Internalizing and externalizing behaviors in high school adolescents in a northern border city of Mexico and their type of family / Conductas internalizantes y externalizantes en adolescentes de una escuela preparatoria en una ciudad fronteriza al norte de México y su tipo de familia

Objective: Identify externalizing and internalizing behaviors in high school adolescents in three schools in a northern border city in Mexico and their type of family. Design: Cross-sectional survey. Location: Three schools in the city of Tijuana, Mexico: two public and one private. Participants: 454 baccalaureate students 14–19 years old. Main measurements: We utilized Youth Self Report Scale, adapted and validated in Spanish, that measure internalization behaviors (anxiety, depression, isolation or somatic complaints), and externalization behaviors (verbal aggressiveness, delinquent behavior and attention-seeking). For dichotomous discrimination between deviant and nondeviant scores, we use the borderline clinical range by classifying YSR scale's T scores≥60, and to analyze the relationship between behavior problems or competencies and living or not in a nuclear family we utilized multiple logistic regression. Results: 55% were female, mean age 16.4 years±0.98, and 62.3% came from a nuclear family. Prevalence of internalizing behaviors was 15.6%, and externalizing behaviors 14.8%. Women had statistically higher mean scores in depressive, anxious and verbally aggressive behavior, somatic complaints, and thought problems. The prevalence of internalizing behaviors in adolescents with nuclear family was 11.7% (n=33), and for adolescents with another type of family was 22.2% (n=38), OR 2.17 (CI 95% 1.30–3.61, p=0.003), but no differences was observed for externalizing behaviors and family type. When adjusted for sex, age, and public or private school, internalizing behaviors and specifically depressive behavior remained significant. Conclusions: We detected a moderate prevalence of internalizing behaviors in Mexican adolescents, predominantly among women, and also observed that not living with a nuclear family increases the odds of presenting internalizing behaviors...(AU)

Objetivo: Identificar conductas internalizantes y externalizantes en adolescentes de escuelas preparatorias en una ciudad fronteriza al norte de México y su tipo de familia. Diseño: Encuesta transversal. Emplazamiento: Tres escuelas de la ciudad de Tijuana, México: dos públicas y una privada. Participantes: 454 estudiantes de preparatoria de 14-19 años de edad. Principales mediciones: Se utilizó la escala Youth Self Report validada al español, que mide conductas internalizantes (ansiedad, depresión, aislamiento y quejas somáticas) y externalizantes (agresión verbal, conducta delictiva y búsqueda de atención). Para la discriminación dicotómica entre puntajes desviados y no desviados, usamos el rango clínico límite al clasificar los T scores de ≥ 60 de la escala YSR, y para analizar la relación entre problemas de comportamiento o competencias y vivir o no en una familia nuclear utilizamos regresión logística múltiple. Resultados: El 55% eran mujeres, la media de edad fue de 16.4 años±0.98, y el 62.3% procedían de familias nucleares. La prevalencia de conductas internalizantes fue de 15.6% y de conductas externalizantes de 14.8%. Las mujeres tenían puntuaciones medias estadísticamente más altas en conducta depresiva, ansiosa y verbalmente agresiva, quejas somáticas y problemas de pensamiento. La prevalencia de conductas internalizantes en adolescentes con familia nuclear fue de 11.7% (n=33), y para adolescentes con otro tipo de familia fue de 22.2% (n=38), OR 2.17 (IC 95% 1.30-3.61, p=0.003), pero no se observaron diferencias para conductas externalizantes y tipo de familia. Al ajustar por sexo, edad y escuela pública o privada, las conductas internalizantes y específicamente la conducta depresiva se mantuvieron significativas...(AU)

Internalizing and externalizing behaviors in high school adolescents in a northern border city of Mexico and their type of family.

OBJECTIVE: Identify externalizing and internalizing behaviors in high school adolescents in three schools in a northern border city in Mexico and their type of family. DESIGN: Cross-sectional survey. LOCATION: Three schools in the city of Tijuana, Mexico: two public and one private. PARTICIPANTS: 454 baccalaureate students 14-19 years old. MAIN MEASUREMENTS: We utilized Youth Self Report Scale, adapted and validated in Spanish, that measure internalization behaviors (anxiety, depression, isolation or somatic complaints), and externalization behaviors (verbal aggressiveness, delinquent behavior and attention-seeking). For dichotomous discrimination between deviant and nondeviant scores, we use the borderline clinical range by classifying YSR scale's T scores≥60, and to analyze the relationship between behavior problems or competencies and living or not in a nuclear family we utilized multiple logistic regression. RESULTS: 55% were female, mean age 16.4 years±0.98, and 62.3% came from a nuclear family. Prevalence of internalizing behaviors was 15.6%, and externalizing behaviors 14.8%. Women had statistically higher mean scores in depressive, anxious and verbally aggressive behavior, somatic complaints, and thought problems. The prevalence of internalizing behaviors in adolescents with nuclear family was 11.7% (n=33), and for adolescents with another type of family was 22.2% (n=38), OR 2.17 (CI 95% 1.30-3.61, p=0.003), but no differences was observed for externalizing behaviors and family type. When adjusted for sex, age, and public or private school, internalizing behaviors and specifically depressive behavior remained significant. CONCLUSIONS: We detected a moderate prevalence of internalizing behaviors in Mexican adolescents, predominantly among women, and also observed that not living with a nuclear family increases the odds of presenting internalizing behaviors. It is important that parents, teachers, and healthcare workers remain vigilant to detect these problems in a timely manner and develop interventions to improve the mental health and well-being of adolescents.

Implementation of medication for opioid use disorder treatment in Indian health clinics in California: A qualitative evaluation.

INTRODUCTION: American Indians and Alaska Native (AIAN) populations are disproportionately affected by opioid misuse. Medication for opioid use disorder (MOUD) is essential to decrease overdose events and overdose deaths. AIAN communities can benefit from MOUD programs that are housed within primary care clinics to improve treatment accessibility. This study aimed to gather information on the needs, barriers, and successes related to implementing MOUD programs in Indian health clinics (IHCs) offering primary care. METHODS: The study used the Reach, Effectiveness, Adoption, Implementation, and Maintenance Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) evaluation framework to structure key informant interviews with clinic staff who received technical assistance for MOUD program implementation. The study incorporated RE-AIM dimensions into a semi-structured interview guide. We developed the coding approach for analyzing interview data using Braun and Clarke's (2006) reflexive thematic analysis in qualitative research. RESULTS: Eleven clinics participated in the study. The research team conducted twenty-nine interviews with clinic staff. We found that inadequate education about MOUD, scant resources, and limited availability of AIAN providers adversely impacted reach. Challenges with integrating medical and behavioral care, patient-level barriers (e.g., rural conditions, geographical dispersion), and limited workforce capacity impacted MOUD effectiveness. Stigma at the clinic level was detrimental to MOUD adoption. Implementation was challenging due to a limited number of waivered providers, and the need for technical assistance and MOUD policies and procedures. Staff turnover and restricted physical infrastructure negatively influenced MOUD maintenance. CONCLUSIONS: Clinical infrastructure should be strengthened. The integration of culture into clinic services must be embraced by staff to support MOUD adoption. Increased representation from AIAN clinical staff is needed to appropriately represent the population being served. Stigma at various levels must be addressed, and the multiple barriers that AIAN communities face must be considered in understanding MOUD program implementation and outcomes.

American Indian and Alaska Native substance use treatment: Barriers and facilitators according to an implementation framework.

INTRODUCTION: Substance use disorder (SUD) and overdose deaths are higher in the American Indian and Alaska Native (AIAN) population than in other racial/ethnic groups. Multi-level gaps hinder SUD treatment for AIAN patients. Few studies have engaged front-line clinicians and administrators of SUD treatment programs serving AIAN patients to identify barriers and facilitators to improve the implementation of effective treatment. METHODS: We conducted key informant interviews with a diverse sample of providers and administrators of SUD treatment programs across California regarding barriers and facilitators to treatment for AIAN patients. An AIAN-majority community advisory board (CAB) guided the development of an interview guide and helped to recruit respondents from five types of SUD programs statewide. Using ATLAS.ti, the research team coded interviews and classified emergent themes as barriers and facilitators related to Outer, Inner, and Individual domains of the Consolidated Framework for Implementation Research (CFIR). RESULTS: Representatives of 13 of 15 invited SUD treatment programs participated and 9 of the 13 interviewed self-identified as AIAN. Related to Outer Setting barriers from coded interviews, a dominant barrier was policies that defund or underfund SUD treatment, especially detoxification centers. Outer Setting facilitators included consistent Indian Health Service (IHS) eligibility criteria, judicial system connections for direct treatment access, and community programs advocating SUD treatment. Key themes related to barriers for the Inner Setting were limited bed capacity, poor coordination of intake and care, and lack of telehealth technology. Facilitators integrated mental health, linkage to external resources, and culturally centered care. Individual-level barriers were negative attitudes such as SUD stigma, distrust of governmental programs, and lack of transportation while individual engagement was facilitated by programs addressing negative attitudes and providing telemedicine for remote care. CONCLUSION: The public health threat of SUD for the AIAN population mandates the implementation of interventions and policies that facilitate care. This qualitative study with primarily AIAN clinical leaders of SUD treatment highlights opportunities to improve care at multiple CFIR levels, focusing on capacity, coordination, culturally congruent care, and community initiatives to promote engagement.

Project SUN: Pilot Study of a Culturally Adapted Smoking Cessation Curriculum for American Indian Youth.

American Indian Alaska Native (AIAN) youth have disproportionately higher rates of commercial tobacco product use compared to other racial and ethnic groups in the U.S. These rates underscore a need for commercial tobacco product cessation interventions that are culturally informed. This project studied the development, implementation, and some impact data of an adapted version of Project EX, an evidence-based intervention for teen smoking cessation. Implementation challenges resulted in a change from a three-arm to a single-arm trial with 37 AIAN youth who participated in an eight-week curriculum. Intent-to-treat analysis with biochemical validation results indicated that 32% (N = 12/37) of youth quit smoking at the three-month follow-up. Participants reported being satisfied with the program overall and enjoying the culturally adapted activities. This study detailed the program's adaptation and lessons learned during implementation.

Low-Income Latina Mothers' Scaffolding of Preschoolers' Behavior in a Stressful Situation and Children's Self-Regulation: A Longitudinal Study.

Objective: Maternal control and directiveness in Latina/o families often do not show the negative associations with child adjustment seen in European American samples. This study tested the self-determination hypotheses that Latina maternal involvement and structure would be positively associated with preschool children's later self-regulation, whereas directiveness and control would show negative relations. Design: At Time 1, 130 low-income Latina mothers were observed helping their 4- to 5-year-old children complete a stressful task. Maternal strategies for scaffolding children's responses to stress were examined with detailed event coding. At Time 1 and Time 2 18 months later, a delay of gratification task assessed children's self-regulation. Results: Children's Time 2 ability to delay gratification at 5½ to 6½ years (controlling for delay of gratification at ages 4 to 5) was predicted by Time 1 maternal scaffolding strategies. Children showing the greatest delay gratification at Time 2 (controlling for delay of gratification at Time 1) had mothers who used instructive praise and nonverbal autonomy-promoting scaffolding strategies at Time 1. Negative predictors included nonverbal attention directing and restriction. Conclusions: The findings highlight the importance of physical guidance in Latina/o families and suggest that highly directive maternal strategies may not interfere with the development of self-regulation as is often found in European American families. These findings will be useful in developing interventions to promote self-regulation in Latina/o children from low-income families.

Substance and Behavioral Addictions among American Indian and Alaska Native Populations.

OBJECTIVE: This paper examines substance and behavioral addictions among American Indian and Alaska Natives (AIAN) to identify the structural and psychosocial risk and cultural protective factors that are associated with substance use and behavioral addictions. METHODS: Five databases were used to search for peer reviewed articles through December 2021 that examined substance and behavioral addictions among AIANs. RESULTS: The literature search identified 69 articles. Numerous risk factors (i.e., life stressors, severe trauma, family history of alcohol use) and protective factors (i.e., ethnic identity, family support) influence multiple substance (i.e., commercial tobacco, alcohol, opioid, stimulants) and behavioral (e.g., gambling) addictions. CONCLUSIONS: There is a dearth of research on behavioral addictions among AIANs. Unique risk factors in AIAN communities such as historical trauma and socioeconomic challenges have interfered with traditional cultural resilience factors and have increased the risk of behavioral addictions. Future research on resilience factors and effective prevention and treatment interventions could help AIANs avoid behavioral addictions.

Randomized Controlled Trial of a Program to Help Latina Mothers Help Their Children Cope with Stress: Effects on Parenting, Child Coping, and Adjustment.

"Madres Apoyando el Desarrollo Emocional de Sus Hijos" ("Mothers Supporting the Emotional Development of Their Children") is a parenting education program designed to help Latina mothers help their school-age children cope with stress. A previous randomized controlled trial, with a pre-post design, showed that the program had the predicted effects on mothers' knowledge, attitudes, and behavior. However, no data were collected from the children in that initial evaluation. The purpose of the present study was to determine if the program impacted children's coping and adjustment. One hundred twenty-two primarily first-generation Latina mothers from rural Washington State were randomly assigned to the intervention or to a no treatment control. Seven implementations of the program were conducted. Mothers and their 8- to 13-year-old children completed assessments 1 week before the program started, 1 week after its completion, and 3 months later. The results for maternal behavior were largely replicated: at posttest, intervention mothers, compared to controls, reported higher levels of emotion coaching, showed greater self-efficacy for helping their child cope with stress, and were more likely to report positive strategies for scaffolding their child's responses to stressful situations. Several maternal effects (e.g., emotion-coaching and maternal efficacy) continued at 3 months. Children of intervention mothers at posttest used more primary control coping strategies and reported fewer emotional symptoms; analyses of mothers' ratings of child adjustment replicated the posttest child effects for emotional symptoms, showed fewer other psychological problems at posttest, and showed greater child prosocial behavior at 3 months. The results further support the program's efficacy and provide the first evidence of its effects on child coping and adjustment.

A qualitative assessment of the perceptions and attitudes towards commercial tobacco policies and education among tribal communities in California.

Background: California has the largest American Indian and Alaska Native (AIAN) population in the United States and faces several commercial tobacco related disparities. This study assessed current interest, readiness, and knowledge regarding commercial tobacco control policies in California Tribal communities.Objectives: A community readiness assessment was conducted in California Tribal communities to understand commercial tobacco policies that included: Tobacco 21 (California State, and now federal, law restricting commercial tobacco sales to age 21 and over), tobacco tax, smoke-free worksites on Tribal lands, smoke-free households, and smoke-free indoor and outdoor areas in multi-unit housing.Methods: Twelve Tribal communities participated in focus groups and interviews between 2016-2019. Content analysis was utilized to code and data were analyzed using ATLAS.ti software.Results: A total of 165 community members participated (65% female), with most expressing support for unwritten, community-based "small p" policies, (e.g., placing signage to create a smoke-free perimeter). However, there was little to no support for "big P" policies (e.g., written ordinances on smoke-free casinos, smoke-free housing). Support for tobacco product taxation varied. The importance of Tribal sovereignty and the need for tobacco prevention and cessation programs for youth were two additional topics that emerged.Conclusions: Participants supported Tribal policies and wished for outsiders to respect Tribal sovereignty in this regard. Communities are currently working to raise awareness about the dangers associated with commercial tobacco use and would benefit from the responsiveness of future funders to these requests.

Twelve-Month Efficacy of an Obesity Prevention Program Targeting Hispanic Families With Preschoolers From Low-Income Backgrounds.

OBJECTIVE: Assess effects of an obesity prevention program promoting eating self-regulation and healthy preferences in Hispanic preschool children. DESIGN: Randomized controlled trial with pretest, posttest, 6- and 12-month assessments. Fourteen waves, each lasting 7 weeks. SETTING: Families recruited from Head Start across 2 sites. PARTICIPANTS: Two hundred fifty-five families randomized into prevention (n = 136) or control (n = 119). INTERVENTION: Prevention received curriculum; control received no curriculum. MAIN OUTCOME MEASURE(S): Feeding knowledge/practices/styles (parent); body mass index percentile, eating self-regulation, trying new foods, and fruit/vegetable consumption (child). ANALYSIS: Multilevel analyses for nested data (time points within families; families within waves) and multinomial regression. RESULTS: Program increased mothers' repeated presentation of new foods (P < 0.05), measured portion sizes (P < 0.05), child involvement in food preparation (P < 0.001), feeding responsiveness (P < 0.001), knowledge of best feeding practices (P < 0.001), and feeding efficacy (P < 0.05); reduced feeding misconceptions (P < 0.01) and uninvolved feeding (P < 0.01). Effects on child eating behavior were minimal. At 12 months, children in the prevention group were less likely to have overweight (P < 0.05) or obesity (P < 0.05). CONCLUSIONS AND IMPLICATIONS: Program effects emphasize the importance of feeding approaches in reducing childhood obesity.

Evaluation of a Program to Help Low-Income, Latina Mothers Help Their Children Cope With Stress.

This paper describes the evaluation of a program that provides low-income Latina mothers with skills to help their children cope with stress. Based on focus groups with mothers and their school-aged children in two locations, we developed a five-week program for helping mothers identify signs of stress in their children, learn effective emotion-coaching skills, and learn how to effectively encourage their children to use coping strategies that match the controllability of the situation. We conducted a randomized controlled trial in an urban (n = 13) and rural (n = 78) location in which we randomly assigned mothers to either an intervention or a no-treatment control condition. We completed eight implementations of the program (2 in the urban sample and 6 in the rural one). To evaluate the program, we collected pre- and post-assessments of mothers' coping knowledge, emotion coaching, strategies for helping their children cope with stress, maternal self-efficacy in helping their children cope, general parenting practices, and general parenting self-efficacy. Observers assessed the fidelity of program delivery. Mothers who received the intervention, in contrast to those in the control condition, showed significant increases in their knowledge of strategies to help their children cope with stress, in reported emotion-coaching skills, and in the reported use of positive strategies for helping their children manage their behavior and emotions in stressful situations (i.e., helping their children relax and calm down, talking with their children about feelings, helping their children problem-solve, encouraging distraction, and helping their children improve their self-esteem). Post intervention, mothers reported increases in their efficacy for helping their children cope with stress. Analyses revealed no significant effects of the program on general parenting or general parenting self-efficacy, but did have the hypothesized effects on maternal knowledge, attitudes, and reported behavior. Subsequent research should examine the degree to which the program has effects over a longer time period and on children's approaches to coping with stress.

A Novel Method to Reveal a Ureolytic Biofilm Attachment and In Situ Growth Monitoring by Electrochemical Impedance Spectroscopy.

The formation of biofilms capable of efficiently carrying out ureolysis is of fundamental importance in several biotechnological systems such as urinary tract infections, building materials and municipal wastewater treatment. This work proposes a straightforward method for the formation of a ureolytic biofilm attached to graphite. The proposed strategy reduced the time needed to complete ureolysis to 3 days instead of 16 days required in suspension culture. To confirm the formation of a ureolytic biofilm, scanning electron microscopy and confocal laser scanning microscopy studies were employed ex situ. However, it is imperative to analyse the biofilm by direct non-invasive techniques. Accordingly, open circuit potential (OCP) and electrochemical impedance spectroscopy (EIS) were used as in situ monitoring techniques. The reduction in OCP from - 0.01 to - 0.2 V vs. Ag/AgCl and the increase in capacitance from 200 to 260 µF cm-2 were related to biofilm attachment. To the best of our knowledge, this is the first time in which a ureolytic biofilm attachment has been analysed by EIS. The increase in the biomass from 0.04 to 2.81 µm3 µm-2 and in average thickness from 10.19 to 32.78 µm was related to biofilm maturation.

Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers.

OBJECTIVE: To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. DESIGN: Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. SETTING AND PARTICIPANTS: Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. INTERVENTION: Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. MAIN OUTCOME MEASURES: Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. ANALYSIS: Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. RESULTS: The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. CONCLUSIONS AND IMPLICATIONS: Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.

Presence of depressive symptoms in medical students in a Mexican public university / Presencia de síntomas depresivos en estudiantes de medicina en una universidad pública de México

Abstract Introduction During their professional training, medical students are subject to diverse stress-causing factors such as academic demands and a highly competitive environment which may threaten their mental health. Objective Identify the presence of depressive symptoms in medical students in a public university in Mexico. Method Descriptive cross-sectional study of a random sample of 203 medical students at the Universidad Autónoma de Baja California from February to April 2018. The PHQ - 9 scale was used, and a cut-off score of ≥ 10 was employed as positive for depressive symptoms. Basic descriptive statistics were utilized to analyze sociodemographic variables such as gender, academic advancement, stage of training (basic science vs. clinical), and the prevalence of the five different categories of the scale. Results Of the medical students surveyed, 20.2% were found positive for depressive symptoms and 7.9% (16) had severe or moderately severe symptoms. Female gender increased the risk of presenting symptoms (OR = 3.5, 95% CI [1.6, 7.6]). Discussion Despite the fact that the prevalence of depressive symptoms encountered was similar to that reported worldwide, it is troubling that one fifth of the surveyed students presented depressive symptoms. These results may justify implementation of preventive strategies by academic authorities to improve student mental health, and maybe even for early detection of risk of major depressive disorder.

Resumen Introducción Durante su formación profesional, los estudiantes de medicina están sometidos a diversos factores generadores de estrés como la exigencia académica y un entorno altamente competitivo, lo cual podría llegar a ser adverso para su salud mental. Objetivo Identificar la presencia de síntomas depresivos en estudiantes de medicina de una universidad pública mexicana. Método Estudio transversal, descriptivo, que se realizó con una muestra aleatoria de 203 estudiantes de medicina de la Universidad Autónoma de Baja California de febrero a abril de 2018. Se utilizó el cuestionario PHQ - 9 tomando el punto de corte ≥ 10 como positivo para síntomas depresivos. Para el análisis de datos se utilizó estadística descriptiva; se estimaron proporciones de las variables sociodemográficas como género, semestre cursado, etapa básica o disciplinar y prevalencias de las diferentes categorías de la escala. Resultados Se encontró una prevalencia de 20.2% de estudiantes de medicina con presencia de síntomas depresivos y el 7.9% reportó síntomas graves o moderadamente graves. Pertenecer al género femenino resultó ser un factor que incrementa las posibilidades de presentar síntomas depresivos (OR = 3.5, IC 95% [1.6, 7.6]). Discusión A pesar de que la prevalencia de síntomas depresivos encontrada fue similar a lo reportado a nivel mundial, preocupa que una quinta parte de los encuestados presentaran síntomas depresivos. Estos resultados podrían permitir justificar a las autoridades académicas y a la comunidad estudiantil la implementación de estrategias preventivas para el mejoramiento de la salud mental de los estudiantes e incluso quizá detectar en forma temprana el riesgo de presentar un trastorno depresivo mayor.

Early meteorological records from Latin-America and the Caribbean during the 18th and 19th centuries.

This paper provides early instrumental data recovered for 20 countries of Latin-America and the Caribbean (Argentina, Bahamas, Belize, Brazil, British Guiana, Chile, Colombia, Costa Rica, Cuba, Ecuador, France (Martinique and Guadalupe), Guatemala, Jamaica, Mexico, Nicaragua, Panama, Peru, Puerto Rico, El Salvador and Suriname) during the 18th and 19th centuries. The main meteorological variables retrieved were air temperature, atmospheric pressure, and precipitation, but other variables, such as humidity, wind direction, and state of the sky were retrieved when possible. In total, more than 300,000 early instrumental data were rescued (96% with daily resolution). Especial effort was made to document all the available metadata in order to allow further post-processing. The compilation is far from being exhaustive, but the dataset will contribute to a better understanding of climate variability in the region, and to enlarging the period of overlap between instrumental data and natural/documentary proxies.

Emotion regulation strategies and childhood obesity in high risk preschoolers.

The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children's weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wait time during the delay of gratification tasks was not a significant predictor. The current findings are consistent with studies showing that for preschool children, summary measures of emotion regulation (e.g., wait time) are not concurrently associated with child obesity. In contrast, the use of emotion regulation strategies was a significant predictor of lower child weight status. These findings help identify emotion regulation strategies that prevention programs can target for helping children regulate their emotions and decrease their obesity risk.

La precisión en la validación de escalas: un proceso continuo y perfectible

Estimado editor, En nuestro artículo (1), mostramos el proceso de adaptación cultural y validación que debería seguir cualquier traducción de escalas antes de que estas sean utilizadas en otro idioma y en otra población, siguiendo los procedimientos recomendados por diversos autores. Coincidimos en la importancia de promover y actualizar este tipo de metodologías para obtener mediciones más confiables, de modo que en el proceso de validación de la Escala de Competencia en el Cuidado del Pie y Comportamientos en el Cuidado de los Pies (FCC/FCB por sus siglas en inglés) realizamos un análisis factorial (AF) cuyo propósito fue valorar si la versión en español era un instrumento válido y confiable en la población que vive con diabetes y, al mismo tiempo comparar si esta versión obtenía puntuaciones psicométricas consistentes con la escala original en idioma inglés. En ese análisis reportamos que emergieron dos factores para el constructo de autoeficacia y seis para el de conductas...

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes.

OBJECTIVE: To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. METHODS: The original FCCS-FCB was translated (and back-translated), the content validated (by a group of health professional experts), and the instrument applied to 304 patients 23-78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs ("self-efficacy," and risk / preventive foot self-care behaviors) was measured using Cronbach's alpha. The constructs were validated using principal component factor analysis. RESULTS: The Cronbach's alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. CONCLUSIONS: The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish-speaking patients with diabetes.

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes / Validez de la versión mexicana del instrumento combinado de las escalas Foot Care Confidence Scale y Foot Care Behavior para la diabetes

OBJECTIVE: To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. METHODS: The original FCCS-FCB was translated (and back-translated), the content validated (by a group of health professional experts), and the instrument applied to 304 patients 23-78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs ("self-efficacy," and risk / preventive foot self-care behaviors) was measured using Cronbach's alpha. The constructs were validated using principal component factor analysis. RESULTS: The Cronbach's alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. CONCLUSIONS: The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish-speaking patients with diabetes.

OBJETIVO: 1) traducir o adaptar transculturalmente el instrumento original combinado (en inglés) de las escalas Foot Care Confidence Scale (Escala de Competencia en el Cuidado del Pie) y Foot Care Behavior (Comportamientos del Cuidado del Pie) (FCCS-FCB) para crear una versión en español de México, y 2) determinar su validez y fiabilidad en una población de personas con diabetes de Tijuana, México. MÉTODOS: Se tradujo al español la escala original FCCS-FCB (y se volvió a traducir al inglés), su contenido fue validado (por un grupo de expertos), posteriormente se aplicó el instrumento a 304 pacientes de 23 a 78 años de edad, pertenecientes a grupos de apoyo al control de la diabetes de Tijuana, México. Mediante el alfa de Cronbach, se midió la coherencia interna de los constructos ("competencia personal" y "comportamientos de riesgo o preventivos de autocuidado del pie"). Los constructos fueron validados mediante análisis factorial de componentes principales. RESULTADOS: El valor de alfa de Cronbach correspondiente a competencia personal fue de 0,782 y de 0,505 para los comportamientos. En el análisis factorial, dos factores explicaron el 49,1% de la variancia total para la competencia personal, y seis factores explicaron el 57,7% de la variancia total para los comportamientos. Los resultados concordaron con los de la versión original (en inglés) del FCCS-FCB. CONCLUSIONES: La versión mexicana del FCCS-FCB es un instrumento fiable y válido recomendado para su empleo en pacientes mexicanos de habla hispana con diabetes.