[Effectiveness of interventions for improving drug prescribing in Primary Health Care]. / Efectividad de las intervenciones para mejorar la prescripción de medicamentos en atención primaria.

OBJECTIVE: To determine the effectiveness of interventions for improving drug prescribing in Primary Health Care units. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Searches were made in MedLine©, ScienceDirect©, Springer©, SciELO©, Dialnet©, RedALyC© and Imbiomed©, in Spanish, English and Portuguese, using keywords "drug prescribing", "intervention studies" and "primary health care", indexed in each data base up to August 2014. SELECTION OF STUDIES: Experimental and quasi-experimental studies were included that had a CASP-score>5 and that evaluated effect of any type intervention on the quality of drug prescription in Primary Health Care. RESULTS: A total of 522 articles were found, and an analysis was performed on 12 that reported 17 interventions: 64.7% educational, 23.5% incorporating pharmacists into the health team, and 11.8% on the use of computer applications. The strong "intervention/improvement" associations were educational interventions OR=2.47 (95% CI; 2.28 - 2.69), incorporation of pharmacists OR=3.28 (95% CI; 2.58 4.18), and use of computer applications OR=10.16 (95% CI; 8.81 -11.71). CONCLUSIONS: The use of interventions with computer applications showed to be more effective than educational interventions and incorporation pharmacists into the health team. Future studies are required that include economic variables such as, implementation costs, drug costs and other expenses associated with health care and treatment of diseases.

Clinical competence of Guatemalan and Mexican physicians for family dysfunction management.

OBJECTIVE: To evaluate the clinical competence of Mexican and Guatemalan physicians to management the family dysfunction. METHODS: Cross comparative study in four care units first in Guadalajara, Mexico, and four in Guatemala, Guatemala, based on a purposeful sampling, involving 117 and 100 physicians, respectively. Clinical competence evaluated by validated instrument integrated for 187 items. Non-parametric descriptive and inferential statistical analysis was performed. RESULTS: The percentage of Mexican physicians with high clinical competence was 13.7%, medium 53%, low 24.8% and defined by random 8.5%. For the Guatemalan physicians'14% was high, average 63%, and 23% defined by random. There were no statistically significant differences between healthcare country units, but between the medium of Mexicans (0.55) and Guatemalans (0.55) (p = 0.02). CONCLUSION: The proportion of the high clinical competency of Mexican physicians' was as Guatemalans.

[Drowning risk factors into cistern for children 1 to 4 years old]. / Factores de riesgo en la asfixia por inmersión en aljibe en niños de uno a cuartro años.

OBJECTIVE: Analyze risk factors for drowning deaths in tanks, from home, for children between one and four years, residents of the metropolitan area of Guadalajara and the neighboring municipalities in the period 2009-2011. MATERIAL AND METHODS: Case-control study, 28 children (cases) between one and four years old, whose cause of death was drowning in the well of your home, from 2009-2011, in the metropolitan zone of Guadalajara and the neighboring municipalities, and 113 children (controls) of the same age, if neighbors whose homes had cistern. Deaths were classified with W73 and W74 codes from International Statistical Classification of Diseases and Related Health Problems (ICD 10th). A questionnaire for variables: age and sex of child; age, marital status, occupation and education of the household head and mother; housing conditions; and location, type and segurity cistern lid, and forms the removal of water therefrom. RESULTS: The rate of drowning deaths, age-specific, was 2.7 deaths per 100,000 children between one and four years of age during the study period. The ages of two and three years had the greatest risk of drowning. Sex had a predominance of children, two girls one over. The heads of families and mothers of cases were younger (< 29 years), with maximum secondary schooling. Most of the houses had not finished complete. The characteristics of de well, as metal lid,foil or plastic, the lack of assurance of the tank and the location of the cover, crossing sites, showed association with death by drowning. The absence of a pump to draw water in cases the proved statistically more significant with p = 0.002. CONCLUSION: The results of our study show the presence of drowning deaths in children between one and four years associated with the type of cistern cover, the locking mechanism, a way of extracting the water and the location of the well, and thus the need to implement preventive measures in education and engineering, to reduce or avoid the risk of death by suffocation in the study group.

Validation of a Mexican food photograph album as a tool to visually estimate food amounts in adolescents.

The aim of the present study was to validate a food photograph album (FPA) as a tool to visually estimate food amounts, and to compare this estimation with that attained through the use of measuring cups (MC) and food models (FM). We tested 163 foods over fifteen sessions (thirty subjects/session; 10-12 foods presented in two portion sizes, 20-24 plates/session). In each session, subjects estimated food amounts with the assistance of FPA, MC and FM. We compared (by portion and method) the mean estimated weight and the mean real weight. We also compared the percentage error estimation for each portion, and the mean food percentage error estimation between methods. In addition, we determined the percentage error estimation of each method. We included 463 adolescents from three public high schools (mean age 17·1 (sd 1·2) years, 61·8 % females). All foods were assessed using FPA, 53·4 % of foods were assessed using MC, and FM was used for 18·4 % of foods. The mean estimated weight with all methods was statistically different compared with the mean real weight for almost all foods. However, a lower percentage error estimation was observed using FPA (2·3 v. 56·9 % for MC and 325 % for FM, P< 0·001). Also, when analysing error rate ranges between methods, there were more observations (P< 0·001) with estimation errors higher than 40 % with the MC (56·1 %), than with the FPA (27·5 %) and FM (44·9 %). In conclusion, although differences between estimated and real weight were statistically significant for almost all foods, comparisons between methods showed FPA to be the most accurate tool for estimating food amounts.

[Falls mortality trends in México, 1979-2010]. / [Tendencia de mortalidad por caídas en México, 1979-2010].

AIM: To analyze the mortality trend by accidental falls in Mexico, from 1979 to 2010. MATERIAL AND METHODS: We used official mortality data in México. Variables included were mortality cause, place of lesion, age, sex, year of mortality registration, size of the town of occurrence, state, occupation, workplace falls. RESULTS: During that period, 124,509 deaths by accidental and intentional falls were registered; of these 77.03% were men. From 1989 (3.20 per 100,000) to 2010 (1.99 per 100,000), the mortality trend was falling (ß = -0.053/ 100,000, p ≤ 0.001). In the majority of states, we found a decreased between 1993-1997 and 2006 to 2010, except in Aguascalientes, Puebla, Baja California Sur, Durango and Nuevo León. CONCLUSIONS: This is the first study in México that showed the descending trend of mortality in accidental falls in the last two decades.

Mortality trend by dengue in Mexico 1980 to 2009.

OBJECTIVE: To describe the mortality of dengue in Mexico during 1980 to 2009. MATERIAL AND METHODS: Dengue mortality data for Mexico were obtained from Instituto Nacional de Estadistica, Geografía e Informática. We used standardized and non-standardized dengue mortality rates per 1,000,000 people and determined the mortality trend. The groups were based on International Classification of Diseases coding criteria (ICD-9 E061 and ICD-10 A91X). The results were stratified by age groups and the frequencies of dengue deaths were compared using relative risk (RR) with its 95% confidence interval. RESULTS: During 1980 to 2009 in Mexico, 549 deaths due to dengue were reported. We found an important variation in the mortality rates during the years studied. We were able to identify three periods: 1980 to 1992, 1994 to 2000, and 2001 to 2009. The mortality rates found are from 0.88/1,000,000 through 0.00/1,000,000. The average mortality rates by decade: 1980 to 1989: 0.53/1,000,000; 1990 to 1999: 0.06/1,000,000; 2000 to 2009: 0.12/1,000,000. In the analysis of mortality by community size during 2000 to 2009, we observed in the small communities with < 2,499 people, the risk is 1.25 times higher than in those with more than 20,000 people. CONCLUSIONS: We found, in general, a sustained decline in the number of deaths by dengue over the last 30 years in Mexico. However, a slow increase was observed since 1994, which may be related to the circulation of DENV2 and DENV3, among other factors. We need to strengthen prevention programs in smaller communities (< 2,499) where we found a higher risk of mortality due to dengue.

[Drowning mortality trends in children younger than 5 years old in Mexico, 1979-2008]. / Tendencia de la mortalidad de la asfixia por inmersión en niños menores de cinco años en México de 1979 a 2008.

OBJECTIVE: To describe mortality trends from drowning in children younger than 5 years old. MATERIALS AND METHODS: Mortality records of children younger than 5 years old were obtained from the National Health Information (SINAIS) system of Mexico from 1979 to 2008. Cause of death by asphyxia was established according to the International Classification of Diseases (ICD 9th and 10th). We analyzed age, sex, federal state, year and place where the event occurred. RESULTS: Fatal drowning diminished from 7.64 in 1979 to 3.59 deaths per 100,000 in 2008. This trend was observed throughout the assessment period and in all federal states. Children younger than 2 years showed the highest rate of death. Mortality was higher in males than females (1.7:1). A great proportion of events happen at home. CONCLUSION: Drowning mortality among children less than 5 years old in Mexico shows a downward trend in all states.

[Trends in mortality by burns in Mexico, 1979-2009]. / Tendencia de mortalidad por quemaduras en México, 1979-2009.

OBJECTIVE: To describe the trends in burn-related mortality rates in Mexico from 1979-2009. METHODS: Burn-related mortality standardized rates and trends were estimated from official mortality data in Mexico. Variables included were:age, sex, federal state and year of death. RESULTS: From 1979-2009, 33,333 burn-related deaths were registered. During this period, the burn-mortality rate decreased, stating from a rate of 2.32/100,000 in 1979 and dropping to 0.72/100,000 in 2007, but in 2008 and 2009 the mortality rates occurred in the states of Baja California, Chihuahua, Baja California Sur,Sonora and Durango, all of these states in the northwest of Mexico. Men were twice as likely as women to die from burns. CONCLUSIONS: Mortality caused by burns in Mexico presents a descendent tendency in most of the states of the Country, with the exception of the northwest region, which may be related to the lack of specialized units in the treatment of burn distance between the population centers and the specialized attention units.

[Prevalence of risk factor for intoxications and poisoning at home related to socioeconomic level]. / Nivel socioeconómico y factores de riesgo en niños para envenenamiento e intoxicación en el hogar.

OBJECTIVE: To identify the prevalence of caries in affiliated children and teenagers at Instituto Mexicano del Seguro Social (IMSS). METHODS: The survey was carried out according to the World Health Organization indexes. The studied was carried out in 1545 boys and girls aged three, five, six, and twelve years and selected by stratified random sampling in seven places of Mexican Republic (Guanajuato, East and West Estado de México, Northwest 1, Northeast 2, Southwest 3, and Southeast 4 DF). RESULTS: The prevalence of caries was 66.9%. Rates were higher in temporary dentition than in permanent teeth (p<3.07). The mean of caries index per tooth in primary dentition in children of six years of age was 3.57±2.8. In the 12 years of age group the average per tooth was 1.97±1.4. The main component in both primary and permanent dentition was caries with 2.49 and 1.56 respectively. CONCLUSIONS: The results of this survey showed slight changes in prevalence and high levels of caries in children.

[Level of functionality among senior citizen packers in a chain of Mexican supermarkets]. / Estado de funcionalidad de adultos mayores empacadores en tiendas de autoservicio.

OBJECTIVE: To identify socio-demographic characteristics and general health conditions among senior citizens working as volunteer packers in a supermarket chain in Mexico. MATERIAL AND METHODS: From May to July 2008 we carried out a cross-sectional analysis in 416 volunteers aged 60 or more years. RESULTS: Mean age was 69.4 years, (range 60-87). Mean level of schooling was elementary school. Men's prior occupation was in the formal sector of the economy vs. women participants who were not. Men were mostly from lower middle class strata and women from lower strata. Most participant's self-perception of health was good although there was an inherent risk of developing obesity. Depression rating scale scores were within normal limits. They had sought work as packers due to financial constraints. CONCLUSIONS: Senior citizens working as paid volunteers seems to promote their physical, mental, social and financial well being. Our findings suggest gender differences within the context of a bleak socio-economic and epidemiological panorama.

[Prevalence of risk factors for drowning at home related to the socioeconomic level]. / Prevalencia de factores de riesgo para asfixias en el hogar relacionados con el nivel socioeconómico.

OBJECTIVE: To measure the association between social economic conditions and the presence of risk factors for drowning at home in children under 5 years old within metropolitan area of Guadalajara. METHODS: Surveyed 439 family houses were lived children less than 5 years old randomly selected during 18 months. Variables included social economic level, demographics, and bodies of water and accessories present at the house. RESULTS: Children in the lower social economic level are exposed more frequently to buckets and laundry tubs in the house than children of medium level families, but not to underground cisterns and wells. No mater the equal number of underground cisterns and wells, safety accessories and equipment are less frequent in low socioeconomic families. Children in the low social economic level spend more time at their homes than medium socioeconomic level children. CONCLUSIONS: It seems that the high frequency of drowning among low social economic families is related to a higher exposure to risk factors. It is necessary to improve mechanisms and change environmental conditions to reduce the number of children drowning at home.

[Differentiated consumption of macronutrients according to sex and age in higher education students]. / Consumo diferenciado de macronutrientes según sexo y edad en estudiantes de educación superior.

OBJECTIVE: To analyze the intake of macronutrients and its relationship with age and sex in higher education students. MATERIALS AND METHODS: A cross-sectional study was carried out with 218 higher education students, aged between 18 and 30 years. A validated and reliable instrument was used to measure macronutrient consumption. RESULTS: Regarding the intake of macronutrients, a statistical difference by sex was observed in favor of men (p>0.05), except for the consumption of proteins in students older than 25 years. In the group under 20 years of age, men showed better protein intake. Finally, in students between 20 and 25 years, the consumption of macronutrients is similar among men and women. DISCUSSION: The results show that the percentage of consumption with respect to ideal value of the estimated requirement for light activity according to FAO/WHO/UN 2004 is below the recommendations, with a macronutrient consumption deficit that ranges between 20% and 60%.

OBJETIVO: Analizar la ingesta de macronutrientes y su relación con la edad y sexo en estudiantes de educación superior. MÉTODOS: Se realizó un estudio transversal conformado con 218 estudiantes de educación superior de 18 a 30 años. Se utilizó un instrumento validado y confiable, para medir el consumo de macronutrientes. RESULTADOS: Respecto a la ingesta de consumo de macronutrientes se observa que hay diferencia estadística por sexo, a favor de los hombres (p>0,05), excepto en el consumo de proteínas en los estudiantes mayores de 25 años. En el grupo etario menor a 20 años, los hombres tienen un mejor consumo de proteínas. En estudiantes de 20 a 25 años el consumo de macronutrientes es parecido entre hombres y mujeres. DISCUSIÓN: Los resultados evidencian que el porcentaje de consumo respecto del valor ideal de requerimiento estimado para actividad ligera según FAO/OMS/ONU 2004, está por debajo, con un déficit de consumo de macronutrientes que oscila entre el 20% y el 60%.

A search for a safer bucket to prevent children drowning at home.

BACKGROUND: Unintentional drowning is the leading cause of death for children younger than 5 years old. A bucket is one of the most common water container in which children can drown. The objective of this work was to evaluate the base diameter of a bucket and the necessary force to shed it. METHODS: This was an experimental study. We used six galvanized buckets of different diameters. Each selected bucket was pulled using a pulley with other buckets full of water until the water spilled out. The statistical analysis was done by linear regression with p less than 0.05 as statistically significant. RESULTS: This research shows a direct relation between the wide base diameter (in a bucket 23 cm high, 25 cm rim, with a 20 cm water depth) and the strength required to spill the liquid contents (ß= 1.21; x= diameter of the base in centimeters; α= 14.59; r= 0.99 and p less than 0.001). CONCLUSIONS: We conclude that the bucket structure could determine the risk of child drowning. The risk could increase directly as its base width increases.

[Mortality from contact with poisonous snakes and lizards in Mexico from 1979 to 2003]. / Mortalidad por contacto traumático con serpiente y lagarto venenosos. México, 1979-2003.

OBJECTIVE: To describe the trend of standardized mortality by contact with poisonous snakes and lizards in Mexico from 1979 to 2003. MATERIAL AND METHODS: We describe the standardized mortality trend by contact with poisonous snakes and lizards occurring in Mexico from 1979 to 2003, and report the mortality data bases from the INEGI (Instituto Nacional de Estadística, Geografía e Informática). We determined frequencies, percentages, mortality rates, standardized mortality rates and mortality relative risks with 95% confidence intervals. RESULTS: The general trend shows a statistically significant descent of 63.8%. The highest mortality rate within the 2000-2003 period was reported in Quintana Roo (7.47/1,000,000), Oaxaca (4.01/1,000,000), Veracruz (1.56/1,000,000), Chiapas (1.48/1,000,000), Campeche (1.43/1,000,000) and Yucatan (1.29/1,000,000). The groups with the highest risk are those older than 60 years and males. CONCLUSIONS: In spite of the detected decrease in mortality, the contact with poisonous snakes and lizards still is a public health problem in Mexico. As timely treatment saves lives, it is necessary to include and offer treatment in all emergency units of the country.

[Epidemiologic profile of children with burns from the Civil Hospital of Guadalajara "Dr. Juan I. Menchaca", 2009-2011]. / Perfil epidemiológico de niños con quemaduras del Hospital Civil de Guadalajara Dr. Juan I. Menchaca, 2009-2011.

BACKGROUND: Burns are a public health problem, ranking among the 20 principal causes of morbidity in Mexico. Children are a more vulnerable group to suffer from these injuries. For that reason, we analyzed cases in order to gain a better comprehension and to propose preventive measures for this problem. The aim of the study was to determine the epidemiological profile of those injuries to allow us to plan and implement actions for burn prevention. METHODS: We conducted a cross-sectional study that included demographic characteristics of the child, the parents and the burn injuries from children treated at this Burn Unit. Statistical analysis was done to calculate amounts, proportions and 95% confidence intervals. RESULTS: The epidemiological profile of the injuries included males (63.4%) <5 years of age (65.2%) with educational level according to their age (56.2%). Parents of the included children were <35 years old with basic educational level. Burns were caused by hot water (56.2%) and occurred between noon and midnight (73.0%). The majority of the burns were shallow and deep second-degree or minor (69.2%) and affected <20% of body surface area (74.5%). CONCLUSIONS: This epidemiological profile paved the way for preventive actions beginning with scientific research to guide the actions in a progressive direction along with the cooperative actions of public and private institutions in the development of programs and strategies. The end result would be the establishment of a public policy for accidental injuries.

[Asphyxiation by suffocation and strangulation in children younger than 15 years of age]. / Asfixia por sofocación y estrangulación en menores de 15 años.

OBJECTIVE: Our aim was to describe non-intentional strangulation or suffocation suffered by children under 15 years of age. METHODS: Records from the Medical Examiner's Office showed child death by non-intentional strangulation or suffocation from January 1, 1991 to December 31, 2001. RESULTS: A total of 44 suffocations or non-intentional strangulations were registered. Overall mortality was 3.62/1,000,000 persons-year (27.57/1,000,000 in children < 1 year of age, 1.94/1,000,000 in older children); 63.6% were males. Most frequent mechanisms included neck entrapment between bars 18.2%, facial obstruction by bed clothes 15.9%, being covered by rubble, sand, or garbage 15.9%, strangulation by cord, chain, or strip 11.4%, and strangulation by dress or bed clothes 9.1%. CONCLUSIONS: Nearly all registered deaths could be prevented by education, supervision, or structural modifications. Strategies should also include obligatory standards for manufacturing and for warnings on labels.

Hábitos e ingesta alimentaria de frutas y verduras en estudiantes de educación superior / Habits and food intake of fruit and vegetables in university students

RESUMEN Introducción: Los hábitos y la ingesta alimentaria saludable en la población son esenciales en el individuo, principalmente los correspondientes a frutas y verduras por los beneficios que proporcionan a la salud. Objetivo: Determinar los hábitos y la ingesta en frutas y verduras en estudiantes. Material y métodos: Se realizó un estudio transversal realizado en 218 estudiantes de educación superior (de 18 a 30 años). Se utilizó un instrumento validado y confiable, para medir los hábitos e ingesta de alimentos. Resultados: Las frutas, como parte de alimentos entre comidas, fueron preferentemente ingeridas por las mujeres más que por los hombres (p= 0,006); fueron ingeridas por todos los estudiantes, preferentemente por los >25 años que por los menores a esta edad (p= 0,05). Las mujeres tuvieron una mayor ingesta de verduras que los hombres (p= 0,07). La preparación de alimentos para su consumo es realizada principalmente por mujeres; y más del 50% los consume fuera de casa. Conclusión: La ingesta en frutas y verduras se encontró por debajo de los 400 g recomendados por la OMS en todos los casos, aún en el grupo de mujeres que las consumieron más entre comidas.

ABSTRACT Background: Eating habits and healthy dietary intake in the population are essential, especially the intake of fruit and vegetable for their health benefits. Therefore, the aim of this work was to understand the habits and the intake of fruits and vegetables among students. Methods: A descriptive cross-sectional study was performed, considering a sample of 218 university students (18 to 30 years old). A validated and reliable instrument was used to measure food consumption and food preparation habits. Results: Fruits as a snack between meals were ingested by more women than men (p= 0.006), the ingestion of fruits was more common among students >25 years compared to younger students (p= 0.05). Women reported a higher intake of vegetables compared to men (p= 0.07). Women mainly prepared food and more than 50% ate outside the home. Conclusion: The ingestion of fruits and vegetables was below WHO recommendations (400 g), even in the group of women who consumed fruit as a snack.

Consumo diferenciado de macronutrientes según sexo y edad en estudiantes de educación superior / Differentiated consumption of macronutrients according to sex and age in higher education students

RESUMEN Objetivo Analizar la ingesta de macronutrientes y su relación con la edad y sexo en estudiantes de educación superior. Métodos Se realizó un estudio transversal conformado con 218 estudiantes de educación superior de 18 a 30 años. Se utilizó un instrumento validado y confiable, para medir el consumo de macronutrientes. Resultados Respecto a la ingesta de consumo de macronutrientes se observa que hay diferencia estadística por sexo, a favor de los hombres (p>0,05), excepto en el consumo de proteínas en los estudiantes mayores de 25 años. En el grupo etario menor a 20 años, los hombres tienen un mejor consumo de proteínas. En estudiantes de 20 a 25 años el consumo de macronutrientes es parecido entre hombres y mujeres. Discusión Los resultados evidencian que el porcentaje de consumo respecto del valor ideal de requerimiento estimado para actividad ligera según FAO/OMS/ONU 2004, está por debajo, con un déficit de consumo de macronutrientes que oscila entre el 20% y el 60%.(AU)

ABSTRACT Objective To analyze the intake of macronutrients and its relationship with age and sex in higher education students. Materials and Methods A cross-sectional study was carried out with 218 higher education students, aged between 18 and 30 years. A validated and reliable instrument was used to measure macronutrient consumption. Results Regarding the intake of macronutrients, a statistical difference by sex was observed in favor of men (p>0.05), except for the consumption of proteins in students older than 25 years. In the group under 20 years of age, men showed better protein intake. Finally, in students between 20 and 25 years, the consumption of macronutrients is similar among men and women. Discussion The results show that the percentage of consumption with respect to ideal value of the estimated requirement for light activity according to FAO/WHO/UN 2004 is below the recommendations, with a macronutrient consumption deficit that ranges between 20% and 60%.(AU)

Prescripción inadecuada de medicamentos: aportaciones de los paradigmas científicos a su conocimiento / Inadequate drugs prescription: contributions of scientific paradigms to your knowledge

Resumen Se realizó una revisión narrativa con análisis temático sobre las aportaciones de los paradigmas científicos al conocimiento de la prescripción inadecuada de medicamentos. Se buscaron artículos de acceso abierto indexados en PubMed© entre 2010-2014, y se sistematizó información sobre el paradigma, tipo de publicación, perspectiva teórica, objetivo, método y resultados. De los 992 artículos encontrados, se seleccionaron 118, y se tomó una muestra propositiva de 15, según su diseño, representando los cuatro paradigmas. Los artículos positivistas reportaron prevalencia, factores asociados, efectividad de intervenciones y criterios de evaluación; los interpretativos explicaron las causas del problema según los involucrados; los críticos denunciaron la influencia de la industria farmacéutica; y el participativo abordó el problema secundariamente y lo solucionó en un escenario para una enfermedad y grupo farmacológico específicos. Se concluyó que la prescripción inadecuada de medicamentos como problema de investigación en salud pública recibe aportes de los cuatro paradigmas, con dominio del positivismo, lo que se atribuye al carácter paradigmático de la ciencia desde la que se le aborda habitualmente, y que una perspectiva multi-paradigmática es el mejor abordaje.

Abstract This study conducted a narrative review with thematic analysis about contributions of scientific paradigms to knowledge of inadequate drugs prescription. We searched open access articles indexed in PubMed© between 2010 and 2014, and we systematized information about scientific paradigm, publication type, theoretical perspective, objective, method and results. From the 992 articles found, 118 were selected. From those, we chose a purposive sample of 15, according to the design of the studies, representing the four paradigms. The positivists articles reported prevalence, associated factors, effectiveness of interventions and evaluation criteria; the interpretive explained the causes of the problem according to those involved; the critics denounced the influence of pharmaceutical industry; and the participative addressed the problem secondarily and solved it in a scenario for a specific disease and pharmacological. We concluded that the inadequate drugs prescription as research problem in public health had contributions from the four paradigms, with dominance of positivism, which is attributed to the paradigmatic perspective of the science, from which it is usually studied, and that a multi-paradigmatic perspective is the best approach to the public health issue.

[Invisibility of working conditions and children's health in the Felipe Angeles market]. / La invisibilidad de las condiciones laborales y de salud de niños del mercado Felipe Angeles.

OBJECTIVE: Identifying the work environment and health of children working in the Felipe Angeles market in Guadalajara. METHODOLOGY: This was a descriptive study which included 198 children working in the aforementioned market. A questionnaire was used which asked about the sociodemographic variables, the work environment and the health of such children. RESULTS: The children working in the market were predominantly male (89.9 %), aged 6 to 17 years old, residing in Guadalajara; 71 % were attending school. 83 % of the children had started working in the market between 7 to 10 years old and 75 % had worked there for 1 year or more. Workdays lasted all week, without rest in 50 % of the cases. The children perceived health risks as concerning abrasion, contusion, fractures, being run over and other psychosocial types related to becoming the victims of theft or becoming addicts. CONCLUSIONS: The children's work environment and health were not suitable for their age and affected their physical and psychosocial state as the site had deficient architecture making it impossible to carry out activities appropriate for their age and provoked workplace risk for which there was no prevention.