2015 life tables of population user of Jalisco's Instituto Mexicano del Seguro Social services / Tablas de vida 2015 de la población usuaria del Instituto Mexicano del Seguro Social de Jalisco

Background: The life table is a useful instrument to measure the impact of health care in a population. In this case we report the situation of the population that use the medical services of the Instituto Mexicano del Seguro Social in the state of Jalisco. Methods: We used the abridged Reed-Merrell method, which shows the life expectancy in five-year age groups. Results: In 2015 life expectancy for people with hospital insurance was 80.51 for women and 77.93 for men. For the total of insured women and men, life expectancy was 77.65 and 73.73 years, respectively. Conclusion: Compared with previous calculations, we observed a deceleration of the gain of life expectancy in both sexes, even though women keep more life expectancy than men.

Introducción: La tabla de vida es un valioso instrumento para medir el impacto de la atención médica en una población. En este caso reportamos la situación de la población usuaria de los servicios de salud del Instituto Mexicano del Seguro Social en el estado de Jalisco, México. Métodos: Se utilizó el método abreviado de Reed-Merrell, que muestra la esperanza de vida en grupos quinquenales de edad. Resultados: En 2015 la esperanza de vida en asegurados hospitalizados hombres fue de 77.93 años y en mujeres, de 80.51 años. Para el total de asegurados mujeres y hombres fue de 77.65 y 73.73, respectivamente. Conclusiones: Si se compara con cálculos previos, se observa una desaceleración en la ganancia de expectativa de vida en pacientes hospitalizados de ambos sexos, aunque se conserva una mayor esperanza para las mujeres.

[Considerations concerning medical knowledge inherited in Mexico from 19th century: the diabetes mellitus case]. / Consideraciones sobre el saber médico heredado en México del siglo XIX: el caso de la diabetes mellitus.

In Mexico, as in the entire Western world, during the 19th century and the beginnings of the 20th century, medical knowledge developed in a remarkable way and the case of diabetes mellitus was not the exception. This situation, which arose on the basis of the antique paradigm, and which in turn was overthrown by the positivism as the emergent paradigm (with its clinical and anatomical, as well as physiopathological and etiopathological viewpoints), was reflected during the 19th the century through its actors and the communications that opened the access of Mexican medicine to the modernity.

En México, como en el mundo occidental, durante el siglo XIX y principios del XX, el conocimiento médico presentó un desarrollo notable y el caso de la diabetes mellitus no es la excepción. Esta situación, originada desde el paradigma antiguo, superado por el paradigma moderno emergente, con sus miradas anatomoclínica, fisiopatológica y etiopatogénica, se refleja en el México decimonónico a través de sus actores y de las comunicaciones que inauguran la entrada de la medicina mexicana a la modernidad.

[Cultural domain of the causes of diabetes in three generations of popular stratum in Guadalajara, Mexico]. / Dominio cultural sobre causas de diabetes en tres generaciones de estratos populares en Guadalajara, México.

BACKGROUND: The growing prevalence of diabetes must be confronted in several ways. Establishing the generational transmission of cultural knowledge offers some guidelines to prevent and control the disease. Once we identify and compare the semantic structures of shared knowledge we lay the foundations of a culturally comprehensive care. The objective was to characterize the main elements about cultural domain of the causes of diabetes in a population of grandparents, parents and children belonging to popular strata in Guadalajara, Jalisco, Mexico. METHODS: A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis.A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis. RESULTS: The studied groups were divided by generation: grandparents, parents and children. The data evidences intergenerational transmission, in form of a basic semantic structure, and a significant consensus around a single model. CONCLUSIONS: The semantic structure on the causes of the diabetes includes: a) the emotions, as traditional dimension; b) certain behaviours related with the lifestyle, as everyday dimension; c) some biomedical concepts, like an emergent dimension.

Introducción: la creciente prevalencia de diabetes se debe afrontar de diversas maneras. Determinar la transmisión generacional del conocimiento cultural ofrece pautas para la prevención y el control de la enfermedad. Al identificar y comparar las estructuras semánticas del conocimiento compartido, sentamos las bases de una atención culturalmente comprensiva. El objetivo es caracterizar los principales elementos relacionados con el dominio cultural sobre las causas de la diabetes en una población de abuelos, padres e hijos pertenecientes a estratos populares en Guadalajara, México. Métodos: estudio antropológico cognitivo en 104 personas seleccionadas al azar en el sector Libertad de Guadalajara, Jalisco, México. Se aplicaron técnicas de listas libres para obtener el modelo semántico y el promedio de conocimiento cultural sobre las causas del padecimiento por análisis de consenso. Resultados: los grupos estudiados se dividieron por generación de abuelos, padres e hijos. Se evidenció transmisión intergeneracional al presentar el conocimiento cultural una estructura semántica básica y un consenso significativo. Conclusiones: la estructura semántica sobre causas de la diabetes incluye como elementos: a) las emociones, como dimensión tradicional; b) conductas relacionadas al estilo de vida, como dimensión cotidiana; c) algunos conceptos biomédicos, como dimensión emergente.

UISESS scale for staging and classifying clinical-epidemiological risk in type 2 diabetes mellitus and for establishing multidisciplinary preventive actions.

PURPOSE: The goal of this study is the creation and use of a five-stage scale for the description of the health status of a type 2 diabetes mellitus patient population, as individuals and as a set. The scale, named UISESS, ranges from the pre-pathological to the sequelae stage, and can help orient multidisciplinary prevention actions. SETTING AND SAMPLING: A sample of nondiabetics (n = 404), together with a census of all type 2 diabetic patients (n = 2,702) over 30 years of age, were obtained from a family medicine clinic of the Mexican Federal Social Security System (IMSS) in Guadalajara, Mexico. DESIGN AND METHOD: A descriptive study in which the Natural History of the Disease and an epidemiological focus on risk were used to create the UISESS scale. Case histories of a total of 3,106 persons from a family practice clinic were used. The data was classified in five stages and three risk control levels were used for analysis. RESULTS: In the type 2 diabetic group, the average age was 57.6 years; 58% were women. In the nondiabetic group, the average age was 55.38 years; 63% were women. The UISESS scale was applied. A large majority (86%) of the studied type 2 diabetic patients were classified within unfavorable stages for controlling their illness, and 65% of the 3,106 people were at high or very high risk of increasing deterioration of their health status. CONCLUSIONS: The UISESS scale appears to be a useful tool to detect the distribution, evolution and control of type 2 diabetes in a population attended at the outpatient clinic of a family medicine unit, according to the Natural History of the Disease.