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This paper explores culturally-related concerns that arose during a multi-year study of obsessive-compulsive disorder (OCD) along the U.S.-Mexico border and describes adaptations made to better connect the research process to study participants. The purpose of this exploration is two-fold: (1) to offer suggestions for culturally sensitive borderland mental health research; and (2) to enhance dialog focused on culture, mental health research and the U.S.-Mexico border. Systematic coding of the written record of weekly research team meetings identified six recurring cultural concerns: emotionally charged and poorly understood terminology; differing meanings of ethnicity and acculturation; quality of life—regional variation and uncertainty; overlap of research and care; hopeful but hesitant; and fatalism. We conclude that diligence in the initial planning phase of a study is only part of the challenge in doing culturally sensitive research. Equally important is an ongoing process of evaluation to make explicit cultural concerns that arise during research, as well as a readiness to implement culturally sensitive research adaptations. [ABSTRACT FROM AUTHOR]

Information and communication technologies (ICTs) have different effects depending on the companies that rely on them. On manufacturing systems, the effective use of ICTs requires a compatible design with the human, technology, and environment. This article analyses the effect of macroergonomic compatibility of ICTs as independent variable on dependent variables of production processes, clients, and organisational performance of manufacturing systems in the Mexican state of Chihuahua. In addition, this paper examines the relationships between these dependent variables. Methodology includes the construction of a questionnaire, administered to middle and senior managers of manufacturing companies to collect information on the macroergonomic practices of ICTs. Also, a factor analysis is carried out to data gathered, and hypotheses are proposed to suggest the effects of ICTs on dependent variables. Afterwards, a structural equations model is constructed and evaluated to test such hypotheses. Results obtained indicate that ICTs are an ideal element to measure macroergonomic compatibility of manufacturing systems, and that this compatibility has positive direct effects on production processes and clients, while significant indirect and total effects on the organisational performance of manufacturing systems. Results also showed that dependent variables clients and production processes had a significant impact on the performance of manufacturing systems. [ABSTRACT FROM AUTHOR]

Background: Baseline patients' characteristics are critical for treatment planning, as these can be moderators of treatment effects. In Mexico, information on treatment seekers with substance use disorders is scarce and limited to demographic characteristics. Objective: This paper presents and analyses demographic characteristics, substance use related problems, clinical features, and addiction severity in a sample of treatment seekers from the first multi-site randomized clinical trial implemented in the Mexican Clinical Trials Network on Addiction and Mental Health. Methods: A total of 120 participants were assessed prior randomization. Chi square or F-tests were used to compare sites across variables. Spearman correlation was used to associate negative consequences of substance use and motivation to change. Results: The majority of participants were men, and the most prevalent substances reported were alcohol, marijuana, and cocaine. Participants were predominantly on the contemplation or action stage of change, and this was correlated with the perception of the negative consequences associated with substance use. Participants reported a high prevalence of substance use related problems. Conclusions: Substance use related problems, clinical features, and addiction severity reported by treatment seekers are important characteristics to take into account when planning treatment as they facilitate tailoring treatment to meet patients' needs. [ABSTRACT FROM AUTHOR]

University Programs for Older Adults (Programas Universitarios para Adultos Mayores or PUMAs) have been developed throughout the world as an outcome of two worldwide policies: Life Long Learning (LLL) and Active Aging as a priority direction (UN, 2002). According to these policies, older persons should become full participants in the development process of a society, sharing in its benefits, while policies and actions should promote a positive view of aging. The present paper sets out to report some of the results from the evaluation of four PUMAs offered in 2009–2010 at four Universities: Autónoma University of Madrid (Spain), Autónoma University of Mexico (Mexico), Catholic University (Chile), and La Habana University (Cuba). With this purpose, a study with quasiexperimental design and nonequivalent control group was carried out. In total, 313 students (75% women, age range 50–87) on these four PUMAs and 190 controls (77% female, age range 50–91) participated in this evaluation study. Pre- and postexperimental and control comparisons results yielded significant differences in the expected direction: those people attending PUMAs significantly improved their self-perception of aging and group stereotypes, as well as significantly reduced their negative affect, and improving their emotional balance. At the same time, their perception of cultural age stereotypes became more negative. The results are discussed from the point of view of the II International Plan of Action on Aging objectives: the reduction of negative stereotypes and the promotion of the role of PUMAs in active aging. [ABSTRACT FROM PUBLISHER]

The objective of this study was to determine the impact of a MOOC on the attitudes of preservice and in-service teachers toward education on death. The study adopted a pre- and post-test design. Participants (N=139) answered the Death Education Attitudes Scale-Teachers (DEAS-T) questionnaire at the beginning and end of the course. The results confirmed significant differences between the pre- and post-course applications in the three scale factors--need for training in the Pedagogy of Death, inclusion of death in education, and educational awareness of death. Open-access, free, mass training through a MOOC could have a positive impact on attitudes toward death education among both pre- and in-service teachers. [ABSTRACT FROM AUTHOR]

Sex workers have been demonstrated to have increased vulnerabilities to HIV and a high population prevalence of the disease. Despite their increased risk, sex workers have been underrepresented in molecular epidemiology studies assessing HIV in Mesoamerica. This study aims to describe the sociodemographic characteristics and phylogenetic profile of HIV-1 within a cohort of HIV-positive female sex workers (FSW) situated at the Guatemala-Mexico border. HIV viral sequences were collected from a cohort of FSW ≥18 years of age from San Marcos, Guatemala (n = 6) and compared to viral sequences collected as part of the Mesoamerican Drug Resistance Monitoring Programme to assess HIV viral diversity in Mexico and Guatemala (n = 3956). All of the FSW sampled were determined to have genetically unrelated HIV infections, suggesting multiple introductions of the virus and/or the potential existence of populations not captured by current surveillance efforts. Many reported numerous vulnerabilities that may have heightened their risk of acquiring and transmitting HIV through sex work activities. Our phylogenetic analysis indicated that national surveillance programmes may not fully capture the viral diversity among FSW and their clients within this region. Additional research is needed to fully capture HIV diversity and transmission in Mesoamerica, especially in the Guatemala-Mexico border region. [ABSTRACT FROM AUTHOR]

Age group typically identifies millennials – those born between 1982 and 2004. Yet our research challenges the designation based on age group by considering this population in the context of an individual's citizenship or culture. Based on tenets of social identity theory, we explore a citizen's personal value orientation and cognitive moral reasoning to discover commonalities or differences across individuals from eight countries. We report wide variations among citizens' personal value orientations and principled moral reasoning despite being borne within an identified age group. We conclude that an individual's geographic context is a stronger classification descriptor based on values and moral reasoning than their age-based generational categories. Implications for business practice and scholarly research are discussed. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to examine the pattern of associations among PD patient and caregiver sleep problems, caregiver burden, and caregiver life satisfaction. A secondary aim was to assess whether the pattern of associations differed between Mexican and U.S. caregivers. Analyses were performed on data obtained from 253 caregivers (M age = 59.92). A composite score was produced for caregiver and patient sleep problems. The Zarit Burden Interview and Satisfaction with Life Scale measured caregiver burden and life satisfaction, respectively. A structural equation model with an invariance design was developed to examine and compare the pattern of associations. The model was generally invariant across U.S. and Mexican caregivers. Three significant indirect effects were found: caregiver sleep problems were negatively associated with life satisfaction via caregiver burden (p = 0.003); PD patient sleep problems were positively related to caregiver burden via caregiver sleep problems (p = 0.005) and life satisfaction via caregiver burden and caregiver sleep problems (p = 0.002). PD patient sleep problems were associated with caregiver sleep problems, leading to increased burden in caregivers and poorer life satisfaction. The findings highlight a potential opportunity for empirically supported sleep interventions. Parkinson's disease is a progressive neurological condition that impacts patient and caregiver quality of life. Patient sleep problems contribute to greater caregiver burden, sleep problems, and reduced life satisfaction. The findings suggest patient and caregiver sleep may be a worthwhile target for intervention in order to reduce risk of caregiver burden and improve life satisfaction. [ABSTRACT FROM AUTHOR]

This study evaluated the risk posed by attachment type in the development of anxiety or depression symptomatology in Mexican adults. This was case-control study in which anxiety and depression symptomatology levels were compared according to the attachment type reported by 3,666 participants. It was found that insecure attachment is a risk factor (p≤.001) for the development of severe levels of depression (OR = 2.12, CI 95%: 1.66–2.70) and anxiety symptomatology (OR = 1.52, 95% CI: 1.30–1.77). Findings are discussed based on their implications for psychiatric nursing practice. The findings of this study enable nurses to consider the empirical validity of attachment theory for studying psychosocial aspects of mental health and to design intervention strategies that promote secure attachment in populations without psychiatric diagnoses to prevent anxiety and depression symptomatology. [ABSTRACT FROM AUTHOR]

This study examines how immigration status and neighborhood collective efficacy shapes mothers' self-efficacy and, in turn, depression. Path analysis was conducted drawing data from 578 Mexican-American and Mexican immigrant mothers who participated in the first wave of the Los Angeles Family and Neighborhood Survey. The results of this study revealed that both neighborhood collective efficacy beliefs and undocumented status are mediated by personal self-efficacy beliefs. This dynamic suggests the importance of addressing undocumented mothers' sense of self-efficacy to reduce the risk of major depression. [ABSTRACT FROM AUTHOR]

Trauma may lead to different psychological changes, both detrimental or beneficial. This study aimed to a better understanding of these consequences by exploring the relations between traumatic experiences and: Posttraumatic growth (PTG), posttraumatic cognitions (PTC), and personality. Mexican university students (n = 161) answered the Global Assessment of Posttraumatic Stress, the Posttraumatic Cognitions Inventory, the Posttraumatic Growth Inventory, and the Millon Multiaxial Inventory. Participants showed a high prevalence of traumatic exposure, standard personality scores, and PTC and PTG presence. Self-blame cognitions were higher in persons with intentional trauma, and guilt was positively associated with PTG. Histrionic personality was associated positively with PTG and negatively with PTC. Mental health implications are discussed. [ABSTRACT FROM AUTHOR]

Women who experience intimate partner violence (IPV) face multiple barriers to seeking help from community resources, but little research has examined the impact of ecological influences on community resource utilisation among women living in low- and middle-income countries. The current study investigated individual-, relationship-, family-, and community-level influences on community resource utilisation among Mexican women experiencing IPV. Using baseline data from 950 women in Mexico City enrolled in a clinic-based randomised controlled trial, multilevel regressions were performed to assess associations between socioecological factors and women's community resource utilisation. 41.3% women used at least one resource. At the individual-level, every additional resource that women were aware of, was associated with a 20% increase in the total number of resources used (p <.001). Every additional lethal risk factor was associated with a 5% increase in the total number of resources used (p =.004). At the family-level, women who reported having an in-law encourage IPV used 46% more resources (p <.001). At the community-level, stronger supportive norms around community resource utilisation was associated with a 6% increase in the total number of resources (p =.01). These findings suggest the importance of addressing family and community factors in the broader ecological context of Mexican women's help-seeking behaviours. [ABSTRACT FROM AUTHOR]

Background: The high prevalence of smoking registered in recent years as well as the extensive use of online text messaging platforms such as WhatsApp and Facebook suggests a correlation between content exchange on these platforms and tobacco smoking by teenagers. Methods: By a cross-sectional study, the social networking activity of 1,329 adolescents was analyzed. Data were collected using a self-administered questionnaire. Results: In the studied population, the prevalence of smoking was 18.6%, and 37.7% declared the regular use of WhatsApp or Facebook to communicate. According to the results, 94.8% of adolescents who used these platforms received text messages with sexual content, and 45.4% shared this content. The logistic regression analysis showed a significant association between active smoking by adolescents using social networks and content exchange deemed inappropriate (receiving: adjusted OR = 5.41; sharing: adjusted OR = 2.49). In the family environment, the lack of communication between adolescents and their parents regarding social network content seems to favor the development of tobacco smoking. Conclusions: It is important that parents fostering constant communication with their children regarding the use of substances such as tobacco and, regularly monitoring who is interacting with their children and sharing content on social networks. [ABSTRACT FROM AUTHOR]

The main aim was to evaluate the measurement properties of the Family Needs Questionnaire-Revised (FNQ-R) in family members of individuals living with severe traumatic brain injury (TBI). A total of 309 family members of individuals with severe TBI from Colombia, Denmark, Mexico, Norway and Spain participated. Rasch analysis of the FNQ-R and its 6 subscales was conducted. The Rasch analysis indicated a lack of fit of the 37-item FNQ-R to one single underlying construct of needs, and less than half of the items were invariant across the countries. Misfit of single items was revealed in the Need for Health Information, Need for Emotional Support, Need for Instrumental Support, Need for Professional Support and Need for Community Support Network subscales. Fit to the Rasch model was obtained after removal of misfitting items. The Involvement in Care subscale had too few items to be adequately assessed by the Rasch approach. The FNQ-R is a well-targeted instrument for assessing the unmet needs of caregivers regarding the need for health information, emotional support, professional support and a community support network after some scoring adjustment and the removal of misfitting items. Caution should be taken when comparing responses across countries. [ABSTRACT FROM AUTHOR]

Mexico's indigenous communities continue to experience higher levels of mortality and poorer access to health care services than non-indigenous regions, a pattern that is repeated across the globe. We conducted a two-year ethnographic study of pregnancies and childbirth in an indigenous Wixárika community to explore the structural causes of this excess mortality. In the process we also identified major differences between official infant mortality rates, and the numbers of infants born to women in our sample who did not survive. We interviewed 67 women during pregnancy and followed-up after the birth of their child. At baseline, socio-demographic data was collected as well as information regarding birthing intentions. In depth-interviews and semi-structured interviews were conducted with 62 of these women after the birth of their child, using a checklist of questions. Women were asked about choices regarding, and experiences of childbirth. Of the 62 women we interviewed at follow-up 33 gave birth at home without skilled attendance and five gave birth completely alone in their homes. Five neonates died during labour or the perinatal period. Concerns about human resources, the structure of service delivery and unwanted interventions during childbirth all appear to contribute to the low institutional childbirth rate. Our data also suggests a low rate of death registration, with the custom of burying infants where they die. This excess mortality, occurring in the context of unnecessary lone and unassisted childbirth are structurally generated forms of violence. [ABSTRACT FROM AUTHOR]

This study analyzed the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in a Mexican sample assessed within 2 months of a major earthquake and examined its relationship with resilience. A sample of 198 participants affected by the earthquake was chosen. The exploratory factor analysis revealed three factors: relationship with others (RO), personal strength (PS), and appreciation of life (AL). The results indicate good reliability, both for the total PTGI (α = 0.95) and for each factor: RO = 0.924, PS = 0.886, AL = 0.856. Because post-traumatic growth has been pointed out to be more characteristic of highly vulnerable people, the positive correlation (r = 0.456) found with resilience suggests that vulnerability is probably not a necessary condition for post-traumatic growth. We can conclude that PTGI is a reliable instrument and that the factorial structure of the instrument seems to vary in different cultures. [ABSTRACT FROM AUTHOR]

Background: Burnout syndrome (BOS) is characterized by emotional exhaustion, depersonalization and reduced personal accomplishment. It affects doctors, patients and their inter-relationship. There is a lack of data on BOS in Mexico. The main objective of the present study is to evaluate the prevalence of BOS in physician members of the Mexican gastroenterological association (MGA) and Mexican association for gastrointestinal endoscopy (MAGE).Materials and Methods: Cross sectional, prospective study through anonymous electronic survey via e-mail, sent to members of the MGA (n = 1192) and MAGE (n = 600). The survey included questions about basic sociodemographic information, Maslach Burnout Inventory, and factors potentially associated with BOS. Continuous variables were summarized as means and ANOVA or Kruskal-Wallis test were used to compare groups. Nominal variables were summarized as proportions and Fisher's exact test or Χ2 test were used, as appropriate.Results: A total of 1792 e-mail invitations were delivered and 411 answers were received with a response rate of 22.9%. The prevalence of BOS according to the Maslach Burnout Inventory was 26.3% (108/411). The prevalence of BOS according to the single-item self-defined burnout question (SISDBOQ) was 32.6% (134/411). The Kappa coefficient for emotional exhaustion between the SISDBOQ and Maslach inventory was 0.48 (p = 0.0001). Factors associated with BOS included performing endoscopic procedures (OR 2.9 (1.2-6.6); p = 0.008), lack of support from colleagues upon complications (OR 0.2 (0.1-0.4); p = 0.0001), receiving frequent reprimands from superiors (OR 2.4 (1.5-3.8); p = 0.0001), work unrelated to medicine (OR 2.4 (1.4-3.9); p = 0.0001), work violence/harassment (OR 3.0 (1.9-4.9); p = 0.0001) and living in a big city (OR 1.9 (1.2-3); p = 0.005).Conclusion: BOS is a frequent entity in Mexican gastroenterologists and endoscopists. There are potentially modifiable factors associated with BOS. [ABSTRACT FROM AUTHOR]

This study evaluates the health literacy of people with type 2 diabetes and its association with health outcomes. We conducted a cross-sectional survey in two family medicine clinics of the Mexican Institute of Social Security that included 778 diabetic patients >19 years of age. The Spanish version of the European Health Literacy questionnaire served to measure health literacy. Multiple logistic regressions were performed to determine the association between the independent variable (health literacy) and dependent variables (good self-rated health, glycemic control, and diabetes-related hospitalizations) after controlling for conceptually relevant patient's characteristics. Only 17.6% of patients had adequate health literacy; while, the remaining percentage showed inadequate (23%), or problematic (59.4%) health literacy. After adjusting for the patients' characteristics, those with adequate health literacy had 4.66 (95%CI: 2.26–9.61) times the odds of good self-rated health compared to those with inadequate literacy. Patients with adequate health literacy had 0.65 (95%CI: 0.49–0.86) times the odds of hospitalization due to diabetes compared to those with inadequate literacy. Compared to inadequate health literacy, problematic literacy was associated with increased odds of glycemic control. In conclusion, healthcare providers should actively address the health literacy needs of patients to increase good self-rated health, glucose control and reduce hospitalizations. [ABSTRACT FROM AUTHOR]

Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May–September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies. [ABSTRACT FROM AUTHOR]

Background: Web-based cognitive-behavioral interventions to reduce substance use can be a useful low-cost treatment for a large number of people, and an attractive option in countries where a greater availability of treatment is needed. Objective: To evaluate the feasibility and initial effectiveness of a web-based cognitive-behavioral intervention for the reduction of substance use and depression compared with treatment as usual, with and without a printed self-help manual. Method: Individuals seeking outpatient treatment for substance use were randomly assigned to one of the following: (1) the web-based Help Program for Drug Abuse and Depression (n = 23); (2) an in-person session with an addiction therapist and use of the Alcohol, Smoking, and Substance Involvement Screening Test Self-Help Strategies guide, followed by treatment as usual (n = 25), or (3) treatment ordinarily offered in the participating treatment centers (n = 26). The study took place in 2013-2014 (trial registration: ISRCTN25429892), and participants completed baseline, posttreatment, and 1-month follow-up evaluation interviews. Results: Treatment retention and data availability were comparable in all three conditions. A reduction was observed from baseline to follow-up in average days of use [F(1,28) = 29.70, p < 0.001], severity of use [F(2,28) = 143.66, p < 0.001], and depressive symptomatology [F = (4)16.40, p < 0.001], independent of the type of treatment provided. Conclusions: The findings suggest that the web-based intervention to reduce substance abuse is feasible, although it is not more effective than other intervention modalities; its effectiveness must be evaluated in a larger sample. Attrition was a main limitation; future studies must improve retention and assess cost-effectiveness. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

To understand the mental health status of Central American migrant men travelling through Mexico to the U.S., we analysed the association between migration-related circumstances/stressors and psychological disorders. In-person interviews and a psychiatric assessment were conducted in 2010 and 2014 with 360 primarily Honduran transmigrant young adult males. The interviews were conducted at three Casas del Migrante (or migrant safe houses) in the migration-corridor cities of Monterrey, and Guadalupe, Nuevo Leon; and Saltillo, Coahuila. The results indicated high levels of migration-related stressors including abuse and a high prevalence of major depressive episodes (MDEs), alcohol dependency, and alcohol abuse. Nested logistic regression models were used to separately predict MDEs, alcohol dependency, and alcohol abuse, assessing their association with migration experiences and socio-demographic characteristics. Logistic regression models showed that characteristics surrounding migration (experiencing abuse, migration duration, and attempts) are predictive of depression. Alcohol dependency and abuse were both associated with marital status and having family/friends in the intended U.S. destination, while the number of migration attempts also predicted alcohol dependency. The results provide needed information on the association between transit migration through Mexico to the U.S. among unauthorised Central American men and major depressive disorder and alcohol abuse and dependency. [ABSTRACT FROM PUBLISHER]

The present study evaluated the exposure of Southeast Mexican population to Aflatoxin M1 (AFM1) and M2 (AFM2) through the consumption of Oaxaca cheese. The intake of Oaxaca cheese was assessed via a food 7-day dairy questionnaire (N = 1100, 2014 and 2015). Thirty Oaxaca cheeses were randomly sampled, and the origin of the samples was also investigated. AFM1 and AFM2 were quantified by HPLC-FD. The exposure was assessed through the combination of the Probabilistic Density Functions (probabilistic approach). The percentage of the population at risk was calculated through the population exceeding the toxicological reference values (TDI). The risk assessment revealed that the population at higher risk to AFM1 and AFM2 was the children, followed by the adolescents and adult women. To our knowledge, the present study is the first to assess the exposure risk of different age groups of a population to AFM1 and AFM2 through the consumption of cheese. [ABSTRACT FROM AUTHOR]

Cybersex is an important manifestation of sexuality among adolescents and young people. However, there is not enough information about this sexual expression, in particular, in cultures such as Latino culture, which has a traditional perception of human sexuality. This study evaluates online sexual activity among Hispanic adolescent and young people. For this purpose, 2,227 participants from Mexico and Spain (between 15 and 25 years old) completed the Internet Sex Screening Test. Our findings reveal that the most common use of cybersex is recreational, although men and women show risk for cybersex abuse. This is associated with pornography consumption, anal sex, sexual orientation, and gender for adolescent and young people. The more conservative and gendered tradition seems to modulate some aspects of cybersex in both groups, who have revealed some differences in their behaviors. Therefore, cybersex is also an expression of sexuality among Hispanic adolescent and young people and should be considered in sexual health promotion programs and policies. [ABSTRACT FROM PUBLISHER]

Background: Given the increased use of psychoactive substances on the United States–Mexico border, a binational study (Tijuana, Mexico–Los Angeles, USA) was conducted to identify the prevalence of substance use in primary care settings. Objectives: To compare the prevalence and characteristics of patients at risk for substance use disorders in Tijuana and East Los Angeles (LA) community clinics with special attention paid to drug use. Methods: This was an observational, cross-sectional, analytical study, comparing substance use screening results from patients in Tijuana and LA. The settings were 2 community clinics in LA and 6 in Tijuana. Participants were 2,507 adult patients in LA and 2,890 in Tijuana eligible for WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) screening during March–October 2013. Patients anonymously self-administered the WHO ASSIST on a tablet PC in the clinic waiting rooms. Results: Of eligible patients, 96.4% completed the ASSIST in Tijuana and 88.7% in LA (mean 1.34 minutes and 4.20 minutes, respectively). The prevalence of patients with moderate-to-high substance use was higher in LA than Tijuana for each substance: drugs 19.4% vs. 5.7%, alcohol 15.2% vs. 6.5%, tobacco 20.4% vs. 16.2%. LA patients born in Mexico had 2x the odds and LA patients born in the United States had 6x the odds of being a moderate-to-high drug user compared to Tijuana patients born in Mexico. Conclusions: Moderate-to-high drug use is higher in LA than in Tijuana but rates are sufficiently high in both to suggest that screening for drug use (along with alcohol and tobacco use) should be integrated into routine primary care of community clinics in both cities. [ABSTRACT FROM AUTHOR]

Background:The U.S. Latino population exhibits poorer glycemic control than the white population, leading to more frequent health complications and greater disease severity. Social support has been shown a significant factor in health and well-being.Purpose:To determine the association between glycemic control and social support in patients enrolled in the Emory Latino Diabetes Education Program (ELDEP).Methods:A descriptive study of the clinical and social support outcomes of 248 Latino patients diagnosed with type 2 diabetes enrolled in a Spanish-language, culturally competent diabetes education program. Hemoglobin A1C, weight, height, body mass index (BMI), blood pressure, and level of perceived social support were assessed at baseline and after 3 months of the intervention.Results:Patients with low levels of perceived social support at baseline had higher A1C (9.8%) than those who reported moderate–high levels of support (8.9%); however, both groups lowered their HbA1C during follow-up (9.8% to 7.5% and 8.9% to 7.7%, respectively;P<  .001). Mean level of social support increased from 21 ± 9 at baseline to 29 ± 7 during follow-up (P<  .001). Overall mean HbA1C decreased 9.1% to 7.7% (P<  .001).Discussion:Participants in ELDEP have improved clinical indicators of care and increased levels of social support.Translation to Health Education Practice:Diabetes health education programs should consider incorporating social support strengthening to improve health outcomes. [ABSTRACT FROM PUBLISHER]

The article discusses research on the individual, sociological and structural/environmental risk factors for depressive symptoms among patients at a clinic in the red light district of Tijuana, Mexico. The study examined the influence of gender, health, illicit drug use, feeling of rejection/deportation, history of forced sex and history of violence on the prevalence of depressive symptoms. The research suggests the need for public health efforts to support mental health services in the region.

Background: Although most people who inject drugs (PWID) in Tijuana, Mexico, primarily inject heroin, injection and non-injection use of methamphetamine and cocaine is common. We examined patterns of polydrug use among heroin injectors to inform prevention and treatment of drug use and its health and social consequences. Methods: Participants were PWID residing in Tijuana, aged ≥18 years who reported heroin injection in the past six months and were recruited through respondent-driven sampling (n = 1,025). Latent class analysis was conducted to assign individuals to classes on a probabilistic basis, using four indicators of past six-month polydrug and polyroute use: cocaine injecting, cocaine smoking or snorting, methamphetamine injecting, and methamphetamine smoking or snorting. Latent class membership was regressed onto covariates in a multinomial logistic regression. Results: Latent class analyses testing 1, 2, 3, and 4 classes were fit, with the 3-class solution fitting best. Class 1 was defined by predominantly heroin use (50.2%, n = 515); class 2 by methamphetamine and heroin use (43.7%, n = 448), and class 3 by methamphetamine, cocaine, and heroin use (6.0%, n = 62). Bivariate and multivariate analyses indicated a group of methamphetamine and cocaine users that exhibited higher-risk sexual practices and lower heroin injecting frequency, and a group of methamphetamine users who were younger and more likely to be female. Conclusions: Discrete subtypes of heroin PWID were identified based on methamphetamine and cocaine use patterns. These findings have identified subtypes of heroin injectors who require more tailored interventions to reduce the health and social harms of injecting drug use. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections including human immunodeficiency virus are international public health concerns. Heterosexual women who are in steady relationships have been described as a particularly vulnerable population at risk for sexually transmitted infections acquired from their male partners. In this pilot study, we describe associations identified via cross-sectional survey among demographic variables, attachment style, and condom use in Mexican heterosexual women (ages 20-44 years, n  =  50) who self-reported current steady partner relationships. Descriptive, bivariate, and correlation analyses were conducted. Secure attachment and condom use were positively correlated with education level. Limited sexual risk prevention knowledge and contraception use, low risk perception within male partner relationships and misconception about proper condom use were identified as sources of elevated risk for sexually transmitted infections via male partners. Implications of findings include sexual health intervention modification to include dialogue concerning the context of steady relationship and sexual risk among Mexican heterosexual women. [ABSTRACT FROM AUTHOR]

Promoting men's participation in unpaid care work is part of the Programme of Action for the International Conference on Population and Development. However, men's involvement in care work does not mirror the advances women have made in paid work outside the home. This mixed method study explores which men are more involved in caregiving, and what childhood and adulthood factors influence their level of involvement. Quantitative research presents findings from 1169 men across six countries with children aged 0–4, and a qualitative study presents findings from in-depth interviews with 83 men engaged in atypical caregiving practices. Survey research finds that being taught to care for children, witnessing one's father take care of one's siblings, respondents' present attitudes about gender equality and having outside help (or none, in some cases) were all also associated with men's higher level of involvement. Qualitative research reveals that men's experiences of violence, the normalisation of domestic work as children and life circumstances rather than greater-than-average beliefs in gender equality all propelled them into care work. Findings suggest that engaging more men into care work implies changes to policies and structural realities in the workplace coupled with changing gender attitudes. These insights inform policy and practice aimed at promoting greater involvement in care work by men. [ABSTRACT FROM PUBLISHER]

Deported injection drug users (IDUs) in Mexico may be vulnerable to HIV infection following expulsion from the USA. We examined factors associated with HIV risk perception among a sample of deportees in Tijuana. From January to April 2010, 313 male IDUs who reported ever being deported from the USA completed a questionnaire. Overall, 35% (N= 110) of deportees perceived HIV risk. In multivariate logistic regression analyses, factors independently associated with HIV risk perception included ever having a steady female partner in Tijuana post-deportation (adjusted odds ratio [AOR]: 2.26; 95% confidence interval [CI]: 1.01–5.07) and years spent in a US prison (AOR: 1.29 per year; 95% CI: 1.13–1.48). Conversely, years of drug injection use (AOR: 0.95 per year; 95% CI: 0.91–0.99), ever witnessing family members use drugs prior to first migration trip (AOR: 0.24; 95% CI: 0.09–0.65), years of residence in the USA (AOR: 0.91 per year; 95% CI: 0.84–0.98) and being a Tijuana native (AOR: 0.40; 95% CI: 0.16–0.99) were negatively associated with HIV risk perception. US–Mexico border cities that receive deported migrants should target HIV prevention interventions to specific subgroups, including drug-using male deportees. Interventions should consider migrant's time in the USA, the role of their social networks, and reducing missed opportunities for HIV testing/education. [ABSTRACT FROM AUTHOR]

Purpose: This study examined relationships between caregiver mental health and the extent to which needs were met in families of individuals with traumatic brain injury (TBI) in Mexico City, Mexico. Method: Sixty-eight TBI caregivers completed Spanish versions of instruments assessing their own mental health and whether specific family needs were met. Results: Twenty-seven per cent of caregivers reported clinically significant depression levels, 40% reported below-average life satisfaction and 49% reported mild-to-severe burden. Several of the most frequently met family needs were in the emotional support domain, whereas the majority of unmet needs were in the health information domain. Family needs and caregiver mental health were significantly and highly related. When family needs were met, caregiver mental health was better. The strongest pattern of connections in multivariate analyses was between family instrumental support (assistance in the completion of daily life tasks) and caregiver burden, such that caregivers with less instrumental support had greater burden. Additional results suggested that instrumental support uniquely predicted caregiver satisfaction with life, burden and depression. Conclusions: Interventions for TBI caregivers, especially in Latin America, should help family members determine how best to meet their health information and instrumental needs, with the former being likely to improve caregiver mental health. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to examine how marianismo is related to the depressive symptoms of Mexican American women with family conflict as a mediator.Participants: During January of 2010, 170 Mexican American women college students in a southern, Hispanic-serving institution were sampled.Methods: A mediation analysis was conducted to determine if parent conflict mediates the relationship between marianismo values and depressive symptoms.Results: Results from Barron and Kenny's1mediation analysis method, in conjunction with a Sobel2test indicated that parent conflict significantly mediated the relation between marianismo and depressive symptoms.Conclusion: Findings and implications of the mediation will be discussed for the mental health and treatment of Mexican American women college students. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the influence of five types of impairments in individuals with traumatic brain injury (TBI)-and caregiver stress due to these impairments-on the mental health of family caregivers in Guadalajara, Mexico. Method: Ninety caregivers completed measures of TBI impairments and of their own mental health. The majority were female (92.20%) with a mean age of 47.12 years (SD = 12.67). Caregivers dedicated a median of 50 hours weekly to caregiving and had spent a median of 11 months providing care. Results: Two canonical correlation analyses suggested that these two sets of variables were broadly related, such that more severe impairments in individuals with TBI and more caregiver stress due to those impairments were associated with lower caregiver mental health. Across both analyses, social impairments were most associated with increased caregiver burden. Follow-up analyses also uncovered that caregiver stress due to cognitive impairments was uniquely associated with caregiver burden and anxiety. Conclusions: These results are the first to provide evidence that social and cognitive impairments in individuals with TBI from Latin America are the impairments most associated with caregiver mental health and highlight the need for interventions that target social and cognitive functioning. [ABSTRACT FROM AUTHOR]

A survey conducted by the National Sleep Foundation found that 20% of Americans have sleep disorders and 45% experience chronic pain. Several authors evaluated the interrelationship between these functions using various instruments such the Pittsburgh Sleep Quality Index (PSQI) and identified that 34% of subjects in the general population have a poor quality of sleep, but there are few studies that assess the quality of sleep in patients with chronic pain of nonmalignant origin. We undertook this study to evaluate the quality of sleep using the PSQI in patients with chronic pain unrelated to cancer. We conducted a clinical, nonrandomized, uncontrolled, descriptive, and prospective study, applying the PSQI through a direct one-time interview to 311 subjects with chronic pain unrelated to cancer. According to the categorization of the PSQI between good and poor sleepers, 89% of the subjects were poor sleepers ( n = 276). There are significant differences in pain intensity according to the categorization of the PSQI, with a higher intensity shown in the 'poor sleepers' (analysis of variance [ANOVA], P = .030). Using a linear regression model to estimate the curve, a higher score is rated on the PSQI global score (ANOVA, P = .000, R2 = .46) with the increase of the intensity of the pain. We conclude that 'poor sleepers' or those who considered their sleep as 'poor quality' have significantly higher pain intensity. This suggests that intensity of pain plays a role in evaluating the quality of sleep in the subjective perception of sleep and instruments that assess quality. [ABSTRACT FROM AUTHOR]

We examined drug-scene familiarity and exposure to gang violence among residents of a migrant farming community in rural Baja California, Mexico. In October 2010, 164 members of a singlecolonia(community) underwent an interviewer-administered survey to assess ‘exposure to gang violence’ and ‘drug-scene familiarity’, as well as other health indicators. Logistic regression was used to identify correlates of exposure to gang violence. Overall, 20% of participants were male, the median age was 27 years, 24% spoke an indigenous language, 42% reported exposure to gang violence and 39% reported drug-scene familiarity. Factors independently associated with exposure to gang violence included being younger (adjusted odds ratio [AOR] =0.80 per 5-year increase, 95% confidence interval [CI]=0.67–0.96), living in the community longer (AOR=1.47 per 5-year increase, 95% CI=1.11–1.72), higher educational attainment (AOR=1.70 per 5-year increase, 95% CI=1.07–1.12) and drug-scene familiarity (AOR=5.10, 95% CI=2.39–10.89). Exposure to gang violence was very common in this community and was associated with drug-scene familiarity, suggesting a close relationship between drugs and gang violence in this rural community. In a region characterised by mass migration from poorer parts of Mexico, where drugs and gangs have not been previously reported, emerging social harms may affect these communities unless interventions are implemented. [ABSTRACT FROM PUBLISHER]

The developmental activities of 328 elite soccer players aged under-16 years from Brazil, England, France, Ghana, Mexico, Portugal and Sweden were examined using retrospective recall in a cross-sectional research design. The activities were compared to the early diversification, early specialisation, and early engagement pathways. Players started their involvement in soccer at approximately 5 years of age. During childhood, they engaged in soccer practice for a mean value of 185.7, s = 124.0 h · year−1, in soccer play for 186.0, s = 125.3 h · year−1, and in soccer competition for 37.1, s = 28.9 h · year−1. A mean value of 2.3, s = 1.6 sports additional to soccer were engaged in by 229 players during childhood. Players started their participation in an elite training academy at 11 to 12 years of age. During adolescence, they engaged in soccer practice for a mean value of 411.9, s = 184.3 h · year−1, in soccer play for 159.7, s = 195.0 h · year−1, and in soccer competition for 66.9, s = 48.8 h · year−1. A mean value of 2.5, s = 1.8 sports other than soccer were engaged in by 132 players during this period. There were some relatively minor differences between countries, but generally the developmental activities of the players followed a mixture of the early engagement and specialisation pathways, rather than early diversification. [ABSTRACT FROM PUBLISHER]

Intergenerational relations of attachment, including adult state of mind, adult care giving quality, and infant behavior, were examined in urban and rural samples. The sample included 66 dyads of contrasting populations, 35 middle-high urban Spanish speaking families and 31 rural Indian peasant families. Measures included the Adult Attachment Interview (George, Kaplan, & Main, 1985/1996), home observations of mother–infant, and the Strange Situation attachment assessment (Ainsworth, Blehar, Waters, & Wall, 1978). Reliability among independent coders of Spanish AAI transcripts was established for the first time. Moreover, significant relations among the instruments were found, supporting the validity of the AAI to predict infant's attachment classifications and mothers sensitive care of their infants across cultures. Results further supported the cross-cultural robustness of core features of attachment theory and, to some extent, the pathway from adult state of mind through responsive care to attachment security. [ABSTRACT FROM PUBLISHER]

The goal of the present study was to test the predictions of two contrasting claims about the role of morphology in subject–verb number agreement production. According to the maximalist view described by Vigliocco, Hartsuiker, Jarema, and Kolk, languages with relatively rich inflectional morphology may be more susceptible to the influence of notional number due to the penetration of meaning into the agreement process. An alternative proposed by Eberhard, Cutting, and Bock predicts the opposite: Languages with richer inflectional morphology are less susceptible to notional number because inflectional morphemes filter the effect of number meaning. In the present experiments, utterances differing in notional number properties were elicited from speakers of two varieties of Spanish that vary in morphological richness. In Experiment 1, participants formed sentences with overt subjects. In Experiment 2, they produced sentences with null subjects. Results supported the hypothesis that richer morphology reduces notional effects during agreement production, both within and across languages. [ABSTRACT FROM PUBLISHER]

Objective: The purpose of this study of Mexican-American mothers of 2-6 year old children was to explore the relationships among maternal attitude, perceived behavioral controls, mother's intent, mother's regulation of her own Simple Carbohydrate Intake (SCI), and mother's child feeding behaviors. The overall objective was to increase understanding of the complex process of intention to eat healthy. Methods: A prospective exploratory design using a convenience sample of a cohort of 82 Mexican-American mothers was used in this study. Structured questionnaires were selected to measure cognitive restraint, disinhibition, hunger, intent to regulate SCI, and mothers' monitoring, restricting, and pressuring of children's diets. Descriptive statistics and correlations were analyzed for each relationship. Results: The relationships between disinhibition, hunger, cognitive restraint, and the intent variable were significant. More than half of these mothers reported limiting soda and candy for themselves. According to the Food Frequency Questionnaire, mothers were regulating only one-third of simple carbohydrate items they intended to regulate. Significant relationships were found between mothers' regulation of her specific SCI and her control of child feeding behaviors including pressuring, monitoring, and restricting. Conclusion: The findings support the idea that mother's eating behaviors, attitudes, and intent may affect how they feed their pre-school children. Nurses need to develop and test interventions targeted at educating Mexican-American mothers about healthy food choices and healthy child feeding behaviors. [ABSTRACT FROM AUTHOR]

This is the first study of nurse-led group therapy in Mexico. Forty-one depressed older adults with a median age of 71 participated in nurse-led cognitive behavioral group therapy once a week for 12 weeks. Participants' scores on the Patient Health Questionaire-9 showed mild to moderate improvement. Participants experienced positive results in personal growth, changing negative thoughts, and relationships with family. An important therapeutic factor was the support of fellow group members. The nurses experienced positive personal and professional growth. Difficulties included physician resistance and a too-rigid cognitive behavioral group therapy model. A combination of cognitive behavioral therapy and supportive group therapy is recommended. [ABSTRACT FROM AUTHOR]

The interdisciplinary field of migration studies is split into internal and international migration, characterised by different literatures, concepts, methods and policy agendas. Most migration scholars nowadays research international migration, even though, quantitatively, internal migration is more important. Yet the distinction between internal and international moves becomes increasingly blurred, not only because of geopolitical events and the changing nature and configuration of borders, but also because migrants' journeys are becoming increasingly multiple, complex and fragmented. We present a schematic model that sets out 10 migration pathways that combine internal and international migration, and return migration, in various sequenced relationships. We survey the limited literature that attempts to compare and integrate internal and international migration within the same theoretical framework, both general models and some case-study literature from Mexico. We consider three approaches where theoretical transfer seems to hold potential: systems approaches, migrant integration, and the migration-development nexus. We conclude that considerable potential exists for integrating the study of internal and international migration, at both the theoretical and the empirical level. Too often one is studied without reference to the other, yielding a partial analysis. However, we baulk at attempting any 'grand theory' of migration which incorporates all types of migration, in all places and at all times. [ABSTRACT FROM AUTHOR]

This article proposes a combination of actions and decisions that companies from the Mexico's software services industry can carry out internally to obtain a sustainable competitive level in the national and international markets. An attitudinal survey1Study that describes what the companies believe they are doing (which does not imply that they are really doing it). was carried out as primary research based on a questionnaire administered to companies throughout the country. The results obtained highlight diverse aspects that appear to be restricting the companies' competitiveness. Some of the most important aspects are (a) lack of specialization, (b) the absence of strategy regarding the schema with which they sell the services, (c) the diversity of prices for each kind of service, and (d) the generalized absence of mechanisms for measuring and evaluating the companies' performance. After a prospective analysis, the article points out that the efforts that are carried out to achieve efficiency, flexibility, innovation, and superior assets will be useful for attaining the desired competitiveness in any of three foreseen scenarios. © 2007 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]