The Impact of Major Earthquakes on Students' Emotional Distress and Internalizing Symptoms, Externalizing Behaviors, and Coping During the Implementation of keepin' it REAL-Mexico.

This article reports on effects of two earthquakes in Mexico on adolescents attending middle school. The earthquakes struck in close succession during the implementation of a school-based prevention program, providing an opportunity to assess emotional distress due to the earthquakes and whether the life skills taught in the program affected how students coped with the natural disaster. The objectives were to (1) evaluate the earthquakes' impact on students' distress; (2) assess if distress is associated with internalizing symptomology and externalizing behaviors; and (3) investigate if students receiving the original and adapted versions of the intervention coped better with the events. A Mexico-US research team culturally adapted keepin' it REAL to address connections between substance use among early adolescents in Mexico and exposure to violence. A random sample of public middle schools from three cities (Mexico City, Guadalajara, and Monterrey), stratified by whether they held morning or afternoon sessions, was selected. A total of 5522 7th grade students from 36 schools participated in the study. Students answered pretest and posttest questionnaires; the latter assessed earthquake-related distress and coping strategies. Earthquake-related distress was associated with all measures of undesired internalizing symptomology and externalizing behaviors. Compared to controls, students in the adapted intervention reported less aggressive and rule-breaking externalizing behavior and less violence perpetration. However, these intervention effects were not moderated by the level of earthquake-related distress, and they were not mediated by positive or negative coping. The findings have implications for prevention intervention research and policy as natural and human-made disasters occur more often.

Migration Intentions and Alcohol Use Among Adolescents in West-Central Mexico.

This study explores the association between migration intentions and alcohol use among west-central Mexico adolescents living in high migration communities. This study used the baseline data from the Family Migration and Early Life Outcomes (FAMELO) project (N = 1286), collected in 2018. We used multiple imputations to address missingness and propensity score matching to reduce the selection bias. We also conducted subgroup analyses to compare gender difference (i.e., boys vs. girls) on the relationship between migration intention and alcohol use. The findings show that for the whole sample, youth with migration intentions had significant higher odds (OR = 1.78; p = .010) of having a lifetime drinking experience when compared to youth who reported no interest in living abroad, but this association remained significant only for boys (OR = 2.14; p = .010). This study makes an important contribution to our understanding of the etiology of migration intentions and alcohol use for adolescents living in sending migration communities. The findings have specific alcohol prevention, policy, and future research implications in Mexico and the U.S.

Use of Violence as a Strategy of Early Adolescents for Rejecting Drug Offers in Mexican Cities.

Drug use and violence are two interconnected problems in violent urban contexts, leading to coercive drug offers. In this study, relationships between drug use, use of violence as a strategy for rejecting drug offers, and exposure to neighborhood violence were analyzed in Mexican students. Data were obtained through a self-report survey and focus groups with lower secondary students in three Mexican metropolitan areas. Both quantitative and qualitative results indicated that students who had used or would use violence as a strategy for rejecting drug offers presented a more problematic psychosocial profile, with exposure to neighborhood violence as the main predictor. These results suggest that Mexican students in violent cities may resort to violence as a strategy for rejecting drug offers.

El consumo de drogas y la violencia son dos problemas interconectados en contextos urbanos violentos y generan ofrecimientos de drogas coercitivos. En este estudio se analizaron las relaciones entre el consumo de drogas, el uso de violencia como una estrategia para resistir ofrecimientos de drogas y la exposición a violencia en el barrio entre estudiantes mexicanos. Se obtuvieron los datos mediante una encuesta de autoinforme y grupos de discusión centrada con estudiantes de educación secundaria en tres áreas metropolitanas de México. Tanto los resultados cuantitativos como los cualitativos indicaron que aquellos estudiantes que habían usado o usarían violencia como una estrategia para resistir ofrecimientos de drogas presentaban un perfil psicosocial más problemático, con la exposición a violencia en el barrio como el principal predictor. Estos resultados sugieren que los estudiantes mexicanos en ciudades violentas pueden recurrir a la violencia como una estrategia para resistir ofrecimientos de drogas.

The Feasibility, Acceptability, and Utility of Mantente REAL: the Culturally Adapted Version of keepin' it REAL for Mexico.

A binational team of investigators culturally adapted, implemented, and tested the efficacy in Mexico of keepin' it REAL, a US-designed prevention intervention for youth. This article reports on the social validity of the adapted intervention by assessing its feasibility, acceptability, and utility, as perceived by participating middle school students, teachers/implementers, and school administrators. Middle schools (N = 36) were randomly assigned to (1) the culturally adapted version for Mexico (Mantente REAL), (2) the original intervention from the USA (keepin' it REAL) translated into Spanish, or (3) a control condition (treatment as usual). Adult and child feedback about the adapted and original versions of the intervention indicate that both are feasible to implement in the Mexican context. Implementation fidelity was equally high for both versions of the manualized intervention. Students, however, were more satisfied with the culturally adapted version than with the non-adapted version. They reported gaining more knowledge, finding it more acceptable, applicable, and authentic, and they reported discussing the program with their family and friends more often. The findings support the feasibility of engaging classroom teachers to implement manualized prevention programs in Mexico. These findings also advance prevention science by documenting the importance of cultural adaptation as a means to increase students' identification with and acceptability of efficacious school-based interventions. The article discusses the practice, policy, and future prevention research implications of the findings for Mexico and their potential generalizability to other middle- and lower-income countries.

Keepin' It REAL-Mantente REAL in Mexico: a Cluster Randomized Controlled Trial of a Culturally Adapted Substance Use Prevention Curriculum for Early Adolescents.

This study assesses the efficacy of a version of the keepin' it REAL (kiREAL) substance use prevention curriculum for middle school students that was culturally adapted for Mexico, renamed Mantente REAL (MREAL), and tested in a cluster randomized controlled trial in Mexico's three largest cities. Student participants were in 7th grade in public middle schools (N = 5523, 49% female, mean age = 11.9). A representative sample of 12 schools from each city, stratified by whether they held morning or afternoon sessions, was randomized to three conditions: culturally adapted MREAL, original kiREAL translated into Spanish, or a treatment-as-usual control group. Regular classroom teachers were trained to deliver the adapted MREAL or the kiREAL manualized curricula. Students with active parental consent completed pretest and post-test questionnaires, 7-8 months apart, at the beginning and end of the 2017-2018 academic year. We assessed the MREAL intervention, relative to kiREAL and controls, with general linear models adjusted for baseline, attrition (24%), non-normal distributions, stratification by city, and school-level clustering. Among students already using the substance more often at pretest, MREAL students had relatively more desirable outcomes, compared to kiREAL and/or to controls, in recent use of alcohol, cigarettes, "hard drugs," heavy episodic drinking, and intoxication. MREAL students reported relatively less violence victimization and perpetration of bullying and relatively more use of three of the intervention's REAL drug resistance strategies (Explain, Avoid, Leave). The adapted version of kiREAL for Mexico showed numerous desired outcomes in areas deliberately targeted in the cultural adaptation. Full protocol can be accessed through Clinical Trials.gov. ID: NCT03233386, "'Keepin' It REAL in Mexico: An adaptation and multisite RCT".

Reciprocal Effects of Alcohol Use and Violence Perpetration Among Early Adolescents in Mexico: A Gendered Analysis.

Although substance use and violent behaviors often emerge together in adolescence, and both have similar widely cited causes and negative consequences for development, it remains unclear whether and how they may be linked causally. This study of early adolescents in Mexico's three largest cities tested whether alcohol use and violence perpetration are temporally related, whether their relationship is unidirectional or reciprocal, and whether the relationship differs by gender and the type of violence. The study employed longitudinal data from seventh grade students (N = 4830; M age = 12.0, range 11-15; 49% female) in 18 public middle schools in Mexico City, Guadalajara and Monterrey. Students completed questionnaires at the beginning, middle, and end of the 2014-2015 academic year. Students' responses to a multi-dimensional violence assessment emerged in two distinct patterns: criminally violent acts, and bullying/aggression. Although males engaged in both types of violence more frequently than females at all three time points, they used alcohol more frequently than females only at the first survey, after which the gender gap disappeared. Cross-lagged multi-group path models showed that, for both males and females, more frequent alcohol use predicted subsequent increases in criminally violent behavior, and bullying/aggression predicted later increases in alcohol use. Reciprocal associations varied by gender and type of violence: Alcohol use was reciprocally linked to criminally violent behavior among males only, and reciprocally linked to bullying-aggression among females alone. The results are interpreted in the context of sharply increasing rates of violence in Mexico and changing gender norms, with implications for youth prevention programs.

Factores Psicológicos y Relaciónales Asociados a Episodios de Embriaguez en Adolescentes Escolares de Guadalajara, México / Psychological and Related Factors Associated with Drunkenness Episodes in Adolescent Students in Guadalajara, Mexico / Fatores Psicológicos e Relações Associados a Episódios de Embriaguez em Adolescentes Escolares de Guadalajara, México

Resumen El objetivo de este estudio fue asociar factores psicológicos y relaciónales vinculados a episodios de embriaguez en 1134 adolescentes escolares de Guadalajara, México. Se evaluaron diez factores psicológicos y relacionales. La variable de desenlace fue episodios de embriaguez durante el último mes. Se encontró una prevalencia de embriaguez de 26.5% con mayor consumo en hombres. Después del análisis de regresión logística los factores asociados a embriaguez fueron tabaquismo, alta autoestima, alta impulsividad, bajo locus de control interno, la presencia de estrés cotidiano y relación distante con el padre. La investigación concluye que los factores psicológicos y relacionales asociados a episodios de embriaguez hicieron referencia a un perfil de omnipotencia altamente influenciable, y al desapego emocional, por lo que el consumo excesivo de alcohol parece perfilarse como una estrategia de seguridad.

Abstract The aim of this study was to identify psychological and related factors linked with drunkenness episodes in 1134 adolescent students in Guadalajara, Mexico. The study evaluated ten psychological and related factors. The outcome variable was the number of episodes of drunkenness in the last month. We found 26.5% more episodes of drunkenness in men. A logistic regression analysis indicated that factors associated with drunkenness were smoking, high self-esteem, high impulsiveness, low self-control, presence of daily stress and distant relationship with father. The study concluded that the psychological and related factors associated with drunkenness episodes were related to a highly impressionable omnipotence profile and emotional indifference, with excessive consumption of alcohol as a safety strategy.

Resumo O objetivo deste estudo foi associar fatores psicológico e relações vinculados a episódios de embriaguez em 1134 adolescentes escolares de Guadalajara, México. Avaliaram-se dez fatores psicológicos e relacionais. A variável de desenlace foi episódios de embriaguez de 26.5 % com maior consumo em homens. Depois da análise de regressão logística, os fatores associados à embriaguez foram tabaquismo, alta autoestima, alta impulsividade, baixo lócus de controle interno, presença de estresse cotidiano e relação distante com o pai. A pesquisa conclui que os fatores psicológicos e relacionais associados a episódios de embriaguez fizeram referência a um perfil de onipotência altamente influenciável e ao desapego emocional; nesse sentido, o consumo excessivo de álcool parece perfilar-se como uma estratégia de segurança.

Traditional gender roles and substance-use behaviors, attitudes, exposure, and resistance among early adolescents in large cities of Mexico.

This study investigated the associations between traditional gender roles (TGRs) and substance use among early adolescents in Mexico's largest cities. The sample of seventh grade students (n = 4,932) attended 26 public schools in Mexico City, Guadalajara, or Monterrey in 2014. Outcomes included recent alcohol, binge drinking, cigarette and marijuana use, and lifetime poly-substance use; substance-use intentions, norms, attitudes, and expectancies; and substance-use exposure (peer use, offers) and resistance (refusal confidence, refusal skills, and decision-making skills). A TGR scale assessed endorsement of a polarized gender division of family labor and power. As hypothesized, among males, TGRs were consistently associated with poorer outcomes, and this association was usually stronger for males than for females. In contrast, among females there was no evidence that TGRs were associated with desirable outcomes. Contrary to expectations, TGRs predicted poorer outcomes for both females and males, and to equivalent degrees, for binge drinking, cigarette use, positive substance-use expectancies, and friends' approval of substance use, and they predicted poorer outcomes for females but not for males on parental disapproval of substance use and drug-resistance skills. Interpretations highlight the persisting aspects of TGRs in the family and conflicting messages for females as Mexico undergoes changes in its gender order.

Long-term effects of the keepin' it REAL model program in Mexico: substance use trajectories of Guadalajara middle school students.

In the face of rising rates of substance use among Mexican youth and rapidly narrowing gender differences in use, substance use prevention is an increasingly urgent priority for Mexico. Prevention interventions have been implemented in Mexico but few have been rigorously evaluated for effectiveness. This article presents the long term effects of a Mexico-based pilot study to test the feasibility of a linguistically specific (Mexican Spanish) adapted version of keepin' it REAL, a school-based substance abuse prevention model program. University affiliated researchers from Mexico and the US collaborated on the study design, program implementation, data collection, and analysis. Students and their teachers from two middle schools (secundarias) in Guadalajara participated in this field trial of Mantente REAL (translated to Spanish). The schools were randomly assigned to treatment and control conditions. The sample of 431 students reported last 30 day substance use at three times (one pretest and two posttests). Changes in substance use behaviors over time were examined using growth curve models. Long term desired intervention effects were found for alcohol and marijuana use but not for cigarettes. The intervention effects were greater for girls than for boys in slowing the typical developmental increase over time in alcohol use. Marijuana effects were based on small numbers of users and indicate a need for larger scale studies. These findings suggest that keepin' it REAL is a promising foundation for cultural program adaptation efforts to create efficacious school-based universal prevention interventions for middle school students in Mexico.

The association between engaging in romantic relationships and Mexican adolescent substance use offers: exploring gender differences.

Gender differences in alcohol, tobacco, and other drugs use in Mexico are rapidly disappearing. This study explores the possible relationship between engaging in romantic relationships on substance use offers and the moderating effects of gender among a group of adolescents (N = 432) living in Guadalajara, Jalisco, Mexico. The data used to test these relationships were collected through self-administered surveys in 2010. OLS regressions were estimated, predicting substance offers. The results demonstrate an association between having been in a relationship and receiving substance use offers in the previous 12 months. Having had a boyfriend/girlfriend had a significant influence on the offers received by adolescent females, but not for males.

Short-term effects on substance use of the keepin' it real pilot prevention program: linguistically adapted for youth in Jalisco, Mexico.

This article presents the short-term effects of a pilot study of keepin'it REAL (Manténte REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students' regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin'it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin'it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin'it REAL in partnership with Mexican investigators and communities may be warranted.

Drug resistance and substance use among male and female adolescents in alternative secondary schools in Guanajuato, Mexico.

OBJECTIVE: Research is limited on the strategies that Mexican adolescents use to resist use of alcohol, cigarettes, and other drugs. Cultural norms and gender socialization patterns concerning the acceptability of use of various substances by women and men influence Mexican youths in their responses to offers of substances. This study explored the drug-resistance strategies used by youth in the central Mexican state of Guanajuato, how their use predicted patterns of substance use, and how these associations differed by gender. METHOD: The analysis used cross-sectional survey data from 702 (60% male) students enrolled in eight alternative secondary education school sites in 2007. Participants reported the drug-resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Past-12-month use of the four drug-resistance strategies employed most often by U.S. youth-refuse, explain, avoid, and leave (R.E.A.L.)-and any other strategies were measured. Composite measures of lifetime and recent use of alcohol, cigarettes, and marijuana were predicted in multivariate ordinary least squares regression analyses. Models were tested with and without controls for the frequency that respondents were offered substances and introduced gender interaction effects. RESULTS: Controlling for substance use offers, more frequent use of a wide repertoire of R.E.A.L. strategies predicted less consumption of alcohol and cigarettes, and using non-R.E.A.L. strategies predicted less marijuana consumption. All of these relationships were either stronger for males than for females or significant for males only. CONCLUSIONS: Gender differences exist in the impact of R.E.A.L. strategies on substance use among youth in Mexico. Despite a narrowing gender gap in substance use in Mexico, large exposure to and susceptibility of substance use remains. Developing effective prevention programs in Mexico based on teaching appropriate drug-resistance strategies and enhancing communication skills could aid in reducing substance use among Mexican adolescents.

Gender differences in drug resistance skills of youth in Guanajuato, Mexico.

Research is limited or absent on Mexican adolescents' exposure to substance offers, ways of dealing with these offers, and possible gender differences in responses to offers. Extending U.S.-based research, this study examines how youth living in the Mexican state of Guanajuato employ the four drug resistance strategies-refuse, explain, avoid, and leave-that are part of the Keepin' It REAL evidence-based drug prevention intervention. The analysis uses cross-sectional survey data from 702 students enrolled in eight alternative secondary education sites in 2007. Participants reported the drug resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Using multivariate regression, findings indicate most youth had developed repertoires of drug resistance strategies that involved multiple REAL strategies and some other strategy as well. For those receiving offers, the most common strategy was to refuse the offer with a simple "no." However, males used all the strategies significantly more often than females for situations involving cigarettes and marijuana as well as when using refuse and non-REAL strategies for alcohol. Possible reasons for the gender difference in use of strategies are discussed. The findings can help inform effective prevention programs based on teaching culturally appropriate drug resistance and communication skills.

[Research in adolescence and youth at the Instituto Mexicano del Seguro Social]. / Investigación en adolescencia y juventud en el Instituto Mexicano del Seguro Social.

Objective: to determine the proportions, types and research areas of studies on young people by the Mexican Institute of Social Security (IMSS) from 1997 to 2006. Methods: we reviewed 4299 published summaries of health national forums sponsored by the IMSS. Results: a total of 274 (6.4 %) studies were found to deal with young people. Their distribution in research areas was as follows: 43 % focused on epidemiology, 33 % clinical medicine, 14 % social issues, 8 % health services, 1 % basic research, and 1 % work and education-related. The study design most often used were: descriptive, 40 %; correlational, 17 %; comparative, 12 %; qualitative, 8.5 %; case- control, 5.5 %; cohort, 5 % and quasiexperimental, 5 %. Of the studies, 57 % were conducted in a research center, and the rest at the hospital or family medicine clinic. In terms of topic areas, the studies were highly varied, with the most frequent ones being: reproductive health, 14 %; oncology, 10 %; addictions, 9 %; and mental health, 7 %. Conclusions: the proportion of research projects carried out by the IMSS involving young people from 1997 to 2006 was 6.3 %. The most frequent style of study was descriptive, and the most common focus was on epidemiological questions.

Objetivo: determinar proporción, tipo y campo de investigación de los estudios que incluyen adolescentes y jóvenes en Instituto Mexicano del Seguro Social entre 1997 y 2006. Métodos: se revisaron 4299 resúmenes publicados en las memorias de los foros nacionales de investigación en salud del Instituto Mexicano del Seguro Social en la década señalada. Resultados: se encontraron 274 (6.3 %) estudios relacionados con niños y adolescentes: 43 % de investigación epidemiológica, 33 % investigación clínica, 14 % investigación social, 8 % servicios de salud, 1 % básica y 1 % laboral y educativa. En cuanto al diseño, 40 % fue descriptivo, 17 % correlacional, 12 % comparativo, 8.5 % cualitativo, 5.5 % casos y controles, 5 % cohorte, 5 % cuasiexperimental y 7 % de otro tipo; 57 % se realizó en unidades y centros de investigación y el resto en unidades hospitalarias y de medicina familiar. En cuanto a la temática, 14 % de salud reproductiva, 10 % oncología, 9 % adicciones y 7 % salud mental. Conclusiones: en el Instituto Mexicano del Seguro Social, la proporción de trabajos de investigación que incluyó adolescentes y jóvenes entre 1997 y 2006 fue de 6.3 %. Los estudios descriptivos y el campo epidemiológico fueron los más comunes.

[Strategies of adolescents according to gender to quit their smoking habit]. / Estrategias de adolescentes según género para cesar su hábito tabáquico.

Objective: to explore and analyze tobacco smoking cessation strategies and identify differences by gender in adolescents. Methods: exploratory study with 62 regular tobacco smoking students from a public high school University of Guadalajara. Free lists were used for data collection. Results: seventy-nine percent of the students had tried to quit tobacco-smoking. Strategies used were focused on volition (53.5 %), substitution (16.3 %), avoiding hanging with smokers (12.8 %), reflexive thinking (10.5 %) and a progressive reducing tobacco smoking (7 %). Differences were found in strategies used by men and women: while the women used a higher rate of reflexive thinking and substituted tobacco smoking by ingesting calories, men avoided hanging out with smokers and substituted tobacco smoking with burning energy strategy. Tobacco smoking reduction was reported as the most efficient strategy. Conclusions: tobacco smoking cessation strategies derived from a cultural notion of tobacco as a vice where the most important issue was making the decision and using one's own resources. To stop smoking tobacco came out as a health need which should be attended by health care services.

[Between clumping and stiffness; family structure of two generations of young people with anorexia or bulimia]. / Entre el aglutinamiento y la rigidez; estructura familiar de dos generaciones de jóvenes con anorexia o bulimia.

Objective: to characterize the structure of two generations with the narrative story of women with anorexia or bulimia. Methods: descriptive, qualitative-type retrospective study. Information was gathered from a genogram of two generations, and focused on tape-recorded interviews with eight young women being treated for anorexia or bulimia. Results: the family structure of both generations was characterized by rigid pattern expressed in a controlled and inflexibility behavior to assume changes displayed in overprotective manners. Contemporary family patterns showed closer bonds between fathers and daughters, and lesser bonds and more rigidity between mothers and daughters. The grandparents' generation did not use health services for attention of eating disorders. Conclusions: bonding and rigidity were the main characteristics of the family structure in both generations. It suggests that these structural patterns are transfered from one generation to the next.

Objetivo: caracterizar la estructura familiar de dos generaciones en mujeres con anorexia o bulimia. Métodos: estudio cualitativo a través de la construcción de un genograma de dos generaciones, entrevistas semiestructuradas y audiograbadas a ocho mujeres jóvenes con tratamiento por anorexia o bulimia. El análisis de los datos fue a través de teoría fundamentada. Resultados: la estructura familiar de ambas generaciones estuvo caracterizada por pautas rígidas expresadas en control e inflexibilidad para asumir cambios, y aglutinamiento manifestado en conductas sobreprotectoras. Las pautas de la familia contemporánea fueron más aglutinadas entre padres-hijas y desligadas y rígidas entre madres-hijas. Conclusiones: el aglutinamiento y rigidez fueron las principales características de la estructura familiar de ambas generaciones. Todo parece indicar que estas pautas estructurales se transmiten de una generación a otra.

[Changes in risk behaviors according to gender in a cohort of high school students]. / Cambios de comportamientos de riesgo según género en una cohorte de estudiantes de preparatoria.

Objective: to analyze changes on risk behavior (RB) by gender in an adolescent student's cohort. Methods: online questionnaire based on YRBSS of CDC with 36 RB was applied in two periods (2003, 2005) to 115 students aged 15 to 19 from High School. Statistics: McNemar and binomial. Results: significant decrease in relation to RB frequency about suicide (general), carry weapons (general and men) and friends fights (general and women), significant increase of RB frequency about alcohol consumption (general and both genders), not quitting (men), non vegetable consumption (general), not condom use (general and women) not using contraceptives (general and women) and alcohol and drugs consumption in car (general). With inadequate exercise and there were contrary trends; with drugs use and sexual violence there was no change. Conclusions: adolescents from both genders start High School with similar profile of wide frequency of RB in both genders, there were only nine significant changes, and six did not have. Few changes by gender were observed, there was an increase in unsafe sex practices and alcohol consumption in women.

Objetivo: analizar el cambio de comportamientos de riesgo y género en estudiantes de 15 a 19 años de edad de una escuela preparatoria. Métodos: en 2003 y 2005 se aplicó un cuestionario en línea, voluntario y confidencial, a 115 estudiantes, basado en Youth risk behavior surveillance system del Center for Disease Control and Prevention con 36 indicadores. El análisis estadístico se llevó a cabo con pruebas de McNemar y binomial. Resultados: disminución significativa de comportamientos de riesgo en suicidio (muestra total), portación de armas (total y hombres) e involucramiento en peleas (total y mujeres), y aumento significativo en necesidad y consumo de alcohol (total y ambos sexos), no dejar de fumar (hombres), no consumir verduras (total), no usar condón (total y mujeres), no usar anticonceptivos (total y mujeres), y consumir alcohol o drogas en vehículos (total). En ejercicio inadecuado hubo tendencias contrarias; en consumo de drogas y violencia sexual no hubo cambios. Conclusiones: se ingresó con amplio rango de frecuencia de comportamientos de riesgo en ambos sexos; hubo nueve cambios significativos (25 %), dos tercios negativos. Preocupa el incremento de los comportamientos de riesgo en sexo inseguro y consumo de alcohol en mujeres.

[Perception of emotional violence in school adolescents: differences in the narrative by gender]. / Percepción de la violencia emocional en adolescentes escolares: diferencias en la narrativa por género.

Objective: to describe the perception of emotional violence (EV) in adolescent students and to analyze differences by gender. Methods: ninety-seven adolescents from a secondary school were included. Data was obtained from audio-recorded interviews on separate focal groups strategy in men and women in which an incomplete projective case-history was used for evoking arguments. Results: a difference was found in the perception of the EV according to gender; the women included the family and masculine figures in the EV context. Men also included the social environment. The motives for EV in the women were attributed to deficient communication, addictions and power relationships with men. A high tolerance for EV was observed in women and a strong internal confrontation. Men showed less tolerance and lesser external confrontation. The women identified addictions and emotional disorders as being consequences of EV, and for men, addictions, criminality and emotional disorders. The parents were the supportive figures. Conclusions: a difference in gender was observed in the perception of the EV. A greater tolerance for EV was identified in female and a lesser perception of the risk for suffering in males.

Objetivo: caracterizar la percepción de los adolescentes sobre la violencia emocional según género. Métodos: se incluyeron 97 adolescentes de una secundaria de Arandas, Jalisco, México. Para la recolección de datos se realizaron entrevistas audiograbadas a grupos focales de hombres y mujeres por separado, en las que se utilizó una historia incompleta proyectiva como evocador del discurso. Resultados: las mujeres incluyeron a la familia y a figuras masculinas en el contexto de la violencia emocional, en tanto los hombres incluyeron, además, el entorno social. Los motivos de la violencia emocional fueron atribuidos a la comunicación defectuosa en mujeres, y adicciones y relaciones de poder en hombres. En las mujeres se observó alta tolerancia la violencia emocional y afrontamiento interno, en tanto los hombres mostraron menor tolerancia y un afrontamiento externo. Las mujeres identificaron como consecuencias las adicciones y trastornos emocionales, mientras que los hombres adicciones, delincuencia y trastornos emocionales. Las figuras de apoyo para ambos fueron los padres como medio para la búsqueda de apoyo profesional. Conclusiones: en las mujeres hubo mayor tolerancia hacia la violencia emocional y en los hombres menor percepción de riesgo.

Development of a Spanish-language version of the Shoulder Disability Questionnaire.

BACKGROUND: The Shoulder Disability Questionnaire (SDQ) is a validated shoulder functional scale that has not yet been translated into Spanish. OBJECTIVE: The objective of this study was to develop and test the consistency of a Spanish translation of The Netherlands version of the SDQ (NSDQ). METHODS: A backtranslation process was used to generate a Spanish version of the NSDQ, called the S-SDQ. Subsequently, both the NSDQ and S-SDQ were administered to 30 bilingual (English/Spanish) subjects. Finally, the S-SDQ was administered to 35 monolingual Spanish-speaking subjects with shoulder pain on 2 occasions. External consistency between NSDQ and S-SDQ scores in the bilingual subjects, and between scores for the 2 S-SDQ applications in the monolingual subjects was assessed using the intraclass correlation coefficient (Ri). Internal consistency of the S-SDQ was assessed with Cronbach's alpha coefficient. RESULTS: In the bilingual subjects, the Ri between the NSDQ and S-SDQ scores was 0.991 (95% confidence interval [CI], 0.981-0.995). In the monolingual Spanish-speaking patients with shoulder pain, the Ri between the 2 S-SDQ scores was 0.99 (95% CI, 0.997-0.999). The Cronbach's alpha coefficient for the S-SDQ was 0.99. CONCLUSIONS: A highly consistent Spanish version of the NSDQ, the S-SDQ, was developed. This can be confidently used in clinical care and research settings for measurement of the functional status of shoulder joint disorders in Spanish-speaking subjects.

[Rheumatic diseases and labor disability in adult rural population]. / Enfermedades reumáticas y discapacidad laboral en población adulta rural.

INTRODUCTION: The prevalence and the functional impact of the musculoskeletal diseases seem to have geographical variability. There is no previous report about those issues for the southern part of Mexico. OBJECTIVE: To assess the prevalence of musculoskeletal pain, rheumatic diseases and self-perceived work disability in adults of Cantamayec, Yucatán, Mexico. MATERIAL AND METHODS: We assessed the presence of musculoskeletal pain, and those who answered affirmatively underwent a clinical evaluation. Diagnostic criteria for rheumatoid arthritis, osteoarthritis, fibromyalgia, gout and soft-tissue pain syndromes were used. RESULTS: Musculoskeletal pain was found in 197/761 (25.8%), a defined rheumatic disease was diagnosed in 156 (20.4%) subjects. The prevalence of soft-tissue pain syndromes was 6.1%; followed by osteoarthritis, 5.8%; rheumatoid arthritis, 4.7%; back pain, 1.8%; fibromyalgia, 1.3%; and gout, 0.7%; self-perceived work disability was found in 144 (18.9%); it was ranked as total by 65 (8.5%) and partial by 79 (10.4%). CONCLUSIONS: Musculoskeletal pain, rheumatic diseases and self-perceived work disability were highly prevalent. Although rheumatoid arthritis prevalence was higher, the prevalence of other rheumatic diseases, musculoskeletal pain, and self-perceived work disability were similar to those previously reported in other countries and regions of Mexico.