Intersectionality and depression symptoms in Mexican adults aged ≥50, MHAS 2001 and 2012.

OBJECTIVE: To analyze, from the perspective of intersectionality, the association of social inequality dimensions (occupation, poverty, and educational level) and socio-demographic and health characteristics with the proportion of depressive symptoms among males and females aged 50 years and older who participated in the 2001 and 2012 waves of the Mexican Health and Aging Study (MHAS). MATERIALS AND METHODS: Descriptive analysis and logistic regression models stratified by sex were performed, including interaction terms between poverty, educational level, and employment conditions on the presence of depressive symptoms. RESULTS: The proportion of females with depressive symptoms was significantly higher than that of males in both waves. A high proportion of older females in poverty, with five years or less of education and manual occupational activities, reported depressive symptoms in the MHAS-2001. The interactions evaluated between occupation, poverty, and educational level were not statistically significant under adjusted models; however, disability and comorbidities were associated with depressive symptoms in both sexes. CONCLUSION: A higher proportion of females have depressive symptoms under conditions of inequality; however, the effect of the intersection between employment and socio-demographic characteristics on depressive symptoms was not observed under adjusted models.

Sleep disorders and fatigue among truck and bus drivers in Mexico.

BACKGROUND: Fatigue and sleep disturbances are among the most common disorders suffered by transport drivers. OBJECTIVE: To identify and analyze working conditions for Mexican federal transportation truck and bus drivers, and their connection with sleep disorders and fatigue. METHODS: A cross-sectional, quantitative study was performed with a convenience sample of 172 drivers (84 truck and 88 bus) by applying the Survey Evaluation and Monitoring of Workers Health (PROESSAT in Spanish) and the Yoshitake Fatigue questionnaire. RESULTS: Night work and performing hazardous work increased the prevalence of sleep disorders (PR = 3.9 and PR = 6.9, respectively). Poor lighting and being paid per trip increased the prevalence of fatigue (PR = 2.8 and PR = 2.5, respectively). CONCLUSION: Several conditions were found to impact health, including long work shifts, strenuous physical effort, night work, little social support, being paid by distance, strict quality controls, and risk of crimes such as extortion, robbery, attacks, and kidnapping.

Principales sesgos en la investigación epidemiológica en salud ocupacional / Main biases in epidemiological research in occupational health

El objetivo de este documento es mostrar una síntesis de los principales sesgos que pueden aparecer en el estudio de la salud del trabajo, sus orígenes y consecuencias. Para ello, se realizó una revisión documental de libros y artículos publicados en los últimos 10 años en inglés y español. Se dejó fuera aquellos documentos que no estuvieran publicados en revistas con comité editorial y en caso de los libros, que no tuvieran registro ISBN. Se incluyeron 7 libros y 14 artículos. Un sesgo es un error sistemático, que sucede en el proceso de investigación y que pueden darse durante la planeación, recolección y procesamiento de datos. Se revisarán dos tipos principales de sesgos: 1) Selección y 2) Información y/o medición, en cada caso se describe la definición, potencial impacto en los resultados y se plantean una serie de ejemplos que ayudan a su compresión. Uno de los efectos principales de la presencia de sesgos en investigación es que ocasiona un error de clasificación en los participantes, que puede ser diferencial o no, esto impacta los resultados al sobre o subestimarlos, en otras palabras, se encuentran efectos mayores a los reales o peor, no los encontramos cuando si existen. Para ilustrar el impacto de los sesgos, se revisan distintos escenarios que ejemplifican los casos de sobreestimación y subestimación que originan resultados poco confiables(AU)

This document aims to show a synthesis of the main biases that can be present in occupational health studies, their origins and their consequences. For this purpose, a documentary review was conducted of books and articles published in the last 10 years in English and Spanish. Excluding those documents that were not published in journals with an editorial board and, in the case of books, that did not have an ISBN registry. A total of 7 books and 14 articles were included. A bias is a systematic error that occurs in the research process and can occur during the data planning, collection, and processing. Two main types of biases will be reviewed: 1) Selection and 2) Information and/or measurement biases, in each case their definition and, their possible impact on the results are described, a series of examples that may help to understand them are provided. One of the main effects of the presence of biases in research is that they cause an error in the classification of participants, which can be differential or not, and this has an impact on the results by overestimating or underestimating them, i.e., finding stronger effects than the real ones, or worse, not finding them when they exist. To illustrate the impact of biases, different scenarios were reviewed that provide examples of cases of overestimation and underestimation that lead to unreliable results(AU)

Working Conditions and the Components of Burnout Among Nursing Staff in a Public Hospital in Mexico City.

BACKGROUND: Working conditions in public hospitals in Mexico City are highly demanding. The need for healthcare is pressing, materials and instruments are scarce, and exposure to pain and suffering is constant. These adverse conditions have an adverse impact on the physical and mental health of healthcare professionals. The nursing staffs are among those who are most affected, and they frequently experience burnout syndrome or one of its several dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment. PURPOSE: The aim of this research was to analyze the relationship among working conditions, related stress, and the dimensions of burnout syndrome in a tertiary care public hospital in Mexico City. METHODS: A cross-sectional design was applied on a random sample of 190 nurses in a public hospital in Mexico City. Working conditions and burnout syndrome were evaluated using standardized instruments. Adjusted prevalence ratios were calculated. Three clusters, one for each burnout dimension, were generated and then evaluated using a correspondence analysis with labor characteristics. RESULTS: One quarter (25%) of the participants self-reported a sense of personal accomplishment, and 12% reported emotional exhaustion and depersonalization. The labor variables that were found to be associated with the dimensions of burnout were workload, performing potentially hazardous work, and conducting tedious tasks. Positive conditions were shown to decrease the prevalence of burnout in all three dimensions. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Working conditions for nursing staff impact the mental health of nurses and affect the quality of the healthcare they provide. The set of work demands and stressors to which they are exposed should be controlled and modified to ensure a healthy work environment.

Work Environment, Mental Health, and Eating Behavior in Mexican Nurses.

Nursing staff in public hospitals face highly demanding working conditions, which are related to mental health and eating problems. The current study aimed to identify the most frequent work characteristics associated with mental health problems and eating behavior in nursing staff. A cross-sectional study was performed on a random sample of 190 nurses at a specialized hospital in Mexico City. Work characteristics, mental health problems (stress, depression, and anxiety), emotional eating, and loss-of-control eating were measured using standardized scales. Associations among relevant work variables and mental health and eating behavior were assessed using logistic regression models adjusted for sociodemographic characteristics. High prevalence of stress (28%), depression (35%), anxiety (33%), emotional eating (27%), and loss-of-control eating (38%) were found. These mental health problems have been associated with variables related to work overload, little appreciation of work, and exposure to the suffering and death of patients. [Journal of Psychosocial Nursing and Mental Health Services, 60(1), 31-37.].

Domestic work, occupational stress and depression in nurses at a public hospital in Mexico City

AIM: To identify the effect of the domestic on the depression of nurses in a public hospital in Mexico City. BACKGROUND: Domestic work performed mainly by women coupled with the demands of work is associated with the possibility of developing mental disorders, especially depression. INTRODUCTION: Working conditions have an impact on the physical and mental health of nurses. Participation in domestic activities adds to wear and tear on workers. METHODS: The research had a cross-sectional design with a random sample of 329 nurses from a third-level hospital in Mexico City. Occupational stress and domestic work were evaluated with nursing Stress Scale questionnaires and the Individual Worker Health Survey (PROESSAT). The DASS-21 subscale was used for depression. The associations were analyzed using logistic regression models. RESULTS: The probability of suffering from depression was 7 times higher for women engaged in domestic work. Experiencing death, lack of support and having an additional job increased their association. DISCUSSION: The work-family conflict, as well as lack of support, is associated with depressive symptoms in nurses. CONCLUSION: There is a need to implement strategic programs that provide nurses with tools to deal with work-family conflict reconciliation. It is necessary to offer more favorable working conditions in the practice of nursing.

Musculoskeletal disorders and occupational demands in nurses at a tertiary care hospital in Mexico City.

OBJECTIVE: Identify the association between working conditions, musculoskeletal symptoms and ergonomic demands on nurses. BACKGROUND: The physical demands of nursing often require repetitive and forced movements that increase the likelihood of developing musculoskeletal disorders, which are the main occupational diseases in this working population. METHODOLOGY: Cross-sectional study of 329 nurses chosen at random. Initial symptoms of musculoskeletal disorders (MSDs) were evaluated using Kuorinka's Nordic questionnaire; occupational demands and domestic activities were evaluated using the Individual Survey for Workers' Health, PROESSAT. Logistic regression models were fit to identify associations between musculoskeletal symptoms and occupational activities. RESULTS: A prevalence of 87% and 83% of musculoskeletal disorders was found in the neck and dorsal/lumbar regions, respectively. Using logistic models, associations were identified between ergonomic requirements, exposure time, domestic work, supervision and discomfort in various regions of the body. CONCLUSIONS: Postural demands are closely associated with the development of musculoskeletal disorders. Early identification and timely intervention are fundamental. IMPLICATIONS FOR NURSING MANAGEMENT: Musculoskeletal disorders are very common among nurses and are closely associated with occupational tasks.

Programa de estímulos económicos y daños a la salud en académicos de seis universidades mexicanas / Economic stimulus programs and adverse health among faculty at six mexican universities

Los docentes e investigadores universitarios participan en diversos programas de estímulos económicos que recompensan la productividad. Para obtenerlos atraviesan por evaluaciones pormenorizadas de la mayoría de actividades laborales que, a la larga, se han constituido en una verdadera sobrecarga laboral. Esta modalidad de trabajo basada en la productividad, ha traído consigo importantes daños en la salud de estos trabajadores. El objetivo de esta investigación es conocer los daños a la salud asociados con las exigencias y condiciones laborales del personal académico y de investigación de seis universidades públicas en México. Para ello se aplicó una encuesta de uso epidemiológico, adaptada del Programa de Evaluación y Seguimiento de la Salud de los Trabajadores (PROESSAT) a las necesidades de cada población. Asimismo, se aplicaron el inventario DASS 21 para valorar ansiedad, depresión y estrés, el cual fue validado con población latina. La prueba Yoshitake para medir fatiga, se validó en población mexicana. Con estos instrumentos se exploraron: datos generales, condiciones del trabajo, consecuencias de la participación en programas de estímulos, exigencias laborales y daños en la salud física y mental. Se indagaron13 distintos trastornos, los de mayor prevalencia fueron: los músculoesqueléticos y la disfonía con una tasa de 37 por cada 100 trabajadores, seguidos del distrés y la lumbalgia con 30 y28 por cada 100 trabajadores. La tasa general de morbilidad fue de 3 trastornos por cada trabajador(AU)

University professors and researchers participate in a variety of economic stimulus programs that reward productivity. In order to receive these payments, they must undergo detailed evaluations of the majority of their job activities. This process has led to a considerable work overload. Evaluations of this type, based on productivity, have caused significant damage to the health of these workers. The objective of this epidemiological survey-based study was to examine adverse health effects associated with the job demands and working conditions of teaching and research faculty at six public universities in Mexico. The survey instrument was derived from the Program for Evaluation and Monitoring of Worker Health (PROESSAT, by its Spanish acronym) and adapted to the needs of the study population. We applied the DASS-21 inventory, previously validated in a Latino population, to assess anxiety, depression and stress. We also administered the Yoshitake test to measure fatigue, which has been validated in a Mexican population. These instruments were used to explore demographic data, working conditions, consequences of participation in stimulus programs, job requirements and adverse physical and mental health effects. We explored 13 different health disorders, of which the most prevalent were musculoskeletal disorders and dysphonia (at 37% each), followed by distress and low back pain (30% and 28%, respectively. The overall morbidity rate was three disorders per worker(AU)

The association between social support and cognitive function in Mexican adults aged 50 and older.

Social support networks are crucial for the health of older adults; however, personal characteristics and time of life may diminish the protective effect of social support. OBJECTIVE: to determine if the presence of social support networks were associated with cognitive impairment among Mexican adults aged 50 or older and if this relationship was different based on age. METHOD: This study analyzed data from the National Representation Survey performed in Mexico, Study on Global Ageing (SAGE) wave 1. Cognitive function was evaluated by a standardized test, social support was evaluated through latent class analysis (LCA). The LCA was run to obtain three subgroups of different Social Support Levels (SSL): low, medium, and high. Logistic regression models, stratified by age, were performed to analyze the association between SSL and cognitive function. RESULTS: For respondents ages 71-80 y/o, there was an inverse relationship with cognitive impairment for those with medium (OR 0.23, p=0.020) and high (OR 0.07, p=0.000) SSL in comparison with low SSL. While social support helped to improve cognitive function in older adults aged 71-80, this same association was not observed in adults of other ages. Those younger than 70 y/o may not need such a strong support network as a result of being more self-sufficient. After 80, social networks were not enough to help diminish the negative impact of cognitive impairment. CONCLUSION: Social support could improve the cognitive function of adults ages 71 and 80; suggesting there could be a window of opportunity to improve cognitive functioning for this group.

Risk factors associated to diabetes in Mexican population and phenotype of the individuals who will convert to diabetes / Factores de riesgo asociados con diabetes en la población mexicana y fenotipo de los individuos que desarrollarán diabetes

Objective. To describe risk factors associated to the incidence of type 2 diabetes (T2D) in Mexican population and to define phenotypic (clinical, anthropometric, metabolic) characteristics present in the individual who will convert to diabetes, regardless of time of onset. Materials and methods. The Mexico City Diabetes Study began in 1990, with 2 282 participants, and had three subsequent phases: 1994, 1998, and 2008. A systematic evaluation with an oral glucose tolerance test was performed in each phase. For diagnosis of T2D, American Diabetes Association criteria were used. Results. The population at risk was 1939 individuals. Subjects who were in the converter stage (initially non diabetic that eventually converted to T2D) had, at baseline, higher BMI (30 vs 27), systolic blood pressure (119 vs 116 mmHg), fasting glucose (90 vs 82mg/dl), triglycerides (239 vs 196mg/dl), and cholesterol (192 vs 190mg/dl), compared with subjects who remained non converters (p<0.05). Conclusion. The phenotype described represents a potentially identifiable phase and a target for preventive intervention.

Objetivo. Describir los factores de riesgo asociados con la incidencia de diabetes tipo 2 (T2D) en la población mexicana, así como el fenotipo de los sujetos que desarrollarán diabetes, independientemente del tiempo que lleve el desarrollo de esta nueva condición. Material y métodos. El Estudio de la Diabetes de la Ciudad de México inició en 1990 y tuvo un total de 2 282 participantes a los que se dio seguimiento en tres ocasiones: 1994, 1998 y 2008. Se realizó una curva de tolerancia a la glucosa para diagnosticar T2D, para lo cual se siguieron los criterios de la Asociación Americana de Diabetes. Resultados. La población en riesgo fue de 1939 sujetos. Los individuos en proceso de desarrollo (aquellos inicialmente no diabéticos que desarrollaron T2D) mostraron niveles más altos de IMC (30 vs 27), presión arterial sistólica (119 vs 116 mmHg), glucosa en ayuno (90 vs 82 mg/dl), triglicéridos (239 vs 196 mg/dl) y colesterol (192 vs 190 mg/dl), comparados con los sujetos que no desarrollaron T2D (p<0.05). Conclusiones. El estado de los individuos que se convertirán en diabéticos es discernible y representa una fase del padecimiento con potencial para la prevención.

Incidence of type 2 diabetes in Mexico: results of the Mexico City Diabetes Study after 18 years of follow-up.

OBJECTIVE: To estimate the incidence of type 2 diabetes (T2D) in Mexican population. MATERIALS AND METHODS: Population based prospective study. At baseline (1990), the population at risk (1939 non-diabetic adults 35-64 years) was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008). American Diabetes Association diagnostic criteria were applied. RESULTS: The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994), third (1998) and fourth (2008) follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases. CONCLUSIONS: This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

Incidence of type 2 diabetes in Mexico: Results of The Mexico City Diabetes Study after 18 years of follow-up / Incidencia de diabetes tipo 2 en México: Resultados del Estudio de la Diabetes en la Ciudad de México después de 18 años de seguimiento

Objective. To estimate the incidence of type 2 diabetes (T2D) in Mexican population. Materials and methods. Population based prospective study. At baseline (1990), the population at risk (1939 non-diabetic adults 35-64 years) was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008). American Diabetes Association diagnostic criteria were applied. Results. The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994), third (1998) and fourth (2008) follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases. Conclusions. This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

Objetivo. Estimar la incidencia de diabetes mellitus tipo 2 (T2D) en México. Material y métodos. Estudio prospectivo, de base poblacional. En el examen basal (1990) se evaluó a 1939 participantes normoglucémicos, con curva de tolerancia a la glucosa. Se realizó examen similar en tres evaluaciones subsecuentes (1994, 1998, 2008). Se aplicaron criterios recomendados por la American Diabetes Association. Resultados. En el tiempo de observación (27842 años persona), la incidencia acumulada de T2D fue de 14.4 y 13.7 por 1000 años persona en hombres y mujeres, respectivamente. En evaluaciones intermedias de (1994, 1998 y 2008) fue de 15.8, 15.7 y 12.7 por 1 000 años persona, respectivamente. Los casos prevalentes tuvieron edad promedio al diagnóstico de 44 años; los incidentes de 56 años. Conclusiones. Esta es la primera estimación a largo plazo de la incidencia de T2D en población mexicana. Los resultados se encuentran entre los más altos informados en el mundo.

Risk factors associated to diabetes in Mexican population and phenotype of the individuals who will convert to diabetes.

OBJECTIVE: To describe risk factors associated to the incidence of type 2 diabetes (T2D) in Mexican population and to define phenotypic (clinical, anthropometric, metabolic) characteristics present in the individual who will convert to diabetes, regardless of time of onset. MATERIALS AND METHODS: The Mexico City Diabetes Study began in 1990, with 2 282 participants, and had three subsequent phases: 1994, 1998, and 2008. A systematic evaluation with an oral glucose tolerance test was performed in each phase. For diagnosis of T2D, American Diabetes Association criteria were used. RESULTS: The population at risk was 1939 individuals. Subjects who were in the converter stage (initially non diabetic that eventually converted to T2D) had, at baseline, higher BMI (30 vs 27), systolic blood pressure (119 vs 116 mmHg), fasting glucose (90 vs 82mg/dl), triglycerides (239 vs 196mg/dl), and cholesterol (192 vs 190mg/dl), compared with subjects who remained non converters (p<0.05). CONCLUSION: The phenotype described represents a potentially identifiable phase and a target for preventive intervention.

El papel del tiempo libre en la salud de un grupo de conductores de carga / The role of leisure in the health of the group of drivers load

El tiempo libre es fundamental en la vida de cualquier individuo, no obstante, su beneficio o repercusiones, han sido poco explorados en el ámbito laboral y extralaboral de los trabajadores y en concreto, sobre el papel que tiene esta variable en la salud. El objetivo de este estudio fue determinar el efecto del tiempo libre en la salud y vida cotidiana de un grupo de operadores de carga, en función del uso activo o pasivo que hacen del mismo. Se realizó un estudio de prevalencia en 119 choferes foráneos. Se utilizó una metodología tanto cuantitativa como cualitativa, a través de una encuesta y cuatro entrevistas. Con los datos obtenidos, se efectuó un análisis descriptivo y de correspondencia. Se encontró que salir a pasear con la familia disminuía en 87% la posibilidad de presentar trastornos del sueño en los conductores (RP .13, IC .03-.63). Se conformaron cuatro conglomerados para ver la relación del tiempo libre con algunos daños a la salud. Destaca que el grupo que utilizaba de manera activa su tiempo libre, tiene menor probabilidad de presentar trastornos mentales, que aquellos que lo utilizaban de manera pasiva. La investigación permitió visualizar cómo la organización del trabajo y las exigencias a las que se someten estos trabajadores, repercuten en su salud y permean su vida cotidiana, por la cantidad de horas laboradas y el tiempo que pasan sin frecuentar a su familia.

Leisure time is essential in the life of any person. Nonetheless, its effects on the health of individuals has received little attention, especially with respect to occupational and nonoccupational settings. To determine whether active or passive engagement in leisure time is associated with health and daily working life, a cross-sectional prevalence study was performed on 119 fuel truck drivers, using. both quantitative and qualitative methods, consisting of a survey and four in-depth interviews. Regularly taking a walk with family members was associated with a decrease of 87% in the prevalence of sleep disorders among the drivers (OR, 0.13, 95% CI, 0.03-0.63). Four groups were constructed to evaluate the relationship between free time and selected health problems. The group that was actively involved in using its leisure time had a lower prevalence of mental health disorders than those who used it passively.. The results of this study allow us to see how work organization and job demands affect the health and daily lives of these workers, due to long working hours and time spent away from family.