Concordancia del IMC y la percepción de la imagen corporal en adolescentes de una localidad suburbana de Yucatán / Concordance of the body mass index and the perception of body image in adolescents in Yucatán

Resumen Introducción Los problemas de la imagen corporal asociados con los riesgos de trastornos alimenticios entre los adolescentes, en particular, la anorexia nerviosa y la bulimia, son considerados temas de salud emergentes a nivel mundial. Las consecuencias que conllevan son físicas, psicológicas y sociales. Objetivo Determinar la concordancia entre el índice de masa corporal y la percepción de la imagen corporal en un grupo de adolescentes. Materiales y Métodos Estudio cuantitativo, observacional, transversal realizado en 84 alumnos, 54.1% hombres y 45.9%, mujeres, con edades entre 10 y 17 años, que cursaban educación básica y secundaria en una localidad suburbana de alta marginación, en Yucatán. Se auto-administró a los estudiantes, el pictograma de Stunkard, para registrar la percepción de la imagen corporal. Para calcular el índice de masa corporal (IMC) se registraron medidas antropométricas de peso y talla, usando una báscula digital marca Tanita, modelo TBC 310 y un estadímetro marca SECA de 2 metros de longitud. Los puntos de corte fueron los establecidos por la Organización Mundial de la Salud. Resultados Los hallazgos, respecto a la percepción de la imagen corporal, mostraron una concordancia insignificante (k= 0.067, p< 0.5); en mujeres es baja, con un valor de k= .223; se perciben normales aun cuando presentan bajo peso, mientras que, las que presentan obesidad, subestiman su estado. En cuanto a los hombres, en los casos de obesidad, la imagen y el IMC son coincidentes, aunque, al mismo tiempo, subestiman la percepción corporal en bajo peso.

Abstract Introduction Body image problems associated with the risk of eating disorders such as anorexia nervosa and bulimia, are considered emerging health issues among adolescents around the world. These problems have both physical, psychological and social consequences. Objective To determine the correlation between body mass index and the body image perception in a group of teenagers. Material and Methods A quantitative, observational, cross-sectional study was carried out in 84 students, 54.1% men and 45.9% women with an age range between 10 and 17 years who were attending primary or secondary school education in a suburban town of high marginalization in Yucatan. Self-applicable Stunkard pictogram was used to record the body image perceptions. To calculate the body mass index (BMI) anthropometric measurements of weight and height were recorded, using a Tanita brand digital scale, TBC model and a stadiometer SECA 310 2 meters length. The cut-off points were those established by the World Health Organization. Results The findings regarding the perception of body image showed no significant concordance (k = 0.067, p <0.5); for women was a low value of k = 0.223, they perceive themselves as normal despite their low weight, and those with obesity underestimate their status. In the group of men, in cases of obesity, image and BMI are coincident while a body perception underestimates low weight. Conclusion It is important to take into the nutritional diagnosis, contents of emotional aspects as self-esteem and feelings that manifest teenagers about their body image for comprehensive preventive care.

[Effect of a community-based intervention to improve the knowledge on the warning signs of maternal complications among Mayan women from Yucatan randomized controlled trial]. / Efecto de una intervención comunitaria para mejorar conocimientos sobre signos de alarma de complicaciones maternas en mujeres mayas de Yucatán, ensayo controlado, aleatorizado.

OBJECTIVE: To evaluate a community-based intervention aimed to improve women's knowledge on alarm signs for preeclampsia-eclampsia, obstetrical hemorrhage, and puerperal sepsis, in Mayan pregnant women in the state of Yucatan, Mexico, in 2008, using participatory methodology. MATERIAL AND METHODS: Community-based randomized controlled trial, with experimental (n = 28) and control (n = 28) groups. Participatory strategies with translators of Mayan language were used. Analysis of differences in differences was carried out to evaluate the effect of intervention. RESULTS: The intervention increased knowledge on alarm signs for preeclampsia-eclampsia in 42.9% (p = 0.012), obstetrical hemorrhage in 32.1% (p = 0.071) and puerperal sepsis in 25.0% (p = 0.659). Control group increased 32.1% (p = 0.033) knowledge on alarm signs for puerperal sepsis. Overall effect of intervention was 33.3% (p = 0.007). CONCLUSIONS: The community-based intervention improved overall knowledge of women on alarm signs and specific knowledge on alarm signs for preeclampsia-eclampsia. It is necessary to spread this methodology, so that a greater number of women of the community will also be benefitted with the intervention.

[Medical-social characteristics of maternal deaths in a Mayan community of Yucatan, Mexico]. / Características médico-sociales de las muertes maternas en una comunidad maya de Yucatán, México.

OBJECTIVE: To describe clinical and sociodemographic characteristics of maternal deaths occurred from 1997 to 2001, so as the access and availability of services of health, in the municipality of Chemax, Yucatan, Mexico. MATERIAL AND METHODS: Acts and certificates of death of women born in the municipality of Chemax were reviewed. The maternal deaths were classified in direct and indirect obstetrical deaths, according to criteria of the International Statistical Classification of Diseases and Related Health Problems (tenth revision). The knowledge of the women on risks in the pregnancy, childbirth and the postpartum period was explored indirectly in the relatives, as well as perceptions of these last ones on the death. The time passed between the search of aid and the attention was calculated. RESULTS: Nine cases of maternal deaths were registered during 1997-2001 period, two of which were findings of the study. The principal cause was the obstetric hemorrhage. The 9 women spoke Mayan an 5 understood in addition the Spanish. The women did not know the obstetrical risks. The perceptions of the relatives on the deaths were bound to myths, lack of information and medical attention. The minimum time of transfer for the attention of the childbirth was of 10 minutes and the maximum of 2 hours. For the attention of the complications, eigth women were transferred to a hospital outside their locality. CONCLUSIONS: The hemorrhage postpartum was the leading cause of maternal death in Chemax. Sociodemographic factors and of access to the health services, characterized to the maternal deaths in this community. Something similar could be happening in other communities very marginalized of Yucatan.

[Under-registry of maternal death in Merida, Yucatan, Mexico (1997-2001)]. / Subregistro de muertes maternas en Mérida, Yucatán (1997-2001).

OBJECTIVE: To analyze the subregistry of maternal deaths in Merida, Yucatan, Mexico. MATERIAL AND METHODS: The subregistry was studied using descriptive, cross-sectional and retrospective approaches. Acts and death certificates of women aged 9 to 50 years that passed away in five years (1997-2001) were reviewed. Additionally, an interview with their relatives was conducted plus a revision of clinical files and reports of autopsies. The maternal deaths were classified according to the criteria of the International Statistical Classification of Diseases and Related Health Problems (tenth revision). Maternal deaths found during the period of study were compared with those reported by the official organism in order to detect their subregistry. RESULTS: 21 cases of maternal deaths were found during the study period, from them 16 were notified officially. The subregistry of maternal deaths was 24% in the five analyzed years. CONCLUSIONS: Maternal mortality continues to be a public health problem in urban areas, like the city of Merida. It is necessary to design strategies to avoid the subregistry and allow the reduction of maternal deaths.

Salud-enfermedad reproductiva: una aproximación de los derechos, reproductivos en Yucatán / Reproductive health-disease: a review about reproductive rights in Yucatán

Objetivo. Caracterizar el perfil de salud-enfermedad reproductiva para Yucatán.Fuentes de obtención de la información. Instituto Nacional de Estadística, Geografía e Informática (INEGI) y Secretaría de Salud. Revistas de las Conferencias Internacionales (Cairo, 1994 y Beijin, 1995) sobre políticas de salud.Resultados. El acceso a la salud y los derechos reproductivos está vinculado a la solución de rezagos sociales tales como desempleo (47.2 por ciento), analfabetismo (15 por ciento), entre otros. Las muertes femeninas durante el proceso reproductivo, seguidas de las muertes por cáncer cervicouterino y mamario, son prevenibles. Accidentes, tuberculosis y SIDA ocupan un lugar importante de este perfil, y afectan a uno u otro sexo. El aborto y la violencia de género son problemas que subyacen y que, junto a enfermedades congénitas, deficiencias en la calidad de atención médica, no se registran adecuadamente; menos se discuten y se atienden. Aspecto que recrudece para la población femenina, su condición marginal al interior de la marginalidad de otros. Conclusiones. La importancia de nuevas política radica en su instrumentación local, partiendo de las diferencias socioculturales. Será importante fomentar cambios substanciales en la calidad de vida de los yucatecos; incorporar elementos innovadores en la búsqueda de nuevos indicadores; en las formas de registro estadístico; en la organización de servicios de salud; y, en las alianzas entre sector gubernamental y no gubernamental; mismas en las que la participación ciudadana adquiera un papel determinante en la transformación en materia de salud y derechos reproductivos.