RESUMO O objetivo deste estudo foi descrever as variações semanais no tipo e duração do treinamento, bem como parâmetros relacionados ao bem-estar, em jogadores de elite de voleibol. Vinte e quarto jovens jogadores de elite de voleibol da seleção Francesa (idade: 17,8 ± 1,0 anos) foram monitorados diariamente, e o tipo de treinamento, a duração do treinamento, a participação em partidas e o status de bem-estar foram medidos durante 22 semanas. A duração do treinamento de voleibol variou de 100 a 510 minutos por semana, enquanto a duração do treinamento de força e condicionamento variou de 97 a 262 minutos por semana. Os níveis de fadiga variaram de 1,5 a 2,8 A.U., e a dor muscular tardia (DMT) variou de 1,5 a 2,5 A.U. Correlação positiva grande foi encontrada entre sono e duração do jogo (r = 0,64) e entre estresse e volume semanal (r = 0,52). Além disso, uma correlação positiva moderada foi encontrada entre fadiga e duração da partida (r = 0,36), entre sono e volume semanal (r = 0,35), entre DMT e duração da partida (r = 0,43), entre estresse e treinamento de força (r = 0,42), treinamento de voleibol (r = 0,35), e duração da partida (r = 0,47). O presente estudo revelou variações naturais no volume de treinamento ao longo da temporada e dependência moderada entre treinamento semanal/duração da partida e status de bem-estar.

ABSTRACT The purpose of this study was to describe weekly variations in the type and duration of training, as well as wellness-related parameters, in elite volleyball players. Twenty-four youth elite volleyball players from the French national team (age: 17.8 ± 1.0 y.o.) were monitored daily, and the type of training, training duration, participation in matches, and wellness status were measured over 22 weeks. Volleyball training duration varied from 100 to 510 minutes per week, while strength and conditioning training duration varied from 97 to 262 minutes per week. Fatigue levels varied from 1.5 to 2.8 A.U., and delayed onset muscle soreness (DOMS) varied from 1.5 to 2.5 A.U. Large positive correlation were found between sleep and match duration (r = 0.64) and between stress and weekly volume (r = 0.52). Additionally, moderate positive correlation were found between fatigue and match duration (r = 0.36); between sleep and weekly volume (r = 0.35); between DOMS and match duration (r = 0.43); between stress and strength training (r = 0.42), volleyball training (r = 0.35), and match duration (r = 0.47). The present study revealed natural variations in training volume across the season and moderate dependency between weekly training/match durations and wellness status.

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

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

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

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

ABSTRACT OBJECTIVE To assess the quality of adolescent friendly health services. METHODS Qualitative assessment using the simulated user technique in first level clinics of Health Services of Morelos, Mexico, during 2018. Ten out of 17 facilities with non-exclusive adolescent friendly services were randomly selected. An additional facility with exclusive adolescent friendly services was included as an intensive subsample. Four adolescents served as simulated users interpreting different cases in the clinics. The total of 43 semi-structured exit interviews were conducted, and two nominal groups were made to assess the perceived quality from the adolescents’ perception of friendliness and experience. Thematic analysis of the data obtained was performed. RESULTS Staff attitude was highlighted as a key element in the adolescents’ experience. Failures were found, such as the existence of bureaucratic barriers to access, lack of signage in clinics, lack of privacy and confidentiality, failure of physical examination during the appointment and lack of monitoring of the reasons for appointment. The exclusive clinic for adolescents offered more appropriate friendly services compared with nonexclusive clinics. CONCLUSION Although the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations. The exclusive clinic for adolescents stood out for having better structured mechanisms that can be implemented in nonexclusive clinics to improve the care process.

RESUMEN OBJETIVO Evaluar la calidad de los servicios de salud amigables para adolescentes. MÉTODOS Evaluación cualitativa utilizando la técnica de usuario simulado en clínicas de primer nivel de los Servicios de Salud de Morelos, México durante 2018. Se seleccionaron aleatoriamente 10 de 17 establecimientos con servicios amigables no exclusivos para adolescentes. Se incluyó adicionalmente un centro con servicios amigables exclusivo para adolescentes como submuestra de tipo intensivo. Cuatro adolescentes fungieron como usuarios simulados interpretando diferentes casos de consulta en las clínicas. Se realizaron 43 entrevistas semiestructuradas de salida y se hicieron dos grupos nominales para evaluar la calidad percibida a partir de la percepción de amigabilidad y la experiencia de los adolescentes. Se realizó análisis temático de los datos obtenidos. RESULTADOS La actitud del personal destacó como un elemento clave para la experiencia de los adolescentes. Se encontraron fallas como la existencia de barreras burocráticas para el acceso, falta de señalamientos en las clínicas, falta de privacidad y confidencialidad, fallas en la exploración física durante la consulta y falta de seguimiento de los motivos de consulta. La clínica exclusiva para adolescentes ofreció servicios amigables más adecuados en comparación con las clínicas no exclusivas. CONCLUSIÓN Aunque en la mayoría de los establecimientos visitados el servicio es accesible, aun distan de cumplir con las características de amigabilidad de acuerdo con las recomendaciones internacionales. La clínica exclusiva para adolescentes destacó al contar con mecanismos mejor estructurados que pueden ser implementados en clínicas no exclusivas para mejorar el proceso de atención.

ABSTRACT OBJECTIVE To assess the quality of adolescent friendly health services. METHODS Qualitative assessment using the simulated user technique in first level clinics of Health Services of Morelos, Mexico, during 2018. Ten out of 17 facilities with non-exclusive adolescent friendly services were randomly selected. An additional facility with exclusive adolescent friendly services was included as an intensive subsample. Four adolescents served as simulated users interpreting different cases in the clinics. The total of 43 semi-structured exit interviews were conducted, and two nominal groups were made to assess the perceived quality from the adolescents’ perception of friendliness and experience. Thematic analysis of the data obtained was performed. RESULTS Staff attitude was highlighted as a key element in the adolescents’ experience. Failures were found, such as the existence of bureaucratic barriers to access, lack of signage in clinics, lack of privacy and confidentiality, failure of physical examination during the appointment and lack of monitoring of the reasons for appointment. The exclusive clinic for adolescents offered more appropriate friendly services compared with nonexclusive clinics. CONCLUSION Although the service is accessible in most of the clinics visited, it is still far from being friendly according to international recommendations. The exclusive clinic for adolescents stood out for having better structured mechanisms that can be implemented in nonexclusive clinics to improve the care process.

RESUMEN OBJETIVO Evaluar la calidad de los servicios de salud amigables para adolescentes. MÉTODOS Evaluación cualitativa utilizando la técnica de usuario simulado en clínicas de primer nivel de los Servicios de Salud de Morelos, México durante 2018. Se seleccionaron aleatoriamente 10 de 17 establecimientos con servicios amigables no exclusivos para adolescentes. Se incluyó adicionalmente un centro con servicios amigables exclusivo para adolescentes como submuestra de tipo intensivo. Cuatro adolescentes fungieron como usuarios simulados interpretando diferentes casos de consulta en las clínicas. Se realizaron 43 entrevistas semiestructuradas de salida y se hicieron dos grupos nominales para evaluar la calidad percibida a partir de la percepción de amigabilidad y la experiencia de los adolescentes. Se realizó análisis temático de los datos obtenidos. RESULTADOS La actitud del personal destacó como un elemento clave para la experiencia de los adolescentes. Se encontraron fallas como la existencia de barreras burocráticas para el acceso, falta de señalamientos en las clínicas, falta de privacidad y confidencialidad, fallas en la exploración física durante la consulta y falta de seguimiento de los motivos de consulta. La clínica exclusiva para adolescentes ofreció servicios amigables más adecuados en comparación con las clínicas no exclusivas. CONCLUSIÓN Aunque en la mayoría de los establecimientos visitados el servicio es accesible, aun distan de cumplir con las características de amigabilidad de acuerdo con las recomendaciones internacionales. La clínica exclusiva para adolescentes destacó al contar con mecanismos mejor estructurados que pueden ser implementados en clínicas no exclusivas para mejorar el proceso de atención.

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

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

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

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

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

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

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

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

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

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

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

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

Resumo: A gravidez na adolescência está associada a desfechos socioeconômicos e de saúde ruins. A taxa de gravidez na adolescência do México é a mais alta entre os países da Organização para a Cooperação e Desenvolvimento Econômico (OCDE). Nosso objetivo foi explorar os fatores associados a gravidezes e partos em adolescentes e mulheres jovens. Usando o Inquérito Nacional de Meninos, Meninas e Mulheres (ENIM) de 2015, examinamos dois desfechos dicotômicos: “ter engravidado” e “ser mãe” em mulheres de 15 a 19 anos e de 20 a 24 anos sem gravidezes durante a adolescência. Realizamos uma análise bivariada para cada faixa etária e usamos modelos lineares generalizados (GLM) para avaliar a associação entre as variáveis de desfecho e variáveis socioeconômicas selecionadas. Entre adolescentes, a frequência escolar e a educação superior reduziram significativamente a probabilidade de ter engravidado ou ser mãe, enquanto ser casada ou morar com o parceiro aumentou essa probabilidade. Ter a primeira relação a uma idade mais avançada associou-se a uma menor prevalência de gravidez. Para mulheres adultas, além da frequência escolar, educação superior e ser casada/morar com o parceiro, a região da residência também teve uma associação significativa com ter estado alguma vez grávida engravidado. Fatores socioeconômicos similares estiveram associados à gravidez e maternidade entre adolescentes e jovens. Contudo, observou-se que adiar a iniciação sexual poderia reduzir a taxa de gravidez na adolescência. Nossos resultados assinalam a importância da frequência escolar e da obtenção da educação superior para a redução das taxas de fecundidade em adolescentes.

Abstract: Adolescent pregnancy is associated with poor health and socioeconomic factors. The adolescent pregnancy rate in Mexico is the highest among the Organization for Economic Co-operation and Development (OECD) countries. We aimed to explore the factors associated with pregnancies and births in adolescent and young adult women. Using the 2015 Mexican National Survey of Boys, Girls, and Women (ENIM), we examined two dichotomous outcomes: “ever pregnant” and “being a mother” in women from 15 to 19 years and from 20 to 24 years without pregnancies during adolescence. We conducted bivariate analysis for each age group and used general linear models (GLM) to assess the association between the outcome variables and selected socioeconomic variables. Among adolescents, school attendance and tertiary education significantly decreased the likelihood of ever having been pregnant or being mothers, while being married/cohabiting increased the likelihood. Older age at first intercourse was negatively associated with ever having been pregnant. For adult women, in addition to school attendance, tertiary education, and being married/cohabiting, the region of residence also showed a significant association with ever having been pregnant. Similar socioeconomic factors were associated with pregnancy and motherhood between adolescents and young adults. However, it was found that delaying sexual debut could reduce the adolescent pregnancy rate. Our results highlight the importance of attending school and attaining tertiary education in reducing adolescent fertility rates.

Resumen: El embarazo durante la adolescencia se asocia con una salud precaria y consecuencias socioeconómicas negativas. La tasa de embarazo adolescente en México es la más alta entre los países de la Organización para la Cooperación y el Desarrollo Económicos (OCDE). Nuestro objetivo fue explorar factores asociados a embarazos y nacimientos en mujeres adolescentes y adultas jóvenes. Utilizando la Encuesta Nacional de Niños, Niñas y Mujeres (ENIM), 2015, examinamos dos resultados dicotómicos: “embarazadas alguna vez” y “ser madre” en mujeres de 15 a 19 años y de 20 a 24 sin embarazos durante la adolescencia. Realizamos un análisis bivariado por grupo de edad y usamos modelos lineales generales (MLG) para evaluar la asociación entre el resultado de las variables y las variables socioeconómicas seleccionadas. Entre adolescentes, la asistencia escolar y contar con educación terciaria disminuía significativamente la posibilidad de haber estado embarazada o ser madres, mientras que estar casada/unida con alguien incrementó la posibilidad. Una edad más avanzada durante las relaciones sexuales estuvo negativamente asociada con haber estado alguna vez embarazada. Para las mujeres adultas, además de la asistencia escolar, educación terciaria, y estar casada/unida con alguien, la región de residencia también mostró una asociación significativa con haber estado alguna vez embarazada. Factores socioeconómicos similares estuvieron asociados con el embarazo y la maternidad entre adolescentes y adultos jóvenes. No obstante, se descubrió que retrasar el inicio de las relaciones sexuales podría reducir la tasa de embarazos adolescentes. Nuestros resultados subrayan la importancia de ir a la escuela y realizar estudios de nivel superior para reducir las tasas de fertilidad adolescentes.

Resumo: A gravidez na adolescência está associada a desfechos socioeconômicos e de saúde ruins. A taxa de gravidez na adolescência do México é a mais alta entre os países da Organização para a Cooperação e Desenvolvimento Econômico (OCDE). Nosso objetivo foi explorar os fatores associados a gravidezes e partos em adolescentes e mulheres jovens. Usando o Inquérito Nacional de Meninos, Meninas e Mulheres (ENIM) de 2015, examinamos dois desfechos dicotômicos: “ter engravidado” e “ser mãe” em mulheres de 15 a 19 anos e de 20 a 24 anos sem gravidezes durante a adolescência. Realizamos uma análise bivariada para cada faixa etária e usamos modelos lineares generalizados (GLM) para avaliar a associação entre as variáveis de desfecho e variáveis socioeconômicas selecionadas. Entre adolescentes, a frequência escolar e a educação superior reduziram significativamente a probabilidade de ter engravidado ou ser mãe, enquanto ser casada ou morar com o parceiro aumentou essa probabilidade. Ter a primeira relação a uma idade mais avançada associou-se a uma menor prevalência de gravidez. Para mulheres adultas, além da frequência escolar, educação superior e ser casada/morar com o parceiro, a região da residência também teve uma associação significativa com ter estado alguma vez grávida engravidado. Fatores socioeconômicos similares estiveram associados à gravidez e maternidade entre adolescentes e jovens. Contudo, observou-se que adiar a iniciação sexual poderia reduzir a taxa de gravidez na adolescência. Nossos resultados assinalam a importância da frequência escolar e da obtenção da educação superior para a redução das taxas de fecundidade em adolescentes.

Abstract: Adolescent pregnancy is associated with poor health and socioeconomic factors. The adolescent pregnancy rate in Mexico is the highest among the Organization for Economic Co-operation and Development (OECD) countries. We aimed to explore the factors associated with pregnancies and births in adolescent and young adult women. Using the 2015 Mexican National Survey of Boys, Girls, and Women (ENIM), we examined two dichotomous outcomes: “ever pregnant” and “being a mother” in women from 15 to 19 years and from 20 to 24 years without pregnancies during adolescence. We conducted bivariate analysis for each age group and used general linear models (GLM) to assess the association between the outcome variables and selected socioeconomic variables. Among adolescents, school attendance and tertiary education significantly decreased the likelihood of ever having been pregnant or being mothers, while being married/cohabiting increased the likelihood. Older age at first intercourse was negatively associated with ever having been pregnant. For adult women, in addition to school attendance, tertiary education, and being married/cohabiting, the region of residence also showed a significant association with ever having been pregnant. Similar socioeconomic factors were associated with pregnancy and motherhood between adolescents and young adults. However, it was found that delaying sexual debut could reduce the adolescent pregnancy rate. Our results highlight the importance of attending school and attaining tertiary education in reducing adolescent fertility rates.

Resumen: El embarazo durante la adolescencia se asocia con una salud precaria y consecuencias socioeconómicas negativas. La tasa de embarazo adolescente en México es la más alta entre los países de la Organización para la Cooperación y el Desarrollo Económicos (OCDE). Nuestro objetivo fue explorar factores asociados a embarazos y nacimientos en mujeres adolescentes y adultas jóvenes. Utilizando la Encuesta Nacional de Niños, Niñas y Mujeres (ENIM), 2015, examinamos dos resultados dicotómicos: “embarazadas alguna vez” y “ser madre” en mujeres de 15 a 19 años y de 20 a 24 sin embarazos durante la adolescencia. Realizamos un análisis bivariado por grupo de edad y usamos modelos lineales generales (MLG) para evaluar la asociación entre el resultado de las variables y las variables socioeconómicas seleccionadas. Entre adolescentes, la asistencia escolar y contar con educación terciaria disminuía significativamente la posibilidad de haber estado embarazada o ser madres, mientras que estar casada/unida con alguien incrementó la posibilidad. Una edad más avanzada durante las relaciones sexuales estuvo negativamente asociada con haber estado alguna vez embarazada. Para las mujeres adultas, además de la asistencia escolar, educación terciaria, y estar casada/unida con alguien, la región de residencia también mostró una asociación significativa con haber estado alguna vez embarazada. Factores socioeconómicos similares estuvieron asociados con el embarazo y la maternidad entre adolescentes y adultos jóvenes. No obstante, se descubrió que retrasar el inicio de las relaciones sexuales podría reducir la tasa de embarazos adolescentes. Nuestros resultados subrayan la importancia de ir a la escuela y realizar estudios de nivel superior para reducir las tasas de fertilidad adolescentes.

RESUMO Objetivo: Investigar o desfecho psicológico em longo prazo em sobreviventes de doenças críticas, após alta da unidade de terapia intensiva. Métodos: Avaliou-se coorte prospectiva de pacientes sobreviventes após admissão a uma unidade de terapia intensiva mista entre janeiro e setembro de 2010, 6 meses e 5 anos após a alta hospitalar. Aplicaram-se em todos os momentos as seguintes escalas: Dementia Rating Scale-2, Hospital Anxiety and Depression Scale, Post-Traumatic Stress Syndrome 14-Questions Inventory, Euro Quality of Life 5 Dimensions (EQ-5-D) e Visual Analogue Scale (EQ VAS). Resultados: Dentre 267 pacientes, 25 foram avaliados após 6 meses (idade: 62 ± 16 anos). Aos 6 meses, 48% apresentavam comprometimento cognitivo; 24% ansiedade, 16% depressão e 16% transtorno de estresse pós-traumático. Foram reavaliados 5 anos após a alta 17 pacientes, com idade: 65 ± 15 anos. Dentre eles, a frequência de comprometimento cognitivo caiu de 47% para 18% (p = 0,063), em razão da melhora destes pacientes ao longo do tempo e do não surgimento desta condição em outros pacientes após a alta. Ainda após 5 anos, apenas 12% da amostra relatou ansiedade, e nenhum tinha depressão ou transtorno de estresse pós-traumático. Não se encontraram diferenças em termos das escalas EQ-5-D e EQ VAS entre as avaliações após 6 meses e 5 anos. Conclusão: Os sobreviventes não apresentaram declínio progressivo da função cognitiva ou da qualidade de vida dentro de 5 anos após a alta da unidade de terapia intensiva. Os sintomas psicopatológicos tenderam a diminuir com o tempo.

ABSTRACT Objective: To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge. Methods: A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods. Results: Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS. Conclusion: Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.

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

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