Introduction. Factors associated with drug use are defined in terms of their proximity to the phenomenon and can be classified as individual, microsocial, and macrosocial. Macrosocial factors include variables of a geographic, economic, demographic, and social nature, which can be compiled from population censuses and surveys. Objective. To determine the levels of risk for drug use in municipalities in Mexico based on macro-social indicators. Method. Retrospective cross-sectional study, based on the analysis of population data, weighted by the Delphi method. Results. Sixty-four municipalities with a high or very high risk of drug use were identified. Factors such as the volume of drug seizures, prevalence of student use, alcohol supply, and inequality among the population were weighted as the factors with greatest risk for drug use. Discussion and conclusion. These data serve as a benchmark for guiding the efficient, rational administration of resources assigned for dealing with the problem of addictions, since they make it possible to identify localities with a greater need for care services. RESUMENIntroducción. Los factores asociados al consumo de drogas se definen en función de su proximidad con el fenómeno y pueden clasificarse en individuales, microsociales y macrosociales. Entre los factores macrosociales se incluyen variables de tipo geográfico, económico, demográfico y social, que es posible integrar a partir de censos y encuestas poblacionales. Objetivo. Determinar niveles de riesgo del consumo de drogas en municipios de la República Mexicana con base en indicadores macrosociales. Método. Estudio transversal retrospectivo, basado en el análisis de datos poblacionales, ponderados mediante el método Delphi. Resultados. Se identificaron 64 municipios con alto o muy alto riesgo de consumo de drogas. Factores como el volumen de decomisos de drogas, prevalencia de consumo en estudiantes, oferta de alcohol y desigualdad entre la población fueron ponderadas como los factores de mayor riesgo para el consumo de drogas. Discusión y conclusión. Estos datos representan un referente para orientar la administración eficiente y racional de los recursos destinados a atender el problema de las adicciones en tanto permiten identificar localidades que requieren servicios de atención con mayor prioridad.Palabras clave: Factores de riesgo, usuarios de drogas, determinantes sociales de la salud, salud mental, técnica Delphi, abuso de sustancias.
Introduction. People with bipolar disorder are at a higher risk of metabolic morbidity and mortality. Chronotype may play a significant role due to its effect on sleep quality, eating patterns, and physical activity. Objective. To compare sleep quality, social jetlag, physical activity, and diet, depending on the chronotype of people with bipolar disorder, and to determine the association between these variables. Method. Cross-sectional, comparative, correlational study. The sociodemographic and clinical characteristics of subjects were assessed. Chronotype was determined using the Composite Scale of Morningness while sleep quality was evaluated through the Pittsburg Sleep Quality Index. Social jet lag was calculated through the absolute difference between the midpoint of sleep on weekends and workdays. Physical activity was measured through the Bouchard Activity Record and diet was evaluated through a food frequency questionnaire. Comparative analyses were performed between chronotype categories and the association between variables was measured. Results. 116 subjects were included. Subjects with evening chronotype reported poorer sleep quality than those with morning chronotype. Eveningness was associated with lower sleep quality scores and more hours of sleep on workdays, as well as with higher consumption of cold meats, calories, and sodium. Trends indicate greater social jet lag and low physical activity levels among evening chronotypes. Discussion and conclusion. The effects of chronotype on study variables require further research to clarify this complex relationship and develop educational strategies to promote sleep hygiene, physical activity, and a healthy diet.
el abuso y dependencia de alcohol son trastornos altamente discapacitantes debido a que tienden a la cronicidad y a la recurrencia. Con frecuencia coexisten con otras condiciones médicas que contribuyen a ensombrecer el pronóstico de los pacientes, ya que empeoran el curso clínico y dificultan su tratamiento y recuperación. identificar las alteraciones comórbidas de carácter médico que se presentan con mayor frecuencia en personas con abuso y dependencia del alcohol. se realizó una revisión documental a partir de las bases de datos PubMed, LILACS y Gale Virtual Reference Library, entre junio y noviembre del 2017. a partir de la estrategia de búsqueda, se seleccionaron 24 artículos para su revisión. Los hallazgos sugieren que los usuarios que consumen bebidas alcohólicas en exceso tienen mayor probabilidad de presentar condiciones médicas comórbidas que afectan al sistema nervioso central, tracto gastrointestinal, hígado y sistema cardiovascular. la frecuencia con la que estos padecimientos se hacen presentes en usuarios de alcohol devela una necesidad de atención no satisfecha y la coexistencia de complicaciones que en la mayoría de los casos son subestimadas e insuficientemente tratadas.
Introduction. The evaluation of methadone maintenance programs reports generally positive outcomes. Objective. To explore the psychosocial factors that contribute to achieve treatment goals even when patients live in conditions of precariousness and exclusion. Method. Qualitative study of multiple cases, with a sample of 12 interviews with patients participating in a maintenance and detoxification program with methadone; a thematic and discursive-narrative analysis was undertaken. Results. We identified the predominance of a typical discursive scheme composed of clearly differentiated narrative segments: previous conditions, establishment of a relationship with the therapeutic system, process of adjustment as a part of treatment and social reintegration. Two main themes were also identified: addiction and dealing with substances, and the problem of normative integration; there was also an experience of acceptance and recognition that constitutes a central factor for treatment. Discussion and conclusion. These findings are discussed in light of the disaffiliated conditions of people using injected heroin and the need to consider psychosocial and normative adjustment as a relevant factor for treatment and social reintegration, which leads to the suggestion to include psychotherapeutic interventions to accompany and reinforce the process.
El propósito de este trabajo fue evaluar la efectividad de la entrevista motivacional en la consulta de nutrición sobre indicadores de riesgo cardiometabólico en pacientes con trastorno bipolar. Se realizó un estudio experimental en que el grupo control recibió orientación nutricional basada en planes de alimentación y el grupo de intervención recibió consulta nutricional incorporando los principios y habilidades de la entrevista motivacional. Los participantes fueron seguidos por tres meses y se realizaron evaluaciones de hábitos alimenticios, actividad física, riesgo cardiometabólico, composición corporal y calidad de vida. El grupo de entrevista motivacional redujo el consumo de carnes (B=-0.45, p=0.032) y embutidos (B=-0.60, p=0.002). Asimismo, la presión arterial diastólica (B=-6.97, p=0.029) y glucemia (B=-9.27, p=0.097) de estos pacientes tendieron a disminuir. La entrevista motivacional promueve cambios que pueden hacer una diferencia clínica; aun en reducidos periodos de tiempo. Los nutriólogos capacitados para su implementación disponen de una herramienta adicional para el manejo de comorbilidad cardiometabólica en población vulner
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