Intersectionality and depression symptoms in Mexican adults aged ≥50, MHAS 2001 and 2012

OBJECTIVE

To analyze, from the perspective of intersectionality, the association of social inequality dimensions (occupation, poverty, and educational level) and socio-demographic and health characteristics with the proportion of depressive symptoms among males and females aged 50 years and older who participated in the 2001 and 2012 waves of the Mexican Health and Aging Study (MHAS).

MATERIALS AND METHODS

Descriptive analysis and logistic regression models stratified by sex were performed, including interaction terms between poverty, educational level, and employment conditions on the presence of depressive symptoms.

RESULTS

The proportion of females with depressive symptoms was significantly higher than that of males in both waves. A high proportion of older females in poverty, with five years or less of education and manual occupational activities, reported depressive symptoms in the MHAS-2001. The interactions evaluated between occupation, poverty, and educational level were not statistically significant under adjusted models; however, disability and comorbidities were associated with depressive symptoms in both sexes.

CONCLUSION

A higher proportion of females have depressive symptoms under conditions of inequality; however, the effect of the intersection between employment and socio-demographic characteristics on depressive symptoms was not observed under adjusted models.

Sleep disorders and fatigue among truck and bus drivers in Mexico

BACKGROUND

Fatigue and sleep disturbances are among the most common disorders suffered by transport drivers.

OBJECTIVE

To identify and analyze working conditions for Mexican federal transportation truck and bus drivers, and their connection with sleep disorders and fatigue.

METHODS

A cross-sectional, quantitative study was performed with a convenience sample of 172 drivers (84 truck and 88 bus) by applying the survey Evaluation and Monitoring of Workers Health (PROESSAT in Spanish) and the Yoshitake Fatigue questionnaire.

RESULTS

Night work and performing hazardous work increased the prevalence of sleep disorders (PR = 3.9 and PR = 6.9, respectively). Poor lighting and being paid per trip increased the prevalence of fatigue (PR = 2.8 and PR = 2.5, respectively).

CONCLUSION

Several conditions were found to impact health, including long work shifts, strenuous physical effort, night work, little social support, being paid by distance, strict quality controls, and risk of crimes such as extortion, robbery, attacks, and kidnapping.

Working Conditions and the Components of Burnout Among Nursing Staff in a Public Hospital in Mexico City

BACKGROUND

Working conditions in public hospitals in Mexico City are highly demanding. The need for healthcare is pressing, materials and instruments are scarce, and exposure to pain and suffering is constant. These adverse conditions have an adverse impact on the physical and mental health of healthcare professionals. The nursing staffs are among those who are most affected, and they frequently experience burnout syndrome or one of its several dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment.

PURPOSE

The aim of this research was to analyze the relationship among working conditions, related stress, and the dimensions of burnout syndrome in a tertiary care public hospital in Mexico City.

METHODS

A cross-sectional design was applied on a random sample of 190 nurses in a public hospital in Mexico City. Working conditions and burnout syndrome were evaluated using standardized instruments. Adjusted prevalence ratios were calculated. Three clusters, one for each burnout dimension, were generated and then evaluated using a correspondence analysis with labor characteristics.

RESULTS

One quarter (25%) of the participants self-reported a sense of personal accomplishment, and 12% reported emotional exhaustion and depersonalization. The labor variables that were found to be associated with the dimensions of burnout were workload, performing potentially hazardous work, and conducting tedious tasks. Positive conditions were shown to decrease the prevalence of burnout in all three dimensions.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Working conditions for nursing staff impact the mental health of nurses and affect the quality of the healthcare they provide. The set of work demands and stressors to which they are exposed should be controlled and modified to ensure a healthy work environment.

Work Environment, Mental Health, and Eating Behavior in Mexican Nurses

Nursing staff in public hospitals face highly demanding working conditions, which are related to mental health and eating problems. The current study aimed to identify the most frequent work characteristics associated with mental health problems and eating behavior in nursing staff. A cross-sectional study was performed on a random sample of 190 nurses at a specialized hospital in Mexico City. Work characteristics, mental health problems (stress, depression, and anxiety), emotional eating, and loss-of-control eating were measured using standardized scales. Associations among relevant work variables and mental health and eating behavior were assessed using logistic regression models adjusted for sociodemographic characteristics. High prevalence of stress (28%), depression (35%), anxiety (33%), emotional eating (27%), and loss-of-control eating (38%) were found. These mental health problems have been associated with variables related to work overload, little appreciation of work, and exposure to the suffering and death of patients. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

The association between social support and cognitive function in Mexican adults aged 50 and older

Social support networks are crucial for the health of older adults; however, personal characteristics and time of life may diminish the protective effect of social support.

OBJECTIVE

to determine if the presence of social support networks were associated with cognitive impairment among Mexican adults aged 50 or older and if this relationship was different based on age.

METHOD

This study analyzed data from the National Representation Survey performed in Mexico, Study on Global Ageing (SAGE) wave 1. Cognitive function was evaluated by a standardized test, social support was evaluated through latent class analysis (LCA). The LCA was run to obtain three subgroups of different Social Support Levels (SSL): low, medium, and high. Logistic regression models, stratified by age, were performed to analyze the association between SSL and cognitive function.

RESULTS

For respondents ages 71-80 y/o, there was an inverse relationship with cognitive impairment for those with medium (OR 0.23, p=0.020) and high (OR 0.07, p=0.000) SSL in comparison with low SSL. While social support helped to improve cognitive function in older adults aged 71-80, this same association was not observed in adults of other ages. Those younger than 70 y/o may not need such a strong support network as a result of being more self-sufficient. After 80, social networks were not enough to help diminish the negative impact of cognitive impairment.

CONCLUSION

Social support could improve the cognitive function of adults ages 71 and 80; suggesting there could be a window of opportunity to improve cognitive functioning for this group.

Incidence of type 2 diabetes in Mexico: results of the Mexico City Diabetes Study after 18 years of follow-up

OBJECTIVE

To estimate the incidence of type 2 diabetes (T2D) in Mexican population.

MATERIALS AND METHODS

Population based prospective study. At baseline (1990), the population at risk (1939 non-diabetic adults 35-64 years) was evaluated with oral glucose tolerance test. Subsequent similar evaluations were done (1994, 1998, 2008). American Diabetes Association diagnostic criteria were applied.

RESULTS

The period of observation was 27842 person-years, the cumulative incidence of T2D was 14.4 and 13.7 per 1000 person-years for men and women, respectively. Incidence was 15.8, 15.7 and 12.7 per 1 000 person-years for the second (1994), third (1998) and fourth (2008) follow-up phases, respectively. The mean age at diagnosis was 44 years for prevalent cases and 56 years for incident cases.

CONCLUSIONS

This is the first estimate of long-term incidence of T2D in Mexican population. The incidence is among the highest reported worldwide. It remained with few changes throughout the study period.

Risk factors associated to diabetes in Mexican population and phenotype of the individuals who will convert to diabetes

 Objective. To describe risk factors associated to the inci­dence of type 2 diabetes (T2D) in Mexican population and to define phenotypic (clinical, anthropometric, metabolic) characteristics present in the individual who will convert to diabetes, regardless of time of onset. Materials and meth­ods. The Mexico City Diabetes Study began in 1990, with 2 282 participants, and had three subsequent phases: 1994, 1998, and 2008. A systematic evaluation with an oral glucose tolerance test was performed in each phase. For diagnosis of T2D, American Diabetes Association criteria were used. Results. The population at risk was 1939 individuals. Sub­jects who were in the converter stage (initially non diabetic that eventually converted to T2D) had, at baseline, higher BMI (30 vs 27), systolic blood pressure (119 vs 116 mmHg), fasting glucose (90 vs 82mg/dl), triglycerides (239 vs 196mg/dl), and cholesterol (192 vs 190mg/dl), compared with sub­jects who remained non converters (p<0.05). Conclusion. The phenotype described represents a potentially identifiable phase and a target for preventive intervention.