Impact of homicide on male life expectancy in Mexico [Impacto de la violencia homicida en la esperanza de vida masculina de México]

Objective. To determine the impact of homicide on male life expectancy in Mexico and its 32 states during the three-year periods 1998-2000 and 2008-2010 and the weight of the different age groups in years of life expectancy lost (YLEL) due to this cause. Methods. Based on official death and population data, abridged tables for male mortality in Mexico as a whole and its states were created for the three-year periods studied. Health-adjusted life expectancy and YLEL for men aged 15 to 75 were calculated by selected causes (homicide, diabetes mellitus, and traffic accidents) and age groups in each three-year period. Results. In the years between the 1998-2000 and 2008-2010 periods, YLEL due to homicide increased both nationally and in 19 states. In four states, the YLEL in 2008-2010 exceeded two, with the state of Chihuahua standing out at 5.2 years. In 14 of the 18 states where health-adjusted life expectancy among men declined between the two three-year periods, the YLEL due to homicide increased. From 2008 to 2010, homicides were the leading cause of YLEL among men aged 20-44. YLEL due to homicide among those aged 15-44 increased between the two three-year periods. Conclusions. The increase in the rate of homicidal violence, especially among young people, is impeding an increase in male life expectancy in Mexico. In several states, such as Chihuahua and Durango, this violence appears to be the main reason for the decline in life expectancy among men aged 15 to 75

Knowledge, attitudes and dietary practices in patients with diabetes mellitus type II [Conocimientos, actitudes y pr�cticas diet�ticas en pacientes con diabetes mellitus II.]

The profile of type-II non-insulin dependent diabetic patients is characterized by overweight; exogenous obesity originates from inadequate nourishment habits and, among other things, educational, cultural, and psychological conditions. With regard to metabolic deficiency control, the explanation is centered fundamentally on the patient's not getting a complete diet. This could be due to a lack of information about their illness, thus becoming a determining factor in their treatment. The purpose of this study was to analyze the level of knowledge, attitudes, and dietary education practices by means of a survey using the likert scale. This was applied by means of a direct and codified interview directed to patients in a Primary Care Health Unit from the Mexican Social Security Institute (IMSS) in Guadalajara, Jalisco, Mexico. 201 Type II diabetic patients, selected from a systematic sample, were studied. The average age was 54 and predominantly female (a ratio of 1.7 to 1). The sample had an academic background not surpassing the elementary school level, and their occupation was that of housewife. Their central glycemia level was, on the average, 191 mg/dl with a standard deviation of 120. The average number of years of having suffered from the illness was 5.5 with a standard deviation of 5. Ninety per cent of the diabetic patients take oral hypoglucemiants. Although there does exist a high level of knowledge and attitudes about dietary education, there exists a low level of educational practices. We observed that only 10 per cent of the diabetic patients have both an acceptable metabolic control (CMA) and a high value in knowledge, attitudes, and practices (CAP).(ABSTRACT TRUNCATED AT 250 WORDS

Knowledge, attitudes and dietary practices in patients with diabetes mellitus type II [Conocimientos, actitudes y prácticas dietéticas en pacientes con diabetes mellitus II.]

The profile of type-II non-insulin dependent diabetic patients is characterized by overweight; exogenous obesity originates from inadequate nourishment habits and, among other things, educational, cultural, and psychological conditions. With regard to metabolic deficiency control, the explanation is centered fundamentally on the patient's not getting a complete diet. This could be due to a lack of information about their illness, thus becoming a determining factor in their treatment. The purpose of this study was to analyze the level of knowledge, attitudes, and dietary education practices by means of a survey using the likert scale. This was applied by means of a direct and codified interview directed to patients in a Primary Care Health Unit from the Mexican Social Security Institute (IMSS) in Guadalajara, Jalisco, Mexico. 201 Type II diabetic patients, selected from a systematic sample, were studied. The average age was 54 and predominantly female (a ratio of 1.7 to 1). The sample had an academic background not surpassing the elementary school level, and their occupation was that of housewife. Their central glycemia level was, on the average, 191 mg/dl with a standard deviation of 120. The average number of years of having suffered from the illness was 5.5 with a standard deviation of 5. Ninety per cent of the diabetic patients take oral hypoglucemiants. Although there does exist a high level of knowledge and attitudes about dietary education, there exists a low level of educational practices. We observed that only 10 per cent of the diabetic patients have both an acceptable metabolic control (CMA) and a high value in knowledge, attitudes, and practices (CAP).(ABSTRACT TRUNCATED AT 250 WORDS

Clinical aptitude of the family doctors front of sick patients with diabetes type two with initial nephropathy [Valoración global de la aptitud clínica de médicos familiares en el manejo de la diabetes mellitus con nefropatía inicial]

The diabetic nephropathy in initial phase requires an opportune identification by family physicians. Indeed, they should be qualified to interpret the data that suggesting that a patient be going through that phase of the illness, in order to orientate the management and processing of the same one, from an integrative perspective. The purpose of this work was to measure the aptitude of the family doctors to interpret, to judge and to propose in front of sick patients with diabetes type two with initial nephropathy. We made this with a representative sample of family physicians in five Family Medicine Units of the Instituto Mexicano del Seguro Social in the city of Guadalajara, Jalisco, Mexico. The main variable of the study was the clinical aptitude of the doctors: interpretation, judgment and proposals carried out in the practice of their profession; and through an ordinal scale, levels of aptitude were defined, which related to the remainder of variables using the medium, Kruskal Wallis stadiometer and χ2

Clinical aptitude of the family doctors front of sick patients with diabetes type two with initial nephropathy [Valoración global de la aptitud clínica de médicos familiares en el manejo de la diabetes mellitus con nefropatía inicial]

The diabetic nephropathy in initial phase requires an opportune identification by family physicians. Indeed, they should be qualified to interpret the data that suggesting that a patient be going through that phase of the illness, in order to orientate the management and processing of the same one, from an integrative perspective. The purpose of this work was to measure the aptitude of the family doctors to interpret, to judge and to propose in front of sick patients with diabetes type two with initial nephropathy. We made this with a representative sample of family physicians in five Family Medicine Units of the Instituto Mexicano del Seguro Social in the city of Guadalajara, Jalisco, Mexico. The main variable of the study was the clinical aptitude of the doctors: interpretation, judgment and proposals carried out in the practice of their profession; and through an ordinal scale, levels of aptitude were defined, which related to the remainder of variables using the medium, Kruskal Wallis stadiometer and ?2

Development and validation of an instrument to measure family physicians' clinical aptitude in metabolic syndrome in Mexico

Objective. The purpose of this work was to measure family physicians' clinical aptitude for the diagnosis and treatment of metabolic syndrome in a representative sample from six Family Medicine Units (UMF) at the Mexican Institute for Social Security (IMSS), in Guadalajara, Jalisco, México. Material and Methods. This is a cross-sectional study. A validated and structured instrument was used, with a confidence coefficient (Kuder-Richardson) of 0.95, that was applied to a representative sample of 90 family physicians throughout six UMFs in Guadalajara, between 2003 and 2004. Mann-Whitney's U and Kruskal-Wallis' tests were used to compare two or more groups, and the Perez-Viniegra Test was used to define aptitude development levels. Results. No statistically significant differences were found in aptitude development between the six family medicine units groups and other comparative groups. Conclusions. The generally low level of clinical aptitude, and its indicators, reflects limitations on the part of family physicians at the IMSS in Jalisco to identify and manage metabolic syndrome

Family doctor clinical aptitude before gestational diabetes patients [Aptitud clínica del médico familiar ante pacientes con diabetes gestacional]

Background: Gestational diabetes mellitus complicates 7% of all pregnancies. Recognizing and treating this entity result in a diminished number of materno-fetal complications; this study explores the family physician clinical aptitude to identify risk factors, to diagnose and treat gestational diabetes. Objective: Identify clinical aptitude level of family physician to the treatment of diabetes gestational patients. Participants and methods: Transversal study to describe the level of clinical aptitude in 85 family physicians working in Guadalajara. Were studied: speciality, genre, work condition, working years, working hours, and place of work. The evaluation instrument was designed to this specific purpose and validated by an expert group; were evaluated four indicators: 1) identification of risk factors, 2) diagnosis, 3) use of therapeutic resources and 4) use of paraclinic resources. Confidence coefficient to the assessment instrument was (21 formula from Kuder-Richardson) 0.92 in global evaluation. Results: The global clinical aptitude in the four family medicine units studied was less than 21 points in 41% of physician population and very low (22 a 40 points) in 38% of the evaluated physicians. Conclusions: The clinical aptitude from family physician in gestational diabetes is low, this situation represents an urgent need to design a system to provide to these groups of health providers specialized continuous education to enhance the attention quality to this group of patients in family medicine units