Perla María Trejo-Ortíz

Validez de dos pruebas para evaluar la percepción materna del peso del hijo

Objective. To assess maternal perception of their children weight using words (PP) and using images (PI) and evaluate the validity of the two tests by determining their sensitivity and specificity. Material and Methods. A total of 418 motherchild diads were selected from urban areas in the Monterrey, Nuevo Leon area. A questionnaire was administered to the mothers about perceptions regarding physical appearance and health. Sensitivity and specificity were calculated and the body mass index measurement of the child was the gold standard. Results. Mothers underestimated overweight (SP) and obesity (OB), with 20.34% of mothers of children with SP and 7.41% of children with OB perceiving their child’s condition with the PP test, and 62.71% of mothers of children with SP and 81.48% of those of children with OB perceiving it with the PI test. The tests had 12% sensitivity and 21% specificity for PP and 75% sensitivity and 15% specificity for PI. Conclusions. The mothers of children with SP-OB underestimate the weight of their children. Images are useful for mothers to recognize their child’s condition.

Calidad de vida profesional y trastornos musculoesqueléticos en profesionales de Enfermería

OBJECTIVE To characterize the conditions of quality of working life, the presence of muscle- skeletal disorders and the association between these variables in nursing staff of a public hospital in Zacatecas, Mexico. METHOD A cross-sectional study with descriptive-correlational scope was designed. A stratified random sampling per shift was used in 107 cases. The Questionnaire Professional Quality of Life (CVP-35) was applied as well as the Nordic Questionnaire Standardized for musculoskeletal pain and work-related risk factors questionnaire. RESULTS The quality of working life gained an average of 55.62 (SD=13.57), the intrinsic motivation was the best rated component with (M=75.06, SD=18.44), contrary to managerial support that got the lowest scores with (M=43.74, SD=21.71). The presence of risk factors in the development work of musculoskeletal problems obtained a mean of 50.10 (SD=26.69). The main musculoskeletal disorders occurred in the neck region, lumbar spine and knees with 42.1% for each one. The quality of working life decreased in the presence of muscle-skeletal problems in the lumbar region with (-0.188, p≤.050), dorsal (-0.206, p≤.050), neck (-0.175, p≤.050) and knees (-0.220, p≤.010). CONCLUSIONS It is necessary to improve the working conditions of nurses to reduce the presence of musculoskeletal problems and improve their quality of working life.

The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children

Obesity is considered the main risk factor associated with the development of insulin resistance (IR). The aim of this study was to evaluate the influence of obesity on puberty onset and IR in Mexican children. A total of 378 children (189 boys and 189 girls) aged 8–14 years participated in the study. IR was estimated using the homeostasis model assessment for IR (HOMA-IR). The mean fasting glucose (FG) and basal insulin levels were 82 mg/dl and 11.0 μIU/ml in boys and 77.3 mg/dl and 12.3 μIU/ml in girls (P < 0.05). Subjects with obesity at Tanner stages II–V showed increased FG levels (P < 0.05). In boys with obesity, there was a decrease in HOMA-IR in Tanner stage IV and differences in age between boys with normal weight and those with obesity in Tanner V, being older the boys with obesity. Obesity in children and adolescents was associated with higher HOMA-IR values. In boys with obesity, IR increased at the end of pubertal maturation, with a delay in puberty. These findings should be considered on the establishment of IR cutoff values for pubertal population in Mexico and in the establishment of strategies to prevent the health problems related to obesity.

Study protocol: intervention in maternal perception of preschoolers’ weight among Mexican and Mexican-American mothers

BackgroundChildhood obesity is a public health issue negatively affecting children’s physical and psychosocial health. Mothers are children’s primary caregivers, thus key players in childhood obesity prevention. Studies have indicated that mothers underestimate their children’s weight. If mothers are unaware of their children’s weight problem, they are less likely to participate in activities preventing and treating excess weight. The “Healthy Change” intervention is designed to change maternal perception of child’s weight (MPCW) through peer-led group health education in childcare settings.Methods/DesignThe “Healthy Change” is a multicenter two-arm randomized trial in four centers. Three centers are in Mexican States (Nuevo Leon, Tamaulipas, and Zacatecas). The fourth center is in San Antonio, Texas, USA. A total of 360 mother-child pairs (90 pairs per center) are to be randomly and evenly allocated to either the intervention or the control group. Intervention group will receive four-session group obesity prevention education. Control group will receive a four-session personal and food hygiene education. The education is delivered by trained peer-mother promotoras. Data will be collected using questionnaires and focus groups. The primary outcome is a change in proportion of mothers with accurate MPCW. Secondary outcomes include change in maternal feeding styles and practices, maternal self-efficacy and actions for managing child excessive weight gain.McNemar’s Test will be used to test the primary outcome. The GLM Univariate procedure will be used to determine intervention effects on secondary outcomes. The models will include the secondary outcome measures as the dependent variables, treatment condition (intervention/control) as the fixed factor, and confounding factors (e.g., mother’s education, children’s gender and age) as covariates. Sub-analyses will be performed to compare intervention effects on primary and secondary outcomes between the samples from Mexico and Texas, USA. Qualitative data will be analyzed through analysis of inductive content. A combined coding model will be developed and used to code transcripts using the NVivo software.DiscussionHealthy Change intervention could help change MPCW, an initial step for obesity prevention among preschoolers. This study presents a first of its kind intervention available in Spanish and English targeting Mexican and Mexican-American mothers in Mexico and USA.Trial registrationISRCTN12281648

Maternal distress and the development of hypertensive disorders of pregnancy

Abstract Despite the implementation of programmes to improve maternal health, maternal and foetal mortality rates still remain high. The presence of maternal distress and its association with the development of pregnancy hypertensive disorders is not well established. The aim of this study was to evaluate the association between maternal distress and the development of hypertensive disorders in pregnancy in a prospective cohort of 321 Mexican women. Symptoms of maternal distressing were evaluated at week 20th of gestation using the General Health Questionnaire. The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the odds of developing a pregnancy hypertensive disorder by 5.1–26.4 times in study population (p values < .05). Our results support the participation of maternal distress in the development of hypertensive disorders of pregnancy. The implementation of effective programmes prioritising risk factors during pregnancy including the presence of maternal distressing factors is recommended. Impact statement What is already known on this subject: Changes in the nervous, endocrine, and immune systems have been observed in pregnant women with distress conditions leading to gestational disorders. What do the results of this study add: The presence of acute somatic symptoms, social dysfunction, anxiety and insomnia increased the developing of hypertensive disorders in Mexican population. What are the implications of these findings for clinical practice and/or further research: These findings may contribute to a better understanding of the role of the maternal stress in the development of hypertensive disorders of pregnancy, and in the implementation of effective programmes for clinical practice prioritising risk factors during pregnancy, including the presence of maternal distressing factors.