Continuous Production of Highly Tuned Silk/Calcium-Based Composites: Exploring New Pathways for Skin Regeneration.

Calcium plays an important role in barrier function repair and skin homeostasis. In particular, calcium phosphates (CaPs) are well established materials for biomedical engineering due to their biocompatibility. To generate biomaterials with a more complete set of biological properties, previously discarded silk sericin (SS) has been recovered and used as a template to grow CaPs. Crucial characteristics for skin applications, such as antibacterial activity, can be further enhanced by doping CaPs with cerium (Ce) ions. The effectiveness of cell attachment and growth on the materials highly depends on their morphology, particle size distribution, and chemical composition. These characteristics can be tailored through the application of oscillatory flow technology, which provides precise mixing control of the reaction medium. Thus, in the present work, CaP/SS and CaP/SS/Ce particles were fabricated for the first time using a modular oscillatory flow plate reactor (MOFPR) in a continuous mode. Furthermore, the biological behavior of both these composites and of previously produced pure CaPs was assessed using human dermal fibroblasts (HDFs). It was demonstrated that both CaP based with plate-shaped nanoparticles and CaP-SS-based composites significantly improved cell viability and proliferation over time. The results obtained represent a first step towards the reinvention of CaPs for skin engineering.

Frequent follow-up of suicidal youth assessed in the emergency room: Long-term trajectory and predictors of suicidality.

Suicide was the second­leading cause of US deaths in 2018 among 15-24-year-olds. Suicide attempts, a risk factor for completions, and suicide ideation have doubled among pediatric emergency room (ER) patients during the past decade. Borderline Personality Disorder (BPD), a comorbid condition, has a 10% suicide rate. We examined the 4-year outcome of a cohort of suicidal adolescents, many also suffering from BPD and having undergone some form of treatment, to identify baseline factors which could inform intervention that would minimize suicidality 4 years post-discharge. METHODS: We conducted a prospective longitudinal study of suicidality at twelve points (four assessment occasions) for 286 suicidal youth presenting to a pediatric ER, most suffering from BPD, with 36 suicide ratings from baseline to 2-, 6- and 48-month follow-up evaluations. We examined the trajectory and predictors of persisting suicidality. RESULTS: Suicidality rapidly decreased within 2 months post-ER-discharge, subsequently remaining low throughout 48 months. Baseline functioning, female sex, stressful life events and BPD impulsiveness were most predictive of persisting suicidality at 48-month follow-up. CONCLUSION: Most suicidal youth, many meeting BPD criteria, no longer feel suicidal 2 months after ER discharge. Management of participants' baseline poor functioning stressful life events and the impulsiveness component of BPD specifically in females could impact suicidality 4 years later, and guide treatment options. The absence of the BPD cognitive and affective subscales as predictors of suicidality at 4-year follow-up may reflect treatment received. Further investigation of treatment effects is warranted and under way.

"I Matter, I Learn, I Decide": An Impact Evaluation on Knowledge, Attitudes, and Rights to Prevent Adolescent Pregnancy.

Adolescent pregnancy is considered a priority public health issue because of its implications in the lives of young mothers, their children, and the well-being of the general population. In this paper, we describe an intervention targeting adolescents (aged 11-19 years old) in a rural context and estimate its impact on key outcomes relevant to early pregnancy prevention: knowledge and self-efficacy concerning sexual and reproductive health, knowledge of sexual and reproductive rights, and attitudes toward gender roles. Our study used a quasi-experimental design comprising 747 adolescents. Three difference-in-differences models (raw, adjusted, and by exposure level) with fixed effects estimated the changes in all outcome measures. Our results showed that the intervention community had a significant improvement in all outcomes, and this improvement was larger in those who received the highest-exposure level of intervention compared to a control community. Our study provides evidence that a community-based intervention, founded on comprehensive sexual education, is a promising approach to improve key outcomes related to early pregnancy in rural contexts. Further research should be undertaken to test how similar strategies focusing on multi-layer early pregnancy determinants work on other sub-groups of vulnerable adolescents, such as school dropouts or those living in disadvantaged circumstances.

[Massive online course "Sexual and reproductive health": changes in knowledge, desertion, disapproval and satisfaction] / Curso masivo en línea "Salud sexual y reproductiva": cambios en conocimientos, deserción, reprobación y satisfacción

OBJECTIVE: To present global results of the dropout and failure and satisfaction of the Massive Open Online Course (MOOC) users, as well as changes in knowledge and practices of personnel registered in "Sexual and Reproductive Health and Prevention of adolescent pregnancy". MATERIALS AND METHODS: Using 45 549 records, we adjust logistic regression models to find associations between variables of dropout and failure. RESULTS: 57.8% of people completed the course and 15.1% failure. Logistic models show that age and position are associated with both dropout and failure. CONCLUSIONS: The MOOC is useful to improve knowledge and skills of health personnel. It is necessary to expand the coverage to professionals who deal with adolescent population, in order to improve sexual and reproductive health and prevent teenage pregnancies.

OBJETIVO: Presentar resultados globales de la deserción, reprobación y satisfacción de los usuarios del Curso Masivo en Línea Abierto (MOOC, por sus siglas en inglés), así como los cambios en conocimientos y prácticas del personal de salud inscrito al MOOC "Salud sexual y reproductiva y prevención del embarazo en adolescentes". MATERIAL Y MÉTODOS: Se analizaron 45 549 registros y se ajustaron modelos de regresión logística para la deserción y reprobación del curso. RESULTADOS: Finalizó el curso 57.8% de los usuarios, mientras que 15.1% reprobó. Los modelos logísticos muestran que la edad y el cargo ocupado se asocian tanto con la deserción como con la reprobación. CONCLUSIONES: El MOOC es una herramienta útil para generar mejoras en conocimientos y competencias. Es necesario ampliar la cobertura a profesionales que tienen trato con población adolescente, con el fin de mejorar la salud sexual y reproductiva y prevenir embarazos en la adolescencia.

[Methodological bases of the measurement of earlychildhood development in the Ensanut 100k survey]. / Bases metodológicas de lamedición de desarrollo infantiltemprano en la Ensanut 100k.

OBJECTIVE: The methods that were carried out for the inclusion of the early childhood development module in the Ensanut 100k are presented. MATERIALS AND METHODS: With this module and the questionnaire for children under five years-old, indicators of the state of health, development and well-being of children in the first five years of life are obtained. From November to December 2017, the sample design, instruments and manuals were defined and a test was carried out. Field staff were trained and standardized. The information was collected between January and June 2018. RESULTS: 3 892 children from 0 to 59 months of age were studied in the DIT Module of the Survey. CONCLUSIONS: Training and standardization of field personnel, by trained and standardized personnel, minimizes information biases.

OBJETIVO: Presentar los métodos realizados para la inclu-sión del módulo de Desarrollo Infantil Temprano (DIT) en la Ensanut 100k. MATERIAL Y MÉTODOS: Con dicho módulo y el cuestionario de menores de cinco años, se obtuvieron indicadores del estado de salud, desarrollo y bienestar de niñas/os en los primeros cinco años de vida.De noviembre a diciembre de 2017, se definió el diseño de la muestra, instrumentos y manuales, y se realizó una prueba piloto. Se capacitó y estandarizó al personal de campo. El levantamiento de información se realizó entre enero y junio de 2018. RESULTADOS: Se estudió en el módulo DIT de la encuesta a 3 892 niños/as de 0 a 59 meses de edad. CONCLUSIONES: La capacitación y estandarización del personal de campo, por parte de personal capacitado y estandarizado, minimiza los sesgos de información.

Contribution of Second and Higher-Order Births to Adolescent Fertility in Mexico.

This study estimates the contribution of second and higher-order births to the adolescent fertility rate in Mexico from 2006 to 2014. We used data from nationally representative surveys for 2006, 2009, and 2014 to estimate the adolescent fertility rate, and the first, second, and higher-order birth components for the triennium prior to each survey at the national and state level. Our results showed that the second and higher-order component was 16.3 births per 1,000 women in 2003-05, 14.9 in 2006-08, and 16.9 in 2011-13. Second and higher-order births represented 25.9 percent of all teen births in 2003-05, 21.6 percent in 2006-08, and 21.9 percent in 2011-13. Second and higher-order births were heterogeneous across states. We found that second and higher-order births are highly prevalent and important contributors to the adolescent fertility rate. Postponing second and higher-order births would benefit both mothers and children. Monitoring them provides crucial information on the demand of targeted health system strategies that address the reproductive health needs of adolescent mothers. Interventions to prevent second and higher-order pregnancies must be developed and implemented.

[Maternal and child healthcare and adolescent maternity in under 100 000 inhabitants communities]. / Atención en salud materno-infantil y maternidad adolescente en localidades menores de 100 000 habitantes.

OBJECTIVE: To compare the coverage of continuous ma- ternal healthcare and early childhood care in women with and without adolescent motherhood (AM) who live in under-100 000-inhabitants communities. MATERIALS AND METHODS: Cross-sectional analysis of Ensanut 100k 2018 of 767 women aged 12 to 49 years living in under-100 000-in- habitants communities who had their last birth two years before the survey. RESULTS: Women with AM have lower continuous coverage of maternal care than those without AM (8.1 and 19.6%, respectively). Infant care coverage with adequate content was lower than 30%, and there were no differences between the groups. CONCLUSIONS: It is necessary to strengthen actions focused on this group of women in order to reduce the gaps in coverage and improve maternal and child health.

OBJETIVO: Comparar la cobertura de atención continua de salud materna y de atención en la primera infancia en mujeres con y sin maternidad en la adolescencia (MA), que habitan en localidades menores de 100 000 habitantes. MATERIAL Y MÉTODOS: Análisis transversal de la Encuesta Nacional de Salud y Nutrición 100k (Ensanut 100k) 2018 en 767 mujeres de 12 a 49 años residentes en localidades con menos de 100 000 habitantes que tuvieron su último hijo dos años anteriores a la encuesta. Se calcularon coberturas de atención a partir de modelos de regresión logística. RESULTADOS: Las mujeres con MA tienen menor cobertura continua en salud materna que las que no tuvieron MA (8.1 y 19.6%, respectivamente). La cobertura de atención del infante con contenido adecuado fue menor a 30% y no hubo diferencias entre los grupos. CONCLUSIONES: Es necesario fortalecer acciones focalizadas en este grupo de mujeres para reducir brechas en las coberturas y mejorar la salud materno-infantil.

[Context and results of early childhood development in 12 to 59 months old children living in Mexico]. / Contexto y resultados del desarrollo infantil temprano en niños y niñas de 12 a 59 meses en México.

OBJECTIVE: To evaluate early childhood development (ECD) and its determinants in 12 to 59 months old children residents of communities <100 000 inhabitants. MATERIALS AND METHODS: The Encuesta Nacional de Salud y Nutrición of communities <100 000 inhabitants (Ensanut 100k) evaluated language level, access to ECD care services and standardized indicators of the eight quality of the development environment. We report indicator prevalence and standardized language scores according to variables of interest. RESULTS: 20.7% of children attended eight wellchild care visits within the first year of life, 13.0% received an ECD assessment, 75.0% receive support for learning, 23.4% have books and 57.7% experiment violent discipline. Improved language levels are associate with socioeconomic capacities, maternal education, preschool attendance, support for learning and household books. Children exposed to more protective factors present a language level 1.5 standard deviations higher than their peers exposed to more risk factors. CONCLUSIONS: There is a need to increase the coverage of ECD care services and to improve early development opportunities within households.

OBJETIVO: Evaluar el desarrollo infantil temprano (DIT) y sus determinantes en niños/as de 12 a 59 meses residentes en localidades de menos de 100 000 habitantes. MATERIAL Y MÉTODOS: . La Encuesta Nacional de Salud y Nutrición en localidades con menos de 100 000 habitantes (Ensanut 100k) evaluó el nivel de lenguaje, acceso a servicios de atención al DIT e indicadores de calidad del contexto de desarrollo. Se estiman prevalencias de indicadores y puntajes estandarizados de lenguaje según variables de interés. RESULTADOS: 20.7% de los niños/as asistió a ocho consultas del niño sano en su primer año, 13.0% recibió evaluación de DIT, 75.0% recibe apoyo al aprendizaje, 23.4% cuenta con libros y 57.7% sufre disciplina violenta. Mejores niveles de lenguaje se asocian con las capacidades económicas, escolaridad materna, asistencia a preescolar, apoyo al aprendizaje y acceso a libros. Los niños/as expuestos a más factores protectores presentan nivel de lenguaje 1.5 DE mayor que en niños/as con más factores de riesgo. CONCLUSIONES: Se requiere aumentar la cobertura de atención al DIT y mejorar las oportunidades de desarrollo en hogares.

[Trends in vaccination coverage among children aged 12-23 and 24-35 months in Mexico. Ensanut 2012 and Ensanut 100]. / Tendencias en las coberturas de vacunación en niños de 12 a 23 y 24 a 35 meses en México.

OBJECTIVE: To evaluate and compare vaccination coverage among children aged 12-23 and 24-35 months living in localities with less than 100 000 inhabitants in Encuesta Nacional de Salud y Nutrición (Ensanut) 2012 and Ensanut 100k (2018). MATERIALS AND METHODS: Estimate of coverage with both surveys. RESULTS: Between 2012 and 2018, according to proof and self-report, the coverage of the basic scheme was maintained in children aged 12-23 (51.6 vs. 60.2%) and 24-35 months (51.4 vs. 50.0%). Similarly, only with proof (53.9 vs. 51.3% and 52.8 vs. 44.2%). In children aged 24-35 months, the coverage of the reinforced basic scheme reinforcements with probative document and self-report (30.9 vs. 34.0%) and only with reinforcements (30.2 vs. 27.8%) was maintained. Coverage with second and third doses of hepatitis B in both age groups decreased; additionally, first dose of measlesmumps-rubella vaccine (SRP, in Spanish) and third dose of Pentavalent in children aged 24-35 months. CONCLUSIONS: Coverages were maintained by schemes, despite reductions in hepatitis B, pentavalent and SRP.

OBJETIVO: Comparar coberturas de vacunación en niños de 12-23 y 24-35 meses de edad de localidades menores de 100 000 habitantes en México, entre 2012 (Encuesta Nacional de Salud y Nutrición Ensanut] 2012) y 2018 (Ensanut 100k). MATERIAL Y MÉTODOS: Estimación de coberturas con ambas encuestas. RESULTADOS: Entre 2012 y 2018, se mantuvo la cobertura del Esquema básico, con comprobante y autorreporte, en niños de 12-23 (51.6 vs. 60.2%) y 24-35 meses (51.4 vs. 50.0%), y sólo con comprobante (53.9 vs. 51.3% y 52.8 vs. 44.2%). Se mantuvo la cobertura del Esquema básico más refuerzos en niños de 24-35 meses, comprobante y autorreporte (30.9 vs. 34.0%) y sólo con comprobante (30.2 vs. 27.8%). Disminuyeron las coberturas con segunda y tercera dosis de hepatitis B en niños de 12-23 y 24-35 meses, y con primera dosis de triple viral (SRP) y tercera de pentavalente en niños de 24-35 meses. CONCLUSIONES: Se mantuvieron las coberturas del Esquema básico y Esquema básico más refuerzos aunque disminuyeron las coberturas con hepatitis B, pentavalente y SRP.

Detection and care practices for postpartum depressive symptoms in public-sector obstetric units in Mexico: Qualitative results from a resource-constrained setting.

BACKGROUND: Postpartum depression (PPD) is amenable to detection and treatment, but effectively addressing it is contingent on policies, practices, and health care providers working together to address the issue. The aim of this study is to describe a sample of health care providers' existing practices in public-sector obstetric units in Mexico related to detecting and offering care to women with depressive symptomology. METHODS: Semi-structured interviews with 40 health care providers (16 physicians, 13 nurses, three social workers, and eight psychologists) from one tertiary-level and two secondary-level, public-sector obstetric units, were conducted by members of a trained research team from May to July 2012. Qualitative data were analyzed in Spanish according to Grounded Theory, using Nvivo 10 software. RESULTS: Lack of hospital guidelines, training, and time constraints are reasons given for not detecting PPD symptoms among women. Providers reported that their role is cursory and limited to giving women anticipatory guidance for what to expect emotionally after childbirth or providing a trusting atmosphere for women to express their feelings. Care is fragmented and inadequate, in part because of the lack of protocols that define who makes mental health referrals and where. Providers indicated PPD is important but not prioritized in health care for pregnant and postpartum women. CONCLUSION: Critical needs in obstetric units include formal mental health care detection and care protocols during the perinatal period, strategies to address mental health needs despite short hospital stays, and training for providers on how to implement detection and care protocols and strategies.

Poor early childhood outcomes attributable to maternal depression in Mexican women.

We aimed to estimate the population fraction of poor early child health and developmental outcomes attributable to maternal depressive symptoms (DS) contrasting it between low- and middle/high-income households. We used a nationally representative probabilistic sample of 4240 children younger than 5 years old and their mothers, derived from the Mexican National Health and Nutrition Survey Data (ENSANUT 2012). Complex survey design, sampling, and analytic weights were taken into account in analyses. DS was measured by CESD-7. Child outcomes were as follows: breastfeeding, attending well-child check-ups, respiratory disease, diarrhea and general health problems, immunization, accidents, growth, obesity, and food insecurity. Prevalence of DS among mothers was 21.36%. In low-SES households, DS was associated with higher risk of never being breastfed (RR = 1.77; p < .05), health problems (RR = 1.37; p < .05), acute respiratory disease (RR = 1.51; p < .05), accidents requiring child hospitalization (RR = 2.16; p < .01), and moderate or severe food insecurity (RR = 1.58; p < .001). In medium- or high-SES households, DS was associated with higher risk of never attending a developmental check-up (RR = 2.14; p < .05) and moderate or severe food insecurity (RR = 1.75; p < .01). Population risks attributable to DS ranged from 2.30 to 17.45%. Prevention of DS could lead to reduction of problematic early childhood outcomes in both low and medium/high SES.

Severe functional difficulties and disabilities in children and adolescents and the Sustainable Development Goals.

OBJECTIVE: To report prevalence of severe child functional difficulties and disability (CFD) in a nationally representative sample of 2 to 17 year-old children in Mexico and describe the inequities faced by children with CFD in relation to a set of Sustainable Development Goals (SDG)-related outcomes. MATERIALS AND METHODS: Using data from the National Survey of Children and Women (ENIM 2015) we estimate prevalence with 95% confidence intervals for the selected indicators. We use chi-square test and confidence intervals inspection to report significant differences between children with and without CFD. RESULTS: 8% of children present at least one CFD. CFD is associated with higher prevalence of underweight and child labor and lower prevalence of adequate early child development. Conclusion. Children with CFD present worst outcomes and require targeted efforts to ensure they meet health and wellbeing targets in the frame of the SDGs.

[Contraception in Mexican adolescents in upper secondary schools: use and unmet needs]. / Anticoncepción en adolescentes mexicanos de escuelas del nivel medio superior: uso y necesidades insatisfechas.

OBJECTIVE: To describe sexual behavior and contraceptive use in adolescent students. MATERIALS AND METHODS: National representative survey in upper secondary schools in Mexico 2014. Logistic regressions identify the factors associated with contraceptive use and unmet needs for contraception (UNC). RESULTS: For male adolescents, non-contraceptive use in the last sexual relation is associated with non-contraceptive use in the sexual debut (OR=11.5; IC95%:5.6,23.4) and not recognizing effective contraceptive methods (OR=2.4;IC95%:1.04,5.5). For female adolescents, non-contraceptive use is associated with non-contraceptive use in sexual debut (OR=4.5;IC95%:2.3,8.4) and low self-efficacy towards condom use and negotiation (OR=3.1; IC95%:1.1,8.2). UNC were associated with insecure attitudes towards condom use and negotiation (OR=3.5;IC95%:1.3,9.4), non-contraceptive use in sexual debut (OR=9.0;IC95%:2.5,32.4) and use of alcohol or drugs during sexual relations (OR=3.0;IC95%:1.1,8.1). CONCLUSIONS: Strategies to ensure contraceptive use from sexual debut onwards are required, promoting self-efficacy and safe sex practices among adolescents.

OBJETIVO: Describir el comportamiento sexual y el uso de anticonceptivos en adolescentes escolarizados. MATERIAL Y MÉTODOS: Encuesta representativa nacional en escuelas de educación media superior en México, realizada en 2014. Modelos logísticos identifican factores asociados al uso de anticonceptivos y a necesidades insatisfechas de anticoncepción (NIA). RESULTADOS: Entre los hombres, no emplear anticonceptivos en la última relación sexual se asocia con la no utilización de éstos durante el debut sexual (RM=11.5; IC95% 5.6-23.4) y desconocer anticonceptivos efectivos (RM=2.4; IC95% 1.04-5.5). Entre las mujeres, no emplear anticonceptivos se asocia con el no uso de éstos durante el debut sexual (RM=4.5; IC95% 2.3-8.4) y la falta de autoeficacia en el uso/negociación del condón (RM=3.1; IC95% 1.18.2). Las NIA se asocian con baja autoeficacia respecto al uso/negociación del condón (RM=3.5; IC95% 1.3-9.4), no usar anticonceptivos en el debut sexual (RM=9.0; IC95% 2.5-32.4) y usar alcohol o drogas en relaciones sexuales (RM=3.0; IC95% 1.1-8.1). CONCLUSIONES: Se requieren estrategias que garanticen el uso de anticonceptivos desde el debut sexual y que promuevan la autoeficacia y las prácticas seguras entre los adolescentes.

Population profiles associated with severe functional difficulties and disability among 5-17 years-old children in México.

OBJECTIVES: To report the prevalence of severe functional difficulties and disability (SFD) in a nationally representative sample of children ages 5 to 17 in Mexico, to identify factors associated with SFD, and population profiles predictive of SFD. MATERIALS AND METHODS: Using data from the National Survey on Children and Women we estimated prevalence and 95% confidence intervals of SFD and risk factors. We fitted bivariate and multivariate logistic regression models. We then examined which combinations of the sociodemographic factors best predicted SFD. RESULTS: The prevalence of SFD was 11.2%. The most prevalent SFD were on the socioemotional dimension (8.3%). The associated risk factors in the three dimensions were: living in a poor household, being a boy, having a mother with basic education or less, and non-indigenous background or living in an urban area. CONCLUSIONS: Identifying groups of the population at higher risk for SFD provides useful information for targeted intervention implementation.

[Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools]. / Educación sexual integral: cobertura, homogeneidad, integralidad y continuidad en escuelas de México.

OBJECTIVE:: To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. MATERIALS AND METHODS:: Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. RESULTS:: The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. CONCLUSIONS:: CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age.

OBJECTIVE: To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. MATERIALS AND METHODS: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. RESULTS: While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. CONCLUSIONS: Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics.

OBJECTIVE: Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability. MATERIALS AND METHODS: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. RESULTS: Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. CONCLUSIONS: This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico.

OBJECTIVE: To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD) among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. MATERIALS AND METHODS: The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM). We used post-estimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. RESULTS: CFD prevalence is 2%, which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. CONCLUSIONS: A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

Provider report of the existence of detection and care of perinatal depression: quantitative evidence from public obstetric units in Mexico.

OBJECTIVE: To provide evidence on perinatal mental healthcare in Mexico. MATERIALS AND METHODS: Descriptive and bivariate analyses of data from a cross-sectional probabilistic survey of 211 public obstetric units. RESULTS: Over half (64.0%) of units offer mental healthcare; fewer offer perinatal depression (PND) detection (37.1%) and care (40.3%). More units had protocols/guidelines for PND detection and for care, respectively, in Mexico City-Mexico state (76.7%; 78.1%) than in Southern (26.5%; 36.4%), Northern (27.3%; 28.1%) and Central Mexico (50.0%; 52.7%). CONCLUSION: Protocols and provider training in PND, implementation of brief screening tools and psychosocial interventions delivered by non-clinical personnel are needed.

[Methodological bases and implementation results of Mexico's National Survey of Children and Women 2015]. / Bases metodológicas y resultados de la implementación de la Encuesta Nacional de Niños, Niñas y Mujeres en México 2015.

OBJECTIVE:: To describe the methodology and the implementation survey results from National Survey of Children and Women Mexico's (ENIM 2015). MATERIALS AND METHODS:: The ENIM 2015 is a probability survey with multistage, stratified and cluster sample, with regional, rural and urban strata, and indigenous population representation.We applied questionnaires to get information from the household, women aged 15 to 49 years, children under five years and children and adolescents aged 5-17 years. RESULTS:: The response rate for households and women was 94%, obtaining information from 10 760 households and 12 110 women; while for children and adolescents and children under five years was 98%, 11 607 and 8 066, respectively. CONCLUSION:: The ENIM 2015 probabilistic design allows generate indicators that can be stratified into five regions, rural and urban strata and from indigenous population, as well as a baseline for 15 indicators of the ODS.