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exclusive breastfeeding (EB) is a protective factor against the development of insulin resistance (IR) as mainstay of the metabolic syndrome.the objective of the study was to evaluate the relationship between EB during the first six months of life and the development of IR through the Homeostasis Model Assessment (HOMA-IR) and Quantitative Insulin Sensitivity Check Index (QUICKI) indexes.a population-based cohort study included 494 adolescent participants, from whom socio-demographic, anthropometric, and cardiometabolic variables were assessed using the HOMA-IR and QUICKI indexes to determine the degree of association between EB and the development IR. The results were expressed in medians.the prevalence of EB was 42%. The results suggest a protective effect of EB on IR, in such a way that for each extra month of EB, the HOMA-IR index decreases in 0.32 (p = 0.005) and the index QUICKI increases in 0.70 (p = 0.008). Regarding waist circumference, body mass index and waist size index, this relationship was not significant.the bivariate and multivariate analyses indicate an epidemiologically significant relationship that demonstrates a protective effect of EB on the HOMA-IR and QUICKI indexes.INTRODUCCIÓN: la lactancia materna exclusiva (LME) es un factor protector contra el desarrollo de resistencia a la insulina (RI) como causa del síndrome metabólico. OBJETIVO: el objetivo del estudio fue evaluar la relación entre la LME los primeros seis meses de vida y el desarrollo de RI, mediante los índicesHomeostasis Model Assessment (HOMA-IR) y Quantitative Insulin Sensitivity Check Index (QUICKI). MATERIAL Y MÉTODOS: estudio de cohorte de tipo poblacional; se incluyeron 494 participantes adolescentes, de los cuales se evaluaron variables sociodemográficas, antropométricas y factores cardiometabólicos mediante los índices HOMA-IR y QUICKI para determinar el grado de asociación entre la LME y el desarrollo de RI. Los resultados fueron expresados en medianas. RESULTADOS: la prevalencia de LME fue del 42%. Los resultados sugieren un efecto protector de la LME sobre la resistencia a la insulina, de tal manera que por cada mes más de duración de LME, disminuye en 0,32 (p = 0,005) el índice HOMA-IR y aumenta en 0,70 (p = 0,008) el índice QUICKI. Para la circunferencia de cintura, el índice de masa corporal (IMC) y el índice-cintura talla (ICT) esta relación no fue significativa. CONCLUSIÓN: los análisis bivariados y multivariados, indican una relación epidemiológicamente significativa que demuestra un efecto protector de la Lactancia Materna Exclusiva sobre el índice HOMA-IR y el QUICKI.

This article analyzes the caregiving trajectory for adults and elderly persons who suffer from diabetes. The objective is to develop a conceptual framework for understanding caregiving changes over time. An ethnographic study was conducted in a poor urban neighborhood in Guadalajara, Mexico, in which 21 caregivers were interviewed and followed from 1997 through 2001. The trajectory has a beginning and an end, and moves through three phases: semi-care, care, and dying. The phases differ by the type and timing of actions undertaken, and the degree to which the caregiver takes over the physical functions and social roles of the sick person.

The mass media are recognized by many social scientists as important sources of medical information for lay people and as a positive influence on those working in the health care professions. However, there is a lack of study about print and mass media reporting on major health problems in developing countries such as Mexico. This article presents the findings of a study conducted to identify specific messages that the Mexican print media convey to the general reader about chronic diseases, especially one of the most important and pervasive, diabetes. We undertook a comprehensive review and content analysis of secondary source media reporting in the Boletin (Bulletin)--published by the Department of Education and Health, Universidad Autónoma Metropolitana, Xochimilco. The Boletin summarizes all articles related to health matters published in 12 national daily newspapers and 3 magazines. Our study covered all issues of the Boletin from 1992 through 1996. Our findings indicate that at times the press and popular print media disseminate an incomplete and often biased picture of chronic diseases prevalent in Mexico. Specifically, the press gives equal or more important coverage of acute diseases, or to AIDS, than to other major chronic conditions. The press also reproduces the biomedical model of disease and does not address topics important to certain segments of the population, including the patient. Moreover, the media may present an overly idealized impression of the capability of health services. Consequently, this failure to address the issues of certain widespread, chronic illnesses is severe enough to ask about the role of the press in medical health care reform. We conclude by suggesting areas for further research.

With the goal to establish a model that relates birth weight to placenta weight, adjusted for the most documented predictors of birth weight, 300 live newborns were studied, all were products of single gestation. Inclusion criteria were newborns with gestational age of 37 weeks or older according to the date of last menstruation, whose mothers did not have diabetes mellitus, high blood pressure, pre-eclampsia, or eclampsia. The weight of the newborn was identified from the anthropometry data collected by previously trained nursing personnel in each of the participating hospitals. Immediately after delivery, the placenta was weighed. Multiple linear regression was used to see the effect of placenta weight and each variable on birth weight. The mean of birth weight was 3,369 g with a standard deviation (SD) of 445 g. Placenta weight had a mean of 537 g (SD: 96 g). The relation between the weight of the placenta and the birth weight was significant, and we found that for each gram increase in placenta weight, birth weight is increased by 1.98 g (SE = 0.25, p < 0.01) and this relation is not linear, since the quadratic term is significant. Placenta weight has a nonlinear relation to the birth weight and is an important predictor of birth weight. Together with the gestational age and the maternal age and size, it explains 32% of the variability of birth weight. Placenta weight can be a ‘sentinel’ indicator of nutritional and/or environmental problems.

This article focuses on home care for chronically ill adults and seniors. According to our thesis, home care should be understood as a self-care system, and its aim is to guarantee the individual's social and bodily survival. Home care consists of three areas, related to illness, the home, and to life history. Caregiving, usually under women's responsibility, is present throughout the history of the illness and the health-seeking process. The article analyzes these issues in light of the ageing process, the epidemiological changes occurring worldwide, and the urgency to incorporate this analysis into the heath care research agenda.

To determine the correlation between pregestational body mass index and certain body composition parameters measured by bioelectric impedance (percentage of fat weight, fat mass, and lean weight) and to compare the body composition of women in immediate puerperal period with non-pregnant women, a cross sectional study was done including 86 women in physiologic puerperal period and 90 healthy non-pregnant women, from the Instituto Mexicano del Seguro Social, in Chihuahua, Mexico, aged 16 to 40 years old. The variables considered were the body mass index (BMI) before pregnancy, percentage of fat, fat mass, lean weight, total water and bio-resistance. Body composition was measured by bioelectric impedance (BIO) from 4 to 12 hours after delivery. Correlation coefFicient for BMI and percentage of fat was r = 0.66 (p0.01), and for BMI and fat mass, it was r = 0.74 (p0.01). In non-pregnant women the total water was 35.5 +/- 5 L and in women in the immediate puerperal period 38.5 +/- 5 L (p0.01). In conclusion, BMI before pregnancy is a suitable predictor for body composition in the puerperal period. However, it does not discriminate important variables such as total body water, so it may be convenient to use BIA for surveillance of body composition during pregnancy.

This article examines the relationship between sociodemographic factors and sources of support in non-insulin dependent diabetes mellitus patients living in a socially deprived area of Guadalajara, Mexico. A total of 121 diabetic subjects and the same number of caretakers, spouses and children, participated in the study. Findings show that some variables of diabetic individuals are associated with caretakers' age, sex and kinship. Moreover, sex distribution of children and family composition were also associated with sources of support. No association was found between disease characteristics and those of caretakers. The impact of these results on health services programs is discussed.

A cross-sectional study was conducted to investigate the prescription patterns of general practitioners for non-insulin dependent diabetes mellitus patients in Guadalajara, Mexico. Two hundred and forty medical prescriptions were evaluated. These were indicated by 16 primary care physicians. Results showed that physicians prescribed pharmacologic agents in 93 per cent of the cases, dietary control in 73 per cent, and physical exercise in 48 per cent. A combination therapy of these three measures was employed in 40 per cent of the patients, but the combination regimen of diet and exercise was given only to 3 per cent of the patients. Data showed significant differences in prescribing patterns according to gender of physicians; male physicians prescribed the three measures by more than 10 per cent; On the contrary, female physicians prescribed the drug as the only therapy 27 per cent of the time. The proportion of prescribing diet and exercise measures increased with more years of professional experience. These observations support the findings that prescription patterns by primary care physicians do not meet the criteria currently recommended by international committees for diabetes therapy. We discuss some implications for the metabolic control of the disease and the quality of medical care.

This work analyzes the findings of a study about the incidence of four mental disorders in a zone of the City of Guadalajara's metropolitan area in the Mexican State of Jalisco. The results show the highest rates belong to depression and aggressive conduct (463 and 489 in 1,000 children). Besides, there were some differences related to their sex and their families income.