se aislo estafilococo dorado en los cultivos de los restos de alimentos (crema chantilly) y en los corpocultivos. En sindrome diarreico con secrecion aumentada que presentaron los sujetos que enfermaron constituyo un modelo natural que permitio la valoracion de la lidamidina, un medicamento antisecretorio intestinal. Existe la posibilidad de que el alimento causante haya sido el pastel de nuez con crema chantilly. Esta sebasa la correlacion estadistica y en los hallazgos de laboratorio