Towards a psychosocial and cultural definition of Mexican homeless girls: a qualitative approach

Homeless women are one of the most vulnerable groups worldwide since they are victims of labor and sexual exploitation, abuse, discrimination and marginalization at a higher rate than the rest of the population. However, currently, Mexico lacks of an accurate definition of such social group, and their characteristics as well as the magnitude and dimensions of the phenomenon are only partially and superficially known. The purpose of this research was to develop and validate a typology of homeless women living in Mexico City. To fulfill this purpose, 300 indepth interviews were conducted and examined thoroughly with a systematic analysis of the content. The main results indicate that homeless women constitute a social group immersed predominantly in circumstances of violence, marginalization, poverty and social exclusion. Also, this collective includes two subgroups: women at risk of homelessness and women emergency sheltered, unsheltered or absolutely homeless and living in places not intended for human habitation. With this typology it is possible to define, characterize and distinguish homeless women. In addition, the phenomenon can be known with more certainty and accuracy enabling, thus, the design of effective treatment strategies.

Enhanced flat adenoma detection rate with high definition colonoscopy plus i-scan for average-risk colorectal cancer screening

Background and aim: The usefulness of high definition colonoscopy plus i-scan (HD+i-SCAN) for average-risk colorectal cancer screening has not been fully assessed. The detection rate of adenomas and other measurements such as the number of adenomas per colonoscopy and the flat adenoma detection rate have been recognized as markers of colonoscopy quality. The aim of the present study was to compare the diagnostic performance of an HD+i-SCAN with that of standard resolution white-light colonoscope. Methods: This is a retrospective analysis of a prospectively collected screening colonoscopy database. A comparative analysis of the diagnostic yield of an HD+i-SCAN or standard resolution colonoscopy for average-risk colorectal screening was conducted. Results: During the period of study, 155/163 (95.1%) patients met the inclusion criteria. The mean age was 56.9 years. Sixty of 155 (39%) colonoscopies were performed using a HD+i-SCAN. Adenoma-detection-rates during the withdrawal of the standard resolution versus HD+i-SCAN colonoscopies were 29.5% and 30% (p = n.s.). Adenoma/colonoscopy values for standard resolution versus HD+i-SCAN colonoscopies were 0.46 (SD = 0.9) and 0.72 (SD = 1.3) (p = n.s.). A greater number of flat adenomas were detected in the HD+i-SCAN group (6/60 vs. 2/95) (p < .05). Likewise, serrated adenomas/polyps per colonoscopy were also higher in the HD+i-SCAN group. Conclusions: A HD+i-SCAN colonoscopy increases the flat adenoma detection rate and serrated adenomas/polyps per colonoscopy compared to a standard colonoscopy in average-risk screening population. HD+i-SCAN is a simple, available procedure that can be helpful, even for experienced providers. The performance of HD+i-SCAN and substantial prevalence of flat lesions in our average-risk screening cohort support its usefulness in improving the efficacy of screening colonoscopies.