Biomedical subjects

Leticia Avila-Burgos

Publications and source records attributed to Leticia Avila-Burgos.

14 recordsLinked to original sources

PubMed2006

[Violence scale and severity index: a methodological proposal for measuring violence by the partner in Mexican women].

OBJECTIVE: To construct and validate a scale to assess violence by the male partner against women. An index of severity of the emotional and physical damage was also designed to assess the intensity of the violent actions against women. MATERIAL AND METHODS: The sample consisted of a total of 26 042 women who participated as respondents in the National Survey on Violence against Women (ENVIM per its abbreviation in Spanish) conducted in Mexico during 2003. Respondents were all users of health services provided by the Mexican government. The questionnaire was organized into 17 sections, one of which was a 27-item scale to assess partner violence. The purpose of this scale was to measure the type (physical, emotional, sexual and financial) and degree of violence based on severity. A severity index was constructed based on two procedures: 1) the validity, reliability, and factor analyses of the scale and 2) the assessment of severity by expert judges who assigned a value to each item of the scale. RESULTS: The validity and reliability results indicated this scale has adequate internal validity (Cronbach's Alpha = 0.99). The factor analysis with Varimax rotation yielded a four-factor solution. The factors were: 1) Psychological violence; 2) Physical violence; 3) Severe physical violence; and 4) Sexual violence. The combination of the four factors accounted for 62.2% of the variance in the scale. Using the ratings from the judges a table of values for each of the violent actions described was obtained. The scores assigned by the judges ranged from 0 to 354. Results revealed a prevalence of 21% partner violence in the last twelve months. The prevalence of psychological violence was 18.5%; of physical violence 10.1%; severe physical violence 6.7% and sexual violence 7.0%. CONCLUSION: The scale of violence described in this article is a very useful and reliable instrument to assess marital violence against women. It is suggested that this instrument be used in other settings to compare results with different samples.

Battered Women↗

PubMed2006

[Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].

OBJECTIVE: To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). MATERIAL AND METHODS: This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. RESULTS: One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). CONCLUSIONS: The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public health services for women suffering from emotional distress and gender violence.

Adolescent↗

PubMed2006

[Physical and sexual abuse during childhood and revictimization during adulthood in Mexican women].

OBJECTIVE: To quantify the association between physical and sexual abuse during childhood and violence during adulthood in a representative sample of female health care users in Mexico. MATERIAL AND METHODS: A questionnaire was administered to 26 042 women over 14 years of age who sought medical consultation from public health care services between October 2002 and March 2003, in all 32 states in Mexico. Two models were constructed: a) Multiple polytomic logistic regression models to explore the association between violent victimization by the partner during adulthood and violence during childhood. b) Multiple logistic regression models to explore the association between experiencing rape during adulthood and violence during childhood. RESULTS: Among women studied, an association was found between experiencing physical violence during childhood and suffering physical and sexual violence from the male partner or experiencing rape, during adulthood. When physical violence during childhood occurred "almost always", it was more likely that the woman undergo physical and sexual violence (OR = 3.1; 95% CI 2.6-3.7) and rape (OR = 2.9; 95% CI 2.4-3.6), during her adult life. In addition, when violence during childhood was more frequent, the likelihood of experiencing violence during adulthood was greater. A positive association was found between physical and sexual abuse before 15 years of age (OR = 2.8; 95% CI 2.2-3.5). Experiencing rape during adulthood was also associated with sexual abuse before 15 years of age (OR = 11.8; 95% CI 10.2-13.7). CONCLUSIONS: In this sample of Mexican women, both physical and sexual violence during childhood has negative results during adulthood, including a greater likelihood of revictimization by the male partner and rape. Physical and sexual abuse during childhood must be prevented or at least detected and treated.

Adolescent↗

PubMed2005

Prevalence and associated factors for temporomandibular disorders in a group of Mexican adolescents and youth adults.

The objective of the study was to determine the prevalence and associated factors for temporomandibular disorders (TMD) in a university sample of Campeche, Mexico. A cross-sectional study was carried out in 506 subjects aged 14-25 years. The subjects were requested to answer questionnaires concerning sociodemographic variables, history of stress, lifestyle, and anxiety. The Research Diagnostic Criteria for TMD (RDC/TMD) was used as TMD diagnostic system by four examiners capacitated and standardized. Data were analyzed using binary logistic regression in STATA. The results showed that 46.1% of the subjects exhibited some grade of TMD. Logistic regression analysis with TMD as the dependent variable identified sex (women odds ratio [OR]=1.7), bruxism (OR=1.5), anxiety (OR=1.6), unilateral chewing (OR=1.5), and an interaction between number of tooth loss and stress as the most significant associated variables, thus (1) the effect of having high levels of stress in the group of subjects without tooth loss (OR=1.2; 95% confidence interval [CI]=0.7-1.8) and (2) the effect of having high levels of stress in the group of subjects with at least one tooth lost (OR=2.4; 95% CI=1.01-5.9). The variables associated with diagnosis of pain were principally psychosocial (stress and anxiety), whereas for the non-pain diagnosis group, the variables were clinical, such as bruxism, chewing site preference, and restorations in mouth. We found associations among variables that were similar to findings in other studies, such as bruxism, tooth loss, stress, and anxiety. The final model explains that the effect of stress on TMD depends of the tooth loss, controlling for sex, bruxism, unilateral chewing, and anxiety. Finally, it can be concluded that the variables associated with pain and non-pain diagnosis were of distinct nature.

Adolescent↗

PubMed2005

Lifestyle and psychosocial factors associated with tooth loss in Mexican adolescents and young adults.

OBJECTIVE: The aim of the present study was to examine: (1) the prevalence of tooth loss in persons living in community dwellings and (2) the strength of the association identified between tooth loss experience and the psychosocial factors of lifestyle, stress, and anxiety. MATERIAL AND METHODS: A cross-sectional study was carried out in a convenience sample where data were collected by means of self-administered questionnaires of lifestyle and psychosocial factors (stress and anxiety) and a clinical examination. A total of 516 subjects aged 14-30 years of age were included in the study. Subjects had a visual dental examination. Prevalence and mean of tooth loss were calculated excluding third molars, and their related factors were adjusted in a binary logistic regression. RESULTS: Mean age of participants was 17.4+/-3.0 years; 45.5% were men. The prevalence of tooth loss (when at least one tooth was lost) was 20.5%. Among the 516 persons, a total of 201 teeth were lost with a mean tooth loss 0.39+/-0.95 overall. Mean tooth loss in subjects with at least one missing tooth was 1.90+/-1.26 teeth. Results adjusted by anxiety in the multivariate logistic regression model showed tooth loss was associated with lifestyle (OR=1.95, 95% CI=1.17 - 3.24), age (OR=2.65, 95% CI=1.64 - 4.26), and Angle's malocclusion II and III (OR=2.86; 95% CI=1.67 - 4.90). A slight association toward tooth loss was observed (p<0.10) in the sex and stress variables. CONCLUSIONS: Lifestyle and tooth loss have a substantial association. According to age group, these results suggest tooth loss is an oral health problem in the study population.

Adolescent↗

PubMed2005

Dental caries and associated factors in Mexican schoolchildren aged 6-13 years.

The objectives of the present study were to establish dental caries prevalence (percentage with caries) and experience in the primary and permanent dentition (dmft and DMFT) of 6 to 13-year-old schoolchildren in Campeche, Mexico, and to estimate the contributing roles of the likely risk indicators. A cross-sectional study was carried out in 1,644 children aged 6-13 years. Self-administered questionnaires obtained information on social, economic, behavioral, and demographic variables. The primary dentition of 1,309 children and the permanent dentition of 1,640 children were evaluated in the oral examinations. The main outcome measures were DMFT, dmft, and SiC indices. Data were modeled using logistic regression analysis. The overall caries prevalence was 77.4%, 73.6% in the primary dentition (61.6% in 6-year-olds), and 49.4% in the permanent dentition. The dmft and DMFT indices were 2.85+/-2.73 and 1.44+/-2.05, respectively (DMFT = 3.11+/-2.62 in 12-year-olds). The SiC index was 6.05 at 12 years of age. Associated variables to dental caries in both dentitions were presence of enamel defects, presence of dental plaque, low socio-economic status, female sex, and older age. Mother's schooling was negatively associated (OR = 0.95) with caries in primary dentition. Caries experience in the primary dentition (OR = 6.02) was positively associated with caries in the permanent dentition. Dental caries status in these Mexican children was closer to the goals proposed by the WHO/FDI for 2000 than previous studies. This study has identified clinical, socio-economic, and behavioral determinants for dental caries in primary and permanent dentition on Mexican schoolchildren.

Adolescent↗

PubMed2005

Socioeconomic determinants of inequality and self-reported morbidity among adolescents in a developing country.

OBJECTIVE: Studies about health inequalities among adolescents have been conducted principally in developed countries. Although adolescents represent 15% of the Mexican population, no studies are available in this specific age group on health inequalities. In this study, we assess differences in the perception of morbidity severity among adolescent students, as well as their association with selected socioeconomic characteristics. METHODS: We carried out a cross-sectional study (base-line of a longitudinal study of adolescent's health) in 1999. Participants were Mexican adolescents (n=12769) aged 12-19 years, attending to public schools selected through of multistage sampling method. We measured the health status through a self-reported morbidity in 2 weeks time. We included several socioeconomic indicators and for statistical analysis we used the multinomial logistic regression model. RESULTS: The prevalence of self-reported health problems was 32%. Women had 23% increased odds for reporting health problems. Age was positively associated to frequency and severity of health problems; also, there was a positive association with the mother's occupation, one-parent homes, and not owning an automobile. CONCLUSIONS: Morbidity reporting rates are higher than expected in this population. Moderate reporting levels are found among social groups, especially when health problems were perceived as moderately severe, suggesting the importance of socioeconomic factors as determinants. Further studies should conducted using different kinds of health indicators in this age group.

Adolescent↗

PubMedDate not supplied

[Regression models for variables expressed as a continuous proportion].

OBJECTIVE: To describe some of the statistical alternatives available for studying continuous proportions and to compare them in order to show their advantages and disadvantages by means of their application in a practical example of the Public Health field. MATERIALS AND METHODS: From the National Reproductive Health Survey performed in 2003, the proportion of individual coverage in the family planning program--proposed in one study carried out in the National Institute of Public Health in Cuernavaca, Morelos, Mexico (2005)--was modeled using the Normal, Gamma, Beta and quasi-likelihood regression models. The Akaike Information Criterion (AIC) proposed by McQuarrie and Tsai was used to define the best model.Then, using a simulation (Monte Carlo/Markov Chains approach) a variable with a Beta distribution was generated to evaluate the behavior of the 4 models while varying the sample size from 100 to 18,000 observations. RESULTS: Results showed that the best statistical option for the analysis of continuous proportions was the Beta regression model, since its assumptions are easily accomplished and because it had the lowest AIC value. Simulation evidenced that while the sample size increases the Gamma, and even more so the quasi-likelihood, models come significantly close to the Beta regression model. CONCLUSIONS: The use of parametric Beta regression is highly recommended to model continuous proportions and the normal model should be avoided. If the sample size is large enough,the use of quasi-likelihood model represents a good alternative.

Family Planning Services↗

PubMedDate not supplied

[Out-of- pocket expenditures during hospitalization of young leukemia patients with state medical insurance in two Mexican hospitals].

OBJECTIVE: To estimate out-of-pocket expenditures for health care during the first hospitalization of children treated for leukemia in two hospitals of the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social-IMSS-). MATERIAL AND METHODS: A cross-sectional study was conducted in Mexico City and Leon, Guanajato, Mexico in 1997. The study population consisted of the parents of 51 children under 15 years of age diagnosed with leukemia, who were hospitalized for the first time in two IMSS hospitals. A questionnaire was applied to participants to obtain direct and indirect expenditures during that period. Consumer price indexes (1997-2002) were used to estimate expenditure prices for 2002. Average expenditures and catastrophic expenditures were estimated. Factors associated with expenditures were analyzed using a linear regression model in which the dependent variable was the total household expenditures during hospitalization. RESULTS: The average household cost per hospitalization was 7,318 pesos, 86% of which corresponded to medical care and 14% to indirect costs. Catastrophic expenditures occurred in 14% of households. In 47% of household expenditures exceeded 100% of the total household income during the hospitalization period. Expenditures during hospitalization were associated with place of residence, income level, and type of medical insurance. CONCLUSIONS: Being an IMSS policyholder decreased out-of-pocket expenditures, but not complementary expenditures, which may still be unaffordable for a large segment of the population. For more than a half of the households studied, continuity of care was compromised, as expenditures during the first hospitalization entailed using up savings, going into debt, and/or selling household property.

Child↗

PubMedDate not supplied

Dental attrition and associated factors in adolescents 14 to 19 years of age: a pilot study.

PURPOSE: This cross-sectional study evaluated the relationship between attrition and diverse variables in 390 Mexican adolescents aged 14 to 19 years. MATERIALS AND METHODS: An ordinal scoring system was used to describe the severity of attrition. RESULTS: Attrition prevalence was 33.3% and was associated with older age, presence of defective restorations, Class II malocclusion, and perception of stress level. CONCLUSION: Our results suggest that attrition is present in 1 of every 3 adolescents.

Adolescent↗

PubMedDate not supplied

Factors influencing the use of dental health services by preschool children in Mexico.

PURPOSE: The purpose of this study was to identify the factors associated with dental health services utilization (DHSU) within a publicly funded oral health program for preschool children in Campeche, Mexico. METHODS: A cross-sectional study in 1,303 preschoolers (3 to 6 years old) enrolled in 10 public schools was conducted. The independent variables were: (1) sex; (2) age; (3) tooth-brushing frequency; (4) caries severity; (5) enamel defects; (6) mother's maximum education level; (7) mother's attitude toward oral health; (8) health services availability; and (9) family's socioeconomic status. The mothers completed a questionnaire, and their children were clinically examined. The DHSU (none vs any) in the previous 12 months was the dependent variable. Data were analyzed using binary logistic regression (BLR). RESULTS: Average age was 4.3 +/- 0.8 years, and 52% of participants were boys. The prevalence of DHSU any was 31%. The variables associated with DHSU were: (1) moderate and high oral health needs; (2) access to private health services; and (3) older age. The authors' model supported an interaction between tooth-brushing frequency and the importance that the mother ascribed to her child's oral health. CONCLUSIONS: A low prevalence of DHSU was observed. The source of health services and oral health needs determined DHSU in this population, with some attitudes and behaviours modifying utilization. These findings have implications for designing oral health care policies to improve the supply of services to children.

Age Factors↗

PubMedDate not supplied

[Association between socioeconomic status and oral hygiene among preschoolers enrolled in the IMSS preventive dental program in Campeche].

OBJECTIVE: Determine the association between socioeconomic status and oral hygiene in the primary dentition of preschool children. MATERIALS AND METHODS: We undertook a cross-sectional study of 1,303 children attending 10 schools in Campeche, Mexico. Every child was clinically examined in a portable dental chair by one of four examiners. We used a questionnaire addressed to the mothers to collect data on socioeconomic and socio demographic variables--including attitudinal variables dealing with the perceived importance of oral health. Oral hygiene was assessed appraising the frequency of tooth brushing and the presence of dental plaque. Data analysis included non-parametric tests using STATA 8.2. RESULTS: Mean age was 4.36 +/- 0.79 years and 48.3% of children were girls. Of the study population, 17.8% (n = 232) were classified as having inadequate oral hygiene, 50.9% (n = 663) having moderate oral hygiene, and 31.3% (n = 408) having adequate oral hygiene. Children who were rated more frequently as having inadequate hygiene (p < 0.05) had mothers with a negative attitude toward oral health, were users only of public medical insurance (as opposed to users of private services), and had not used dental services in the year prior to the study. Finally, we observed a decrease in the adequacy of oral hygiene associated with a decrease in socioeconomic status. CONCLUSIONS: Our findings showed that oral hygiene was closely associated with socioeconomic status. This implies that if a reduction of oral health inequalities is to be achieved, the strategies and resources targeting these goals must take into account the existing differences between population groups with more or fewer social disadvantages.

Child, Preschool↗

PubMedDate not supplied

[Socioeconomic inequalities in oral health: dental caries in 6 to 12 year-old children].

OBJECTIVE: To explore the association between caries indices in primary and permanent dentition and socioeconomic indicators at the individual and ecologic levels in 6-12 year old children. MATERIALS AND METHODS: A comparative analysis of two datasets depicting oral health status in Campeche, México, with 2,939 children distributed equally by age and sex, was carried out. Oral health indices were contrasted at different cut-off points in primary and permanent dentitions (dmft, DMFT, dmft+DMFT and SiC indices) with independent variables such as place of residence (urban, marginal-urban) and mother's highest level of schooling (years of formal education) as socioeconomic variables (SES), as well as other sociodemographic variables using models of binary logistic regression in STATA 8.2. RESULTS: The mean age was 8.85 +/- 1.83 years and 56.6% were girls. Nine models were generated in which changes in socioeconomic variables were linked to changes in oral health features in this community (both in terms of prevalence and severity), except for DMFT > 0 at 12 years of age. CONCLUSIONS: In general, children of lower SES had greater caries experience and higher caries severity, in both primary and permanent dentitions. The relationships between oral health disparities and independent variables were confirmed in children living in geographically contiguous areas.

Child↗

PubMedDate not supplied

[Attention of crashed patients hurt on the road].

OBJECTIVE: To describe main factors that are important in the attention of crashed patients, in emergency services in Cuernavaca, Morelos, México. MATERIAL AND METHODS: A cross-sectional study that included all people hurt on the road that were attended on emergency services between February and April of 2001. The emergency services of the following hospitals were used: Hospital General Regional 1 of the IMSS, Hospital General "José G. Parres" of the SSA, and two private hospitals, located in Cuernavaca city. The variables were social demography, related to the crash event and the injury that needs medical attention; and dependent variable was the opportunity for the attention. Different kinds of analysis were applied, such as simple, bivaried and of multiple logistic regressions. RESULTS: 382 cases were recorded, 72.2% of them were male victims and the average age was young-adults. The traffic accidents were the main cause of these lesions. Emergency medical attention was required mainly on weekends (57.3%). The main anatomic regions hurt were (46.3%) the head, face and neck; 56% of the wounds were minor, 41.1% of the wounds were serious or severe and only 2.9% of them were extremely severe. The time for attention on the emergency services on Cuernavaca was too long. It was an average of one hour and 56 minutes for serious or severe wounded victims and one hour and 48 minutes for extremely severe wounded victims, and therefore they didn't meet the optimal standard time. The factors associated with opportune medical attention were: high level of education and age, as well as the use of an ambulance to be transported to the hospital and require hospitalization. The severe of the wounds had no influence. CONCLUSIONS: The final model show different social demographic factors as age, level of education and the opportune medical attention. Therefore it is clear that there is not a well emergency system between the different hospitals to provide opportune and effective medical attention.

Accidents, Traffic↗