Blood, Sweat, and/or Tears: Comparing Nervios Symptom Descriptions in Honduras.

With the aim of advancing the cross-cultural investigation of the folk illness nervios, I conducted a dual-sited comparative study of symptom descriptions among two diverse research settings in Honduras. Baer et al. (Cult Med Psychiatry 27(3):315-337, 2003) used cultural consensus modeling (CCM) to confirm a core description of nervios among four Latino groups in the US, Mexico, and Guatemala, but observed that overall agreement and average competence in a shared illness model decreased along a gradient from presumably more-to-less economically developed sites. This has left unresolved whether such variation extends to other Latin American regions. This paper is an exploratory analysis of inter- and intracultural variation in nervios symptom descriptions by 50 Hondurans from the market town of Copán Ruinas (n = 25) and city of San Pedro Sula (n = 25). I performed CCM using a combination of free-listing, pile-sorting, and rating activities to establish if respondents across sites share a single model of nervios. I found consensus for the San Pedro Sula subsample, but not for Copán Ruinas or for the overall sample. Results suggest nervios is constitutive of differing forms of distress ranging from chronic illness to acute suffering, as well as anger- and panic-based manifestations that overlap with biomedical ideas about depression, anxiety, and panic disorder. This variation derives in part from demographic factors such as age, gender, and residence, but may also result from ethnic and regional diversity among subsamples. However, consensus only being present among San Pedro Sula respondents suggests their greater awareness of cultural distinctions between biomedical and folk medical knowledge, which is likely due to their exposure to manifold health frameworks in those settings.

A decade of rapid change: Biocultural influences on child growth in highland Peru.

OBJECTIVES: In the past decade many areas of Peru have been undergoing extreme environmental, economic, and cultural change. In the highland hamlet of Chugurpampa, La Libertad, climate change has ruined harvests and led to frequent periods of migration to the coast in search of livelihood. This biocultural research examines how the changes could be affecting the growth of children who maintain residence in the highlands. METHODS: Clinical records from the early 2000s were compared to those from the early 2010s. Charts were randomly selected to record anthropometric data, netting a sample of 75 children ages 0-60 months of age. Analysis of covariance was run to compare mean stature, weight, and BMI between cohorts. Percentage of children who fall below the -2 threshold for z-scores for height and weight were compared by age and cohort. RESULTS: A significant secular trend in growth was found, with children born more recently larger than those born a decade before. The effect is most notable in the first year of life, with the growth advantage attenuated by the age of 3 for height and age 4 for weight. While children were unlikely to be stunted from 0 to 3 years of age, 44% of the later cohort were stunted and 11% were underweight from 4 to 5 years of age. CONCLUSIONS: Three possible explanations for the rapid shift are entertained: more time spent on the coast during gestation and early childhood, which may attenuate the effect of hypoxia on child growth; dietary change; and increased use of biomedicine.