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PubMed1989

Mexico, maquiladoras, and occupational medicine training.

Industrialization and its concomitant social and environmental effects in developing countries are considered in this paper. Mexico offers one example of economic progress achieved through the promotion of industrial growth. Recognising the need for trained experts with global experience in occupational health, the University of Arizona (UA) has begun a programme to train occupational and preventive medicine residents in international aspects of occupational health in the nearby industrialized border regions of Mexico. By using the maquiladora (assembly plant) industries and the resources of the Instituto Mexicano del Seguro Social with the State of Sonora, residents observe existing problems in occupational safety and health in addition to adding to their understanding of the need for worldwide cooperation for research and reform in this field.

Arizona↗
PubMed2005

Perceived health needs of elderly Mexicans living on the U.S.--Mexico border.

UNLABELLED: This descriptive study explores the health beliefs of an underserved elderly group to gain insight regarding their self-perceived health needs. Focus groups were conducted with 112 elderly Mexicans living on the U.S.-Mexico border. Participants were asked questions regarding positive aspects of aging, self-perception of health status, and health care service needs. DISCUSSION: Many felt having knowledge gained from life experience and raising a family was positive; participants indicated their overall health status was poor; and they believed it was difficult to access quality health care services. Many participants self-reported that health status depended on socioeconomic status, family support, chronic diseases, and previous lifestyle. These findings can help develop culturally appropriate interventions designed to improve the overall health of the elderly living on the U.S.-Mexico border.

Aged↗
PubMed2002

Targeting performance of three large-scale, nutrition-oriented social programs in Central America and Mexico.

This study evaluated whether three nutrition-oriented programs in Central America and Mexico have been successful in targeting those households most vulnerable to undernutrition and poverty. For each country, nationally representative data sets were used to estimate cutoff points dividing the population into 10 equal-sized groups according to child anthropometric measurements (age-standardized height) and household income (per capita household expenditures). Households meeting eligibility criteria were then assessed using special baseline surveys or national data obtained before implementation of the program. Children in these households were classified according to national deciles of height-for-age, and households were classified according to expenditure deciles. In spite of markedly differing targeting strategies, each of the programs was well targeted, with 45% (Honduras and Mexico) and 52% (Nicaragua) of children in eligible households coming from the lowest two deciles of the national distributions, and virtually none from the upper two deciles. Similar results pertained to household income. These experiences demonstrate that vulnerable households can be targeted relatively straightforwardly, and that the need to do this does not in every case imply household-level income screening.

Adult↗
PubMed2006

The relative effect of self-management practices on glycaemic control in type 2 diabetic patients in Mexico.

OBJECTIVE: In this study, we examined the relative impact of self-management activities on glycaemic control in a population at high risk for developing complications. METHODS: Patients diagnosed with diabetes mellitus of at least 1 year in duration at 30 years of age or older were sampled from the Instituto de Mexico Seguro Social (IMSS) Family Medicine Clinics in Guadalajara, Mexico (n=800). Demographic, clinical and health behaviour variables were used to predict good/poor glycaemic control, as measured by haemoglobin Alc (A1C). RESULTS: Most (72.24%) patients had poor control (A1C > or = 7.0). Hyperglycaemia was significantly associated with factors not under patient control, such as having diabetes for a longer time [odds ratio (OR) = 2.40, 95% confidence interval (CI) 1.39, 4.14], having a first-degree relative with diabetes (OR= 1.52; 95% CI 1.06, 2.19), and being prescribed anti-diabetic medications, e.g. insulin (OR = 7.88, 95% CI 2.42, 25.63). After controlling for these variables, the only self-management variable that reduced the likelihood of hyperglycaemia was following a special diet (OR=0.49; 95% CI 0.32, 0.76). Furthermore, depression had an important effect on self-management, as those with lower levels of depressive symptoms were more likely to follow a diet and exercise. DISCUSSION: While patients in this population have little control over many factors associated with glycaemic control, an important exception is diet. However, because of the adverse effect of depression on dieting, both depression management and dietary education are important for this population.

Adult↗
PubMed2002

Antibiotic susceptibility patterns of Helicobacter pylori strains isolated from northeastern Mexico.

There are reports of increased antibiotic resistance rates in Helicobacter pylori strains around the world. The aim of this study was to determine the susceptibility patterns in H. pylori strains isolated in Monterrey, Mexico. We studied 62 strains isolated from the same number of symptomatic adult patients. Metronidazole (Mtz), clarithromycin (Cla), amoxicillin (Amx) and tetracycline (Tet) were tested by the E-test method. We observed that 37.1% of the strains were resistant to Mtz (MIC > or = 8 mg/L), and 8.1% to Cla (MIC > or = 8 mg/L), but we did not observe resistance to Amx (MIC > or = 2 mg/L) or Tet (MIC > or = 4 mg/L). In northeastern Mexico, the percentage of resistant strains was similar to that observed in developed countries. These results confirm that it is necessary to evaluate the susceptibility patterns of H. pylori strains by geographic area.

Adolescent↗
PubMedDate not supplied

Selecting high-priority hazardous chemicals for tri-national control: a maximum-utility method applied to Mexico.

The dispersion of persistent, bioaccumulative toxic chemicals poses risks to human health and the integrity of the ecosystem on a continental scale. Mexico, the United States, and Canada sought to add two pollutants to an existing list of four subject to North American Regional Action Plans (chlordane, DDT, mercury, PCBs). Mexican negotiators used results from an internal selection process, applying 14 criteria in five categories-physicochemical, health-endpoint, data quality/quantity, exposure potential, and control feasibility-to a baseline group of over 4,700 substances. Using policy analysis by the multiattribute maximum-utility method, progressive application of criteria and weighting algorithms acted like successive filters to identify priority lists of 15 and 7 substances/substance groups for Mexico. The 15 are: 1) benzo-a-pyrene (1 other PAHs); 2) cadmium; 3) heptachlor; 4) hexachlorobenzene; 5) lead; 6) lindane (+ other HCH isomers); 7) 2,3, 7,8-tetrachlorodibenzo-p-dioxin (&plus other PCDDs); 8) aldrin; 9) arsenic; 10) chromium; 11) carbon tetrachloride; 12) 3-3'-dichlorobenzidine; 13) dieldrin; 14) nickel; and 15) toxaphene. The first seven are the priority list of seven.

Algorithms↗
PubMedDate not supplied

Occupational health in Mexico.

This article describes the current situation of occupational health (OH) in Mexico, including socioeconomic context, legislation, health system, and educative and investigative resources, as well as the practice of OH. Workplace accidents per 100 workers decreased from 7.23 to 2.3 workers in 20 years; deaths decreased from 1.68 to 0.9 per 10,000 workers, while the occupational disease rate increased from 0.6 to 1 per 10,000 workers. This can be interpreted as an improvement in preventive measures as well as problems of recognition and registry. In Mexico OH faces challenges that range from needs for professional training and performance to needs for development of legal measures, coordination, information, and research.

Humans↗
PubMed2005

Socioeconomic factors and low birth weight in Mexico.

BACKGROUND: Low birth weight (LBW) is a public health problem linked to lack of equity in populations. Despite efforts to decrease the proportion of newborns with LBW, success has been quite limited. In recent years, studies focused on explaining how social factors influence this problem have shown that populations with greater inequities have a greater proportion of newborns with LBW. METHODS: The objective was to describe socioeconomic factors related to LBW adjusted by demographic, reproductive and health services variables in Mexico City. A case-control study was carried out in three hospitals with gynaecological and obstetrics services in Mexico City during the first half of 1996. During the recruiting period all children with LBW (cases), defined as newborns weighing <2500 grams, were matched with children born on the same day to control for time of birth. Upon arrival at the hospital for delivery, women were interviewed to determine if they met our inclusion criteria. Women with a history of chronic conditions and those with twin or multiple pregnancies were excluded. Variables with clinical and statistical significance were included in a multivariate model (logistic regression). RESULTS: We found that low socioeconomic level was the most important risk factor for LBW and was independent of other factors, including those related to reproduction and nutrition, smoking, morbidity during pregnancy, accessibility to health services and prenatal care (OR 2.68; 95% CI 1.19, 6.03). CONCLUSION: We found that socioeconomic factors are relevant to LBW. However further research should be done in different population groups as well as developing precise ways of measuring socioeconomic factors and their role in reproductive health.

Adolescent↗
PubMed2006

Consenting of the vulnerable: the informed consent procedure in advanced cancer patients in Mexico.

BACKGROUND: A topic of great concern in bioethics is the medical research conducted in poor countries sponsored by wealthy nations. Western drug companies increasingly view Latin America as a proper place for clinical research trials. The region combines a large population, modern medical facilities, and low per capita incomes. Participants from developing countries may have little or non alternative means of treatment other than that offered through clinical trials. Therefore, the provision of a valid informed consent is important. METHODS: To gain insight about some aspects of the informed consent procedure in a major cancer centre in Mexico, we conducted a three-step evaluation process: 1) a ten point multiple choice survey questionnaires, was used to explore some aspects of the patients' experiences during the informed consent process, 2) researchers' knowledge about specific aspects of the informed consent was evaluated in this study using survey questionnaires; and 3) the comprehensibility, readability and number of pages of the consent forms were analysed. The socioeconomic and educational level of the patients, were also considered. Results were reported using a numerical scale. RESULTS: Thirty five patients, 20 doctors, and 10 individuals working at the hospital agreed to participate in the study. Eighty three percent of the patients in the study were classified as living in poverty; education level was poor or non existent, and 31% of the patients were illiterate. The consent forms were difficult to understand according to 49% of the patients, most doctors agreed that the forms were not comprehensible to the patients. The average length of the IC documents analysed was 14 pages, and the readability average score was equivalent to 8th grade. CONCLUSION: The results presented in this work describe some relevant characteristics of the population seen at public health care institutions in Mexico. Poverty, limited or no education, and the complexity of the information provided to the patients may question the validity of the informed consent procedure in this group of patients.

Attitude↗
PubMed2006

Threatened edible insects in Hidalgo, Mexico and some measures to preserve them.

Edible insects are a natural renewable resource that provides food to many ethnic groups in Mexico. Some of these species are overexploited because of increased consumption, caused by the huge human population growth in the area and because of the large demand of these insects from many restaurants in Mexico and in other countries. In Tulancalco, a small arid village in the State of Hidalgo, I carried out studies on edible insects over 25 years. The inhabitants of this village have a natural economy and use some 30 species of insects as food. At present, we have noticed a decrease in the population of several species due to overexploitation, which is carried by non-qualified independent workers who are not natives of the town. These gatherers sell their catch to make a living, thus contributing to the socioeconomic factors associated with this issue. These actions have degraded the ecosystems of this area, and consequently the prevention of these measures is critical. The study species in this paper include 14 threatened species and we discuss some pragmatic measures that could implemented to avoid their extinction. In addition, some actions for the preservation of the ethnoentomobiodiversity in the area are proposed.

Agriculture↗
PubMed2003

Nutritional factors and breast cancer in Mexico.

Breast cancer (BC) morbidity and mortality in Mexico are on the rise, affecting younger women with more frequency. Nutritional factors are often mentioned as determinants of BC but their relevance is not well established in Latin-American countries, where dietary habits show great variation. From a study population previously assembled in Mexico City, 141 histologically confirmed cases of BC were matched by age (+/-3 yr) to an equal number of hospital controls. A food frequency questionnaire was administered to all subjects and the risk of BC was estimated in relation to the intake of selected nutrients. The findings of this study show a protective effect against BC due to a high intake of polyunsaturated fat (odds ratio, OR = 0.10, 95% CI = 0.02-0.40, P for trend = 0.001) and vitamin E (OR = 0.10, 95% CI = 0.02-0.44, P for trend = 0.003) among postmenopausal women. In addition, our findings also suggest that a high intake of total fiber (OR = 0.29, 95% CI = 0.08-1.10, P for trend = 0.080) and carotenes (OR = 0.42, 95% CI = 0.16-1.14, P for trend = 0.088) lowers BC risk among premenopausal women. The relationship between the intake of nutrients and BC risk needs further confirmation.

Adult↗
PubMed2004

Chlamydial infection in women along the US-Mexico border.

Few studies have reported on sexually transmitted infections at the US-Mexico border, so the prevalence of Chlamydia trachomatis in this population remains uncertain. This binational project investigated the prevalence of, and risk factors for, C. trachomatis among women along the Arizona, US-Sonora, Mexico border. Women who self-referred for routine gynaecological care were invited to complete an interviewer-administered questionnaire and to undergo a Pap smear, C. trachomatis test, and HPV test. In 2270 women, C. trachomatis prevalence overall was 8.2% as measured by hybrid capture and 2.6% by enzyme immunoassay. Infection was associated with young age, a history of new sexual partner(s) in the previous three months, HPV infection, and proximity of clinic to the international border. Antibiotic use in the previous 30 days was associated with decreased odds of infection. Women in Arizona-Sonora border communities are at increased risk for C. trachomatis infection compared to women attending clinics in non-border locations.

Adolescent↗
PubMed2003

Relationship of blood and bone lead to menopause and bone mineral density among middle-age women in Mexico City.

To describe the relationship of blood lead levels to menopause and bone lead levels, we conducted a cross-sectional study on 232 pre- or perimenopausal (PreM) and postmenopausal (PosM) women who participated in an osteoporosis-screening program in Mexico City during the first quarter of 1995. Information regarding reproductive characteristics and known risk factors for blood lead was obtained using a standard questionnaire by direct interview. The mean age of the population was 54.7 years (SD = 9.8), with a mean blood lead level of 9.2 microg/dL (SD = 4.7/dL) and a range from 2.1 to 32.1 microg/dL. After adjusting for age and bone lead levels, the mean blood lead level was 1.98 microg/dL higher in PosM women than in PreM women (p = 0.024). The increase in mean blood lead levels peaked during the second year of amenorrhea with a level (10.35 microg/dL) that was 3.51 microg/dL higher than that of PreM women. Other important predictors of blood lead levels were use of lead-glazed ceramics, schooling, trabecular bone lead, body mass index, time of living in Mexico City, and use of hormone replacement therapy. Bone density was not associated with blood lead levels. These results support the hypothesis that release of bone lead stores increases during menopause and constitutes an internal source of exposure possibly associated with health effects in women in menopause transition.

Adult↗
PubMed2003

Aryl hydrocarbon receptor-mediated activity of particulate organic matter from the Paso del Norte airshed along the U.S.-Mexico border.

In this study, we determined the biologic activity of dichloromethane-extracted particulate matter < 10 micro m in aerodynamic diameter (PM10) obtained from filters at three sites in the Paso del Norte airshed, which includes El Paso, Texas, USA; Juarez, Chihuahua, Mexico, and Sunland Park, New Mexico, USA. The extracts were rich in polycyclic aromatic hydrocarbons (PAHs) and had significant biologic activity, measured using two in vitro assay systems: ethoxyresorufin-(O-deethylase (EROD) induction and the aryl hydrocarbon-receptor luciferase reporter system. In most cases, both EROD (5.25 pmol/min/mg protein) and luciferase activities (994 relative light units/mg) were highest in extracts from the Advance site located in an industrial neighborhood in Juarez. These values represented 58% and 55%, respectively, of induction associated with 1 micro M ss-naphthoflavone exposures. In contrast, little activity was observed at the Northeast Clinic site in El Paso, the reference site. In most cases, luciferase and EROD activity from extracts collected from the Tillman Health Center site, situated in downtown El Paso, fell between those observed at the other two sites. Overall, a statistically significant correlation existed between PM10 and EROD and luciferase activities. Chemical analysis of extracts collected from the Advance site demonstrated that concentrations of most PAHs were higher than those reported in most other metropolitan areas in the United States. Calculations made with these data suggest a cancer risk of 5-12 cases per 100,000 people. This risk estimate, as well as comparisons with the work of other investigators, raises concern regarding the potential for adverse health effects to the residents of this airshed. Further work is needed to understand the sources, exposure, and effects of PM10 and particulate organic material in the Paso del Norte airshed.

Air Pollutants↗
PubMed2004

Blood lead secular trend in a cohort of children in Mexico City (1987-2002).

We determined the secular trend in blood lead levels in a cohort of 321 children born in Mexico City between 1987 and 1992. Blood lead level was measured every 6 months during a 10-year period. We modeled the effect of yearly air lead concentration nested within the calendar year in which the child was born, family use of lead-glazed pottery, socioeconomic status, year in which the child was born, age of the child at the time of blood lead measurement, place of residence, and an indicator variable for subjects with complete or incomplete blood lead values. The yearly mean of air lead of the Valley of Mexico decreased from its highest level of 2.80 microg/m3 in 1987 to 0.07 microg/m3 in 2002. The contribution of air lead to blood lead according to year of birth was strongest for subjects born in 1987 and fell to nearly zero for children born in 1992. The geometric mean of the entire cohort rose from 8.4 microg/dL in the first year of life to 10.1 microg/dL in the second and decreased thereafter until it reached 6.4 microg/dL at 10 years of age. Children of families who used lead-glazed ceramics had blood lead levels 18.5% higher than did children of nonusing families. Children who belonged to the lowest socioeconomic levels had blood lead levels 32.2% higher than did those of highest socioeconomic levels. Children who lived in the northeast part of the city had blood lead levels 10.9% higher compared with those who lived in the southwest.

Child↗
PubMed1996

Metals in lung tissue from autopsy cases in Mexico City residents: comparison of cases from the 1950s and the 1980s.

In autopsies performed on residents of Mexico City during the 1950s and 1980s (45 males and 24 females and 42 males and 42 females, respectively), concentrations of cadmium, copper, cobalt, nickel, and lead in the lungs were studied by atomic absorption spectrometry. Sharp increases were noted in samples taken in the 1980s compared to those from the 1950s. In samples from both time periods, the concentrations were influenced by gender. Smoking was not associated with higher levels of the metals. Only lead seemed to have a relation with age. The enormous differences by gender in the 1950s could be due to different patterns of exposure. The differences among samples from both periods appear to be associated with the increase of air pollutants in the metropolitan areas of Mexico City during the years under study. These results reinforce the importance of studying lung tissue to monitor air pollution by metals.

Adolescent↗
PubMed2002

Severity of intimate partner abuse indicators as perceived by women in Mexico and the United States.

OBJECTIVE: Women in Cuernavaca, Mexico and Los Angeles, California were surveyed to examine differences in their perceptions of the severity of domestic violence indicators. METHODS: One hundred twenty women in each country rated the severity of 26 domestic violence indicators which were part of an abuse screen used for an ongoing study of the prevalence of abuse. Rasch analysis was conducted to determine the linear relationship in the perceptions of the severity of each event between the two countries. RESULTS: The Rasch calibrated logit values show that women in the US rated 24 of the 26 events as more severe than women in Mexico. However, items were ranked in similar order and a clear linear pattern was established. In both countries, being shot with a gun was the most severe event and a partner becoming jealous was the least severe. CONCLUSION: The country of origin did not dictate which events were most severe but did influence how severe these events were perceived.

Adult↗
PubMed2003

Attitudes toward menopause in relation to symptom experience in Puebla, Mexico.

OBJECTIVE: To examine how attitudes toward menopause were associated with symptom frequencies after controlling for menopause status and level of education. METHODS: Women aged 28-70 (n = 755) were interviewed from May, 1999 through August, 2000 in the city of Puebla, Mexico. Over 90% of the sample were aged 40-60. Participants were asked to select from a set of dichotomies to describe "how a woman feels during menopause." Symptom frequencies were assessed by a checklist of everyday complaints experienced during the two weeks before interview. Symptom presence or absence was examined in relation to attitudes while controlling for menopause status and level of education using binary logistic regression analyses. RESULTS: The majority of respondents said that a menopausal woman feels "insecure" and "unattractive" yet "complete," "necessary," and "successful." Pre-menopausal women and respondents who had undergone a hysterectomy were more likely to express negative attitudes. Post-menopausal women and women with fewer years of education were significantly more likely to report symptoms such as hot flashes, joint aches, and nervous tension. A range of negative attitudes were associated with nervous tension, feeling blue, and head aches; however, only a few negative attitudes were significantly predictive of estrogen-related symptoms (e.g., hot flashes). CONCLUSIONS: There is a high value placed on both external appearance and familial responsibility among menopausal women in Puebla, Mexico, and negative characterizations of menopause reflect these values. Negative attitudes were associated with more frequently reported symptoms compared with positive attitudes. The challenge remains to separate factors related to the hormonal changes of menopause from those not associated with hormonal changes to better understand symptom experience.

Adult↗