Asociación de la violencia obstétrica, control prenatal y embarazo no planeado con la prematurez / Association of obstetric violence, prenatal control, and unplanned pregnancy with prematurity

Resumen La prematurez (PM) neonatal es un problema mayor de salud pública en el mundo, debido a su frecuencia de presentación y los años de vida potencialmente perdidos; además, es la principal causa de muerte en menores de cinco años. Entre las consecuencias negativas de la PM están las discapacidades del aprendizaje, visual y auditiva. Múltiples son los factores asociados a la PM; algunos pueden ser detectados y modificados de forma oportuna en las consultas prenatales y también, en las preconcepcionales. Por otro lado, la PM no es solamente responsabilidad del prestador de los servicios de salud, sino también del sistema de salud, el cual, debe otorgar los recursos mínimos necesarios para monitorear y mantener a la embarazada en un estado óptimo de salud para evitarla, y en caso de presentarse, debe contar con la infraestructura hospitalaria básica que permita la viabilidad del producto y evitar su muerte. Aunado a lo anterior, se debe de considerar la responsabilidad de la paciente y su pareja, debido a que en ellos recae la obligación de llevar un estilo de vida saludable y acudir a las consultas preconcepcionales y control prenatal.

Abstract Neonatal prematurity (MP) is a major public health problem in the world, due to its presentation frequency and the years of life potentially lost; In addition, it is the main cause of death in children under five years of age. Among the negative consequences of MP are learning, visual and hearing disabilities. There are multiple factors associated with MP; some can be detected and modified in a timely manner in prenatal consultations and in preconception. On the other hand, MP is not only responsibility of the health service provider, but also of the health system, which must grant the minimum resources necessary to monitor and maintain the pregnant woman in an optimal state of health to avoid it, and if it occurs, the hospital must have the basic infrastructure that allows the viability of the product and prevents its death. In addition, the responsibility of the patient and her partner must be considered since they are obliged to lead a healthy lifestyle and attend preconception consultations and prenatal care.

Obesity, physical activity and prediabetes in adult children of people with diabetes.

OBJECTIVES: Determine prevalence of obesity / overweight, physical activity (PA) and prediabetes in adult children of parents with type 2 diabetes; identify differences according to sociodemographic variables, and describe the relationship of obesity/overweight with fasting glucose (FG) and glycosylated hemoglobin (A1C). METHODS: Cross-sectional study in 30 Mexican families with 53 participating adult children. Obesity / overweight was determined with Body Mass Index (BMI), Waist Circumference (WC) and body fat percentage (BFP); PA with the short International Physical Activity Questionnaire (IPAQ), and prediabetes with FG. RESULTS: 64% of participants presented obesity / overweight, 32% low PA, and 19% prediabetes. Men had higher WC than women (U= 219, p= 0.03). Women showed more BFP than men (U= 142, p <0.01). Blood glucose was related to BFP (rs= 0.336, p < 0.05), the A1C with the BMI (rs= 0.417, p <0.01), WC (rs= 0.394, p<0.01), BFP (rs= 0.494, p<0.01) and intense PA (rs= - 0.285, p<0.05). CONCLUSIONS: High prevalence of obesity / overweight and low PA were found. The FG was related only to BFP and A1C, in addition to BMI, WC and inversely with intense BP. It is recommended to modify the educational strategies of nursing at a family level.

Obesity, physical activity and prediabetes in adult children of people with diabetes / Obesidade, atividade física e pré-diabetes em filhos de pessoas com diabetes / Obesidad, actividad física y prediabetes en hijos de personas con diabetes

ABSTRACT Objectives: Determine prevalence of obesity / overweight, physical activity (PA) and prediabetes in adult children of parents with type 2 diabetes; identify differences according to sociodemographic variables, and describe the relationship of obesity/overweight with fasting glucose (FG) and glycosylated hemoglobin (A1C). Methods: Cross-sectional study in 30 Mexican families with 53 participating adult children. Obesity / overweight was determined with Body Mass Index (BMI), Waist Circumference (WC) and body fat percentage (BFP); PA with the short International Physical Activity Questionnaire (IPAQ), and prediabetes with FG. Results: 64% of participants presented obesity / overweight, 32% low PA, and 19% prediabetes. Men had higher WC than women (U= 219, p= 0.03). Women showed more BFP than men (U= 142, p <0.01). Blood glucose was related to BFP (rs= 0.336, p < 0.05), the A1C with the BMI (rs= 0.417, p <0.01), WC (rs= 0.394, p<0.01), BFP (rs= 0.494, p<0.01) and intense PA (rs= - 0.285, p<0.05). Conclusions: High prevalence of obesity / overweight and low PA were found. The FG was related only to BFP and A1C, in addition to BMI, WC and inversely with intense BP. It is recommended to modify the educational strategies of nursing at a family level.

RESUMO Objetivos: Determinar a prevalência de obesidade/sobrepeso, atividade física (AF) e pré-diabetes em filhos de pessoas com diabetes mellitus tipo 2; identificar diferenças de acordo com variáveis sociodemográficas e descrever a relação de obesidade/sobrepeso com a glicose em jejum (GJ) e a hemoglobina glicosilada (HbA1c). Métodos: Estudo transversal em 30 famílias mexicanas com 53 filhos participantes. A obesidade/sobrepeso foi determinada por meio do Índice de Massa Corporal (IMC), Circunferência da Cintura (CC) e percentual de gordura corporal (GC); a AF com o Questionário Internacional de Atividade Física curto (IPAQ) e pré-diabetes com a GJ. Resultados: 64% dos participantes apresentaram obesidade/sobrepeso, 32% baixa AF e 19% pré-diabetes. Os homens tiveram maior CC do que as mulheres (U= 219, p= 0.03). As mulheres mostraram mais GC do que os homens (U= 142, p <0.01). A glicose sanguínea esteve relacionada com a GC (rs= 0.336, p < 0.05), a HbA1c com o IMC (rs= 0.417, p <0.01), CC (rs= 0.394, p<0.01), GC (rs= 0.494, p<0.01) e AF intensa (rs= - 0.285, p<0.05). Conclusões: Foram encontradas altas prevalências de obesidade/sobrepeso e baixa AF. A GJ esteve relacionada somente com a GC e a HbA1c, além da GC, teve relação com o IMC, CC e de maneira inversa com a AF intensa. Recomenda-se modificar as estratégias educativas de enfermagem a nível familiar.

RESUMEN Objetivos: Determinar prevalencia de obesidad/sobrepeso, actividad física (AF) y prediabetes en hijos de personas con diabetes tipo 2; identificar diferencias de acuerdo a variables sociodemográficas y describir la relación de obesidad/sobrepeso con glucosa en ayuno (GA) y hemoglobina glucosilada (A1c). Métodos: Estudio transversal en 30 familias mexicanas con 53 hijos participantes. La obesidad/sobrepeso se determinó con Índice de Masa Corporal (IMC), Circunferencia de Cintura (CC) y porcentaje de grasa corporal (GC); la AF con el cuestionario IPAQ corto y prediabetes con GA. Resultados: 64% de los participantes presentó obesidad/sobrepeso, 32% baja AF y 19% prediabetes. Los hombres tuvieron mayor CC que las mujeres (U= 219, p= 0.03). Las mujeres mostraron más GC que los hombres (U= 142, p <0.01). La glucosa sanguínea estuvo relacionada con la GC (rs= 0.336, p < 0.05), la A1c con el IMC (rs= 0.417, p <0.01), CC (rs= 0.394, p<0.01), GC (rs= 0.494, p<0.01) y AF intensa (rs= - 0.285, p<0.05). Conclusiones: Se encontraron altas prevalencias de obesidad/sobrepeso y baja AF. La GA estuvo relacionada sólo con GC y la A1c además con el IMC, CC y de manera inversa con la AF intensa. Se recomienda modificar las estrategias educativas de enfermería a nivel familiar.

Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States.

This study examined self-care behaviors and their relationship to glycemic control in low-income Mexican adults with type 2 diabetes in Southeastern Tamaulipas, México. A total of 135 patients were enrolled from 17 community health centers. The most frequent self-care behavior was medication management (80%), and the least frequent self-care behavior was self blood glucose monitoring (7%). All the patients demonstrated poor glycemic control, with glycated hemoglobin > 7%. Self-care behaviors were associated with fasting blood glucose (rs = .223, p = .005). Medication management was influenced by cognitive performance, F(1, 130) = 4.49, p = .036, and depression, F(1, 130) = 8.22, p = .005. Dietary behaviors were influenced by previous diabetes education, F(1, 130) = 6.73, p = .011. These findings indicate that education and cognitive behavioral interventions in Spanish for Mexican adults with type 2 diabetes are urgently needed.

[ANTHROPOMETRIC INDICATORS AND CARDIOMETABOLIC EVENTS AMONG SCHOOL-AGED CHILDREN FROM SONORA, MEXICO]. / INDICADORES ANTROPOMÉTRICOS Y SU ASOCIACIÓN CON EVENTOS CARDIOMETABÓLICOS EN ESCOLARES DE SONORA, MÉXICO.

INTRODUCTION: obesity in childhood is predictive of obesity in adulthood and it is associated with adverse health effect apparent since childhood; however, the joint assessment of obesity and adverse events among children in clinical settings is unusual. OBJECTIVES: to assess the association of overweight and obesity, abdominal obesity, and excess body fat with systolic [SBP] and diastolic [DBP] blood pressure, lipid profile and glucose levels; and to identify the best anthropometric indicator of such events. MATERIAL AND METHODS: we conducted a cross-sectional study in a sample of 412 schoolchildren. The presence of overweight and obesity, abdominal obesity and excess body fat was determined among all participants; levels of total cholesterol, triglycerides, high and low density lipoproteins, and glucose were measured in a subsample (n = 133). The associations of interest were assessed using adjusted linear and logistic regression models. RESULTS: 33% of the children were overweight or obese. Overall, overweight, obesity, abdominal obesity, and excess body fat were associated with elevated SBP and DBP and with a lipid profile and glucose levels that could indicate health risks among these children. Overweight and obesity were the best predictors of such events. CONCLUSIONS: among these school-aged children, we observed that obesity was associated with high odds of having adverse health outcomes such as high blood pressure, lipids and glucose. Such adverse events can be predicted by the presence of obesity measured by BMI, which is a noninvasive, inexpensive and easy to implement measure.

Introducción: la obesidad durante la niñez es predictiva de obesidad en la adultez y se asocia a eventos adversos para la salud observables desde etapas tempranas; sin embargo, la evaluación conjunta de obesidad y eventos adversos en los menores no es parte de la atención médica habitual. Objetivos: evaluar la asociación de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal con la presión arterial sistólica [PAS] y diastólica [PAD], y el perfil de lípidos y glucosa; e identificar el mejor indicador antropométrico de dichos eventos. Material y métodos: estudio transversal en 412 escolares a quienes se les determinó la presencia de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal. Los niveles de colesterol total, triglicéridos, lipoproteínas de alta y baja densidad y glucosa se determinaron en una submuestra (n = 133). Las asociaciones se evaluaron con modelos de regresión lineal y logística ajustados. Resultados: el 33% de los participantes tuvieron sobrepeso u obesidad. El sobrepeso, la obesidad, la obesidad abdominal y el exceso de grasa corporal se asociaron con un incremento de PAS y PAD, y con un perfil de lípidos y glucosa que representan riesgos para la salud. El sobrepeso y la obesidad fueron los mejores predictores de dichos eventos. Conclusiones: en nuestra población, la obesidad se asoció con mayor posibilidad de presentar eventos adversos para la salud como PA elevada, niveles de lípidos y glucosa altos. La obesidad puede ser determinada con el IMC, que es un índice de bajo coste, no invasivo y de fácil implementación.

Indicadores antropométricos y su asociación con eventos cardiometabólicos en escolares de Sonora, México / Anthropometric indicators and cardiometabolic events among school-aged children from sonora, Mexico

Introducción: la obesidad durante la niñez es predictiva de obesidad en la adultez y se asocia a eventos adversos para la salud observables desde etapas tempranas; sin embargo, la evaluación conjunta de obesidad y eventos adversos en los menores no es parte de la atención médica habitual. Objetivos: evaluar la asociación de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal con la presión arterial sistólica [PAS] y diastólica [PAD], y el perfil de lípidos y glucosa; e identificar el mejor indicador antropométrico de dichos eventos. Material y métodos: estudio transversal en 412 escolares a quienes se les determinó la presencia de sobrepeso y obesidad, obesidad abdominal y exceso de grasa corporal. Los niveles de colesterol total, triglicéridos, lipoproteínas de alta y baja densidad y glucosa se determinaron en una submuestra (n = 133). Las asociaciones se evaluaron con modelos de regresión lineal y logística ajustados. Resultados: el 33% de los participantes tuvieron sobrepeso u obesidad. El sobrepeso, la obesidad, la obesidad abdominal y el exceso de grasa corporal se asociaron con un incremento de PAS y PAD, y con un perfil de lípidos y glucosa que representan riesgos para la salud. El sobrepeso y la obesidad fueron los mejores predictores de dichos eventos. Conclusiones: en nuestra población, la obesidad se asoció con mayor posibilidad de presentar eventos adversos para la salud como PA elevada, niveles de lípidos y glucosa altos. La obesidad puede ser determinada con el IMC, que es un índice de bajo coste, no invasivo y de fácil implementación (AU)

Introduction: obesity in childhood is predictive of obesity in adulthood and it is associated with adverse health effect apparent since childhood; however, the joint assessment of obesity and adverse events among children in clinical settings is unusual. Objectives: to assess the association of overweight and obesity, abdominal obesity, and excess body fat with systolic [SBP] and diastolic [DBP] blood pressure, lipid profile and glucose levels; and to identify the best anthropometric indicator of such events. Material and methods: we conducted a cross-sectional study in a sample of 412 schoolchildren. The presence of overweight and obesity, abdominal obesity and excess body fat was determined among all participants; levels of total cholesterol, triglycerides, high and low density lipoproteins, and glucose were measured in a subsample (n = 133). The associations of interest were assessed using adjusted linear and logistic regression models. Results: 33% of the children were overweight or obese. Overall, overweight, obesity, abdominal obesity, and excess body fat were associated with elevated SBP and DBP and with a lipid profile and glucose levels that could indicate health risks among these children. Overweight and obesity were the best predictors of such events. Conclusions: among these school-aged children, we observed that obesity was associated with high odds of having adverse health outcomes such as high blood pressure, lipids and glucose. Such adverse events can be predicted by the presence of obesity measured by BMI, which is a noninvasive, inexpensive and easy to implement measure (AU)

Educación, actividad física y obesidad en adultos con diabetes tipo 2 desde la perspectiva del autocuidado de Orem / Education, Physical Activity and Obesity among Adults with Type II Diabetes from the Standpoint of Orem's Self-care Theory / Educação, atividade física e obesidade em adultos com diabete tipo 2 a partir da perspectiva do autocuidado de Orem

Objetivos: describir la relación de la actividad física (pasos/día)/ejercicio con la obesidad (índice de masa corporal, circunferencia de cintura y grasa corporal) en adultos con diabetes tipo 2. Se planteó además: 1) determinar la relación de la educación/comprensión en diabetes con la actividad física/ejercicio, y 2) establecer diferencias de actividad física/ejercicio y obesidad/sobrepeso de acuerdo con variables sociodemográficas. Materiales y métodos: diseño descriptivo correlacional, muestra aleatoria de 124 pacientes de 17 centros comunitarios de Tampico, Tamaulipas, México. Las mediciones incluyeron: podómetro New-Life Style 2000, cuestionarios de autocuidado y Perfil de Cuidado en Diabetes, IMC, CC y grasa corporal. Los datos se analizaron con medidas de tendencia central, correlación de Spearman, prueba U de Mann-Whitney y Kruskal Wallis. Resultados: el promedio de pasos/día mostró relación inversa con el IMC (r s = - 0,282, p < 0,01) y la CC (r s = - 0,300, p < 0,01). La comprensión en diabetes tuvo relación positiva con el ejercicio (r s = 0,179, p = 0,04). Las mujeres fueron quienes tuvieron mayor porcentaje de grasa corporal (p < 0,05). Conclusiones: los hallazgos tienen implicaciones importantes para el ejercicio práctico de la profesión de enfermería que juega un papel esencial en el fomento de la actividad física y otros comportamientos básicos de autocuidado a través de la educación. La educación basada en teoría se hace necesaria para el avance en el conocimiento de la disciplina.

Objectives: Describe the relationship between physical activity (steps/day)/exercise and obesity (body mass index, waist circumference and body fat) in adults with type II diabetes. The study also was intended to: 1) determine the relationship between education/ understanding of diabetes and physical activity / exercise, and 2) to identify differences in physical activity / exercise and overweight / obesity according to a set of socio-demographic variables. Materials and methods: The study was descriptive and correlational in design, with a random sample of 124 patients from 17 community centers in Tampico, Tamaulipas, Mexico. The measurements include: the New Lifestyles 2000 pedometer, plus questionnaires on self-care and the Diabetes Care Profile, BMI, WC and body fat. The data were analyzed with measures of central tendency, the Spearman correlation, the Mann- Whitney U testand the Kruskal Wallis test. Results: The average number of steps / day showed an inverse relationship to the BMI (r s = - 0.282, p < 0.01) and WC (r s = - 0.300, p < 0.01). Understanding diabetes had a positive relationship to exercise (r s = 0.179, p = 0.04). Those with a higher percentage of body fat were women (p < 0.05). Conclusions: The findings have important implications for professional nursing practice, which plays a crucial role in promoting physical activity and other self-care behavior through education. Theory-based education is necessary for the advancement of knowledge in the discipline.

Objetivos: descrever a relação da atividade física (passos/dia)/exercício com a obesidade (índice de massa corporal, circunferência de cintura e gordura corporal) em adultos com diabete tipo 2. Além disso, propôs-se: 1) determinar a relação da educação/compreensão em diabete com a atividade física/exercício, e 2) estabelecer diferenças de atividade física/exercício e obesidade/excesso de peso de acordo com variáveis sociodemográficas. Materiais e métodos: desenho descritivo correlacional, amostra aleatória de 124 pacientes de 17 centros comunitários de Tampico, Tamaulipas, México. As medições incluíram: pedômetro New-Life Style 2000, questionários de autocuidado e Perfil de Cuidado em Diabete, IMC, CC e gordura corporal. Os dados foram analisados com medidas de tendência central, correlação de Spearman, prova U de Mann-Whitney e Kruskal Wallis. Resultados: a média de passos/dia mostrou relação inversa com o IMC (r s = - 0,282, p < 0,01) e a CC (r s = - 0,300, p < 0,01). A compreensão em diabete teve relação positiva com o exercício (r s = 0,179, p = 0,04). As mulheres foram as que tiveram maior porcentagem de gordura corporal (p < 0,05). Conclusões: as descobertas têm implicações importantes para o exercício prático da profissão de enfermagem que desenvolve papel essencial no fomento da atividade física e outros comportamentos básicos de autocuidado por meio da educação. A educação baseada em teoria se faz necessária para o avanço no conhecimento da disciplina.