Relaciones Intrafamiliares y Riesgo de Suicidio de Estudiantes Mexicanos de Bachillerato / Intra-Family Relationships and Suicide Risk in Mexican Highschool Students

Resumen La cantidad de muertes por suicidio en México aumenta en promedio 2.35% cada año y se concentra en los grupos de edad de 15 a 24 años. Aunque se sabe que múltiples factores familiares intervienen en el comportamiento suicida de los adolescentes, las formas de evaluarlos han sido heterogéneos. El objetivo fue identificar la relación entre las relaciones intrafamiliares y el riesgo de suicidio en estudiantes de un bachillerato de Aguascalientes. Se implementó un diseño correlacional con muestra tipo censo mediante el uso de las escalas de Plutchik de riesgo suicida y Relaciones Intrafamiliares, cuyas subescalas evalúan unión y apoyo, expresión y dificultades. La información se analizó mediante estadísticas descriptivas, de correlación y regresión lineal. De los 946 participantes se encontró riesgo suicida en casi 20%, predominando las mujeres. Se encontró una relación significativa entre el riesgo suicida y las tres subescalas de relaciones intrafamiliares, aunque sólo Expresión y Dificultades mantuvieron esa correlación en el modelo de regresión lineal. Se concluye que la dinámica familiar en que se desarrollan los jóvenes influye en el riesgo suicida, aunque no constituya causa suficiente. Se sugiere considerar variables psicosociales y usar instrumentos adaptados a cada población en el estudio del suicidio adolescente.

Abstract The number of deaths by suicide in Mexico increases an average of 2.35% each year, concentrating mainly on the age groups of 15 to 24 years. Although multiple family factors are known to play a role in adolescent suicidal behavior, the ways in which they are assessed have been heterogeneous. The objective was to identify the relationship between the components of intrafamily relationships and the risk of suicide in high school students in Aguascalientes. A correlational investigation was implemented, with a census-type sample design using scales: Plutchik's suicide risk and Intrafamily Relationships conformed bay expression, union and difficulties subscales. The information was analyzed with the SPSS program using descriptive statistics, correlation and linear regression. Of the 946 participants, suicidal risk was found in almost 20%, predominantly women. A moderate but significant relationship was found between suicide risk and the three subscales of intrafamily relationships, although only two of them, Expression and Difficulties, maintained this correlation when incorporated together with the other variables to a linear regression model. It is concluded that the family dynamics in which young people develop influences suicide risk. It´s suggest to consider psychosocial variables and adapted scales in the adolescent suicide studies.

Efectos sobre factores ocupacionales y en el medio ambiente originados por el proceso de descarne a partir del curtido / Effects on occupational factors and environment as a result from rawhide process of the tanning

La ciudad de León cuenta con 500 empresas de curtiduría y 9 dedicadas al procesamiento del sebo cuyos subproductos (descarne) son desechos que se vierten al medio ambiente en grandes cantidades, ya que no representan un interés para su procesamiento y comercialización, lo que ha causado diversos problemas de contaminación en las zonas habitacionales circundantes por el vertido de aguas residuales, residuos sólidos y emisiones atmosféricas. El impacto al medio se puede considerar como adverso, directo y temporal; reversible, pero con un alto costo económico, lo que implica la necesidad de establecer medidas preventivas de control y mitigación. En el presente estudio se describen las etapas delproceso, las buenas y malas prácticas, los procedimientos estándares de operación y los impactos al medio ambiente originados por el inadecuado manejo de los residuos de las industrias sebaderas. Los resultados muestran que el 80 por ciento de las empresas procesadoras carece de sistemas de almacenamiento adecuado y no poseen sistemas de control ambiental. De igual manera, la mayoría de los operarios no cuenta con equipos de protección personal y no existe un adecuado manejo de sustancias utilizadas en los procesos, lo que incrementa el riesgo de accidentes laborales.

The city of León has 500 tannery companies and nine work in fat processing, whose by-product waste (rawhide) is dumped to the environment in tons because there is no interest in processing and commercializing this substance. This situation has caused several contamination problems in surrounding residential areas because ofthe discharge of wastewater, solid waste, and atmospheric emissions. Impact on environment can be considered as adverse, direct and temporal, as well reversible, but excessively expensive, which involvesthe need of established preventive measures of control and mitigation.The present study describes the different stages of the process, goodand bad practices, standard operational procedures, and environmentalimpacts due to the inadequate handling of waste by these companies. Results show that 80 percent of the processing companies lack appropriate storage systems and do not have an environmental control system. Additionally, most of the operators do not have personal protective equipment and there is not a proper handling of the substances used in processes; this increases the risk of work-related accidents.

El autoconcepto de mujeres sometidas a histerectomía / The women's selfconcept submitted to hysterectomy

Objetivo: el propósito del presente estudio fue comparar los puntajes del autoconcepto obtenidos por un grupo de mujeres antes y un año después de que fueron sometidas a histerectomía. Material y métodos: estudio prospectivo en el que participaron 44 mujeres de 30 a 60 años. Ninguna tenía antecedentes de trastornos psiquiátricos o de uso de fármacos antipsicóticos y/o antidepresivos. El autoconcepto de las mujeres se evaluó con la escala de Tennesse, que incluye una evaluación global y nueve sub-escalas específicas, y que ha sido previamente validado en población mexicana. Para analizar la información se elaboró un programa de computadora y los datos se analizaron con la prueba T para muestras dependientes. Resultados: la edad y escolaridad promedio y desviación estandar (X ± DE) de las participantes fue de 44,5 ± 6,9 y 5,8 ± 3,6 años respectivamente; 39 mujeres de las 44 completaron su evaluación un año después. La calificación global del autoconcepto disminuyó significativamente un año después de que se les practicó la histerectomía (642,3 ± 73,7 vs. 592,1 ± 34; p< 0,001). Ocho de las nueve subescalas también disminuyeron significativamente (p< 0,01). Conclusión: el autoconcepto y ocho sub-escalas de éste disminuyeron significativamente en este grupo de mujeres sometidas a histerectomía. El efecto que pudieran tener la ansiedad que produce la cirugía y el duelo provocado por la esterilidad se evitaron en este estudio al evaluar a las mujeres un año después del procedimiento. El efecto psicosocial de este tipo de cirugías debe considerarse en la preparación de las pacientes y de sus parejas.

Objective: the aim of this study was to compare the self-concept scores before and one year after hysterectomy, of a group of Mexican women. Methods: trought a prospective study, 44 female subjects from 30 to 60 years were evaluated using the Tennesse self-concept scale. Subjects were included if they did not have psychiatric diseases neither use antipsychotic / antidepressive drugs. A software was designed to analyze the information, and the scores of total and the nine individual profiles of self-concept were compared pre and post hysterectomy, using a dependent Student's T test. Results: the mean age and the schooling level of the volunteers were: 44.5 ± 6.9 years and 5.8 ± 3.6 (mean ± SD), respectively. From the 44 women evaluated in the pre-test, 39 complete the evaluation after one year of following. The mean values of the global self-concept scale decreased significantly (p< 0.001) from the beginning (642.3 ± 73.7) to one year after the hysterectomy (592.1 ± 34). The mean values of 8 from the 9 profiles, also decreased significantly (p< 0.01). Conclusion: hysterectomy decreases eight of the nine profiles of the self-concept of the women evaluated. The evaluation of the subjects self-concept one year after the hysterectomy, avoid the influence of grief by sterility or anxiety by the surgery itself. The decreases in the self-concept of a women submitted to hysterectomy should be considered in the clinical practice to prevent psychological effects.

Frecuencia de asma en preescolares con historia de maltrato y su relación con el tipo de maltrato experimentado / Frequency of asthma in preschool children with history of mistreatment and its relation with the type of mistreatment experienced

Introducción. La relación entre asma y maltrato infantil no está del todo clara. Objetivo: reconocer la presencia de asma en grupos de niños que padecieron formas diferentes de maltrato infantil. Métodos. Estudio de tipo retrospectivo que se basó en la revisión de expedientes de menores albergados en una casa cuna del estado de Guanajuato. Se utilizó la chi cuadrada y razón de momios para determinar la fuerza de la relación entre ambas variables y el aumento del riesgo de desarrollar asma después de haber padecido alguno de los tipos de maltrato. Resultados. Quienes experimentaron abandono ingresaron a más temprana edad al albergue (en su mayoría del género femenino), que posteriormente tuvieron mayor riesgo de ser diagnosticados con asma que los menores que padecieron otras formas de maltrato (razón de momios de 2.092 contra 0.549, respectivamente). Conclusiones. Los niños que fueron víctima de abandono tuvieron mayor probabilidad de desarrollar asma a diferencia de los que padecieron otros tipos de maltrato.

Introduction. The relation between asthma and child mistreatment is not absolutely clear. The objective was recognizing asthma in preschool children that suffered diverse forms of mistreatment. Methods. Retrospective study based on medical files revision of children sheltered in a foster house in Guanajuato. Chi square and odds ratio were used to assess the force of the association between both variables and the increase in the risk of developing asthma after suffering some type of mistreatment. Results. Those who experience abandonment were the youngest at his entrance to the foster house (mainly of the feminine gender), that later had a high risk being diagnosed with asthma compared with children who suffered other types of mistreatment (odds ratio 2.092 vs 0.549, respectively). Conclusions. Children that were victims of abandonment had a higher probability to develop asthma than other type of mistreatment victims.

Maltrato y suicidio infantil en el Estado de Guanajuato

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SUMMARY The understanding of child suicide has achieved more and more specific notions since it started to be studied from the theory of adult suicide. Now, the implication of certain factors such as the evolution of death conceptualization, the desire of joining an absent significant person, the premeditation of the suicidal act, the involvement of family environment as a contributing or protective factor, or a previous mistreatment experience, has become clearly recognized. Suicides which occur during the childhood period have been associated to previous sexual-nature abuse experiences. In adult suicides, the presence of some kind of mistreatment during their childhood period has also been found. Both phenomena, mistreatment and child suicide, are usually under-registered because of the variability of their defining approaches or because of some cultural influences such as violence occurring naturally or negation of child suicide or premeditation. It is postulated that the mechanics of child mistreatment traps the abuser into a dynamics based on the inequality of physical, intellectual and/or moral conditions; this reality plus the defenseless nature of children, impedes the termination of that situation unless it finishes by means of another violent act such, as a suicide. Furthermore, the consequences suffered by a child victim of mistreatment can become contributing factors for a suicidal behavior consummation. Consequently, dysfunctions or disturbances on cognitive, psychological, identity, belonging or hopelessness state of the victim, as well as the emotional pain caused by the mistreatment may favor a suicide behavior. Therefore, the purpose of this study is to determine the presence of any given type of child mistreatment in children (since eight to 14 years old) that incurred in a suicide in the State of Guanajuato between 1995 and 2001. The methodology used for this descriptive, observational, retrospective and transversal study, was ex-post-facto (after the event), since the technique for data gathering was carried out by psychological autopsy. This technique facilitates an access into the families and to the understanding of their dynamics, and also to recognizing the circumstances prior to the decease. This technique included one or several interviews with people close to deceased child, besides a detailed analysis of the suicidal event and of all the deceased child's residual belongings (suicide notes in this case). This study searched some direct and indirect indicators of a possible child mistreatment suffered by suicidal children. The psychological autopsy was conformed by a Questionnaire of Psychosocial data, a Suicidal Act Evaluation Questionnaire and by an Informant's Reliability Scale. Because of the lack of specific backgrounds for the cases of child suicide, the Psychological Questionnaire was specifically developed for this study. Studied cases were those belonging to child suicides, up to 14-year-old children, who consummated their death in the State of Guanajuato in the 1995 to 2001 period. The files were obtained by the General Attorney Department. With the information extracted from such files, we proceeded to establish phone and mail contact with relatives of the deceased children. Later on, some interviews were carried out with one or more people close to each child; these interviews were held by psychologists qualified in Psychological Autopsy and Emotional Contention Techniques. The examined data came basically from the Psycho-Social Questionnaire and from the Content Analysis of suicide notes. The analysis method for first data, of quantitative nature, was by frequency distribution and correlation, computed by SPSS statistical software. Qualitative data resulting from the analysis of suicide notes content were verified by a technical jury integrated by three participating clinical psychologists. Results: Twenty nine suicide cases were analyzed, representing 69% of child suicides up to 14-year-old children in the State of Guanajuato within the aforementioned period. The rest of the files were not included in this research because the impossibility for locating the victim's relatives due to changes of residence, and in a lower percentage because they refused to participate in the study due to the emotional pain of talking about the suicide event, or because they ignored the minor child's data regarding the circumstances and causes of his death. Of all the examined cases, 19 (65.5%) were men and 10 (34.5%) were women. The range of child suicides' age was from eight to 14 years old, with a 12.55 year-old average and a 1.62 year-old standard deviation. Five suicide notes were analyzed, which belonged to 4 children: 3 girls (one of them left two notes) and one boy. With respect to 72.4% of the cases, the interviewed persons were first-degree relatives and regarding the remaining percentage, they were cousins, uncles or grandparents who reported having had a close relationship with the deceased child. The average age of the interviewees was 43 years, with a standard deviation age of 17.19 years. In almost half of the suicides (51.7%) some kind of violence was suffered. According to the interviewees' statements, 31% of the children who committed suicide had suffered some kind of psychological mistreatment, 41.1% of them had received some of kind of physical mistreatment, 3.4% were victims of sexual abuse and 10.34% were neglected. Almost a quarter of all the children had suffered two or three kinds of mistreatment. Additionally, 41.4% of suicidal children had seen physical violence at home. Four of the suicide notes included explicit declarations of mistreatment experiences. Other variables that were found were the presence of previous suicide attempts in 20.7% of the cases; and a 26.3% of cases where a relative also had a previous suicide attempt. Family alcohol consumption was detected in 65.5% and drug consumption in 24% of the cases. Further analysis show a correlation between child previous suicide attempts and psychological mistreatment (p= 0.004) or any other kind of violence exposure (p= 0.015). It is concluded that an important percentage of children who incurred in a suicide were indeed victims of some kind of child mistreatment, of which physical one was particularly evident. However, neither physical nor sexual abuse can be separated from their implicit component: the emotional mistreatment. Studies of pure qualitative nature could contribute with more information about the dynamics that associates both phenomena. It is deemed that child mistreatment prevention would directly impact both suicide occurrence for the same group of age, and probably also within adult populations thus reducing its prevalence.