Local research ethics committees of the Mexican Institute of Social Security: results of a national survey.

OBJECTIVE: To identify the structure, composition and work of the local research ethics committees (LRECs) of the Mexican Institute of Social Security (IMSS) in Mexico. DESIGN: A descriptive cross-sectional study was performed that included all LRECs of the IMSS. METHODS: A total of 335 questionnaires coded in advance were posted to each LREC secretary. The requested information was from January to December 2001. RESULTS: The response rate was 100%. Two hundred and thirty-eight (71%) LRECs were reported as 'active' during the evaluation period. Although almost all LRECs were composed of diverse professionals, physicians dominated the LRECs' membership. The rejection rate for research projects was lower than 1 per 1000, and less than half of the LRECs held meetings to issue a report of projects' evaluation. CONCLUSIONS: LRECs need to foster good ethical research; implementation of an audit system to examine their work might help improve LRECs' performance and accountability.

[Sustained feeding in acute diarrhea in children below 5 years of age]. / Alimentación sostenida durante diarrea aguda en niños menores de cinco años.

OBJECTIVE: To identify locally available and culturally acceptable foods for children with acute diarrhea, and test their acceptance and effect on the child's weight. MATERIAL AND METHODS: 142 mothers of children younger than five years of age living in rural communities were interviewed to indentify culturally accepted diets by means of group sorting. These were displayed in a multidimensional scale. A descriptive study was performed of the clinical course of 54 children, ages 4 to 50 months who received the designed diets during the first 48 hours of diarrhea. RESULTS: The designed diets considered age of the child, and stage of the disease. Children spent 47.6 +/- 22.2 h in the hospital during which they consumed 44.8 +/- 28.6 kcal/kg/day (additional to breast milk) and they gained 70.6 +/- 179.7 g. A direct relationship was observed between increasing age and larger caloric intake, and between this and greater weight gain. CONCLUSION: Children showed good acceptance of diets. Caloric intake was enough to prevent weight loss.

[Family and individual consumption of table salt in the State of Mexico]. / Consumo familiar e individual de sal de mesa en el Estado de México.

The present study was carried out within the framework of the State Program for the Fluoridation of Table Salt in the State of Mexico. An estimate of the daily consumption of salt was carried out by home interviews in four communities within the state. Such communities covered a wide range of urban-rural population and socio-economic status, as well as several concentrations of fluoride in drinking water and sources of distribution of salt. Results showed that the daily consumption of salt for children 1-3 years old had a mean of 1.9 g/day, while children 4-6 years old consumed a mean of 3.4 g/day. Adult males (23-50 years old) consumed a mean of 6.9 g/day and adult females (23-50 years old) consumed 5.4 g/day. Although these estimates may overestimate the real intake of table salt, based on these data the additional intake of fluoride would be of 0.5, 0.8, 1.7 y 1.3 ppm/day for each of these groups.

[Experiences in community participation to promote nutritional education]. / Experiencias en participación comunitaria para promover la educación en nutrición.

This paper presents several experiences obtained in the Rural Research Center of the Solís Valley in relation to community participation programs. The main objective of these projects was to improve the nutritional practices of children in the rural areas of highland Mexico. As first experience, small groups were formed with mothers, fathers, married couples and teenagers. Each of these groups started a project oriented to promote nutritional self-sufficiency. One group of mothers was successful in assuring the provision of government subsidized milk in their community. A second group of mothers started a chicken-raising farm, but the project failed because all the chicken died in an epidemic. The group of fathers started a sheep-raising project as the first step to get a milk-producing cow. The sheep-raising was successful, but when the sheep were sold each man in the group kept the revenue to himself and the group disappeared. The married couples were successful both in a home-gardening project and in a chicken-raising farm. The teenagers were also successful with their home-gardening project and acted as "injection groups" to spread the project in other communities. As a second experience in community participation, community health workers taught mothers how to use locally available food to improve their diets, preparing culturally acceptable food recipes. This intervention was successful in increasing mother's awareness of a balanced diet. A second intervention combined the presentation of a drama ("peasant's theater") in order to increase mother's participation in these projects.(ABSTRACT TRUNCATED AT 250 WORDS)

[An evaluation of a symposium via satellite on alcoholism and drug dependence]. / Evaluación de un simposio vía satélite sobre alcoholismo y farmacodependencia.

Results of a test given to participants in a symposium on alcoholism and drug abuse are presented. The symposium was broadcast via satellite simultaneously to five cities in Mexico, and included 8 pretaped panels covering topics on alcoholism and drug abuse. The methodology used for broadcasting the symposium allowed the interactive exchange of information between expert lecturers and participants. The quantitative and qualitative evaluation used the pretest-posttest design. Most of the participants were physicians (28.9%) followed by psychologists (25.7%) and social workers (18.1%). The global cognitive change among participants was 6 per cent. Almost 77 per cent of participants had scores between 51 and 70 points (over a possible maximum score of 100) in the pre-evaluation test, and 76.4 per cent had scores between 61 and 80 points in the postevaluation test. Health professionals with 1-3 years of experience had the largest change in scores (9%), followed by those with 3 to 5 years experience (8%). Professionals with 5 to 10 years of experience had a change of 5 per cent. Physicians showed the greatest cognitive change (7%) followed by psychologists and social workers with 5 per cent change. In the qualitative evaluation, 87.6 per cent of participants thought that the educational method used was "Excellent" of "Good". With respect to the satellite transmission, 79.4 per cent of participants thought it was "Excellent" or "Good". It is concluded that this type of educational events are useful in reaching health professionals who otherwise would not have access to specialized and updated information.(ABSTRACT TRUNCATED AT 250 WORDS)

[Efficacy of a rice-based beverage for the management of dehydration caused by acute diarrhea in children]. / Eficacia de una bebida a base de arroz en el manejo de la deshidratación por diarrea aguda en niños.

We tested the clinical efficacy of a rice-powder gruel (RPG) as an oral rehydration solution in a randomized clinical trial, comparing it with oral rehydration salts (ORS) prepared as recommended by WHO. RPG was prepared as mothers do it in a rural area, according to previous ethnographic work. RPG has sugar but no sodium or other electrolytes. Seventy patients under 5 years old with mild to moderate dehydration due to acute diarrhea were included in the trial. Ninety-two percent of children were successfully rehydrated with RPG and 91% of children were successfully rehydrated with ORS. Patients in the study group required less time to rehydrate and presented a reduction in fecal output as compared with the control group. We propose that the rice-powder gruel should find its place as a first line of treatment at the home level, when oral rehydration salts are not available, to prevent dehydration in the child affected with acute diarrhea, and that its use should be closely linked to no suspension or rapid reintroduction of oral feeding to provide an external source of sodium and other nutrients.

[The use of beverages and food at home during acute infantile diarrhea: an ethnographic study in a rural Mexican area]. / Uso de bebidas y alimentos en el hogar durante la diarrea aguda del niño: estudio etnográfico en una zona rural mexicana.

A structured interview was applied through a personal interview to 142 peasant mothers aimed at exploring some beliefs about childhood diarrheal disease and the use of home-made beverages and feeding habits during the illness. The majority answered they used to give a herbal tea (90%) or a rice-based beverage (77%) to their child with diarrhea. Only 18% mentioned the use of oral rehydration packages. Sixty-three percent avoid certain foods while 25% withhold all food, usually for more than 24 hours, to a sick child. It is justified to assess the clinical efficacy of a rice-powder solution in the prevention of severe dehydration, as well as to promote an uninterrupted diet based on locally accepted and available foods, in the home management of a child with acute diarrhea.

[Variations in the individual consumption of table salt with or without chili in food, in a community of México]. / Variaciones en el consumo individual de sal en presencia o ausencia de chile en la comida, en una comunidad de México.

The present study was carried out in a rural community in the central plateau of Mexico, with the objective of estimating the mean daily consumption of table salt at the family and individual level, and to determine if the individual taste to salt added to the food at the table, varied with the presence or absence of a hot species, "chile", to the food. Our results showed variability in three "barrios" of the community, which go from the central, more urban-type (Temascalcingo) to an intermediate-type (Boquí), and to a more rural-type (Bonshó), showing the highest mean consumption of salt at the family level in the most urban barrio (47.2 g/day), while the mean family consumption in the other two barrios (28.2 and 33.9 g/day, respectively) was lower. At the individual level, there were differences in salt consumption associated to sex and age. The highest consumptions were found in the more urban-type barrio, in which men in the 15-22 year-old group consumed a mean of 9 g/day, and women in the 7-14 year-old group consumed a mean of 6.37 g/day. When the individual taste for salt added to foods commonly prepared in the community were studied, we found a statisticaly significant difference in individual taste associated with the presence or absence of chile in the food. In two of the study meals (breakfast and lunch) the total grams of salt added to the food which did not contain chile was significantly higher than the salt added to the food which contained chile, suggesting that the presence of the specie may account for a great part of the need to enhance food flavor. This in turn could explain the smaller consumption of table salt in the more rural-type section of the population noted in the first part of the study, in which families tend to add more chile to their food than in the urban-type settings.