Comparative Bioavailability of Metformin Hydrochloride Oral Solution Versus Metformin Hydrochloride Tablets in Fasting Mexican Healthy Volunteers.

INTRODUCTION: Metformin tablets may be challenging to swallow not only for those patients with dysphagia but also for children and the elderly. A metformin solution was developed for easier administration and flexible dose adjustment mantained with the same bioavailability of tablets. The objective of this study was to assess the single-dose oral bioavailability of metformin hydrochloride administered as an oral solution (500 mg/5 mL) compared with metformin hydrochloride 500 mg tablets in fasting Mexican healthy volunteers. METHODS: A randomized, single dose, two-period, two-sequence, crossover study design with a 7-day washout interval was conducted. Subjects were randomly assigned to receive a single dose of 500 mg metformin hydrochloride, either as an oral solution (test drug) or as a tablet (reference drug), after 10 h of fasting. Plasma samples (16) were collected over a 16-h period after drug administration. Bioequivalence was declared when the ratio for the 90% confidence intervals (CI) of the difference in the means of the log-transformed area under the concentration-time curve from time 0 to the last observed concentration time (AUC0-t), the area under the concentration-time curve extrapolated to infinite time (AUC0-∞), and the maximum plasma concentration (Cmax) of the two products were within 0.80 and 1.25 interval. Plasma concentrations were analyzed using reverse phase chromatography by tandem mass spectrometry (LC-MS/MS). Safety and tolerability of metformin were also assessed in all subjects. RESULTS: 24 subjects were enrolled and completed the study (15 female and 9 male). Test and reference metformin hydrochloride were bioequivalent during the extent of exposure since AUC0-t and Cmax 90% CIs corresponded to 89.77-101.08% and 89.63-102.48%, respectively, both being within the pre-specified acceptance range criteria (80-125%). There were two adverse events (AE) with the reference formulation that were not related to the study drug. CONCLUSIONS: Bioequivalence in healthy volunteers in fasting conditions of the two metformin hydrochloride formulations (oral solution and tablets) was established, being the difference in means of AUC0-t, AUC0-∞ and Cmax within the acceptance range (80-125%). Oral solution formulation could offer the advantages of allowing adjusted doses and easier swallowing for every patient. Plain language summary is available for this article. TRIAL REGISTRATION: National Clinical Trials Registry (RNEC by its Spanish acronym), BD METF-Sil No. 86-15. Mexican Medicine Agency (COFEPRIS) Registry: 153300410B0368. FUNDING: Laboratorios Silanes, S.A. de C.V.

Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model.

OBJECTIVES: To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. METHODS: Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. RESULTS: Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. CONCLUSIONS: Although, proposed variables explained individually active aging, only coping with aging explained global active aging.

Factores que contribuyen al Envejecimiento Activo en los adultos mayores, desde el marco del Modelo de Adaptación de Roy / Fatores que contribuem ao Envelhecimento Ativo nos adultos maiores, desde o marco do Modelo de Adaptação de Roy / Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model

Objective. To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. Methods. Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. Results. Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. Conclusion. Although, proposed variables explained individually active aging, only coping with aging explained global active aging. (AU)

Objetivo. Determinar las variables que contribuyen a la explicación del envejecimiento activo de acuerdo con el modelo de adaptacion de Roy. Métodos. Estudio descriptivo correlacional; se hizo muestreo por conveniencia y bola de nieve. Se incluyeron 200 adultos mayores. Se utilizaron los instrumentos: a) escala geriátrica de depresión de Yesavage, b) cuestionario de estado mental de Pfeiffer, c) Actividades básicas de la vida diaria, d) Actividades instrumentales de la vida diaria, e) escala de esperanza, f) reactivos de mecanismos de afrontamiento del inventario de Envejecimiento exitoso (afrontamiento al envejecimiento), y g) el cuestionario de apoyo social Duke-UNC-11. El envejecimiento activo se conformó por independencia en las actividades básicas e instrumentales de la vida diaria, libre de síntomas de depresión, buen estado mental y percepción de salud buena. Los datos se analizaron a partir de estadística descriptiva e inferencial, y modelos de regresión lineal y múltiple. Resultados. El 51% de los participantes mostró envejecimiento activo (42% en hombres y 56% en mujeres). De las variables propuestas, el modelo lineal generalizado mostró que los años de padecer la enfermedad, (Λ=0.922; p=0.008), el afrontamiento al envejecimiento (Λ=0.582; p=0.001), y el apoyo social percibido (Λ=0.885; p= 0.001), presentaron efecto sobre las variables que conformaron el envejecimiento activo. Estas tres variables explicaron el 5% de las actividades de la vida diaria, 41% de las instrumentales, 12.5% de la percepción de salud, 26% del estado mental y el 21% de la depresión. La esperanza y trabajo voluntario no fueron significativas. Al dicotomizar las variables del envejecimiento activo se encontraron efectos negativos de la edad y positivos del afrontamiento al envejecimiento. Conclusión. Aunque en este estudio se encontró que las variables propuestas explican en forma individual las variables del envejecimiento activo, solamente el afrontamiento al envejecimiento explicó la varianza del envejecimiento activo en forma global. (AU)

Objetivo. Determinar as variáveis que contribuem à explicação do envelhecimento ativo de acordo ao modelo de adaptação de Roy. Métodos. Estudo descritivo de correlação, se fez amostragem por conveniência e bola de neve. Se incluíram 200 adultos maiores. Se utilizaram os instrumentos: a) escala geriátrica de depressão de Yesavage, b) questionário de estado mental de Pfeiffer, c) Atividades básicas da vida diária, d) Atividades instrumentais da vida diária, e) escala de esperança, f) reativos de mecanismos de afrontamento do inventário de Envelhecimento de sucesso (afrontamento ao envelhecimento), e g) o questionário de apoio social Duke-UNC-11. O envelhecimento ativo se conformou por independência nas atividades básicas e instrumentais da vida diária, livre de sintomas de depressão, bom estado mental e percepção de boa saúde. Os dados se analisaram através de estatística descritiva e inferencial, e modelos de regressão lineal e múltipla. Resultados. 51% dos participantes mostrou envelhecimento ativo (42% em homens e 56% em mulheres). Das variáveis propostas o modelo lineal generalizado mostrou que os anos de padecer a doença, (Λ=0.922; p=0.008), o afrontamento ao envelhecimento (Λ=0.582; p=0.001), e o apoio social percebido (Λ=0.885; p=0.001), apresentaram efeito sobre as variáveis que conformaram o envelhecimento ativo. Estas três variáveis explicaram 5% das atividades da vida diária, 41% dos instrumentais, 12.5% da percepção de saúde, 26% do estado mental e 21% da depressão. A esperança, e trabalho voluntário não foram significativas. Ao classificar as variáveis do envelhecimento ativo se encontrou efeito negativo da idade e positivo do afrontamento ao envelhecimento sobre o envelhecimento ativo global. Conclusão. Embora neste estudo se encontrou que as variáveis propostas explicam em forma individual as variáveis do envelhecimento ativo, somente o afrontamento ao envelhecimento explicou a variável do envelhecimento ativo em forma global. (AU)

Factors associated with glycemic status and ability to adapt to changing demands in people with and without type 2 diabetes mellitus: A cross-sectional study.

OBJECTIVES: Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients. The purpose was to investigate the explained variance of socio-demographic, metabolic, anthropometric, clinical, psychosocial, cognitive, and lifestyle variables on glycemic status and on the ability to adapt to changing demands in people with and without type 2 diabetes mellitus in Monterrey, Mexico. METHODS: Adults with (n = 30, mean age 46.90 years old, 33.33% male) and without (n = 32, mean age: 41.69 years old, 21.87% male) type 2 diabetes mellitus were studied. Glycemic status was assessed using Bio-Rad D-10 Hemoglobin A1c Program, which uses ion-exchange high-performance chromatography. Stroop 2 test was used to assess the ability to changing demands. RESULTS: In participants with type 2 diabetes mellitus, less years of education, negative self-actualization, and higher levels of cholesterol and triglycerides explained more than 50% of the variance in glycemic status. In participants without type 2 diabetes mellitus, the variance (38.7%) was explained by total cholesterol, metabolic syndrome, high-density lipoprotein, and self-actualization scores; the latter in opposite direction. The ability to adapt to changing demands was explained by total cholesterol, malondialdehyde, insulin resistance, and triglycerides. In participants without type 2 diabetes mellitus, the contributing variables were metabolic syndrome and nutrition scores. CONCLUSION: Results showed significant effect on at least one of the following variables (socio-demographic, metabolic, or lifestyle subscale) on glycemic status in people with and without type 2 diabetes mellitus. The ability to adapt to changing demands was explained by metabolic variables but only in participants without type 2 diabetes mellitus. Preference for unhealthy behaviors (implicit or automatic responses) outweighs healthy lifestyle practices in people with and without type 2 diabetes mellitus.

Perspectiva espiritualidad en integrantes de alcohólicos anónimos: estudio piloto / Perspective spirituality in members of alcoholics anonymous: pilot study

La espiritualidad es un concepto que se ha relacionado de manera positiva con la salud física y mental de las personas y se ha observado que juega un papel importante en el manejo y recuperación del abuso de sustancias como el alcohol. El objetivo principal de este estudio fue determinar la perspectiva espiritual de los integrantes de AA (Alcohólicos anónimos). El diseño fue cuantitativo, descriptivo de corte transversal. La población estuvo conformada por integrantes de AA de 3 municipios suburbanos de Nuevo León, México. Se realizó un muestreo no probabilístico, la muestra estuvo conformada por 35 adultos pertenecientes a los grupos de AA, se utilizó la Escala de Perspectiva Espiritual (SPS). Los resultados muestran que el promedio del índice de espiritualidad en los participantes fue de 66.33 (DE = 17.23), el promedio de prácticas espirituales fue de 59.64 (DE = 25.11) y el de creencias espirituales fue de 70.70 (DE = 16.60). Se concluye que los integrantes de AA tienen un nivel alto de espiritualidad total, en prácticas espirituales y en creencias espirituales (AU)

Spirituality is a concept that has been linked positively with physical and mental health of people and has been found to play an important role in the management and recovery of substance abuse like alcohol. The main objective of this study was to determine the spiritual perspective of the members of AA. The design was quantitative, descriptive cross-sectional. The population consisted of members of AA 3 suburban municipalities of Nuevo Leon, Mexico. A non-probability sampling was performed, the sample consisted of 35 adults from AA groups, Spiritual Perspective Scale (SPS) was used. The results show that the average rate of spirituality in the participants was 66.33 (SD = 17.23), the average spiritual practices was 59.64 (SD = 25.11) and spiritual belief was 70.70 (SD = 16.60). It is concluded that AA members have a high level of total spirituality, spiritual practices and spiritual beliefs (AU)

Randomized clinical trial of the safety and immunogenicity of the Tdap vaccine in pregnant Mexican women.

Immunization with the tetanus, diphtheria, and pertussis (Tdap) vaccine raises controversies on immunogenicity and possible antibody interference. We performed an experimental, double-blind, parallel group controlled clinical trial to evaluate the safety and immunogenicity of the Tdap vaccine in 204 pregnant women and their children and to determine its interference in antibody production. Pregnant women 18 to 38 y of age with 12 to 24 weeks gestation, a low obstetric risk, and without serious disease were randomly selected. The experimental group received 0.5 mL IM of Tdap and the control group normal saline. Six blood samples were drawn before and after solution application, and from the umbilical cord of the infants and at 2, 4, and 6 months of age. Pertactin and Pertussis toxin antibodies and possible interference of maternal antibodies with the vaccine were determined. In the experimental group, antibodies against Bordetella pertussis pertactin (anti-PRN) (112 E/mL 95% CI 89.9-139.9) and antibodies against pertussis toxin (anti-PT) (24.0 E/mL, 95% CI 18.3-31.4) were elevated in the mother before vaccination. These were higher in the umbilical cord and descended in the infant at 2 months (71.4 (95% CI 56.8-89.7 and 10.9; 95% CI 8.7-13.7, respectively). Anti-PT showed a delay in production. Tdap safety was confirmed with only mild local pain at 24 and 48 hours. Anti-PRN and anti-PT antibodies in the infant descend at 2 months of age. There is a delay in anti-PT in children of immunized mothers. Further studies are needed to elucidate its clinical significance.

Motivaciones para la actividad física deportiva y consumo de alcohol en estudiantes de preparatoria / Motivations for sports activities and alcohol use in high school students

RESUMEN La actividad física deportiva se ha considerado un factor protector de consumo de alcohol, no obstante la relación de estas variables no es consistente. Objetivo: Identificar la relación entre las motivaciones para la ac tividad física deportiva, días y minutos utilizados y el consumo de alcohol en adolescentes. Material y método: Diseño descriptivo correlacional con muestreo aleatorio estratificado, con asignación proporcional al tamaño del estrato. En cada estrato se usó muestreo por conglomerados unietápico. La muestra fue de 415 adolescentes, con poder de 0,90. Se aplicó Escala de Medida de los Motivos para la Actividad Física-Revisada [MPAM-R], Cuestionario de Identificación de los Trastornos debidos al Consumo de Alcohol [AUDIT]. Resultados. Los días (rs=0,254, p<0,001) y minutos (rs=0,253, p<0,001) dedicados a la actividad física deportiva relacionaron positivamente con las motivaciones. Se identificó una relación positiva entre motivaciones intrínsecas para la actividad física deportiva y consumo sensato de alcohol (p=0,049). Así también, los días (r=0,253, p<0,001) y minutos (rs=0,270, p<0,001) utilizados en la actividad física deportiva relacionaron positivamente con el consumo de alcohol. Conclusión: Las motivaciones se asociaron con los días y minutos dedicados a la actividad física deportiva y con el consumo sensato de alcohol. Los días y minutos dedicados a la actividad física deportiva también presentaron una relación positiva con el consumo de alcohol. Se propone desarrollar modelos predictivos, que sean la base de futuras intervenciones de enfermería enfocadas a la promoción de la salud y prevención del consumo de alcohol, mediante estrategias de motivación de la actividad física deportiva.

ABSTRACT Alcohol use and abuse is a public health problem, it is a causal factor for more than 200 diseases and injuries; sports activity has been considered a protective factor for alcohol use, however, the relationship of these variables is not consistent. Objective: To identify the relationship between motivations for sports activity, measuring days and minutes dedicated to it, and alcohol use in teenagers. Methods: A descriptive correlational design with stratified random sampling and proportional allocation to the stratum size was used. A single stage cluster sampling was conducted for each stratum. The sample included 415 teenagers with a power of 0.90. The Scale of Motives for Physical Activity Measurement-Revised [MPAM-R] and the Alcohol Use Disorders Identification Test [AUDIT] were used. Results: The number of days (rs=0.254, p<0.001) and minutes (rs=0.253, p<0.001) spent in sports activities by teenagers were positively and significantly correlated with alcohol use [AUDIT]. Likewise, the number of days (r=0.253, p<0.001) and minutes (rs=0.270, p<0.001) spent in sports activities were positively and significantly correlated with motivations. Conclusions: The number of days and minutes spent in sports activities by teenagers is related to alcohol use and motivations. There is a need for predictive models as a basis for future nursing interventions focused on health promotion and alcohol use prevention by using strategies that promote sports activities.

Patrones de consumo de drogas lícitas e ilícitas de los pacientes que ingresan a una sala de urgencias / Patterns of consumption of licit and illicit drugs patients entering an emergency room

ResumenIntroducción. El objetivo de este trabajo es identificar la disposición de las personas que acuden a una sala de urgencias en cuanto a modificar sus conductas de consumo de drogas lícitas e ilícitas.Método. El estudio fue de tipo descriptivo con un diseño transversal. La población la constituyeron 83 pacientes mayores de 18 años que sufrieron un accidente o lesión por violencia relacionado con el consumo de drogas y que ingresaron a la sala de urgencias de una institución pública de tercer nivel de atención en Monterrey, México. El muestreo se realizó en el año 2011.Resultados. La población de estudio estuvo integrada principalmente por hombres (fi=79, hi=95,2%), cuya ocupación era la de trabajador (fi=54, hi=71,1%), que ingresaron a la sala de urgencias por lesiones por violencia (fi=42, hi=50,6%), principalmente por consumo de alcohol (fi=71, hi=85,5%), seguido por el de marihuana (fi=7, hi=8,5%). Los participantes se encontraron mayormente en la etapa de contemplación, en un 62,2% (fi=46) y 77,8% (fi=7), respecto de drogas lícitas e ilícitas.Conclusión. Esencialmente, los entrevistados se encuentran en la etapa de contemplación tanto para el consumo de drogas licitas e ilícitas, lo cual precisa una corrección de tales conductas.

AbstractBackground. To identify the arrangement of people to change their consumption behavior of licit and illicit drugs that go to an emergency room.Method. A descriptive cross-sectional design study. The population of patients older than 18 who suffered an accident or injury by violence related to drug use and admitted to the emergency room of a public institution of tertiary care in Monterrey, Mexico, was established. 83 people participated and sampling was conducted in the year 2011.Results. The study oblation consisted mainly of men (fi=79, hi=95,2%), mostly whose occupation was that of worker (fi=54, hi=71,1%), admitted to the emergency room for injuries by violence (fi=42, hi=50,6%). Participants are mostly in the contemplation stage, 62,2% (fi=46) and 77,8% (fi=7), to legal and illegal drugs.Conclusion. Essentially the participants are in the contemplation stage for both legal and illegal consumption of drugs, indicating a correction to their behavior.

Family, obesogenic environment, and cardiometabolic risk in mexican school-age children / Familia, medio ambiente obesogénico, y riesgo cardiometabólico en niños en edad escolar en México

Introduction: Obesity in children is considered a risk factor for metabolic and cardiovascular disorders at an early age. Objective: To identify the relationship among environmental and family variables on cardiometabolic risk factors (CMRF) in school-age children, and to compare such CMRF by weight status. Material and methods: A cross-sectional design was used. A 228 children and their mothers were randomly selected from public and private elementary schools. Measurements in children included: body fat percentage (BFP), systolic and diastolic blood pressure (SBP, DBP), acanthosis, lipids, glucose, C-reactive protein (CRP), and self-care activities. Mothers were assessed for: BFP, sociodemographic, family history, mothering style. School environment variables were also evaluated. Results: Children and mother's mean ages were 8.5 and 36.8 years, respectively. Mother schooling mean was 12.4 years. Overweight or obese (Ow/OB) children (70.2%) showed higher values in SBP (p = 0. 040), low-density cholesterol (p = 0. 018), triglycerides (p = 0. 003), glucose (p = 0. 022) and CRP (p = 0. 001) and lower in high-density cholesterol (p = 0. 004). Age and child gender, mothering, and mother schooling influenced CMRF [Wilk's Lamda = 0.65, F = 21.71, p < 0.001]. Conclusions: Children with Ow/OB in a obesogenic environment are more likely to develop CMRF. It is necessary to promote the identification and treatment of CMRF at an early age as well as promote healthier family and school environments.

Introducción: La presencia de obesidad en niños se considera un factor de riesgo para enfermedades metabólicas y cardiovasculares a temprana edad. Objetivo: Identificar la influencia del ambiente/familia en los factores de riesgo cardiometabólico (FRCM) en escolares y compararlos con su condición de peso. Material y métodos: Diseño transversal explicativo. La muestra estuvo conformada por 228 pares madre-hijo seleccionados aleatoriamente de escuelas primarias públicas y privadas. Mediciones en Niños: porcentaje de grasa corporal (PGC), presión arterial sistólica (PAS) y diastólica (PAD), acantosis, lípidos, glucosa, proteína C reactiva (PCR) y autocuidado; Madres, PGC, datos sociodemográficos, historia familiar, crianza materna; y en escuelas: ambiente escolar. Resultados: Edad promedio: niños 8.5 años y madres 36.8 años. La escolaridad materna promedio fue 12.4 años. Los niños con sobrepeso u obesidad (SP/OB) (70.2%) mostraron valores más altos en la PAS (p = 0.040), colesterol baja densidad (p = 0.018), triglicéridos (p = 0.003), glucosa (p = 0.022) y PCR (p = 0.001) y más bajos en colesterol de alta densidad (p = 0.004). Tanto la edad y género del niño como la escolaridad y estilo de crianza materno influyeron en los FRCM [Lamda de Wilk = 0.65, F = 21.71, p < 0.001] Conclusiones: La presencia de SP/OB fue alta, y en conjunto con un ambiente familiar obesogénico favorecen la prevalencia de FRCM. Es necesario promover un diagnóstico y tratamiento de FRCM a temprana edad, así como favorecer ambientes familiares y escolares más saludables.

Connection between competence, usability, environment and risk of falls in elderly adults.

OBJECTIVE: To determine connections between competence, usability, environment and risk of falls in elderly adults. METHOD: Correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. RESULTS: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. CONCLUSION: This study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Connection between competence, usability, environment and risk of falls in elderly adults / Relação entre competência, usabilidade, ambiente e risco de quedas em idosos / Relación entre competencia, usabilidad, entorno y riesgo de caídas en el adulto mayor

Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Objetivo: determinar a relação entre competência, usabilidade e ambiente com risco de quedas em idosos. Método: estudo descritivo correlacional, incluindo 123 homens e mulheres idosos de 70 anos para mais. Os dados foram coletados com os instrumentos Escala de Tinetti, Escala CESD-7, Avaliação Cognitiva Montreal, Questionário de Usabilidade na Moradia e Housing Enabler; e um instrumento de coleta de dados para antecedentes sociodemográficos e de saúde. Para a análise dos dados, foi utilizada estatística descritiva e inferencial, em que foram ajustados modelos lineares multivariados e de regressão logística. Resultados: 42,0% dos idosos apresentaram quedas, sendo maior a prevalência nas mulheres e no grupo de 70-75 anos. Como risco de quedas, foram encontrados o ambiente físico da moradia, caminhada e usabilidade. Encontrou-se relação negativa entre usabilidade com sintomas depressivos, saúde cognitiva, equilíbrio, caminhada, ambiente social e físico p<0,05; e forte correlação positiva entre caminhada e equilíbrio p<0,05. Conclusão: o estudo contribui para melhor compreensão formal do fenômeno das quedas ao encontrar relação entre a usabilidade com o risco de quedas, e com outras variáveis que se relacionam com as quedas.

Objetivo: determinar la relación de la competencia, usabilidad y del entorno con el riesgo de caídas en el adulto mayor. Método: estudio descriptivo correlacional, se incluyeron 123 adultos mayores hombres y mujeres de 70 años y más. Los datos fueron recolectados con los instrumentos Escala de Tinetti, Escala CESD-7, Evaluación Cognitiva Montreal, Cuestionario de Usabilidad en la Vivienda y Housing Enabler; y una cédula de datos para antecedentes sociodemográficos y de salud. Para el análisis de datos se utilizó una estadística descriptiva e inferencial, en donde se ajustaron modelos lineales multivariados y de regresión logística. Resultados: el 42,0% de los adultos mayores había presentado caídas, con una mayor prevalencia en las mujeres y en el grupo de 70-75 años. El entorno físico de la vivienda, marcha y usabilidad se establecieron como riesgos de caída. Se encontró una relación negativa entre la usabilidad y los síntomas depresivos, la salud cognitiva, el equilibrio, la marcha, el entorno social y físico p<0,05; y una fuerte correlación positiva entre la marcha y el equilibrio p<0,05. Conclusión: el estudio contribuye a comprender mejor el fenómeno de las caídas al encontrar relación entre la usabilidad con el riesgo de caída, y con otras variables.

A physical-cognitive intervention to enhance gait speed in older Mexican adults.

PURPOSE: To test the effects of a physical-cognitive exercise intervention on gait parameters under dual-task conditions in community-dwelling older adults. DESIGN: A repeated-measures quasi-experimental design, with control and exercise groups, was used. SETTING: Study participants consist of a convenience sample recruited from senior citizens' centers in Monterrey, Mexico. SUBJECTS: A total of 143 sedentary participants ages 65 to 92 years per group participated. INTERVENTION: A combined 45- to 60-minute program of physical and cognitive exercises was conducted in three weekly sessions during 12 weeks for the exercise group. Measures . The spatial gait parameters of speed (cm/s), step width, and stride length (cm); and the temporal parameters of single and double support time, cadence (steps per minute), and swing time(s) were measured using the GaitRite. Counting backwards or naming animals represented cognitive performance. ANALYSIS: Two (groups: exercise group vs. control group) by three (time: baseline, week 6, and week 12) repeated-measures multivariate analysis of variance (MANOVA) was applied. RESULTS: Repeated-measures multivariate analysis of variance revealed a significant group effect (Wilks lambda F4,279 = 6.78, p < .001); univariate analysis showed significant differences for gait speed (m/s), stride length, cadence, step width, and double support time. Time-by-group interaction showed significance in gait speed and stride length. CONCLUSION: The exercise group participants showed increased gait speed, cadence, and stride length, and reduced their step width and time spent with both feet on the ground. Walking while simultaneously performing a cognitive task might prepare older adults for competing/interfering demands from their environments. The protective health benefits of this intervention remain to be investigated.

Validación del índice de satisfacción con la vida en la tercera edad / Validation of the Life Satisfaction Index for the Third Ag / Validação do índice de satisfação com a vida na terceira idade

Objetivos: estudiar la estructura factorial del Life Satisfaction Index for the third age, short form (LSITA-SF), su consistencia interna, la validez de contenido y de constructo, y la validez divergente y convergente. Este índice se propone como uno de los indicadores subjetivos del envejecimiento exitoso, que a su vez representa el modo de autoconcepto del Modelo de Adaptación de Roy y se contrasta con una medición breve de sintomatología depresiva (CESD-7 por sus siglas en inglés) y con la dimensión de salud física del SF-12. El CESD-7 representó un estímulo contextual y el SF-12 representó el modo fisiológico. Materiales y métodos: estudio realizado en México, en donde a una muestra no probabilística de 255 participantes voluntarios de 60 a 100 años se le aplicaron las escalas LSITA-SF, CESD-7 y SF-12. Tres expertos evaluaron su validez de contenido. Se calculó la consistencia interna mediante el alfa de Cronbach, el análisis factorial exploratorio por componentes principales y rotación Varimax, el análisis factorial confirmatorio por máxima verosimilitud, y para la validez divergente y convergente se usaron coeficientes de correlación de Spearman. Resultados: la validación de contenido fue adecuada. El modelo con mejor ajuste fue el de 3 factores correlacionados (X ² [41, N = 255] = 77,30, p = 0,001; GFI = 0,96; AGFI = 0,935 y RMSEA=0,059 [IC 90% = 0,038-0,079]) al que se eliminó un reactivo. La consistencia interna fue α = 0,80. La correlación entre LSITA-SF y CESD-7 fue de r s = -0,38; el coeficiente de correlación entre LSITA-SF y SF-12 fue de r s = 0,32. Conclusión: la escala LSITA con 11 reactivos muestra confiabilidad y validez incipiente. Es recomendable continuar su validación para su uso en países hispanoparlantes.

Objectives: Study the factor structure of Life Satisfaction Index for the third age, short form (LSITA-SF), its internal consistency, content validity, and to contrast its divergent validity. This index is proposed as a subjective indicator of successful aging Roy Adaptation Model, self concept mode. It is contrasted to a brief measurement of depression (CESD-7) that served as contextual stimuli in a major study. Materials and methods: The LSITA-SF scale and the (CESD-7) were applied to a non-probabilistic sample of 255 mexican volunteers from 60 to 100 years old. The content validity was evaluated by three experts. The internal consistency was calculated by the Cronbach's Alpha coefficient, the factor analysis by Principal Component Analysis and Varimax rotation, the confirmatory factor analysis by Maximum Likelihood and the divergent validity by the Spearman correlation coefficient. Results: The content validity was adequate. A three correlated factors model showed the best fit (X² [41, N = 255] = 77.30, p = 0,001, GFI = 0,96, AGFI = 0,935, and RMSEA = 0,059), one item was deleted. Internal consistency was (α = 0,80). The correlation between LSITA-SF11 and CESD-7 was moderate (r s = -0,38); and between LSITA-11 and physical health measured by five items of SF-12 was (r s = 0,32). Conclusion: The 11-items LSITA scale shows preliminary good properties of reliability and validity in Mexican elderly people. We suggest its study for further validation in Mexico and other Spanish speaking countries.

Objetivos: estudar a estrutura fatorial do Life Satisfaction Index for the third age, short form (LSITA-SF), sua consistência interna, a validade de conteúdo e de construto, e a validade divergente e convergente. Este índice se propõe como um dos indicadores subjetivos do envelhecimento bem-sucedido que, por sua vez, representa o modo de auto-conceito do Modelo de Adaptação de Roy e se contrasta com uma medição breve de sintomatologia depressiva (CESD-7 por suas siglas em inglês) e com a dimensão de saúde física do SF-12. O CESD-7 representou um estímulo contextual e o SF-12 representou o modo fisiológico. Materiais e métodos: estudo no México, onde a uma amostra não probabilística de 255 participantes voluntários de 60 a 100 anos foram aplicadas as escalas LSITA-SF, CESD-7 e SF-12. Três especialistas avaliaram sua validade de conteúdo. Calculou-se a consistência interna mediante o alfa de Cronbach, a análise fatorial exploratório por componentes principais e rotação Varimax, a análise fatorial confirmatória por máxima verossimilitude, e para a validade divergente e convergente se usaram coeficientes de correlação de Spearman. Resultados: a validação de conteúdo foi adequada. O modelo com melhor ajuste foi o de 3 fatores correlacionados (X²[41, N = 255] = 77,30, p = 0,001; GFI = 0,96; AGFI = 0,935 e RMSEA = 0,059 [IC 90% = 0,038-0,079]) ao que se eliminou um reativo. A consistência interna foi α = 0,80. A correlação entre LSITA-SF e CESD-7 foi de (r s = -0,38; o coeficiente de correlação entre LSITA-SF e SF-12 foi de (r s = 0,32. Conclusão: a escala LSITA com 11 reativos mostra confiabilidade e validade incipiente. É recomendável continuar sua validação para seu uso em países hispanofalantes.

Self-care behaviors and health indicators in adults with type 2 diabetes.

This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006). The results showed a low self-care behaviors index (X = 36.94, SD=15.14). A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, p<.001), triglycerides (r s=-.208, p=.040), BMI (r s=-.248, p=.014) and body fat percentage (r s=-.221, p=.029). Multivariate analysis revealed the influence of self-care behaviors on HbA1c, BMI and body fat percentage with explained variances of 9 to 41% (p < .05). From all self-care dimensions, diet was the most predictive for health indicators, moderated by gender and understanding of diabetes contents (p< .05).

Self-Care Behaviors and Health Indicators in Adults with Type 2 Diabetes / Condutas de autocuidado e indicadores de saúde em adultos com diabetes tipo 2 / Conductas de autocuidado e indicadores de salud en adultos con diabetes tipo 2

This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006). The results showed a low self-care behaviors index (X > or = 36.94, SD=15.14). A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, p<.001), triglycerides (r s=-.208, p=.040), BMI (r s=-.248, p=.014) and body fat percentage (r s=-.221, p=.029). Multivariate analysis revealed the influence of self-care behaviors on HbA1c, BMI and body fat percentage with explained variances of 9 to 41 percent (p < .05). From all self-care dimensions, diet was the most predictive for health indicators, moderated by gender and understanding of diabetes contents (p< .05).

Estudo descritivo correlacional que teve como objetivo analisar as condutas de autocuidado e a sua relação com indicadores de saúde, representados pelo controle glicêmico, perfil de lipídios, índice de massa corpórea (IMC), circunferência da cintura e porcentagem de gordura corporal, em amostra aleatória de 98 adultos com diabetes tipo 2, de uma zona conturbada em Nuevo León, México (agosto 2005/maio 2006). Os resultados mostraram índice de autocuidado baixo (X > ou = 36,94, dp=15,14). Encontrou-se correlação significativa entre o autocuidado e a hemoglobina glicolisada (HbA1c) (r s=0,379, p<0,001), triglicerídeos (r s=0,208, p=0,040), IMC (r s=0,248, p=0,014) e gordura corporal (r s=0,221, p=0,029). A análise multivariada revelou influência do autocuidado em HbA1c, IMC e gordura corporal com variâncias explicadas de 9 a 41 por cento (p<0,05). Das dimensões do autocuidado, a dieta foi o principal fator de predição moderado pelo gênero e a compreensão dos conceitos sobre o diabetes (p<0,05).

Se trata de un estudio descriptivo y correlacional que tuvo como objetivo analizar las conductas de autocuidado y su relación con indicadores de salud, representados por el control de la glucemia, perfil de lípidos, IMC, circunferencia de cintura y porcentaje de grasa corporal, en una muestra aleatoria de 98 adultos con diabetes tipo 2 de un zona periférica de la ciudad de Nuevo León, en México; los datos fueron recolectados entre agosto del 2005 y mayo del 2006. Los resultados mostraron un índice de autocuidado bajo (promedio= 36,94 y desvío estándar=15,14). Se encontró correlación significativa entre el autocuidado y la HbA1c (r s= 0,379, p< 0,001), triglicéridos (r s= 0,208, p=0,040), IMC (r s= -.248, p=0,014) y grasa corporal (r s= 0,221, p=0,029). El análisis multivariado reveló influencia del autocuidado en HbA1c, IMC y grasa corporal con varianzas explicadas de 9 por ciento a 41 por ciento (p <0,05). De los factores del autocuidado, la dieta fue el principal factor de predicción moderado por el género y la comprensión de los aspectos de la diabetes (p<0,05).

Validación del instrumento: afrontamiento y proceso de adaptación de Roy en pacientes con diabetes mellitus tipo 2 / Instrument validation: Roy´s coping and adaptation process in patients with type 2 diabetes mellitus

Objetivo: valorar las propiedades psicométricas de la escala de afrontamiento y proceso de adaptación de Roy en población mexicana.Materiales y métodos: la escala se aplicó a 200 participantes con diabetes mellitus tipo 2. Para validar el constructo se realizó la extracción de factores con componentes principales y rotación Varimax, con Eigenvalores por arriba de 1 y cargas de factor mayores a ,30.Resultados: seis reactivos fueron eliminados del análisis por mostrar correlación negativa con la correlación total de la escala. El análisis de componentes principales inicial reveló nueve factores con una variación explicada de 65,29 por ciento. Sin embargo, no se consideraron tres factores por contener cada uno de ellos solamente un reactivo. Por tanto, la escala final se acepta con 38 reactivos. El coeficiente de confiabilidad Alfa de Cronbach fue de, 93.Discusión: el análisis reveló seis factores, uno más de lo reportado por Roy, y con mayor variación explicada. Algunos reactivos parecen no ser bien comprendidos por los participantes.Conclusiones: este artículo aporta una aproximación metodológica para explorar la adecuación de un instrumento a una población diferente para la que originalmente fue diseñado. Se concluye que la escala tiene consistencia interna y validez de constructo incipiente, los datos reportados en este estudio deben tomarse en cuenta con cautela. Es conveniente revisar de nuevo los reactivos y adecuarlos a la cultura particular, y probar la escala de nuevo con pacientes con enfermedades crónicas degenerativas a fin de contar con instrumentos culturalmente equivalentes.

Metabolic control of adults with type 2 diabetes mellitus through education and counseling.

PURPOSE: To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care. DESIGN: A quasi-experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylated hemoglobin (HbAlc), psychosocial, and clinical variables. FINDINGS: Results showed a significant decrease in HbAlc in the experimental group, as well as positive effects of self-care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self-care actions. CONCLUSIONS: The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self-care agency, adaptation, and barriers were predictors of self-care measures and level of HbA1c.

[Drug consumption and occupational violence in working women, a multicenter study: Mexico, Peru, Brazil]. / Consumo de drogas e violencia laboral em mulheres que trabalham, um estudo multicêntrico: México, Peru, Brasil.

The purposes of the study were: 1) Determine the proportion of working women who consume drugs; 2) identify some occupational and personal risk factors that can predict drugs consumption; 3) identify the presence of occupational violence and its relation with drugs consumption; 4) identify differences and similarities in drugs consumption and occupational violence among women from three communities in Mexico (Monterrey), Peru (Lima) and Brazil (Rio de Janeiro). A multicenter, descriptive, correlational and comparative study was carried out, with a sample of 903 women. The results show that 11% of the participants in Mexico consume alcohol, 53% in Peru and 45% in Brazil. The consumption of illicit drugs corresponded to 5% in Mexico and 6% in Peru. The presence of occupational violence was found in 16% of the Mexican participants, 24% of the Peruvians and 39% of the Brazilians.

Consumo de drogas y violencia laboral en mujeres que trabajan, un estudio multicéntrico: México, Perú, Brasil / Drug consumption and occupational violence in working women, a multicenter study: Mexico, Peru, Brazil

Los propósitos del estudio fueron: 1) Determinar la proporción de consumo de drogas de las mujeres que trabajan; 2) Identificar algunos factores de riesgo personales y laborales que puedan predecir el consumo de drogas; 3) Identificar la presencia de violencia laboral y su relación con el consumo de drogas; 4) Identificar diferencias y similitudes de consumo de drogas y violencia laboral en las mujeres de las tres comunidades de México (Monterrey), Perú (Lima) y Brasil (Rio de Janeiro). El estudio fue multicéntrico, descriptivo, correlacional y comparativo, con una muestra de 903 mujeres. En los resultados se observa que la proporción de consumo de alcohol en México fue del 11 por ciento, en Perú del 53 por ciento y en Brasil del 45 por ciento. El consumo de drogas ilícitas en México fue del 5 por ciento y en Perú del 6 por ciento. La presencia de violencia laboral fue del 16 por ciento en las mexicanas, 24 por ciento en las peruanas y 39 por ciento en las brasileñas

Consumo de drogas y violencia laboral en mujeres trabajadoras de Monterrey, N. L., México / Drug consumption and occupational violence in working women of Monterrey, N. L., Mexico

O propósito do estudo foi explorar o consumo de drogas e violência ocupacional em uma amostra de 669 mulheres maiores de idade, que trabalham e moram em treze Areas Geo-Estatísticas Básicas de Monterrey, Nuevo León, México. Foi adotado um desenho descritivo e correlacional com abordagem qualitativa. Resultados revelaram que 37,1 por cento das mulheres consumiram álcool, 29,1 por cento tabaco, 0.4 por cento maconha, 0,1 por cento inaláveis e, entre as drogas médicas, 5 por cento consumiu tranqüilizantes e 1,0 por cento outras sustâncias (barbitúricos, antidepressivos, Tylenol/Codeína). O teste qui-quadrado não encontrou diferença significativa dos fatores sócio-demográficos e ocupacionais com o consumo de drogas (p>.05), exceto com a forma de trabalho (c2=18.08, gl=4, p=.001). No entanto, o índice de violência mostrou associação positiva com o consumo de drogas (p<.05). Foram encontrados 126 casos de violência, dos quais 34 narraram sua experiência. A percepção do consumo de drogas e violência identificou-se em 2 categorias: A Conceptualização da Violência Ocupacional e a Relação entre a Violência e o Consumo de Drogas.