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BACKGROUND: Phase angle (PhA) is an indicator of cellular health, function, and integrity. PhA has been considered an indicator of nutritional and health status, but it is uncertain whether it could be used as a fitness or athletic performance indicator. OBJECTIVE: To analyze the relationship between PhA and the fitness and athletic performance of adolescent boxers and to know whether this association is independent of body composition. METHODS: Thirty-seven trained youth boxers (15-18 y old) participated in the study. Participants underwent anthropometry and bioelectrical impedance assessments. The following tests were conducted: Fitness-Gram battery; speed, agility, and quickness; ball throws; punch impact force; bench press maximal strength; and vertical and horizontal jumps. Linear regression models were estimated and adjusted by covariates. RESULTS: The PhA was related to upper-limb strength. Nevertheless, in linear regression models, after adjusting models by body composition, only PhA remained as a predictor of relative maximal strength. The PhA was not a predictor of speed, agility, and quickness; cardiorespiratory fitness; or lower-limb power, in which adiposity was the main predictor of fitness. CONCLUSIONS: In adolescent boxers, PhA can predict upper-limb maximal strength independently of bioelectrical impedance analysis premises. However, compared with mucle mass, PhA is not a better predictor of upper-limb maximal strength.
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OBJECTIVE: To evaluate the modifying effect of social capital on the relationship between living in violent communities and the presence of psychological distress in adolescents and youth in Mexico. METHOD: The analysis of the Social Cohesion Survey for the Prevention of Violence and Crime (ECOPRED, by its acronym in Spanish) was conducted. The analytic sample consisted of 39,639 participants aged 12 to 29 years. Community violence and social capital were measured at the census tract level using the average answers of a household's head sample. These environmental variables were independent of the experiences of the participants. Social capital variables included structural (social ties, recreational participation, collaborative participation, and social cohesion), and cognitive (trust in neighbors) dimensions. Multilevel structural equation models were used. RESULTS: Recreational participation, collaborative participation, and social cohesion modified the relationship between community environments and psychological distress. In females who lived in places with less recreational participation or less social cohesion, the higher the social disorder, the higher the psychological distress. A similar relationship between vandalism and psychological distress was identified, but only in males who lived in places with less collaborative participation, and in females with less social cohesion. CONCLUSIONS: Our results suggest that dimensions of the structural social capital (organization and interest in the community and its members) were the ones that had the buffering effect of the exposure to disordered community environments on psychological distress.
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The objective of this study was to evaluate the association of maternal cardiometabolic markers trajectories (glucose, triglycerides (TG), total cholesterol, systolic blood pressure (SBP) and diastolic blood pressure (DBP)) with estimated fetal weight trajectories and birth weight in Mexican pregnant women without medical complications. Cardiometabolic marker trajectories were characterized using group-based trajectory models. Mixed-effect and linear regression models were estimated to assess the association of maternal trajectories with estimated fetal weight and birth weight. The final sample comprised 606 mother-child dyads. Two trajectory groups of maternal cardiometabolic risk indicators during pregnancy were identified (high and low). Fetuses from women with higher values of TG had higher weight gain during pregnancy ( ß ^ = 24.00 g; 95%CI: 12.9, 35.3), were heavier at the sixth month ( ß ^ =48.24 g; 95%CI: 7.2, 89.7) and had higher birth weight ( ß ^ = 89.08 g; 95%CI: 20.8, 157.4) than fetuses in the low values trajectory. Fetuses from mothers with high SBP and DBP had less weight in the sixth month of pregnancy ( ß ^ = - 42.4 g; 95%CI: - 82.7, - 2.1 and ß ^ = - 50.35 g; 95%CI: - 94.2, - 6.4), and a higher DBP trajectory was associated with lower birth weight ( ß ^ = - 101.48 g; 95%CI: - 176.5, - 26.4). In conclusion, a longitudinal exposition to high values of TG and BP was associated with potentially adverse effects on fetal growth. These findings support the potential modulation of children's phenotype by maternal cardiometabolic conditions in pregnancies without medical complications.
Subject(s)
Cardiovascular Diseases , Fetal Development , Humans , Female , Pregnancy , Birth Weight , Weight Gain , Triglycerides , Cardiovascular Diseases/etiologyABSTRACT
The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.
Subject(s)
Crime Victims , Exposure to Violence , North American People , Adolescent , Adult , Female , Humans , Male , Crime Victims/psychology , Cross-Sectional Studies , Violence , Child , Young AdultABSTRACT
Abstract: The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.
Resumen: La asociación entre la violencia comunitaria y la salud mental se ha evaluado mediante informes de experiencias individuales, especialmente de adolescentes y jóvenes, pero poco se sabe sobre el efecto de residir en comunidades desordenadas y violentas. El objetivo de este estudio fue comprobar si existe una relación entre residir en entornos comunitarios desordenados y violentos y el distrés psicológico en adolescentes y jóvenes mexicanos, independientemente de su experiencia individual de victimización, así como evaluar el posible efecto modificador del sexo y la edad en esta asociación. Los datos provienen de una encuesta transversal que tomó como muestra representativa a 39.639 adolescentes y jóvenes de entre 12 y 29 años, residentes en ciudades mexicanas. Los entornos comunitarios desordenados y violentos se evaluaron mediante informes de una muestra secundaria de adultos que residían en las mismas comunidades donde vivían los participantes. El análisis exploratorio de datos posibilitó crear tres variables contextuales relacionadas con el entorno comunitario desordenado y violento: desorden social, vandalismo y delincuencia. Se estimaron modelos de regresión lineal multinivel con intercepto aleatorio. Los adolescentes y jóvenes que residían en ambientes con mayor desorden social presentaron mayor distrés psicológico. Los varones en entornos con más vandalismo tenían un mayor nivel de distrés psicológico. Inesperadamente, las mujeres que viven en comunidades con mayores niveles de delincuencia tuvieron menos síntomas. Es necesario enfrentar la violencia existente en las comunidades para generar estrategias que reduzcan no solo la delincuencia, sino también el desorden social y el vandalismo que pueden contribuir al desarrollo de efectos negativos en la salud mental.
Resumo: A associação entre violência comunitária e saúde mental tem sido estudada por meio de relatos de experiências individuais, particularmente em adolescentes e jovens, mas pouco se sabe sobre o efeito de viver em comunidades desordenadas e violentas. O objetivo deste estudo é determinar se há relação entre viver em ambientes comunitários desordenados e violentos e estresse psicológico em adolescentes e jovens mexicanos, independentemente de sua experiência individual de vitimização, e avaliar o potencial efeito modificador do sexo e da idade sobre essa associação. Os dados são de uma pesquisa transversal com uma amostra representativa de adolescentes e jovens residentes em cidades mexicanas, incluindo 39.639 participantes com idades de 12 a 29 anos. Ambientes comunitários desordenados e violentos foram avaliados por meio de relatos de uma amostra secundária de adultos que viviam nas mesmas comunidades onde os participantes viviam. Por meio da análise exploratória de dados, foram criadas três variáveis contextuais relacionadas ao ambiente comunitário desordenado e violento: desordem social, vandalismo e criminalidade. Foram estimados modelos de regressão linear multinível com interceptação aleatória. Adolescentes e jovens que viviam em ambientes com maior desordem social apresentaram maior estresse psicológico. Homens em ambientes com mais vandalismo apresentaram maior nível de estresse psicológico. Inesperadamente, as mulheres de comunidades com níveis mais altos de criminalidade tiveram menos sintomas. É preciso enfrentar a violência existente nas comunidades, gerando estratégias que reduzam não só a criminalidade, mas também a desordem social e o vandalismo que possam contribuir para o desenvolvimento de efeitos negativos na saúde mental.
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Resumen El propósito de este trabajo fue evaluar la efectividad de la entrevista motivacional en la consulta de nutrición sobre indicadores de riesgo cardiometabólico en pacientes con trastorno bipolar. Se realizó un estudio experimental en que el grupo control recibió orientación nutricional basada en planes de alimentación y el grupo de intervención recibió consulta nutricional incorporando los principios y habilidades de la entrevista motivacional. Los participantes fueron seguidos por tres meses y se realizaron evaluaciones de hábitos alimenticios, actividad física, riesgo cardiometabólico, composición corporal y calidad de vida. El grupo de entrevista motivacional redujo el consumo de carnes (B=-0.45, p=0.032) y embutidos (B=-0.60, p=0.002). Asimismo, la presión arterial diastólica (B=-6.97, p=0.029) y glucemia (B=-9.27, p=0.097) de estos pacientes tendieron a disminuir. La entrevista motivacional promueve cambios que pueden hacer una diferencia clínica; aun en reducidos periodos de tiempo. Los nutriólogos capacitados para su implementación disponen de una herramienta adicional para el manejo de comorbilidad cardiometabólica en población vulnerable.
Abstract The purpose of this work was to assess the effectiveness of the motivational interviewing in the nutrition consultation on indicators of cardiometabolic risk in patients with bipolar disorder. An experimental study was conducted in which the control group receives nutritional guidance based on feeding plans and the intervention group received nutritional consultation incorporating the principles and skills of the motivational interviewing. Participants were followed by three months and evaluations of eating habits, physical activity, cardiometabolic risk, body composition and quality of life were carried out. The motivational interviewing group reduced the consumption of meats (B=-0.45, p=0.032) and sausages (B=-0.60, p=0.002). Likewise, the diastolic blood pressure (B=-6.97, p=0.029) and glycemia (B=-9.27, p=0.097) of these patients tended to decrease. Motivational interviewing promotes changes that can make a clinical difference, even in short periods of time. Nutritionists trained for its implementation have an additional tool for the management of cardiometabolic comorbidity in a vulnerable population.
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Introducción: A nivel global ha existido un incremento en el peso corporal. Ante ello, se han implementado programas para diagnosticar y tratar la obesidad. Se requiere documentar si dichos programas han propiciado que las personas con obesidad reciban diagnóstico y tratamiento eficaz. Objetivo: Determinar y comparar los cambios entre 2006 y 2018 en las prevalencias de diagnóstico y tratamiento de la obesidad y pérdida intencional de peso en adultos mexicanos e identificar si en este periodo existieron cambios en las disparidades sociales en dichos eventos. Materiales y métodos: Se analizaron las bases de datos de la Encuesta Nacional de Salud y Nutrición de México realizada en 2006 (N=26.738) y 2018 (N= 12.205), Los eventos fueron diagnóstico y tratamiento de obesidad y de pérdida intencional de peso en adultos mexicanos con IMC > 30. Las variables independientes fueron: sexo, edad, índice de masa corporal, nivel socioeconómico y región geográfica. Resultados: De 2006 a 2018, aumentó la prevalencia de personas con obesidad que recibieron diagnóstico (de 20,4% a 51,1%) o tratamiento (de 8,3% a 21,4%). La prevalencia de pérdida intencional de peso también aumentó (de 5,5% a 10,0%), pero esto básicamente ocurrió en las personas con nivel socioeconómico alto. En modelos multivariados se observó que, las mujeres, las personas con mayor IMC y quienes tenían mayor nivel socioeconómico tuvieron mayor probabilidad de recibir diagnóstico y tratamiento. Conclusiones: Aunque en México el acceso a diagnóstico y tratamiento a la obesidad se ha incrementado, la prevalencia de pérdida intencional de peso es baja, además, persisten disparidades socioeconómicas en estos eventos(AU)
Introduction: Worldwide, there has been an increase in body weight. Because of this, programs have been implemented to diagnose and treat obesity. It is required to document whether these programs have led people with obesity to receive effective diagnosis and treatment. Objective: To determine and compare the changes between 2006 and 2018 in the prevalences of diagnosis and treatment of obesity and intentional weight loss among Mexican adults and to identify whether there were changes in the social disparities in these events during this period. Materials and methods: The databases of the National Health and Nutrition Survey of Mexico carried out in 2006 (N=26,738) and 2018 (N= 12,205) were analyzed. The events were diagnosis and treatment of obesity and intentional weight loss in Mexican adults with BMI > 30. The independent variables were sex, age, body mass index, socioeconomic status, and geographic region. Results: From 2006 to 2018, the prevalence of people with obesity who received the diagnosis (from 20.4% to 51.1%) or treatment (from 8.3% to 21.4%) increased. The prevalence of intentional weight loss also increased (from 5.5% to 10.0%), but this was mainly in people with high socioeconomic status, Multivariate regression models revealed that, women, people with a higher BMI, and those with a higher socioeconomic status were more likely to receive diagnosis and treatment. Conclusions: Although in Mexico access to diagnosis and treatment of obesity has increased, the prevalence of intentional weight loss is low,In addition, socioeconomic disparities persist in these events(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Weight Loss , Obesity/diagnosis , Obesity/therapy , Socioeconomic Factors , Body Weight , Body Mass Index , Overweight , Sociodemographic FactorsABSTRACT
Abstract Introduction In high-income countries, sexual minorities are at a higher risk for disordered eating behaviors. It is not known whether these findings can be extrapolated to Mexico. Objective Determine whether there are any differences in disordered eating behaviors among Mexican youth according to sexual orientation and analyze the potential role of experiences of violence and discrimination as mediators of these differences. Method Data from a representative sample of Mexican youth (12 to 29 years old, n = 27,876) were analyzed. Three groups were identified: young people who were not in love (NIL), who were in love with people of the opposite sex (ILOS), or in love with people of the same sex (ILSS). Restrictive behaviors, secret eating, and self-induced vomiting were identified through a scale created for the survey. Results ILSS men had a higher risk of restrictive thoughts and behaviors (B = .31), secret eating (OR = 2.21), and self-induced vomiting (OR = 3.65) than ILOS youth. Among women, there was only a difference in self-induced vomiting (RM = 2.49). In both sexes, being a young ILSS had an indirect effect on restrictive behaviors through its association with experiences of violence, discrimination at school, and sexual violence. Discussion and conclusion . Mexican sexual minority men are at a higher risk of disordered eating behaviors, whereas sexual minority women are at a higher risk of purging. Part of the differences in restrictive behaviors were explained by the increased risk for experiences of prejudice faced by sexual minority youth.
Resumen Introducción En países de alto ingreso, las minorías sexuales tienen mayor riesgo de conductas alimentarias de riesgo. Se desconoce si esos hallazgos pueden ser extrapolados a México. Objetivo Determinar si existen disparidades en las conductas alimentarias de riesgo entre los jóvenes mexicanos según la orientación sexual y analizar el papel potencial de las experiencias de violencia y discriminación como mediadoras de tales disparidades. Método Se analizaron datos de una muestra representativa de jóvenes mexicanos (12 a 29 años, n = 27,876). Se identificaron tres grupos: jóvenes sin enamoramiento (sE), con enamoramiento por personas del otro sexo (cEOS) o con enamoramiento por personas del mismo sexo (cEMS). Las conductas restrictivas, comer a escondidas e inducirse vómito se identificaron a través de una escala creada para la encuesta. Resultados Los hombres cEMS tuvieron mayor riesgo de pensamientos y comportamientos restrictivos (B = .31), comer a escondidas (RM = 2.21) e inducirse vómito (RM = 3.65) en comparación con los jóvenes cEOS. Entre las mujeres, solo hubo diferencia en inducirse vómito (RM = 2.49). En ambos sexos, ser un joven cEMS tuvo un efecto indirecto sobre las conductas restrictivas a través su asociación con experiencias de violencia y discriminación escolares y violencia sexual. Discusión y conclusión Los hombres de minorías sexuales mexicanas tienen mayor riesgo de conductas alimentarias de riesgo, y las mujeres de minorías sexuales tienen mayor riesgo de una conducta de tipo purgativo. Parte de las disparidades en conductas restrictivas se explicaron por el mayor riesgo de experiencias de prejuicio que enfrentan los jóvenes de minorías sexuales.
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Our aim was to develop and validate an equation to predict total energy expenditure (TEE) based on anthropometric measurements and physical activity questionnaires that can be applied among non-institutionalized Mexican adults. To meet this aim, a validation study was conducted with a sample of Mexican adults (n=115, 37% men) that were randomly divided into two groups to develop and validate new equations to estimate TEE. TEE was measured by indirect calorimetry and heart rate monitoring for at least three days. These measurements were considered as the reference method. The predictors of TEE were age, sex, fat and fatfreemass, body weight and physical activity level (PAL), which was assessed with two questions. The accuracy of factorial methods (e.g. FAO/WHO or Ainsworths metabolic equivalents list) and empirical equations to estimate TEE was compared. Multiple linear regression and Intra-class correlation coefficients were estimate as agreement measurement. The equation developed is as follows: TEE (kcal / d) = 1331.712 - (686.344 x sex, men: 1, women: 2) + (18,051 x body weight, kg) - (16.020 x age, years) + (894.007 x PAL). The accuracy of the equation was modest in the development (R2 = 54.4, standard error = 511.3) and validation (R2 = 59.2, standard error = 372.8) samples. However, this equation had higher accuracy than factorial methods or empirical equations. The equation was developed to estimate the TEE of Mexican adults, which can be used as a general guide to provide nutritional counselling. (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Energy Metabolism , Anthropometry , Motor Activity , Mexico , Surveys and Questionnaires , Calorimetry, IndirectABSTRACT
ABSTRACT OBJECTIVE: To determine the possible existence of differences in blood pressure change over time according to stature in Mexican adults. METHODS: We analyzed the National Household Living Standards Survey databases following household members between 2005 and 2009. We selected participants who were between 20 and 40 years old (n = 7,130). We estimated multilevel models with random intercept to analyze differences in blood pressure changes according to stature. We adjusted the models for age, locality size, geographic region, per capita family income, waist-to-height ratio, physical activity, alcohol consumption, smoking, and use of antihypertensive drugs. RESULTS: In both sexes, baseline blood pressure tended to be lower as stature decreased. The differences were maintained in both the crude and adjusted models. In men, the increases in systolic pressure over time tended to be higher as stature increased. CONCLUSIONS: Contrary to what studies observed in high-income countries, in Mexico blood pressure was positively associated with stature.
RESUMEN OBJETIVO: Determinar si existen diferencias en el cambio de la presión arterial a lo largo del tiempo de acuerdo con la estatura en adultos mexicanos. MÉTODOS: Se analizaron las bases de datos de la Encuesta Nacional de Niveles de Vida de los Hogares en la que se siguieron a los miembros de los hogares entre el 2005 y 2009. Se seleccionaron a los participantes que tenían entre 20 y 40 años (n = 7,130). Se estimaron modelos multinivel con intercepto aleatorio para analizar diferencias en los cambios de la presión arterial de acuerdo con la estatura. Los modelos fueron ajustados por edad, tamaño de localidad, región geográfica, ingreso familiar per cápita, índice cintura-estatura, actividad física, consumo de alcohol, tabaquismo y uso de antihipertensivos. RESULTADOS: En ambos sexos, la presión arterial inicial tendió a ser menor conforme la estatura fuese menor. Las diferencias se mantuvieron tanto en los modelos crudos como en los modelos ajustados. En los varones los incrementos de la presión sistólica a lo largo del tiempo tendieron a ser mayores conforme la estatura era más alta. CONCLUSIONES: Contrario a lo observado en países de altos ingresos, en México la presión arterial se asoció positivamente con la estatura.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Body Height , Antihypertensive Agents/therapeutic use , Blood Pressure , Brazil , Mexico/epidemiologyABSTRACT
Resumen El objetivo del estudio fue conocer la relación de las experiencias de homofobia con la adherencia al tratamiento anti-retroviral (TAR) en hombres que tienen sexo con hombres (HSH). Para ello, se realizó una encuesta transversal con una muestra por conveniencia de HSH que vivían con VIH (n=340) atendidos en dos instituciones públicas de salud de la Ciudad de México. La información sobre la adherencia al TAR en el mes previo de los participantes y sus experiencias de violencia, discriminación y homofobia internalizada se recopiló mediante un cuestionario. Entre 14% y 33% de los HSH reportaron alguna experiencia de discriminación y entre 41% y 60% experimentaron violencia. Cuando los HSH habían experimentado ambos tipos de estresores, el riesgo de baja adherencia TAR fue mayor (RP=6.49 para mes previo) que cuando habían experimentado sólo una de ellas (RP=4.36 para violencia y RP=5.67 para discriminación). Los profesionales de la salud deben ser sensibles a cómo el ambiente sociocultural puede afectar las prácticas de autocuidado de HSH, incluyendo la adherencia al TAR.
Abstract The aim of the study was to know the relationship of homophobic experiences with adherence to antiretroviral treatment (ART) in men who have sex with men (MSM) in Mexico City (CDMX). A cross-sectional study was conducted with a convenience sampling of MSM who lived with HIV, treated at two public health institutions at Mexico City (n=340). A questionnaire was applied to record information related to the adherence to ART of the participants and their experiences of violence and discrimination associated with homophobia and internalized homophobia. Between 14% and 33% of MSM reported experiences of discrimination and between 41% and 60% experienced violence. When participants had jointly experienced both types of stressors, the risk of low adherence to ART in the previous month was higher (RP=6.49) than when they had experienced only one of them (RP=4.36 for violence and RP=5.67 for discrimination). Health professionals must be sensitive to how the sociocultural environment can affect self-care among MSM including ART adherence.
Subject(s)
Humans , Male , Therapeutics , HIV , Homophobia , Sexual and Gender MinoritiesABSTRACT
INTRODUCCIÓN. Analizar la relación entre el estigma percibido por VIH y la adherencia al tratamiento antirretroviral (TAR) en personas con VIH en la ciudad de México. MATERIAL Y MÉTODOS. Se utilizó un diseño mixto incluyendo una encuesta transversal y entrevistas a profundidad. En la encuesta se aplicó un cuestionario a 557 personas con VIH de dos instituciones públicas. En el cuestionario se incluyó una escala de estigma asociado al VIH con dos variables: ocultamiento de su seroestado a personas no cercanas y revelación de su seroestado a familiares y amigos. Mediante modelos de regresión logística se evaluó la asociación del estigma percibido con la baja adherencia al TAR, i.e. la omisión de la toma de medicamentos antirretrovirales en el día, la semana y el mes previos. Las entrevistas a profundidad tuvieron la finalidad para explorar las experiencias respecto a las dificultades para adherirse al TAR. RESULTADOS. Las personas que ocultaban su enfermedad tuvieron mayor probabilidad de no adherencia (RM=2.33). Los entrevistados que no habían revelado su seroestado a personas cercanas también tuvieron una mayor probabilidad de no adherencia (RM=2.35). Coincidentemente, en las entrevistas se evidenció que las experiencias de discriminación o las expectativas de ser discriminado hacen que las personas oculten su enfermedad y esto propicia la omisión de toma de medicamentos. DISCUSIÓN. Es necesario promover acciones orientadas a eliminar el estigma asociado al VIH como una medida fundamental para incrementar la adherencia al TAR. (AU)
INTRODUCTION. To analyze the relationship between HIV-associated perceived stigma and adherence to antiretroviral therapy (ART) in people with HIV in Mexico City. MATERIAL AND METHODS. A mixed methods approach was used including in-depth interviews and a cross-sectional survey. In-depth interviews were conducted to explore barriers to ART adherence. In the survey, a questionnaire was given to 557 people with HIV treated in two public health institutions. The questionnaire included an assessment of HIV-associated perceived stigma; exploratory factor analysis demonstrated two outcomes: concealment of serostatus and revelation of the serostatus to family and friends. Logistic regression models were used to assess the association of HIV-associated stigma with low ART adherence on the previous day, week and month. RESULTS. People who concealed their disease had higher risk of non-adherence (RM=2.33). Participants who had not revealed their serostatus to friends or relatives also had a higher probability of non-adherence (RM= 2.35). Coincidentally, the interviews showed that the experiences of discrimination or the expectations of being discriminated against make people conceal their illness and are thus prone to non-adherence. DISCUSSION. It is necessary to promote actions aimed at eliminating HIV-related stigma as a fundamental measure to increase adherence to ART. (AU)
Subject(s)
Humans , Male , Adult , HIV Infections/psychology , HIV Infections/drug therapy , Anti-Retroviral Agents/therapeutic use , Social Stigma , Treatment Adherence and Compliance , Logistic Models , Interviews as Topic , Surveys and Questionnaires , Factor Analysis, Statistical , Longitudinal Studies , Healthcare Disparities , MexicoABSTRACT
Resumen Introducción: Se ha señalado que factores como obesidad, diabetes, hipertensión y edad influyen en la progresión de COVID-19; sin embargo, la evidencia para otras condiciones no es concluyente. Objetivo: Identificar qué antecedentes clínicos están relacionados con la gravedad de COVID-19 y si la edad funge como un modificador de efecto de la relación entre comorbilidades cardiometabólicas (CCM) y progresión de COVID-19. Método: Se analizaron los datos de casos confirmados ≥ 20 años (n = 155 017). La hospitalización, el desarrollo de neumonía, el requerimiento de intubación, el ingreso a la unidad de cuidados intensivos y la muerte constituyeron las variables dependientes en la estimación de modelos de regresión de Poisson y la interacción entre edad y CCM, las independientes. Resultados: Tener CCM, así como otras comorbilidades, se relacionó directamente con la progresión de COVID-19. El riesgo de gravedad de COVID-19 asociado a las CCM fue menor conforme la edad era mayor. El asma y el tabaquismo no fueron factores de riesgo para la progresión de COVID-19. Conclusión: En la población mexicana, el riesgo de progresión de COVID-19 asociada a comorbilidades fue mayor en los adultos jóvenes.
Abstract Introduction: Obesity, diabetes, hypertension and age have been pointed at as factors that influence on the progression of COVID-19; however, evidence for other conditions is inconclusive. Objective: To identify which clinical characteristics are related to COVID-19 severity and to determine whether age acts as a modifier of the relationship between cardio-metabolic comorbidities (CMC) and COVID-19 progression. Method: Data on ≥ 20-year-old confirmed cases (n = 155 017) were analyzed. Hospitalization, development of pneumonia, intubation requirement, intensive care unit admission and death were the dependent variables in Poisson regression models estimation, whereas the interaction between age and different CMCs were the independent variables. Results: Having CMCs, as well as other comorbidities, was directly related to COVID-19 progression. The risk for COVID-19 severity was lower as age was more advanced. Asthma and smoking were not risk factors for the progression of COVID-19. Conclusion: In the Mexican population, the risk of COVID-19 progression associated with comorbidities was higher in young adults.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , COVID-19/diagnosis , Severity of Illness Index , Age Factors , COVID-19/complications , MexicoABSTRACT
Objetivo. Determinar si existen disparidades asociadas a la estratificación socioeconómica, la etnicidad, los servicios médicos y la región geográfica en la progresión de la enfermedad por coronavirus (COVID-19) en adultos mexicanos infectados por SARS-CoV-2. Método. Se analizaron los datos registrados por la Dirección General de Epidemiología de la Secretaría de Salud del Gobierno Federal de México respecto de los casos confirmados de infección por SARS-CoV-2. El análisis se limitó a los datos de adultos de 20 años o más registrados hasta el 10 de julio del 2020 (n=234 870). Los indicadores de severidad de la COVID-19 fueron hospitalización, desarrollo de neumonía, requerimiento de intubación o ingreso a la unidad de cuidados intensivos, y muerte. Se estimaron diferencias de acuerdo con el nivel de marginación municipal, la pertenencia a un grupo indígena, la región geográfica y el sector de los servicios. A partir de modelos de regresión multinivel se estimaron razones de prevalencias (RP). Resultados. Las personas que residían en municipios con mayor marginación tuvieron mayor riesgo de presentar los cuatro indicadores de formas severas de COVID-19 (RP=1,05 o 1,06). Las personas indígenas tuvieron mayor riesgo de neumonía (RP=1,22), hospitalización (RP=1,14) y muerte (RP=1,23). Entre los casos atendidos en servicios privados fue menor el riesgo de muerte (RP=0,40), pero mayor el uso de intubación o ingreso a la unidad de cuidados intensivos (RP=4,45). Conclusiones. Las tendencias observadas indican que los efectos de la COVID-19 no solo se deben a las características biológicas del SARS-CoV-2, sino también a los recursos (o falta de ellos) para enfrentarlo, los cuales están distribuidos por procesos sociales.
Objective. To determine if there are disparities associated with socioeconomic stratification, ethnicity, medical services, and geographic region in the progression of coronavirus disease (COVID-19) in Mexican adults infected with SARS-CoV-2. Method. We analyzed data registered by the General Direction of Epidemiology of the Ministry of Health of the Federal Government of Mexico regarding the confirmed cases of SARS-CoV-2 infection. The analysis was limited to data from adults 20 years and older recorded up to July 10, 2020 (n=234 870). Indicators of severity of COVID-19 were hospitalization, development of pneumonia, requirement for intubation or admission to the intensive care unit, and death. Differences were estimated according to the level of municipal marginalization, belonging to an indigenous group, geographic region, and service sector. Prevalence ratios (PR) were estimated using multilevel regression models. Results. People who lived in municipalities with greater marginalization were at greater risk of presenting the four indicators of severe forms of COVID-19 (PR=1.05 or 1.06). Indigenous people were at greater risk of pneumonia (PR=1.22), hospitalization (PR=1.14) and death (PR=1.23). Among the cases treated in the private health sector, the risk of death was lower (PR=0.40), but the use of intubation or admission to the intensive care unit was higher (PR=4.45). Conclusions. The trends observed indicate that the effects of COVID-19 are not only related to the biological characteristics of SARS-CoV-2, but also to the resources (or lack thereof) to deal with it, which are distributed by social processes.
Subject(s)
Socioeconomic Factors , Coronavirus Infections , Socioeconomic Factors , Health Status Disparities , Ethnicity , COVID-19 , Socioeconomic Factors , Coronavirus Infections , Socioeconomic Factors , Health Status Disparities , Ethnicity , MexicoABSTRACT
Abstract Background: Physical fitness is the ability to perform activities of daily living without excessive fatigue. The potential protective role of fitness against high blood pressure in childhood is relevant to diminish the risk of hypertension in adulthood. A negative association between cardiorespiratory fitness (CRF) and hypertension has been found in the pediatric population. However, the role of body mass as a confounding variable of this association has not been evaluated. This study aimed to analyze whether the association between fitness and blood pressure in Mexican schoolchildren is independent of body mass. Methods: A cross-sectional study was conducted with a sample of 1010 children (574 females and 436 males) aged 9-12 years (mean age = 10.3 ± 0.9 years) from 13 elementary schools in Mexico City. Fitness was evaluated with tests from the FitnessGram® battery. Z-scores of body mass index (BMI)-for-age and height-for-age were estimated. Results: Low fitness showed a high prevalence (from 45.8% for trunk lift to 77.5% for push-ups). Children with poor CRF (assessed by the 20-m progressive aerobic cardiovascular endurance run test) and upper body strength (assessed by push-ups) showed a higher probability of hypertension (p < 0.05). However, these differences disappeared after adjusting for BMI. Conclusions: After considering the body mass, cardiorespiratory and musculoskeletal fitness were not independent predictors of blood pressure.
Resumen Introducción: La condición física es la habilidad de realizar actividades de la vida diaria sin fatiga excesiva. El potencial papel protector de una buena condición física contra la presión arterial elevada es relevante, ya que, si no se atiende, esta elevación en la presión arterial comúnmente conduce a hipertensión en la vida adulta. Se ha documentado una asociación negativa entre la condición cardiorrespiratoria con la hipertensión de la población pediátrica. Sin embargo, no se ha evaluado el papel de la masa corporal como una variable de confusión de esta asociación. El objetivo de este estudio fue evaluar si la asociación entre la condición física y la presión sanguínea es independiente de la masa corporal en escolares mexicanos. Métodos: Estudio transversal con una muestra de 1010 escolares (574 de sexo femenino y 436 de sexo masculino) de 9 a 12 años (edad promedio = 10.3 ± 0.9 años) de 13 escuelas de primaria de la Ciudad de México. La condición física se evaluó con la batería FitnessGram®. Se estimaron puntuaciones Z del índice de masa corporal (IMC) para la edad. Resultados: La prevalencia de baja condición física fue alta (de 45.8% en la prueba de levantamiento de tronco a 77.5% en la prueba de lagartijas). Los escolares con baja condición cardiorrespiratoria (evaluada con la carrera progresiva de resistencia cardiovascular aeróbica de 20 m) y fuerza superior del cuerpo (evaluada con la prueba de lagartijas) mostraron una mayor probabilidad de presentar hipertensión (p < 0.05). Sin embargo, estas diferencias desaparecieron al ajustar por el IMC. Conclusiones: Después de considerar la masa corporal, la condición cardiorrespiratoria y musculoesquelética no son predictores independientes de la presión sanguínea.
Subject(s)
Child , Female , Humans , Male , Blood Pressure/physiology , Exercise/physiology , Physical Fitness/physiology , Cardiorespiratory Fitness/physiology , Activities of Daily Living , Body Mass Index , Cross-Sectional Studies , Exercise Test , Hypertension/epidemiology , MexicoABSTRACT
Resumen Introducción: Los modos activos de transporte (caminar o andar en bicicleta) tienen efectos benéficos para la salud, por lo cual deben identificarse factores que los promuevan. El objetivo de este estudio fue analizar la relación de los modos de transporte utilizados por la población pediátrica mexicana para acudir a la escuela con las características sociodemográficas, socioeconómicas y de inseguridad pública a nivel estatal. Métodos: Se estimó la frecuencia de los modos de transporte utilizados por los escolares y adolescentes para trasladarse a la escuela (con la base de la Encuesta Intercensal 2015). En un análisis ecológico (i.e., entidades federativas como unidades de observación) se obtuvieron correlaciones con estadísticas a nivel estatal con inseguridad alimentaria, nivel de urbanización y mortalidad por muertes violentas. Resultados: El modo de transporte más frecuente fue caminar (66.2%), seguido por el automóvil (16.2%) y el transporte público (15.3%). El transporte activo fue más frecuente en individuos del sexo masculino, escolares, personas de nivel socioeconómico bajo, zonas rurales, la región sur y aquellos cuyo traslado requería menos de 15 minutos. El transporte pasivo fue más frecuente en individuos del sexo femenino, adolescentes, personas de nivel socioeconómico alto y en zonas urbanas. En los estados más urbanizados fue menos frecuente el transporte activo y más prevalente el trasporte motorizado. La inseguridad pública se relacionó negativamente con el uso de bicicleta. Conclusiones: Se requiere mantener o incrementar el uso de modos de transporte activos en la población pediátrica mexicana mediante políticas públicas que mejoren el entorno y garanticen ambientes seguros.
Abstract Background: Active commuting (walking or cycling) is associated with benefits to health; thus, it is required to identify factors that promote it. The objective of this study was to analyze the relationship between the transport modes used by Mexican pediatric population to commute to school with sociodemographic and socioeconomic individual characteristics and public insecurity at the state level. Methods: The frequency of transport modes used by schoolchildren and adolescents to commute to school (walking, cycling, private car and public transport) were estimated using the database of the Encuesta Intercensal 2015. In an ecological analysis (i.e., states as observation units) correlations with food insecurity, urbanization level, and violent deaths statistics at state-level were obtained. Results: The most frequent transportation mode was walking (66.2%), followed by car (16.2%) and public transportation (15.3%). Active commuting (walking or cycling) was more frequent in males, schoolchildren, low socioeconomic status, living in rural or southern areas and those who spent <15 min to commute. Passive commute was more frequent among females, adolescents, high socioeconomic status, and living in urban areas. In the more urbanized states, active transportation was less frequent, but motorized transportation was more prevalent. Public insecurity was negatively related to cycling. Conclusions: Maintaining or increasing active commuting among Mexican pediatric population is necessary through public policies aimed to improve physical and social environment.
Subject(s)
Adolescent , Child , Female , Humans , Male , Students/statistics & numerical data , Transportation/statistics & numerical data , Bicycling/statistics & numerical data , Walking/statistics & numerical data , Rural Population/statistics & numerical data , Schools/statistics & numerical data , Socioeconomic Factors , Urban Population/statistics & numerical data , MexicoABSTRACT
Abstract: Objective: To analyze the contribution of natural, processed and ultra-processed foods to energy and nutrient supply in Mexican households. Materials and methods: The database of the National Household Expenditure Survey 2013 was analyzed (n=58 001), which is a cross-sectional survey. Food supply (g/adult equivalent/day) and energy, macro- and micro-nutrient supplies were estimated. Foods were classified following the Nova system. Households sociodemographic characteristics were analyzed as covariates. Results: Natural foods (NF) contributed with more energy (55.0%) followed by ultra-processed foods (UPF, 21.2%). NF were the main source of most nutrients. Processed culinary ingredients (PCI) and processed foods (PF) had high content of energy, total fats, and saturated fats, but low content of certain micronutrients. Sodium was mainly available in PF (34.6%) and UPF (31.4%). Sugar-sweetened beverages, fast foods, and biscuits and cookies were the main UPF in terms of energy supply. Conclusions; In Mexican households, the PCI, PF and UPF had low nutritional quality.
Resumen: Objetivo: Analizar la contribución de los alimentos naturales, procesados y ultraprocesados a la disponibilidad de energía y nutrientes en los hogares mexicanos. Material y métodos: Se analizó la base de datos de la Encuesta Nacional de Gasto de los Hogares 2013 (n= 58 001), la cual es una encuesta transversal. Se estimó la disponibilidad de alimentos (g/adulto equivalente/día), energía y nutrientes. Los alimentos fueron clasificados siguiendo el sistema Nova. Resultados: Los alimentos naturales (AN) y los ultraprocesados (AUP) contribuyeron con más energía. Los AN fueron la principal fuente de la mayoría de los nutrimentos. Los ingredientes culinarios procesados (ICP) y los alimentos procesados (AP) tenían alto contenido de energía, grasas totales y grasas saturadas pero bajo contenido de ciertos micronutrientes. El sodio estaba disponible principalmente en AP y AUP. Las bebidas azucaradas, comidas rápidas, galletas y panes fueron los principales AUP. Conclusión: En México, los ICP, AP y AUP tienen baja calidad nutricional.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Energy Intake , Food/classification , Nutritive Value , Socioeconomic Factors , Sodium, Dietary/administration & dosage , Dietary Fats/administration & dosage , Nutrients , Family Characteristics , Cross-Sectional Studies , Micronutrients , Fatty Acids/administration & dosage , Fast Foods , Food Handling , Sugar-Sweetened Beverages , MexicoABSTRACT
RESUMEN El trabajo aborda una faceta dentro del humanismo martiano que refleja sus consideraciones en su bregar por tierras de América. Sus postulados constituyen un imprescindible legado para formar en los estudiantes universitarios valores éticos que los conviertan en mejores seres, humanos y profesionales. En su recorrido desde México hacia Guatemala, el Apóstol pretende resaltar la figura del negro de raza pura que allí vivía. Estas consideraciones se ofrecen a partir del texto Livingstone. El artículo tiene como objetivo develar algunas ideas que permitan un desarrollo político-ideológico, ético y estético integral donde se destaque el conocimiento y respeto por la historia, la autoctonía de los pueblos americanos y la cultura patrias.
ABSTRACT The work addresses a facet within Martian humanism that reflects its considerations in its struggle for the lands of America. Its postulates constitute an essential legacy to form in university students ethical values that turn them into better beings, human beings and professionals. On his journey from Mexico to Guatemala, the Apostle pretends to highlight the figure of the black of pure race that lived there. These considerations are offered from the Livingstone text. The article aims to reveal some ideas that allow a political-ideological, ethical and integral aesthetic development where knowledge and respect for history, the autochthony of the American people and the patriotic culture are highlighted.
ABSTRACT
Fundamentos: Los alimentos y bebidas reducidos en energía (AB-RE) podrían considerarse como una alternativa para la prevención de sobrepeso, ya que cuentan con menos calorías que el producto original. El objetivo fue conocer la adquisición de AB-RE en hogares mexicanos y su relación con la disponibilidad de energía y nutrientes. Métodos: Se analizó la Encuesta Nacional de Gasto de los Hogares, 2013. Se identificaron a los hogares que habían adquirido algún AB-RE. Se estimó la composición nutricional de 185 alimentos para determinar la disponibilidad de energía y nutrientes en los hogares. Resultados: El 6,3% de los hogares adquirieron algún AB-RE. Estos alimentos estaban más disponibles conforme aumentaba la edad, la escolaridad del cabeza de familia o el ingreso familiar; cuando existía seguridad alimentaria o el hogar se localizaba en la región norte. En los hogares que adquirieron AB-RE existió mayor disponibilidad de energía, carbohidratos, proteínas, lípidos y ácidos grasos saturados, calcio, potasio, zinc y sodio; pero menor de fibra, colesterol, vitamina C y hierro. Conclusiones: La disponibilidad de AB-RE está relacionada con mayor disponibilidad de energía. Con su promoción se debe hacer énfasis en que los hogares no adquieran otros productos de densidad energética moderada o alta
Background: Energy-reduced food and beverages (ER-FB) could be considered as an alternative for overweight, asthey have fewer calories than the original product. The objectives of the study were: 1) to know the sociodemographic characteristics of Mexican households that purchase ER-FB, and 2) to know whether nutrient and energy availability differ according to the acquisition of ER-FB. Methods: The database of the National Household Expenditure Survey 2013 was analyzed. Households that purchased ER-FB were identified. Nutritional composition of 185 foods and beverages was estimated to determine energy and nutrient availability in the households. Results: 6.3% of Mexican households purchased any ER-FB. It was more frequent that these foods and beverages were more available as age and household head education were higher, as well as the family income, when the household had food security, and was located in the north region. Households with ER-FB supply had greater availability of energy, carbohydrates, proteins, total fat, saturated fat, calcium, potassium, zinc, and sodium; but lower of fibre, cholesterol, vitamin C, and iron. Conclusions: ER-FB supply is related to higher energy availability. Therefore, in their promotion it should be emphasized to not acquire other products of moderate or high energy density
Subject(s)
Humans , Food Analysis/statistics & numerical data , Food Quality , Feeding Behavior , Nutrients/analysis , Food Preferences , Mexico/epidemiology , Nutritive Value , 51397 , Nutrition Surveys/statistics & numerical data , Food Labeling/statistics & numerical data , Overweight/epidemiology , Obesity/epidemiologyABSTRACT
Abstract Objective: To develop and validate equations to estimate the percentage of body fat of children and adolescents from Mexico using anthropometric measurements. Methods: A cross-sectional study was carried out with 601 children and adolescents from Mexico aged 5-19 years. The participants were randomly divided into the following two groups: the development sample (n = 398) and the validation sample (n = 203). The validity of previously published equations (e.g., Slaughter) was also assessed. The percentage of body fat was estimated by dual-energy X-ray absorptiometry. The anthropometric measurements included height, sitting height, weight, waist and arm circumferences, skinfolds (triceps, biceps, subscapular, supra-iliac, and calf), and elbow and bitrochanteric breadth. Linear regression models were estimated with the percentage of body fat as the dependent variable and the anthropometric measurements as the independent variables. Results: Equations were created based on combinations of six to nine anthropometric variables and had coefficients of determination (r2) equal to or higher than 92.4% for boys and 85.8% for girls. In the validation sample, the developed equations had high r2 values (≥85.6% in boys and ≥78.1% in girls) in all age groups, low standard errors (SE ≤ 3.05% in boys and ≤3.52% in girls), and the intercepts were not different from the origin (p > 0.050). Using the previously published equations, the coefficients of determination were lower, and/or the intercepts were different from the origin. Conclusions: The equations developed in this study can be used to assess the percentage of body fat of Mexican schoolchildren and adolescents, as they demonstrate greater validity and lower error compared with previously published equations.
Resumo Objetivo: Desenvolver e validar equações para estimar o percentual de gordura corporal (%GC) de crianças e adolescentes do México com medidas antropométricas. Métodos: Foi feito um estudo transversal com 601 crianças e adolescentes do México cinco e 19 anos. Os participantes foram divididos aleatoriamente nos seguintes dois grupos: a amostra de desenvolvimento (n = 398) e a amostra de validação (n = 203). A validade das equações publicadas anteriormente (por exemplo, Slaughter) também foi avaliada. O %GC foi estimado por absorciometria de dupla energia de raios X (raios X de dupla energia [DXA]). As medidas antropométricas incluíram estatura, altura sentado, peso, circunferências da cintura e do braço, dobras cutâneas (tríceps, bíceps, subescapular, suprailíaca e panturrilha) e larguras do cotovelo e bitrocantérica. Os modelos de regressão linear foram estimados com o %GC, a variável dependente e as medidas antropométricas como as variáveis independentes. Resultados: As equações foram criadas com base nas combinações de seis a nove variáveis antropométricas e apresentaram coeficientes de determinação (r2) iguais ou superiores a 92,4% para meninos e 85,8% para meninas. Na amostra de validação, as equações desenvolvidas apresentaram altos valores de r2 (≥ 85,6% em meninos e ≥ 78,1% em meninas) em todos os grupos, baixo nível de erros padrão (EP ≤ 3,05% em meninos e ≤ 3,52% em meninas) e os interceptos não foram diferentes da origem (p > 0,050). Com as equações publicadas anteriormente, os coeficientes de determinação foram menores e/ou os interceptos foram diferentes da origem. Conclusões: As equações desenvolvidas neste estudo podem ser usadas para avaliar o %GC das crianças em idade escolar e adolescentes mexicanos, pois têm uma maior validade e menor erro em comparação com as equações publicadas anteriormente.