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.

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.

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.

Adaptación cultural de instrumentos de medida sobre estigma y enfermedad mental en la Ciudad de México / Cultural adaptation of instruments to measure stigma and mental illness in Mexico City

This article forms part of a collaborative study in which research teams from Canada and Mexico participated. The general objective is to describe the cultural adaptation and semantic validation of three instruments for measuring stigma and mental illness in Mexico City. The criteria of understanding, acceptance, relevance and semantic integrity were used to adapt the following instruments: The Internalized Stigma Inventory (ISMI), the Opinions on Mental Illness Survey (OMI) and the Devaluation and Discrimination Scale (DDS). Four Individual interviews and four group interviews were carried out with 37 informants from different groups (health personnel, persons with diagnostic of mental disorders, relatives and the general population). Lastly, an analysis was carried out on the contents of the information obtained. The instruments proved to be culturally appropriate for the population in Mexico in the various groups studied. The adapted versions would be useful for establishing comparative analyses with other countries. The scope and limitations of the process of semantic equivalence were analyzed in the transcultural research.

Este trabajo forma parte de un estudio colaborativo en el que participan equipos de investigación en Canadá y México. El objetivo general consiste en describir el proceso de adaptación cultural y validación semántica de tres instrumentos de medición sobre el estigma y la enfermedad mental en la Ciudad de México. A partir de los criterios de comprensión, aceptación, relevancia e integridad semántica se adaptaron los siguientes instrumentos: el Inventario de Estigma Internalizado (ISMI), el Cuestionario de Opiniones hacia la Enfermedad Mental (OMI) y la Escala de Percepción de la Devaluación y Discriminación hacia la Enfermedad Mental (DDS). Para ello se llevaron a cabo cuatro entrevistas individuales y cuatro grupales con 37 informantes de diversos sectores (personal de salud, personas con diagnóstico de trastorno mental grave, familiares y población general). Finalmente se efectuó un análisis de contenido de la información obtenida. Los instrumentos adaptados fueron culturalmente apropiados para la población de los diferentes grupos estudiados en México. Las versiones adaptadas serán de utilidad para establecer análisis comparativos con otras regiones. Se analizan los alcances y limitaciones del proceso de equivalencia semántica en la investigación transcultural.

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.

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.

Conductas alimentarias de riesgo e imagen corporal de acuerdo al índice de masa corporal en una muestra de mujeres adultas de la ciudad de México

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Abstract: Studies conducted in adolescent and young women have showed that body image perception and dissatisfaction are highly related with risk eating behaviors, particularly with compensatory behaviors. It has also been found that these women tend to overestimate their body size, showing more dissatisfaction. Many studies on eating disorders have been developed in adolescents, but, what happens with adult women? Adult women show periods of pregnancy, nursing, menstrual disorders and, a decrease in physical activity and, at the psychological level there is a lack of emotional stability and depression. These episodes in general, have influence in feeding and body image, that could lead to risky eating behaviors (restricted dieting, fasting, skipping meals among others) affecting directly the state of health, because latter they can develop into eating disorders. Undoubtedly, inadequate feeding can cause malnutrition and nutrimental deficiencies, provoking physiological alterations such as osteoporosis, anemia or hypokaliemia, and also, somatic complications during pregnancy, including abortions and low weight in the new born. Objective. To determine the relationship between body mass index (BMI), risky eating behaviours, body perception and body dissatisfaction in Mexican adult women from 25 to 45 years of age in Mexico City. Methods. A non probabilistic sample of 659 women from 25 to 45 years of age (X=38.27; SD=4.4) was used. To collect the sample, an area of the Questionnaire for Health and Feeding called scale of risk factors associated to eating disorders (EFRATA) and body image was used. This is a self-report questionnaire, validated for this population. Its main purpose is to measure risk eating behaviors and body image. Questions refer to risky eating behaviors (binge eating, compensatory behaviors, restricted dieting, preoccupation about weight and figure), with 4 answering options: 1) Never, 2) Sometimes, 3) Frequently, and 4) Always. Body Image was measured through two dimensions: (a) Body perception was measured through five specific items and (b) Body dissatisfaction was measured with a nine body figure scale, from thin to obese. The BMI was obtained from weight and height self-report (BMI=kg/m2). Self report measures of weight and height have been found reliable; as there is a high correlation with data taken directly, the difference between them is 1.14 kg/m2, which does not interfere significantly. The cut points recommended by the Expert Committee (OMS), are: low weight from 15 to 18.5; normal weight from 18.51 to 24.99; overweight from 25 to 29.99; obesity from 30 to 39.99 and morbid obesity higher than 40. Results. Body Mass Index distribution of the sample was: 1.1% low weight, 53.6% normal weight, 32.3% overweight, 12.4% obesity, and 0.6% of women were morbidly obese. Body perception distribution was: 0.9% very thin, 15.3% thin, 44.4% normal, 32.6% overweight and 6.8% obese. Results related to body dissatisfaction, showed that more than % of the sample was dissatisfied; 70.1% of the women were dissatisfied with their body image and wanted to be thinner and, 8.7% wanted to gain weight. It was found that a large percentage of women (79%) are dissatisfied with their body image. From this percentage 70.1 wanted to be thinner and, 8.7% wanted to gain weight. As to the relationship between BMI distribution and body dissatisfaction it was found that 14% of underweight and 54.2% normal weight women want to be even thinner. The findings of the study showed that women with higher BMI, displayed more risky eating behaviors. Women with overweight and obesity displayed the higher percentages in binge eating. A Pearson correlation was carried out to look for significant differences between BMI, risky eating behaviors and the two dimensions of body image (perception and dissatisfaction). Results indicated that BMI was significantly correlated with binge eating, body dissatisfaction and body image perception. Discussion. This study supported important information about the relation between BMI and risky eating behaviors in Mexican adult women. The most important result was to confirm the presence of disordered eating typical of eating disorders among adult women. Even though the data obtained do not demonstrate the diagnosis of an ED, it shows the presence of some of the characteristic symptoms, which means that these are commonles found among the general population. Although isolated symptoms are not a necessary indicator of the development of the disease, in a way they point out the individuals who are at risk of threatening their physical and mental health. On the other hand, one of the risks that adds to this particular population is the fact that all of them are mothers, as some research findings have confirmed the relationship between the mother's eating behaviors and the appearance of eating disorders in their children. The results obtained in this research show that the BMI of the sample tends to be in the overweight (32.3%) and obese ranges (13%). These results agree with those of the National Nutrition Survey of 1999, were 52.5% of the women were classified as overweight or obese (30.8% as overweight and 21.7% as obese). These scores are important not just because they favor chronic-degenerative diseases, but also because of the great association between overweight and obesity with risky eating behaviors, something that could be confirmed in this study, as individuals with higher BMI, displayed more risky eating behaviors. The results of this study have consistently supported the positive relationship between BMI, binge eating, body dissatisfaction and body image perception, although group differences attributed to age were not statistically significant. Finally, another important contribution of this study, is the use of a reliable and valid multidimentional questionnaire developed in Mexico, specifically designed for the study of two very complex issues such as risky eating behaviors and body image. The main limitations of the study were that the findings were primarily based on self-report data and the use of a non-probabilistic sample of Mexican adult women.

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

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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.

El agua y el suelo en la zona metropolitana del valle de Mexico / x

La ciudad de México representa uno de los ejemplos más dramáticos de la lucha del hombre por dominar a la naturaleza al grado de transformarla de manera profunda, sin tener claridad sobre los efectos de estas transformaciones. Al inicio del siglo 21 ha concentrado una población del orden de 19 millones de habitantes y se han urbanizado casi 2 mil kilómetros cuadrados. Los patrones de asentamiento dentro del Valle de México han generado impactos negativos que en la actualidad ponen en riesgo el futuro de la metrópoli.

Programa mexicano de "registro y vigilancia epidemiologica de malformaciones congenitas" / Mexican program of \"Registry and monitoring of external birth defects\"

En este trabajo se presentan la metodologia y los datos de prevalencia del programa mexicano de "Registro y Vigilancia Epidemiológica de Malformaciones Congénitas Externas". Este programa constituye un estudio multicéntrico de casos y controles basado en el examen clínico de todos los nacimientos vivos y muertos para la detección de malformaciones congénitas y obtención de información sobre productos malformados y sus respectivos controles, en el que participan 25 hospitales de la ciudad de México y de varios estados del paú. Los resultados iniciales del programa muestran que en Méxica, aproximadamente uno de cada 50 recién nacidos vivos y uno de cada nueve nacidos muertos presenta una o más malformaciones mayores ylo menores, lo que las convierte en un serio problema de atención médica perinatal y de la infancia.

La morbimortalidad debido a los sismos de septiembre de 1985 en la ciudad de México / Morbili-mortality due to the september 1985 earthquokes in Mexico City

La descripción epidemiológica de los daños a la salud sufridos por los habitantes de la ciudad de México, como consecuencia de los sismos de septiembre de 1985, fue realizada a partir de información periodística y de un banco de datos destinado a la localización de personas. Se estimó que las tasas de mortalidad y morbilidad a nivel nacional, de 17.21 y 51.6 por 100,000 habitantes, respectivamente, fueron mucho menores que las estimadas para otras naciones en sismos de magnitudes similares. Las tasas de morbilidad y los porcentajes de atención médica otorgada en las diversas delegaciones políticas del Distrito Federal, mostraron variacion es que se relacionaron con la situación geográfica de las mismas y la distribución de los servicios médicos existentes. A las tres semanas del primer sismo aun se desconocía el paradero de poco más del 24% de las personas investigadas durante un seguimiento telefónico de una muestra de los contactos de las personas desaparecidas, mientras que 28.3% fueron reportandas como fallecidas. Se sugiere que los países en riesgo de sufrir los efectos de diversos desastres de origen natural, establezcan sistemas de comunicación centralizados para facilitar la distribución de los recursos, la localización de personas, el otorgamiento de los servicios médicos de emergencia y la organización de las actividades civiles

Enfermedad diarréica después de los sismos de 1985 en México / Diarrheal diseases after the earthquakes of 1985 in México

En este artículo se presentan los resultados de un estudio sobre la incidencia y prevalencia de diarreas en la ciudad de México después de los sismos del 19 y 20 de septiembre de 1985. Este estudio se llevó a cabo en dos fases, en áreas de estratos socioeconómicos bajo y medio, con y sin alteraciones del suministro de agua entubada. Los probables factores de riesgo en el estrato socioeconómico bajo se determinaron a través de un estudio de casos y controles. La carencia de agua entubada representó un factor de riesgo para la presencia de diarreas, y se observó que este factor fue mayor y más persistente en el área socioeconómica baja, en donde se encontraron casos agudos y crónicos asociados con falta de agua para aseo, y casos crónicos asociados con ingesta de agua envasada en bolsas de plástico y no hervida. Algunos comportamientos y hábitos en la población, como hervir el agua y consumir agua "comercial", tuvieron efectos protectores

Prevalencia del síndrome de estrés postraumatico en la población sobreviviente de un desastre natural / Prevalence of the postraumatic stress syndrome among the survivals of a natural disaster

En este artículo se presentan los resultados de un estudio sobre la prevalencia del Síndrome de Estrés Postraumático en la población sobreviviente a los sismos de septiembre de 1985 en México. Este estudio se llevó a cabo durante los meses de octubre y noviembre de 1985 en una muestra de 532 indivíduos seleccionados de la población de 114 albergues públicos. La información de obtuvo mediante una entrevista basada en la Entrevista de Diagnóstico Psiquiátrico elaborada por Spitzer y en el Cuestionario de Entrevista Diagnóstica del Instituto Nacional de Salud Mental de EUA. El Síndrome de Estrés Postraumático se encontró en 32% de la plobación estudiada