Financing marine protected areas through visitor fees: insights from tourists willingness to pay in Chile.

Tourism is a financing mechanism considered by many donor-funded marine conservation initiatives. Here we assess the potential role of visitor entry fees, in generating the necessary revenue to manage a marine protected area (MPA), established through a Global Environmental Facility Grant, in a temperate region of Chile. We assess tourists' willingness to pay (WTP) for an entry fee associated to management and protection of the MPA. Results show 97 % of respondents were willing to pay an entrance fee. WTP predictors included the type of tourist, tourists' sensitivity to crowding, education, and understanding of ecological benefits of the MPA. Nature-based tourists state median WTP values of US$ 4.38 and Sun-sea-sand tourists US$ 3.77. Overall, entry fees could account for 10-13 % of MPA running costs. In Chile, where funding for conservation runs among the weakest in the world, visitor entry fees are no panacea in the short term and other mechanisms, including direct state/government support, should be considered.

Analysis of evolution of mental and behavioral disorders through International Classification of Diseases review / Análise da evolução dos transtornos mentais e comportamentais ao longo das revisões da Classificação Internacional de Doenças / Análisis de la evolución de los trastornos mentales y comportamentales a lo largo de las revisiones de la Clasificación Internacional de Enfermedades

This study aimed to describe the creation and evolution of three diagnostic categories of the chapter V of the International Classification of Diseases ICD, denominated in ICD-10: 1) Mood disorders, 2) Schizophrenia and 3) Mental and behavioral disorders due to psychoactive substance use, since the sixth to the tenth review (current). The changes of these categories within the ICDs were described, along with the code changes and it was quantified the grouping, categories and subcategories numbers. We observed significant changes, incorporations of new definitions and redefinitions. It was concluded that the changes followed the course of the diseases and psychiatric disorders that were full with prejudice and exclusion expressions, especially in addition to expanding the number of categories, the improvement in the content of Chapter V.

Este estudo teve por objetivo descrever a criação e a evolução de três categorias diagnósticas do capítulo V da Classificação Internacional de Doenças, denominadas na Classificação Internacional de Doenças-10: 1) transtornos de humor, 2) esquizofrenia e 3) transtornos mentais e comportamentais, devido ao uso de substâncias psicoativas, desde a sexta revisão à décima (atual). Foram descritas as mudanças dessas categorias entre as Classificações Internacionais de Doenças, as mudanças de códigos e quantificado o número de agrupamentos, categorias e subcategorias. Observaram-se mudanças significativas, incorporações de novas definições e redefinições. Concluiu-se que as alterações ocorridas acompanharam a trajetória das doenças e transtornos psiquiátricos que foram carregados de expressões que remetem ao preconceito e à exclusão, destacando-se, além da expansão do número de categorias, o melhoramento no conteúdo do capítulo V.

Este estudio tuvo por objetivo describir la creación y la evolución de tres categorías diagnósticas del capítulo V de la Clasificación Internacional de Enfermedades-CID, denominadas en CID-10: 1) Trastornos de humor, 2) Esquizofrenia y 3) Trastornos mentales y comportamentales debido al uso de substancias psicoactivas, desde la sexta revisión a la décima (actual). Fueron descritos los cambios de esas categorías entre CID, los cambios de códigos y cuantificado el número de agrupamientos, categorías y subcategorías. Se observaron cambios significativos, incorporaciones de nuevas definiciones y redefiniciones. Se concluyó que las alteraciones ocurridas acompañaron la trayectoria de las enfermedades y trastornos psiquiátricos que fueron cargados de expresiones que remeten preconcepto y exclusión, destacándose además de la expansión del número de categorías, el mejoramiento en el contenido del capítulo V.

Screening for sleep disorders in pediatric primary care: are we there yet?

OBJECTIVES: Obstructive sleep apnea (OSA) and habitual snoring are highly prevalent childhood conditions and have been associated with a large array of negative health outcomes. Although guidelines were published by the American Academy of Pediatrics (AAP) a decade ago recommending routine screening of sleep-disordered breathing (SDB) in primary care settings, it remains unclear to what extent such guidelines have been implemented and resulted in effective SDB screening. The aim of this study was to determine if AAP guidelines are adhered to in pediatric primary care. STUDY DESIGN: In all, 1032 electronic charts of children 4 to 17 years old presenting for well-child visits to 17 pediatricians between January 1 and December 31, 2010, were manually reviewed. Abstracted data included demographic variables and documentation of snoring as well as other sleep-related complaints. RESULTS: The mean age was 8.5 ± 3.9 years (mean ± standard deviation), 49.9% were male, and 79.7% were Hispanic; 24.4% (n = 252) were screened for snoring. Of the children screened for sleep-related issues, 34.1% (n = 86) snored, but the majority of them (61.6%, n = 53) received no further evaluation. In the present sample, 0.5% (n = 5) had a diagnosis of OSA. CONCLUSIONS: The low prevalence of OSA may be explained by the relatively low frequency of sleep-related problem screening by pediatricians and thus the inordinately low adherence to the AAP guidelines. Modification and transition to electronic medical records as well as expanded efforts to educate health care providers and caregivers may improve detection and timely treatment of children at risk for SDB.