Neck circumference cut-offs for overweight and obesity in a group of Mexican adolescents.

BACKGROUND/OBJECTIVES: Neck circumference (NC) has been used for screening overweight/obesity for its high correlation with age, weight, body mass index (BMI), and waist circumference (WC). Cut-offs should be population specific. The aim of the study was to obtain cut-offs of NC for overweight/obesity in Mexican adolescents and to correlate them with anthropometric indicators. SUBJECTS/METHODS: Weight, height, BMI, NC, WC, and mid-upper arm circumference (MUAC) of 465 12-14-year-old Mexican-mestizo students attending a public school in Mexico City were assessed. Using receiver operating characteristics analyses, neck cut-offs were obtained according to the WHO age and sex criteria for overweight/obesity. RESULTS: NC cut-offs with the highest sensitivity and specificity for males and females, respectively, were as follows: 30.0 and 29.3 cm for 12-year-olds; 31.9 and 30.4 cm for 13-year-olds; and, 33.5 and 30.7 cm for 14-year-old adolescents. Overweight/obesity was identified with NC cut-offs in 80% of males and 86% of females, and showed significant correlations (p < 0.01) in males and females with weight (r = 0.821 and r = 0.840, respectively), BMI (r = 0.649 and r = 0.819, respectively), WC (r = 0.710 and r = 0.813, respectively) and MUAC (r = 0.736 and r = 0.815, respectively). CONCLUSIONS: Neck circumference may be used as a first-stage screening tool or jointly with BMI to identify overweight/obesity in 12-14-year-old Mexican adolescents.

Changes related to gender, geographic population and habitat in the antennal phenotype of Triatoma patagonica Del Ponte, 1929 (Hemiptera: Reduviidae).

Triatomines undergo morphological changes as an adaptive response to different habitats (wild, peridomestic, domestic, laboratory). The characterization of the antennal phenotype provides information on intraspecific variation caused by geographical origin and/or habitat. Triatoma patagonica Del Ponte, 1929 is known to occur in peridomiciles of rural areas in Argentina, where it also invades non-colonized dwellings. Here we describe and compare the antennal phenotype of T. patagonica in populations of different geographic origin, and explore possible modifications induced by laboratory rearing with the aim of investigating the range of phenotypic variation of the species for the first time. Sixty antennas of adult males and females of T. patagonica belonging to two peridomiciliary populations of different geographical origin were analyzed. Four types of sensilla were observed in three antennal segments, showing sexual dimorphism in the species. The multivariate analysis separated the populations of similar habitat (peridomicile) but different geographical origin, without showing differences between the peridomiciliary and laboratory populations of the same geographical origin. These results suggest phenotypic plasticity in T. patagonica, which would allow the species to adapt to a wide range of habitats without having a close association with a given host and its environment. The range of antennal phenotypic variation of T. patagonica would also be an indicator of its current stage of adaptation to the human environment.

Fluoride content in table salt distributed in Mexico City, Mexico.

OBJECTIVE: The aim of this study was to analyze table salt available in Mexico City's market to identify the fluoride concentrations and to compare these with the Mexican regulations. METHODS: We analyzed 44 different brands of table salt. All samples were purchased at random in different stores, supermarkets, and groceries from Mexico City's metropolitan area and analyzed in triplicate in three different laboratories (nine determinations per sample) with an Orion 720 A potentiometer and an Orion 9609 BN ion-specific electrode. RESULTS: Fluoride concentration in the samples varied from 0 ppm to 485 ppm. It was found that fluoride concentration varied widely among the analyzed brands. Also, we found that fluoride concentration in 92 percent of the analyzed samples did not match with that printed on the label. Only 6.8 percent of the analyzed samples contained fluoride concentrations that meet Mexican and WHO regulations. CONCLUSIONS: The broad variation in the analyzed samples suggests that Mexican Public Health authorities must implement more stringent regulation guidelines and procedures for controlling the distribution of salt and its fluoride concentration for human consumption.

Atención prenatal en el primer nivel de atención: características de los proveedores que influyen en la satisfacción de las usuarias / Prenatal care in the primary level of healthcare: provider characteristics which influence users' satisfaction

OBJETIVO: Evaluar el nivel de satisfacción alcanzado por las usuarias de los servicios de atención prenatal en el primer nivel de atención en México, y comparar con algunas características del proveedor y del servicio. MATERIAL Y MÉTODOS: Mediante la aplicación de una encuesta transversal, en el año 2000, se investigaron 217 pares de proveedores-usuarias de servicios de salud, entrevistados en 95 unidades de atención de primer nivel de ocho entidades federativas de la República Mexicana. Se recopiló información mediante: a) observación directa de la consulta médica, b) entrevistas a proveedores y usuarias, y c) aplicación de cuestionario y examen de conocimiento a los proveedores. Se analizó la relación existente entre la capacidad de resolución clínica de los proveedores, el trato recibido durante la consulta y la satisfacción sobre la misma que la usuaria manifestó en entrevista directa. Para ello se calcularon las medidas de resumen y dispersión de las principales categorías, así como análisis bivariado y de tendencias. RESULTADOS: La satisfacción de las usuarias de los servicios de atención prenatal está relacionada con el trato recibido durante la consulta y el tiempo que esperó para recibirla, pero no con la capacidad de resolución clínica del profesional, ni con su edad o género. El trato recibido durante la consulta por la paciente también se asoció con su nivel socioeconómico y se encontró que las usuarias más pobres reciben, proporcionalmente, peor trato. CONCLUSIONES: Los servicios de salud podrían realizar evaluaciones de la satisfacción de sus pacientes en relación con la consulta recibida, en especial en aquellos lugares en los que existe escasez de recursos y/o condiciones de desigualdad económica. En estos casos la prestación de los servicios puede profundizar las diferencias entre la población, y afectar más a la población más pobre.

OBJECTIVE: To assess the satisfaction level attained by prenatal care users in primary health services in Mexico, and to compare the level of satisfaction according to characteristics of the provider and the service. MATERIAL AND METHODS: A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care units in eight Mexican states. The information was collected through a) direct observation of the medical encounter, b) interviews with providers and users, and c) a questionnaire and knowledge examination to providers. Users' satisfaction was analyzed according to providers' clinical ability and the treatment received during the visit. Summary and dispersion measures of the main issues were calculated, as well as bivariate and trends analysis. RESULTS: User satisfaction in prenatal care is associated with the treatment received during the visit and to the waiting time before being attended, but not with the provider's clinical ability, nor with his or her age or gender. The treatment received during the visit was also associated with the user's socioeconomic level, where the poorer users received the worst treatment. CONCLUSIONS: Health services should assess users' satisfaction according with the type of medical encounter, particularly where resources are scarce and where economic disparities are present. In such cases, the provision of healthcare services may intensify inequality, with greater impact on the poorest.

[Prenatal care at the first level of care: characteristics of providers that affect users' satisfaction]. / Atención prenatal en el primer nivel de atención: características de los proveedores que influyen en la satisfacción de las usuarias.

OBJECTIVE: To assess the satisfaction level attained by prenatal care users in primary health services in Mexico, and to compare the level of satisfaction according to characteristics of the provider and the service. MATERIAL AND METHODS: A cross-sectional survey was conducted to analyze data from 217 care provider-user pairs. Interviews were carried out in 95 primary care units in eight Mexican states. The information was collected through a) direct observation of the medical encounter, b) interviews with providers and users, and c) a questionnaire and knowledge examination to providers. Users' satisfaction was analyzed according to providers' clinical ability and the treatment received during the visit. Summary and dispersion measures of the main issues were calculated, as well as bivariate and trends analysis. RESULTS: User satisfaction in prenatal care is associated with the treatment received during the visit and to the waiting time before being attended, but not with the provider's clinical ability, nor with his or her age or gender. The treatment received during the visit was also associated with the user's socioeconomic level, where the poorer users received the worst treatment. CONCLUSIONS: Health services should assess users' satisfaction according with the type of medical encounter, particularly where resources are scarce and where economic disparities are present. In such cases, the provision of healthcare services may intensify inequality, with greater impact on the poorest. The English version of this paper is available at:http://www.insp.mx/salud/index.html.