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.

Descriptive, Longitudinal Study Results Applied to Statistical Models to Assess the Impact of Early Microbiological Cultures on the Economic Burden of Treatment for Infected Diabetic Foot Ulcers at a Mexican Public Health Facility.

Infection plays a critical role in health care and impacts the cost of the treatment of diabetic foot ulcers (DFU). To examine the cost reduction associated with the multidisciplinary treatment of infected DFU (IDFU) by obtaining early (ie, within 48 hours of admission) microbiological culture results, a descriptive, longitudinal study was conducted. Data were collected prospectively from patient medical charts of a cohort of 67 patients (mean age, 56.14 ± 12.3 years; mean duration of diabetes, 14.95 ± 8 years) with IDFU treated at a Mexican public health facility from January 1 to April 30, 2010. Information included demographic data (age, gender, marital status, time elapsed since first diagnosis of diabetes mellitus type 2 [DM2]), and the following clinical records: Wagner classification, bacterium type, antimicrobial resistance, length of hospital stay, and the antibiotic schedule utilized, as well as number and type of laboratory tests, medications, intravenous therapy, surgical and supportive treatment, type and number of specialists, and clinical outcome. Microcosting was used to calculate the unit cost of each medical treatment element. Using the Monte Carlo and Markov predictive simulation economical models, cost reduction associated with early identification of the specific microorganism through bacterial culture in IDFU was estimated. Based on the statistical results, differences between real and estimated costs when including early microbiological culture were identified and the number and type of most common species of infectious bacteria were detected. The total cost observed in the patient cohort was $502 438.04 USD, mean cost per patient was $7177.69 ± $5043.51 USD, and 72.75% of the total cost was associated with the hospital stay length. The cost of the entire treatment including antibiotics was $359 196.16 USD; based on the simulation of early microbiological culture, the model results showed cost could be reduced by 10% to 25% (in this study, the cost could be as low as $304 624.63 USD). The use of early microbiological cultures on IDFU to determine the appropriate antibiotic can reduce treatment costs by >30% if hospital stay is part of the consideration.

Prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos de una institución educativa y de salud, en la ciudad de Guadalajara, México, en 2012 / Prevalence of professional burnout syndrome among dentists in the education and health sectors in the city of Guadalajara, Mexico, 2012

Introducción: el objetivo fue determinar la prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos del sector salud y del educativo y analizar los factores de riesgos sociodemográficos y laborales. Métodos: estudio observacional, descriptivo y transversal, mediante el censo del personal odontológico del área metropolitana de Guadalajara, México, del Instituto Mexicano del Seguro Social y de la Universidad de Guadalajara, donde participaron 138 de ellos, aplicándoseles una ficha de identificación y el Maslach Burnout Inventory-Human Services Survey en forma autoadministrada. Las estadísticas descriptivas y el análisis inferencial se hicieron con apoyo del SPSS 15.0 y Epi-infoV6.1. resultados: se logró el 92% de respuesta. Se detectó frecuencia del síndrome de agotamiento profesional (burnout) en el 52% de ellos. Se obtuvieron diferencias significativas en función de la contratación definitiva. Conclusiones: el síndrome de agotamiento profesional (burnout) es frecuente (52%) en los odontólogos. Sus principales factores de riesgo: laborar en una institución de salud, el ser varón, mayor de 40 años, sin pareja estable y con más de 15 años con pareja, el no tener hijos, ser especialista, con 10 años o más de antigüedad laboral y en el puesto actual de trabajo, turno matutino, tener contratación definitiva y laborar en otro trabajo. La afectación del agotamiento emocional se comporta como el síndrome. Los niveles medios de las subescalas se encuentran en general cerca de la normalidad. Se encontró una correlación negativa entre las subescalas agotamiento emocional y despersonalización y positiva entre la falta de realización personal en el trabajo con la presencia del síndrome.

Introduction: the goal of this study was to determine the prevalence of professional burnout syndrome among dentists working in the education and health sectors and to analyze socio-demographic and labor-related risk factors. Methods: this was an observational, descriptive, transversal study through a census with dental personnel in the metropolitan area of Guadalajara, Mexico, the Social Security Institute of Mexico, and the University of Guadalajara; the sample included 138 professionals who completed an identification form and the self-administered Maslach Burnout Inventory-Human Services Survey. Descriptive statistics and inferential analyzes were conducted with SPSS 15.0 and Epi-info V6.1. results: 92% of participants responded the survey, and professional burnout syndrome was found in 52% of them. Significant differences were observed in relation to tenured jobs. Conclusions: professional burnout syndrome is frequent among dentists (52%). The main risk factors associated to it include: working in a health institution, being a male, being over 40 years, with no permanent partner and with more than 15 years with a partner, not having children, being a specialist, with 10 or more years of seniority and in the current job, day shift, and having tenure while working somewhere else. Emotional exhaustion also makes part of the syndrome. The average levels of the subscales are generally near normal. A negative correlation was found between emotional exhaustion subscales and depersonalization, and a positive relation between the lack of personal accomplishment at work and presence of the syndrome.

Análisis de los posibles factores de riesgos sociodemográficos y laborales y prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos mexicanos / Analysis of Possible Sociodemographic and Occupational Risk Factors and the Prevalence of Professional Exhaustion Syndrome (Burnout) in Mexican Dentists

Objetivo: Determinar la prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos y analizar los posibles factores de riesgos sociodemográficos y laborales. Métodos: Estudio observacional, descriptivo y transversal, mediante el censo del personal odontológico de la Zona Metropolitana de Guadalajara, México, del Instituto Mexicano del Seguro Social, de la Universidad de Guadalajara y de los que ejercen la práctica privada, en el que participaron 203. Se les aplicó una ficha de identificación y el Maslach Burnout Inventory-Human Services Survey en formulario autoaplicable. Las estadísticas descriptivas y el análisis inferencial se realizaron mediante SPSS 15.0 y EpiInfo V6.1. Resultados: Se logró el 88,3 % de respuesta. La frecuencia del síndrome de agotamiento profesional (burnout) detectada es del 52,2 %. Se obtuvieron diferencias significativas en función de la contratación definitiva. Se observó correlación negativa entre las subescalas agotamiento emocional y despersonalización y correlación positiva con la falta de realización personal en el trabajo. Conclusiones: El síndrome de agotamiento profesional (burnout) es frecuente (52,2 %) entre los odontólogos. Sus posibles factores de riesgo: laborar en una institución pública, ser varón mayor de 40 años sin pareja estable o con más de 15 años en pareja, no tener hijos, ser especialista con 10 años o más de antigüedad laboral y en el puesto actual de trabajo, turno matutino, contratación definitiva y tener otro trabajo. La afectación del agotamiento emocional se comporta como el síndrome. Los niveles medios de las subescalas se encuentran en general cerca de la normalidad. Se encontró una correlación negativa entre las subescalas agotamiento emocional y despersonalización y positiva entre la falta de realización personal en el trabajo con la presencia del síndrome. Lo anterior nos lleva a considerar la necesidad de establecer medidas preventivas en el ámbito laboral y personal o realizar programas de intervención individuales, sociales u organizacionales para reducir la prevalencia encontrada.

Objectives:To determine the prevalence of professional exhaustion syndrome (burnout) in dentists and to analyze possible sociodemographic and occupational risk factors. Methods: An observational, descriptive and cross-sectional survey of 203 dental staff of the Metropolitan Zone of Guadalajara, Mexico, from the Mexican Social Security Institute, University of Guadalajara, and those in private practice. A self-reported identification form and the Maslach Burnout Inventory-Human Services Survey were used to gather data. Descriptive statistics and inferential analyzes were performed using SPSS 15.0 support and EpiInfo V6.1. Results: There was an 88.3 % response. Professional exhaustion syndrome (burnout) was detected in 52.2 % of them. Significant differences were obtained depending on the employment contract. A negative correlation was observed between the subscales emotional exhaustion and depersonalization, and a positive one between the lack of personal accomplishment at work. Conclusions: Professional exhaustion syndrome (burnout) is common (52.2 %) for dentists, their possible risk factors: working in a public institution, being male, over 40 years, without a regular partner, and with more than 15 years with a partner, not having children, being a specialist with 10 years or more in an institution and the current job, morning shift, permanent recruitment, and having another job. The involvement of emotional exhaustion behaves like the syndrome. Average levels of the subscales are generally near normal. A negative correlation was found between the subscales emotional exhaustion and depersonalization, and positive between the lack of personal fulfillment at work with the presence of the syndrome. This leads us to consider the need for preventive measures in the workplace and personnel, as well as intervention programs at an individual, social or organizational level to reduce the prevalence found.

[Analysis of Possible Sociodemographic and Occupational Risk Factors and the Prevalence of Professional Exhaustion Syndrome (Burnout) in Mexican Dentists]. / Análisis de los posibles factores de riesgos sociodemográficos y laborales y prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos mexicanos.

OBJECTIVES: To determine the prevalence of professional exhaustion syndrome (burnout) in dentists and to analyze possible sociodemographic and occupational risk factors . METHODS: An observational, descriptive and cross-sectional survey of 203 dental staff of the Metropolitan Zone of Guadalajara, Mexico, from the Mexican Social Security Institute, University of Guadalajara, and those in private practice. A self-reported identification form and the Maslach Burnout Inventory-Human Services Survey were used to gather data. Descriptive statistics and inferential analyzes were performed using SPSS 15.0 support and EpiInfo V6.1. RESULTS: There was an 88.3% response. Professional exhaustion syndrome (burnout) was detected in 52.2% of them. Significant differences were obtained depending on the employment contract. A negative correlation was observed between the subscales emotional exhaustion and depersonalization, and a positive one between the lack of personal accomplishment at work. CONCLUSIONS: Professional exhaustion syndrome (burnout) is common (52.2%) for dentists, their possible risk factors: working in a public institution, being male, over 40 years, without a regular partner, and with more than 15 years with a partner, not having children, being a specialist with 10 years or more in an institution and the current job, morning shift, permanent recruitment, and having another job. The involvement of emotional exhaustion behaves like the syndrome. Average levels of the subscales are generally near normal. A negative correlation was found between the subscales emotional exhaustion and depersonalization, and positive between the lack of personal fulfillment at work with the presence of the syndrome. This leads us to consider the need for preventive measures in the workplace and personnel, as well as intervention programs at an individual, social or organizational level to reduce the prevalence found.

Depresión en el personal sanitario femenino y el análisis de los factores de riesgos sociodemográficos y laborales / Depression in Female Healthcare Workers and Analysis of Socio-demographic and Work-related Risk Factors

Objetivo: Determinar la prevalencia de depresión en el personal sanitario femenino y analizar los factores de riesgo socio demográficos y laborales. Métodos: Estudio observacional, descriptivo y transversal, con 190 mujeres del Instituto Mexicano del Seguro Social, a quienes se les aplicó una ficha de identificación y el cuestionario clínico de diagnóstico para cuadros depresivos. Resultados: La tasa de respuesta fue del 86,0 %. El 52,2 % tenía más de 40 años de edad; el 61,0 %, pareja estable; el 75,3 %, hijos, y el 51,5 %, nivel de escolaridad mayor a 12 años. El 71,0 % mostró una antigüedad institucional mayor de 10 años y el 56,3% reveló una antigüedad en el puesto de actual menor a 10 años; predominaron el turno vespertino en el 52,1 %, la contratación de base en el 90,0 % y el no tener otro trabajo en el 8,6 %. Se detectó depresión en 18,9 %; 9,5 % presentó reacción de ansiedad; 8,4 %, depresión moderada, y 1,1 %, depresión severa. No hubo diferencias significativas en la variable socio-demográficas y laboral, a excepción de tener pareja estable, antigüedad institucional mayor de 10 años, trabajar solamente en la institución, tabaquismo y alcoholismo negativos. Conclusiones: La depresión presentó una prevalencia del 18,9 %. Los factores de riesgo fueron: ser trabajadora social, mayor de 40 años, con pareja estable y con menos de 15 años con ella, tener hijos, escolaridad mayor de 12 años, con más de 10 años de antigüedad institucional y en el puesto actual de trabajo, turno matutino, contratación de base y no tener otro trabajo aparte del institucional...

Objective: To determine the prevalence of depression in women healthcare workers and to Analyze the socio-demographic and work-related risk factors. Material and methods: This is an observational, descriptive, and transversal study. 190 female healthcare workers of the Mexican Social Security Institute were assessed by an identification form and a self-administered diagnostic clinical questionnaire of depressive symptoms. Results: The response rate was 86.0 %. All were women, 52.2 % were over 40 years old, 61.0 % had a steady partner, and 75.3 % reported having children. 51.5 % had more than 12 years of schooling 71.0 % had been at the institution over 10 years, and 56.3 % had been at their current position for less than 10 years. 52.1 % had the afternoon shift, 90.0 % were hired directly, and 8.6 % had no other job outside the institution. Depression was detected in 18.9 % of the women. 9.5 % had anxiety reactions, 8.4 % moderate depression, and 1.1 % severe depression. There were no significant differences according to socio-demographic and work-related variables, except for having a stable partner, being at the institution for more than 10 years, working only at the institution, and non-use of tobacco and alcohol. Conclusions: Depression showed a prevalence of 18.9 %. Risk factors were being a social worker, being more than 40 years old, having a stable partner for less than 15 years, having children, having over 12 years of schooling, working for more than 10 years at the institution in the current position, having the morning shift, being a direct hire employee, and not having another job outside the institution...

[Food habits and culture factors in pregnant adolescents]. / Hábitos de alimentación y factores culturales en adolescentes embarazadas.

The purpose of this study was to identify the food habits of pregnant adolescents and their perception about which, of her cultural concepts, have higher influence. 54 subjects between 12 and 19 years old from Guadalajara City were included and socioeconomic, dietetic data, as food frequency consumption and cultural concepts about feeding were also explored. Chi square was used for identifying association between variables. The fat intake was lower in late vs. Early and middle stage of adolescence (57 vs. 71 g/d, p = 0.05). The iron, calcium and zinc intake was also deficient in the early/middle stage; meanwhile, the folic acid consumption was very low in the late stage of adolescence. Corn tortillas were the most consumed cereal and food (93-96%); junk food and sodas (62 and 55%) prevailed in the early/middle stage. About local costumes, "tacos", "pozole" and burgers were the most referred (74.1%). They also mentioned that fat (36.7%), junk food (30%), chili (26.7%), sodas (23.3%), processed meals (26.7%) and salt (10%) were harmful. They also believed that vegetables (77%), fruits (60 %), milk (21%), broths (17%), and meat (12.5%) were beneficial; and, 96% considered that chicken and bean broths were nutritious (myth). There were some prohibited foods (taboos) during pregnancy: chili (48%), junk food (20%), and salt (16%). Prejudices were more common among later adolescents (60.9%) (p = 0.03). The erratic food habits and the conceptual confusion of these adolescents cause a low intake of nutrients and place them in a nutritional risk.

[The meaning of type 2 diabetes mellitus from the patient's perspective]. / El significado de la diabetes mellitus tipo 2 desde la perspectiva del paciente.

INTRODUCTION: Medical anthropology considers the sociocultural aspects of illnesses, from the biomedical definition of the experience of the one who suffers the illness. This is what makes the difference between a disease and an illness, in other words, an explanatory model of illness. OBJECTIVES: To show the cultural consensus elaborated and shared by a group of diabetics through personal experience, of the causes, symptoms, treatment and complications of type 2 diabetes mellitus; to highlight the importance this has in the daily medical practice, and to understand the meaning of type 2 diabetes from the patient's perspective. MATERIAL AND METHODS: 88 patients were studied in an interactive process, with an interview outline that was applied in an open form at the waiting rooms for outpatients at two family medicine units of the Mexican Institute of Social Security (IMSS) in Guadalajara, Jalisco. RESULTS: The way in which patients construct a definition and an explanation of their illness is a syncretism of lived experiences done in a procedural manner. In this reconciliation, patients with diabetes integrate biomedical elements, alternative medicines, deities and even sorcery. CONCLUSIONS: These previously mentioned factors should be considered when in contact with the patient if one thinks that the influence of a doctor or institutional health care provider has the objective of achieving a greater effectiveness in the long-term handling of these patients.

Cementerios y salud pública en Guadalajara / Cementeries and public health in Guadalajara

Introducción: el presente estudio tiene el objetivo de dar cuenta de la institucionalización de la muerte a través del tiempo en los cementerios de la ciudad de Guadalajara.Diseño: descriptivo.Material y método: revisión de escritos y documentos localizados referentes a Campos Santos y Cementerios, en los archivos públicos y eclesiásticos de la ciudad de Guadalajara. Jalisco. México.Resultados: la influencia religiosa y familiar en la disposición de los cadáveres durante la colonia, se ve sustituida por la intervención del Estado en forma de control de los cuerpos muertos a través de una legislación influenciada por los conocimientos de la época.Discusión: en los cementerios en la ciudad de Guadalajara, hasta mediados del siglo XX, las representaciones y la legislación, cambiaron poco en términos de controlar, organizar y secuenciar la vida y la muerte de los ciudadanos. Sin embargo, a inicios del actual siglo XXI, la modernidad con sus contradicciones, se revierte al Estado controlador de los cuerpos muertos, en cuanto otros procesos, como el de urbanización-industrialización, que reclaman espacios para los cuerpos de los vivos.Actualmente las estrategias del Estado para disponer los cadáveres, se orientan hacia la minimización del cuerpo, sin perder el control.

Esperanza de vida en la población usuaria del IMSS. como indicador de la acción de la seguridad social / Life expectancy in an IMSS user population as an indicator of social security action

Se construyó una tabla de vida para la población usuaria del Instituo Mexicano del Seguro Social, Delegación Jalisco, con el fin de conocer la esperanza de vida (EV) en esa población, sus diferencias en cuanto a grupo etáreo, sexo y variaciones de tendencia. Fue utilizado el método abreviado de Reed y Merrel, con datos obtenidos de los certificados de defunción de 1996. Se calculó una EV al nacer de 76.36 años para hombres y 79.7 para mujeres, cifras superiores a la nacional (70.8 años) y a la de Jalisco (72.17 años). Es notable una mejoría en la EV general, hay un cambio positivo de 3.31 puntos respecto al año de 1983. Concluimos que nuestra población está al borde de una transición demográfica consumada, con un incremento del grupo de 20 a 64 años, y que se requiere adoptar los servicios a la nueva estructura de salud poblacional. Por ello, el equipo de salud deberá estrechar su labor participativa con la población, teniendo a la seguridad social como base de la promoción y cuidado de la salud