An Exploratory Pilot Study of Childhood Injuries on Cattle Farms in Jalisco,Mexico

ABSTRACT

Childhood agricultural injuries have been a concern in the United States for many years. Much research has been performed on the cause and prevention of such injuries. The North American Guidelines for Children's Agricultural Tasks (NAGCAT) have been developed in the United States to address the common agricultural tasks and injuries sustained by children. Data are lacking concerning the common agricultural tasks and injuries of children working on Mexican farms. The goal of the study was to determine if the NAGCAT guidelines developed for the United States may be applicable to children in Jalisco, Mexico. Interviews of local physicians were performed regarding their perception of common childhood agricultural injuries. Interviews about common childhood agricultural tasks and injuries were performed at 27 farms through the help of a local cooperative. Work practices at these farms were also observed. Emergency department records were reviewed for childhood agricultural injuries. Surveys of local cattle farms revealed the most common childhood agricultural tasks were feeding animals, milking cows, and cleaning corrals. Through the same cattle farm interviews, the most common childhood agricultural injuries included being kicked by an animal, scorpion bites, cuts, and falls. Physician interviews revealed machinery, poisonings, cuts, and lacerations as the most common injuries. Due to the lack of adequate documentation, the emergency department medical record review was not useful. The NAGCAT guidelines address many of the common tasks and injuries in the Tepatitlán area, including animal care, operating machinery, and cleaning corrals. There are other common injuries in the Tepatitlán area such as scorpion bites for which no NAGCAT guidelines currently exist but for which guidelines could be developed. Once translated to Spanish and adjusted for cultural relevancy, the NAGCAT guidelines would address many of the common agricultural tasks and injuries of children in Jalisco, Mexico.     

An experience with public education in nutritional health in 2 communities in Jalisco, Mexico

This study describes a popular educational process conducted in two communities in Jalisco, Mexico. The purpose was to add an alfalfa concentrate to the population's diet as an alternative, locally available food source. Previous studies had shown that alfalfa contains high protein, vitamin, and essential amino acid levels and can be useful to supplement and improve child nutrition. This resource had not been used previously due to lack of knowledge concerning its properties and harvesting and processing procedures and because it had traditionally been used as livestock feed. The current study included four steps: 1) community knowledge, 2) a community survey using interviews, home visits, and child nutrition evaluation, 3) formation of work groups in a community meeting, and 4) an educational program, working with a self-diagnostic tool taking child nutritional status into account. Our work focused on two areas simultaneously: family nutrition and the alfalfa concentrate as a way to improve it. Although this process was lengthy, it resulted in the acceptance and inclusion of alfalfa concentrate. In addition, the community groups formed in the process remain as an ongoing organizational resource.     

Chemical Composition and Antinutrient Content of three Lupinus Species from Jalisco,Mexico

In this study, the proximal chemical analysis and contents of antinutritional factors (lectins, antitrypsin activity, cyanogenic glycosides, alkaloids, phytates and α -galactosides) of Lupinus exaltatus, L. reflexus, and L. mexicanus seeds were determined. The seeds of these lupins comprised 384.1, 388.0, 367.0 g/kg protein, which contained all the essential amino acids for human beings except glutamine and asparagine in their seed protein. OnlyL. exaltatus was free from lectins. Trypsin inhibitor concentrations ranged from 1.12 to 2.05 TIU/mg. Cyanogenic glycosides were present at low concentrations in the studied lupins. Total alkaloid content ranged from 14.0 to 44.0 g/kg and phytate content ranged from 11.1 to 1.856 g/kg. The main α -galactosides found in seeds were raffinose, stachyose, verbacose and ajucose. Stachyose was the predominant sugar in the studied species. Therefore, these wild lupins could be considered a good source of protein after a suitable reduction in the content of alkaloids.     

An exploratory pilot study of childhood injuries on cattle farms in Jalisco, Mexico

Childhood agricultural injuries have been a concern in the United States for many years. Much research has been performed on the cause and prevention of such injuries. The North American Guidelines for Children's Agricultural Tasks (NAGCAT) have been developed in the United States to address the common agricultural tasks and injuries sustained by children. Data are lacking concerning the common agricultural tasks and injuries of children working on Mexican farms. The goal of the study was to determine if the NAGCAT guidelines developed for the United States may be applicable to children in Jalisco, Mexico. Interviews of local physicians were performed regarding their perception of common childhood agricultural injuries. Interviews about common childhood agricultural tasks and injuries were performed at 27 farms through the help of a local cooperative. Work practices at these farms were also observed. Emergency department records were reviewed for childhood agricultural injuries. Surveys of local cattle farms revealed the most common childhood agricultural tasks were feeding animals, milking cows, and cleaning corrals. Through the same cattle farm interviews, the most common childhood agricultural injuries included being kicked by an animal, scorpion bites, cuts, and falls. Physician interviews revealed machinery, poisonings, cuts, and lacerations as the most common injuries. Due to the lack of adequate documentation, the emergency department medical record review was not useful. The NAGCAT guidelines address many of the common tasks and injuries in the Tepatitlán area, including animal care, operating machinery, and cleaning corrals. There are other common injuries in the Tepatitlán area such as scorpion bites for which no NAGCAT guidelines currently exist but for which guidelines could be developed. Once translated to Spanish and adjusted for cultural relevancy, the NAGCAT guidelines would address many of the common agricultural tasks and injuries of children in Jalisco, Mexico.     

Regional variations in cardiovascular mortality in Sweden--structural vulnerability in the local community

The aim of this investigation was to study the connection between various phenomena in the local community and the number of deaths from ischemic heart disease (IHD) for both men and women in the 45-64 age group in the period 1979-1983. The result reveals considerable regional variation. Those areas with an above average male IHD mortality also tended to differ from the norm as regards labour market, and socioeconomic conditions. There was a tendency for unemployment to be higher, the level of employment to be lower, and the number of households with no or only one person gainfully employed larger; there also tended to be more people who had taken or been forced into early retirement, average incomes tended to be lower and there was an above average proportion of blue-collar workers and a below average proportion of white-collar workers. Furthermore, there proved to be a larger proportion of older men. The factors which did not seem to be related to the number of IHD deaths were the divorce rate in the community and the degree of population density. As regards women, there was a less marked connection between the various regional phenomena and the number of IHD deaths. The mortality rate proved to be related to only two factors: the level of unemployment in the community and the proportion of high-income earners. There was a tendency, albeit weak, that areas with an above average mortality also had an above average rate of unemployment and a lower than average proportion of high-income earners.(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessment of the Levels of Polybrominated Diphenyl Ethers in Blood Samples from Guadalajara,Jalisco, Mexico

The purpose of this study was to measure levels of polybrominated diphenyl ethers (PBDEs) in the blood of children (50 individuals) living in Guadalajara, Jalisco, Mexico. We analyzed six PBDE congeners by gas chromatography–mass spectrometry. Total PBDE levels ranged from not detectable (nd) to 15.2 μg/L on a whole-weight basis and from nd to 6,435 ng/g lipid on a lipid-weight basis. The dominant congener in our study was BDE-153, followed by BDE-154, BDE-99, BDE-100, and BDE-47. Levels of BDE-209 were below the detection limit. Our data indicate that children living in the areas studied in this work are exposed to high levels of PBDEs.     

Arsenic in drinking water in the Los Altos de Jalisco region of Mexico.

OBJECTIVE: To establish the degree of contamination by arsenic in drinking water in the Los Altos de Jalisco (LAJ) region of west-central Mexico, and to estimate the levels of exposure that residents of the area face. METHODS: Total arsenic concentration (the sum of all arsenic forms, organic and inorganic) was determined for 129 public water wells in 17 municipal capitals (cabeceras municipales) of the LAJ region, using inductively coupled plasma-optical emission spectroscopy. For most of the wells, water samples were taken in both November 2002 and October 2003. The levels of exposure to arsenic were estimated for babies (10 kg), children (20 kg), and adults (70 kg). RESULTS: Mean concentrations of arsenic higher than the Mexican national guideline value of 25 micro g/L were found in 44 (34%) of the 129 wells. The mean concentration of total arsenic for the 129 wells ranged from 14.7 micro g/L to 101.9 micro g/L. The highest concentrations were found in well water samples collected in the cities of Mexticacán (262.9 micro g/L), Teocaltiche (157.7 micro g/L), and San Juan de los Lagos (113.8 micro g/L). Considering the global mean concentration for all the wells in each of the 17 cities, the mean concentration of arsenic exceeded the Mexican guideline value in 7 of the cities. However, the global mean concentration in all 17 cities was higher than the World Health Organization guideline value of 10 micro g/L for arsenic. The range of the estimated exposure doses to arsenic in drinking water was 1.1-7.6 micro g/kg/d for babies, 0.7-5.1 micro g/kg/d for children, and 0.4-2.7 micro g/kg/d for adults. CONCLUSIONS: At the exposure doses estimated in the LAJ region, the potential health effects from chronic arsenic ingestion include skin diseases, gastrointestinal effects, neurological damage, cardiovascular problems, and hematological effects. While all the residents may not be affected, an important fraction of the total population of the LAJ region is under potential health risk due to the ingestion of high levels of arsenic. Epidemiological studies to determine the arsenic levels in the blood, hair, and nails of humans should be conducted in the LAJ region to help assess the relationship between the prevalence of health problems and the chronic ingestion of arsenic.     

Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

Introduction  

Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results.     

Dietary fat and antioxidant vitamin intake in patients of neurodegenerative disease in a rural region of Jalisco,Mexico

Objective

To evaluate and compare the intake of lipids and (A, E, and C) vitamins in patients with and without possible neurodegenerative diseases.

Methods

Twenty adults with possible Alzheimer's disease or Parkinson's disease and 41 control subjects (50–89 years old) from a rural region were studied. Dietary intake was evaluated with the analysis of macronutrients and micronutrients conducted by a food frequency questionnaire and 24 hours dietary record. Analyses were adjusted for age, sex, body mass index, and energy intake. Through interrogation and use of medical record form of health secretary we obtained information about the sociodemographic characteristics. Multivariate analysis of variance to allow for covariated adjustment was used.

Results

Patients had a lower energy intake, vitamin C (P = 0.016), fruits (P < 0.001), vegetables (P = 0.037), and oils and fat (P = 0.002), than the controls. Interestingly, the C vitamin intake in patients was still higher than the recommended. Patients had a higher consumption of cereals (P = 0.017), high-animal fat diet (P = 0.024), and whole milk (P < 0.001); 2.4% of the controls smoke and 5% are alcohol consumers. Eighty-five percent of patients and 78% of the controls do not have physical activity. Family history of subjects in this study indicated chronic diseases.

Conclusion

The subjects included in this study had a high intake of C vitamin, this is due to the consumption of fruits and vegetables. However, patients with possible Alzheimer's or Parkinson's disease had a lower intake of fruits and vegetables, which could be due to type of food to which they have access.     

Ozone, area social conditions, and mortality in Mexico City

We investigated whether the association of daily mortality and ambient ozone differs by age and area social conditions of the region of residence using a time-series analysis. The study setting was metropolitan Mexico City, a high altitude city situated in a valley, with an estimated 20 million inhabitants, large socioeconomic gradients, and ozone levels frequently exceeding international standards. We stratified daily deaths by six census-derived socioeconomic indicators, based on characteristics of the county where decedents lived. We used Poisson regression to model the association between daily mortality and ozone levels (on the day of death and the previous day) in separate models, stratified by area socioeconomic level and age, and controlling for time trends and temperature. Ozone was positively associated with total mortality [0.65% increase per 10 ppb increment, 95% confidence interval (CI): 0.02%, 1.28%] and for mortality among those over age 65 [1.39% increase per 10 ppb increment, 95% CI: 0.51%, 2.28%]. Associations between ozone and all-age mortality did not show any consistent patterns according to socioeconomic gradients. We conclude that elderly people are at higher risk for ozone-associated mortality. Though county-level social indicators in Mexico City were not strong markers of vulnerability to ozone-associated acute mortality in this analysis, complex associations between individual and area-level factors may exist that would require additional data and further analyses to elucidate.     

Cross-national comparison of injury mortality: Los Angeles County, California and Mexico City, Mexico

BACKGROUND: Cross-national comparisons of injury mortality can suggest possible causal explanations for injuries across different countries and cultures. This study identifies differences in injury mortality between Los Angeles (LA) County, California and Mexico City DF, Mexico. METHODS: Using LA County and Mexico City death certificate data for 1994 and 1995, injury deaths were classified according to the International Classification of Diseases Ninth Revision-Clinical Modification external cause of injury codes. Crude, gender-, and age-adjusted annual fatality rates were calculated and comparisons were made between the two regions. RESULTS: Overall and age-adjusted injury death rates were higher for Mexico City than for LA County. Injury death rates were found to be higher for young adults in LA County and for elderly residents of Mexico City. Death rates for motor vehicle crashes, falls, and undetermined causes were higher in Mexico City, and relatively high rates of poisoning, homicide, and suicide were found for LA County. Motor vehicle crash and fall death rates in Mexico City increased beginning at about age 55, while homicide death rates were dramatically higher among young adults in LA County. The largest proportion of motor vehicle crash deaths was to motor vehicle occupants in LA County and to pedestrians in Mexico City. CONCLUSIONS: These findings illustrate the importance of primary injury prevention in countries having underdeveloped trauma care systems and should aid in setting priorities for future work. The high frequency of pedestrian fatalities in Mexico City may be related to migration of rural populations, differing vehicle characteristics and traffic patterns, and lack of safety knowledge. Mexico City's higher rate of fall-related deaths may be due to concurrent morbidity from chronic conditions, high-risk environments, and delay in seeking medical treatment.     

Polybrominated diphenyl ethers (PBDEs) levels in blood samples from children living in the metropolitan area of Guadalajara,Jalisco, Mexico

The aim of this study was to perform a polybrominated diphenyl ethers (PBDEs) exposure assessment using blood samples collected from children living in the metropolitan area of Guadalajara, Jalisco, Mexico (GDL). Five congeners of PBDEs were analyzed using a gas chromatography/mass spectrometry technique. The blood concentrations of total PBDEs ranged from 5.50 to 169 ng/g lipid (42.0 ± 18.0 ng/g lipid; mean ± standard deviation). Regarding BDE congeners, the main congener (highest blood levels) was BDE99 (14.5 ± 5.50 ng/g lipid), followed by BDE100 (9.80 ± 3.40 ng/g lipid) and BDE154 (9.80 ± 5.90 ng/g lipid), and finally BDE153 (5.80 ± 2.30 ng/g lipid) and BDE47 (2.20 ± 1.20 ng/g lipid). In conclusion, blood PBDEs concentrations of concern were detected in this study, as blood levels were similar to the ones found in North America (the highest worldwide).     

Increased fall-related mortality rates in New Mexico, 1999-2005

Objective

In 2000, fall injuries affected 30% of U.S. residents aged ≥65 years and cost $19 billion. In 2005, New Mexico (NM) had the highest fall-related mortality rate in the United States. We described factors associated with these elevated fall-related mortality rates.

Methods

To better understand the epidemiology of fatal falls in NM, we used state and national (Web-based Injury Statistics Query and Reporting System) vital records data for 1999–2005 to identify unintentional falls that were the underlying cause of death. We calculated age-adjusted mortality rates, rate ratios (RRs), and 95% confidence intervals (CIs) by sex, ethnicity, race, and year.

Results

For 1999–2005 combined, NM''s fall-related mortality rate (11.7 per 100,000 population) was 2.1 times higher than the U.S. rate (5.6 per 100,000 population). Elevated RRs persisted when stratified by sex (male RR=2.0, female RR=2.2), ethnicity (Hispanic RR=2.5, non-Hispanic RR=2.1), race (white RR=2.0, black RR=1.7, American Indian RR=2.3, and Asian American/Pacific Islander RR=3.1), and age (≥50 years RR=2.0, <50 years RR=1.2). Fall-related mortality rates began to increase exponentially at age 50 years, which was 15 years younger than the national trend. NM non-Hispanic individuals had the highest demographic-specific fall-related mortality rate (11.8 per 100,000 population, 95% CI 11.0, 12.5). NM''s 69.5% increase in fall-related mortality rate was approximately twice the U.S. increase (31.9%); the increase among non-Hispanic people (86.2%) was twice that among Hispanic people (43.5%).

Conclusions

NM''s fall-related mortality rate was twice the U.S. rate; exhibited a greater increase than the U.S. rate; and persisted across sex, ethnicity, and race. Fall-related mortality disproportionately affects a relatively younger population in NM. Characterizing fall etiology will assist in the development of effective prevention measures.Falls are the leading cause of nonfatal injuries (2001–2007) and the third most common cause of unintentional injury-related death (with motor vehicle crashes and poisoning ranking first and second, respectively) among all ages in the United States (1999–2007).¹ Falls are also a leading cause of injury-related death in other developed countries.^2,3 Older adults are most affected by fall-related mortality. In 2000, 30% of U.S. residents aged ≥65 years sustained a fall-related injury, and these injuries cost approximately $19 billion.⁴We observed that New Mexico (NM) had the second-highest fall-related mortality rates in 1999–2005 and conducted this analysis to better characterize the epidemiology of fatal falls in this state. Some factors identified as potentially associated with this observation included racial/ethnic health disparities, age and sex structure of the population, and decreased access to care (because of distant location to a health-care facility or cost of care). Understanding the epidemiology of fatal falls is important for prioritizing public health resources. It also enhances the ability to evaluate the effectiveness of interventions that are intended to reduce fall-related deaths and injuries.     

Spatio-temporal patterns of diarrhoeal mortality in Mexico

Diarrhoeal mortality rates in Mexican children dramatically declined during the 1980s and 1990s, concomitant with a temporal shift in peak deaths from summer to autumn-winter. The spatial dynamics of these patterns have not previously been studied. We first describe the seasonal features of paediatric diarrhoeal mortality in Mexico as a whole, then across individual states. While no geographical gradients in the magnitude of diarrhoeal mortality rates have been detected in recent years, we identified a distinct spatial pattern in the timing of peak mortality rate. In the 1980s the summer peak mortality was earliest around Mexico's capital and later in states to the southeast and northwest. Our results suggest that the direction and timing of those annual waves are related to the mean monthly precipitation and mean daily temperature. This pattern has disintegrated in recent years as the summer peak has diminished.     

Infant mortality and crisis in Mexico.

Data derived from the Encuesta Nacional de Fecundidad y Salud (ENFES) confirm that overall levels of infant mortality in Mexico have been steadily declining. However, a more specific analysis furnishes evidence that this decline has occurred at varying rates within different social groups, reflecting an increase in social inequalities. The analytical strategy used in this article leads to three basic conclusions: (1) the impact of the economic crisis on infant mortality is reflected not in a reversal of the declining trend but an increase in social inequalities; (2) certain variables universally accepted as determinants of infant mortality, such as mother's education, seem nonsignificant for some social sectors; and (3) certain biodemographic characteristics assumed to have a uniform mortality-related behavior vary among sectors, suggesting that even these constants are determined by social factors.