Normas sociales, publicidad y consumo alimentario en escolares: modelado mediante lógica difusa tipo 2 / Social norms, advertising and food consumption in schoolchildren: modeling using fuzzy logic

Resumen: México ocupa el primer lugar en obesidad infantil en el mundo, por lo que resulta importante identificar variables asociadas al consumo alimentario. El objetivo del presente trabajo fue establecer si la forma en que el consumo de alimentos se modifica en función de las normas sociales alimentarias y la publicidad alimentaria que recibe la población infantil escolar. Se diseñó un estudio multivariado predictivo utilizando sistemas de lógica difusa tipo dos de intervalo (IT2 FLS), y comparando su ajuste con modelos convencionales, como la regresión lineal múltiple (RLM). Se trabajó con las respuestas emitidas por 196 niños en un estudio previo y almacenadas en una base de datos, seleccionando solo las que correspondieron a las variables de interés para el estudio. Las normas sociales a evitar, el número de comidas y la compra de alimentos por la publicidad alimentaria permitieron predecir el consumo alimentario de los niños mediante IT2 FLS. En RLM las horas de comidas tuvo mayor capacidad predictiva que el número de comidas. El IT2 FLS proporcionó un mayor coeficiente de determinación (R2 = 0.649), que el de la RLM (R2 = 0.370). El consumo alimentario, al ser un fenómeno multicausal y complejo, puede ser mejor predicho al utilizar métodos de análisis que manejen de forma más flexible la incertidumbre, como lo hace la IT2 FLS.

Abstract: Mexico ranks first in childhood obesity in the world, so it is important to identify variables associated with food consumption. The objective of this work was to establish whether the way in which food consumption is modified depending on social food norms and food advertising received by school children. A predictive multivariate study was designed using interval type two fuzzy logic systems (IT2 FLS), and comparing its fit with conventional models, such as multiple linear regression (RLM). We worked with the responses issued by 196 children in a previous study and stored in a database, selecting only those that corresponded to the variables of interest for the study. The social norms to avoid, the number of meals and the purchase of food through food advertising made it possible to predict children's food consumption through IT2 FLS. In RLM, mealtimes had a greater predictive capacity than the number of meals. The IT2 FLS provided a higher coefficient of determination (R2 = 0.649) than that of the RLM (R2 = 0.370). Food consumption, being a multicausal and complex phenomenon, can be better predicted by using analysis methods that manage uncertainty more flexibly, as the IT2 FLS does.

The Role of Community Health Agents in Promoting Social Change in Peru.

BACKGROUND: Community health agents (CHAs) provide basic health services and increase health care access thereby improving health outcomes for peri-urban regions in Peru. Few studies analyze the effect that becoming a CHA has on women's interpersonal interactions. We aim to explore the impact CHAs may have on gender and social norms through their roles as trusted leaders in male-dominated communities. METHODS: We conducted six 90-minute group discussions with CHAs working in Huancayo and Trujillo, Peru. We designed the discussions to extract data about family and community norms that changed as a result of working as a CHA. RESULTS: A total of 53 female CHAs participated in six discussion groups. CHAs reported shifting family support (a change in how their family supported them in their role as a CHA), gaining status within their family (feeling more valued for their knowledge and experience), and shifting family gender roles (men and boys taking on more household responsibilities) as a result of their work. CHAs also reported a change in community norms and felt they were more valued and respected within their communities as women leaders. CONCLUSIONS: Working as a CHA creates an opportunity to enact social change through altering family dynamics and community perceptions. Moreover, empowering women to become CHAs not only generates tangible benefits in community health, but can help create social change that ultimately improves the lives of women and realize their human rights.

Framing substance use as "recreational" is neither accurate nor helpful for prevention purposes.

This debate paper discusses six reasons why the term "recreational substance use" should be avoided. (1) Social norms and beliefs are drivers of behavior; therefore, the normalized use of the term conveys injunctive norms of a fully socially acceptable substance. Injunctive norms are the most important drivers of initiation into substance use. (2) The illusion of being in control, suggesting that if consumed for leisure and recreation it can easily be controlled; (3) Idealized social representations that fuel an idealized image of an alternative glamourous or mindful consumption culture; (4) Downplaying potential harms; (5) The implicit promise of everyday pleasure, the ever-growing potency of cannabis products does not fit the narrative of its use for recreation; (6) Industry as a trojan horse branding discourse of the concept of medical cannabis to normalize the image of non-medical use: to complement "therapeutic" with "recreational". "Recreational use" is a subjective ill-defined term. This debate paper aims to find a better terminological solution, honestly denominating with a neutral, unbiased, and objective connotation what is now called "recreational use". Thus, we propose using the term "non-therapeutic" use.

A Qualitative Assessment of Social Norms Related to Seeking Help for Intimate Partner Violence in Honduras.

Intimate partner violence (IPV) is a major public health issue in Honduras and other low- and middle-income countries, with few victims seeking help. While structural factors, such as lack of services and economic barriers, are often cited as reasons for not seeking help, social and cultural factors may also play a role. This study aims to describe the normative social environment that may hinder women's help-seeking behaviors for IPV. Thematic analysis was conducted on data from four focus group discussions with 30 women at a busy health center in urban Tegucigalpa, Honduras. Data were coded inductively and themes were identified deductively using the theory of normative social behavior and its components (descriptive and injunctive social norms, expected outcomes, and groups of reference). Four themes emerged: social norms and expected outcomes that discourage IPV help-seeking; factors that determine the direction of a social norm, either discouraging or encouraging help-seeking; groups of reference for IPV victims; and society sets women up for failure. Social norms, expected outcomes, and groups of reference hinder women's help-seeking behavior after IPV. These findings have significant implications for designing effective interventions and policies to support women and their families affected by IPV.

Formación de valores y bioética en los profesionales de la salud en Cuba / Formation of values and Bioethics in Cuban health professionals

La Bioética es la disciplina que estudia los problemas éticos que surgen en relación con la salud. Es el educador quien desempeña el papel principal al analizar los aspectos metodológicos en el proceso de articulación docente-asistencial para lograr una enseñanza con valores éticos en los futuros profesionales, apoya al estudiante con un enfoque personalizado, afectivo, comunicativo y reflexivo, enmarcado en el cumplimiento de la misión social y humana que implica ser un profesional de la Medicina. El objetivo de los autores es socializar elementos del pensamiento bioético relacionados con la formación de valores en los estudiantes, destacando el humanismo y la solidaridad, con una coherente sistematización del conocimiento sobre las diferentes corrientes bioéticas en el proceso formativo en el campo de la salud.

Bioethics is the discipline which studies ethical problems that arise in relation to health. Teachers are the ones who play the main role when analyzing methodological aspects in the teaching-care process to achieve teaching with ethical values in future professionals and support students with a personalized, affective, communicative and reflective approach, framed in the fulfillment of the social and human mission that being a medical professional implies. The objective of the authors is to socialize elements of bioethical thought related to the formation of values in students, highlighting humanism and solidarity, with a coherent systematization of knowledge about the different bioethical currents in the health training process.

Prejudice and Egalitarian Norms: Analysis Based on Moral Judgment / Preconceito e Normas Igualitárias: Análises a Partir do Julgamento Moral

Abstract Based on the social psychology of development, this study investigated whether differences in moral reasoning would imply differences in prejudice, conforming with an egalitarian norm and in the use of moral justifications for the suppression of prejudice. A total of 555 Brazilians participated in this study, the final sample being composed of 500 Brazilians, who answered an online questionnaire with measurements used to assess the variables of interest in the research. Based on descriptive and inferential statistical analyses, the results indicated a relationship between differences in moral judgment and differences in the level of prejudice, in accordance with the egalitarian norm and the use of moral justifications. The results are discussed from the perspective of social psychology and moral development.

Resumo A partir da psicologia social do desenvolvimento, este estudo investigou se diferenças no raciocínio moral implicariam em diferenças no preconceito, na conformidade com uma norma igualitária e no uso de justificativas morais para supressão do preconceito. Participaram deste estudo um total de 555 brasileiros(as), sendo a amostra final composta por 500 brasileiros(as), que responderam um questionário on-line com medidas utilizadas para avaliar as variáveis de interesse da pesquisa. Baseados em análises estatísticas descritivas e inferenciais, os resultados indicaram uma relação entre diferenças no julgamento moral e diferenças no nível de preconceito, de conformidade com a norma igualitária e com o uso de justificativas morais. Os resultados foram discutidos a partir da psicologia social e do desenvolvimento moral.

Butler e a psicanálise: do fracasso das normas à estranheza do gozo / Butler and psychoanalysis: from the failure of norms to the uncanniness of jouissance / Butler y el psicoanálisis: del fracaso de las normas a la rareza del goce

O objetivo deste artigo é fazer avançar o debate entre a psicanálise e os estudos queer, em especial a partir da interlocução traçada por Judith Butler com os trabalhos de Freud e Lacan. Retomando o modo como Butler articula Foucault, Derrida e a psicanálise para pensar os problemas de gênero, evidenciamos que a teoria psicanalítica permite à filósofa situar, a partir de sua concepção da melancolia de gênero, os pontos de fracasso da norma em função da vida psíquica do poder. Ainda que a cisheterossexualidade normativa imponha um roteiro de identificações e escolhas de objeto a seus sujeitos, há uma imprevisibilidade na maneira pela qual cada um responderá às injunções normativas da cultura, o que aponta para uma falha das normas em determinar completamente a subjetividade. A melancolia de gênero se torna, assim, uma marca da importância da psicanálise no percurso de Butler. Em seguida, discutimos as interpelações da filósofa ao simbólico lacaniano, bem como as nuances progressivamente introduzidas em sua leitura da diferença sexual. Ao longo do percurso de Butler, a diferença sexual deixa de ser considerada uma teoria da heterossexualidade e passa a ser apresentada como um conceito-borda, uma fronteira vacilante, que tomamos aqui como um convite para produzirmos uma releitura não normativa da diferença sexual na psicanálise a partir da teoria lacaniana da sexuação. Finalmente, localizamos a estranheza do gozo e o caráter irredutível da sexualidade às normas sociais como um importante eixo partilhado entre Butler e a psicanálise.(AU)

The aim of this article is to branch out the debate between psychoanalysis and queer studies, focusing on the interlocution drawn by Judith Butler with the works of Freud and Lacan. Returning to the way Butler articulates Foucault, Derrida and psychoanalysis to think about gender trouble, we show that psychoanalytic theory allows the philosopher to situate, from her conception of gender melancholy, the points of failure of the norm in function of the psychic life of power. After all, even though normative cis-heterosexuality imposes a script of identifications and object-choices on its subjects, there is an unpredictability to the way in which each one will respond to the normative injunctions of culture, so that norms fail to fully determine subjectivity. Gender melancholy thus becomes a mark of the importance of psychoanalysis in Butler's path. Then, we discuss the philosopher's interpellations to the Lacanian symbolic order, as well as the nuances progressively introduced in her reading of sexual difference. Along Butler's path, sexual difference is no longer considered a theory of heterosexuality and is presented as a border-concept, a vacillating frontier, which we take here as an invitation to produce a non-normative rereading of sexual difference in psychoanalysis, resorting to the Lacanian theory of sexuation. Finally, we locate the uncanniness of jouissance and the irreducible character of sexuality to social norms as an important shared axis between Butler and psychoanalysis.(AU)

El objetivo de este artículo es hacer avanzar el debate entre el psicoanálisis y los estudios queer, enfatizando la interlocución trazada por Judith Butler con los trabajos de Freud y Lacan. Volviendo a la forma en que Butler articula a Foucault, Derrida y el psicoanálisis para pensar los problemas de género, mostramos que la teoría psicoanalítica permite a la filósofa ubicar, desde su concepción de la melancolía de género, los puntos de falla de la norma en función de la vida psíquica del poder. Aunque la cis-heterosexualidad normativa imponga identificaciones y elecciones de objeto a sus sujetos, hay una imprevisibilidad en la forma en que cada uno responderá a los mandatos normativos de la cultura, lo que apunta a un fracaso de las normas para determinar completamente la subjetividad. La melancolía de género se convierte, entonces, en una marca de la importancia del psicoanálisis en la trayectoria de Butler. En seguida, discutimos las interpelaciones de la filósofa a lo simbólico lacaniano, así como los matices progresivamente introducidos en su lectura de la diferencia sexual. A lo largo de la trayectoria de Butler, la diferencia sexual deja de ser considerada una teoría de la heterosexualidad y pasa a ser presentada como un concepto-borde, um límite vacilante, que tomamos aquí como una invitación para producirmos una relectura no normativa de la diferencia sexual en psicoanálisis a partir de la teoría lacaniana de la sexuación. Finalmente, ubicamos la rareza del goce y el carácter irreductible de la sexualidad a las normas sociales como un importante eje compartido entre Butler y el psicoanálisis.(AU)

Jerarquización de zonas de atención prioritaria para la minimización del riesgo biológico en situación de crisis / Ordering areas for priority public health interventions during infectious disease outbreaks

RESUMEN Objetivo Proponer una herramienta para identificar sectores de población que requieren mayor atención por parte de autoridades locales o gubernamentales en situaciones de crisis biológica, considerando los factores que influyen en la adherencia a las normas de minimización de riesgos. Metodología Se implementó un algoritmo de ordenamiento, tomando como referencia las restricciones de julio del 2021 en Ecuador. El contexto del estudio se resume en siete sectores urbanos de la ciudad de Guayaquil, con una población caracterizada por un nivel de educación promedio por debajo de la educación secundaria superior (70%) y más del 50% entre 20-34 años, con alguna ocupación en el medio de una economía popular debilitada. Siete factores de riesgo fueron identificados después de un análisis estructural de la hipótesis de adherencia (x2/gl=3,6; CFI≥0,91; TLI≥0,90; RMSEA≤0,05), basado en una muestra aleatoria de n=515 adultos viviendo en las áreas afectadas. Resultados El seguimiento de las normas está influenciado por la percepción del clima de seguridad, el riesgo percibido y el entendimiento del riesgo. El umbral de ordenamiento (h) permite establecer relaciones unidireccionales entre variables. Conclusiones Los resultados muestran que Vergeles, Norte y Fertisa representan los sectores con mayor prioridad de atención en materia de salud pública {A4,A5,A6}>{A2}>{A3}>{A1}>{A7}. Se requiere identificar más factores para garantizar una diferenciación óptima.

ABSTRACT Objective To propose a tool to identify local communities that require public health work priority, taking into account factors that influence adherence to risk minimization guidelines, especially in lock-down environments and unconventional workplaces. Methodology An ordering algorithm, based on the theory of uncertainty, was applied to classify population zones exhibiting high levels of infection and non-compliance with regulations in Guayaquil, during the last 'weekend' lockdown episode in July 2021. Seven urban sectors showed the highest number of infections (more than 70% of the local population): Vergeles (A1), Samanes (A2), Socio Vivienda (A3), Guasmo Norte (A4), Fertisa (A5), Alborada (A6), Urdesa (A7). Seven risk factors were identified after a path analysis of compliance hypothesis (x2/gl=3,6; CFI≥0,91; TLI≥0,90, RMSEA≤0,05), based on a random sample of n=515 adults living in the affected areas. Results Adherence to norms is influenced by the safety climate, perceived risk and risk understanding. The ordering threshold (h) leaded unidirectional relationships between variables. Conclusions: Adding more factors are believed to increases the differentiation path. The results showed that Vergeles, Norte and Fertisa were the areas with the highest priority for public health care {A4,A5,A6}>{A2}>{A3}>{A1}>{A7}.

Determinantes de la conducta planeada como predictores del consumo de tabaco y alcohol en adolescentes / Determinants of Planned Behavior as Predictors of Tobacco and Alcohol Consumption in Adolescents

Resumen: Objetivo: Conocer el efecto de los determinantes de la conducta planeada sobre el consumo de tabaco y alcohol en adolescentes de preparatoria. Material y Métodos: Se realizó un estudio correlacional predictivo en 735 adolescentes estudiantes de preparatorias públicas, ubicadas en 14 complementos urbanos pertenecientes al Estado de Nuevo León, México. Los datos se obtuvieron mediante cuestionarios autoadministrados, para variables sociodemográficas, consumo de tabaco y alcohol, actitud, norma subjetiva y control conductual percibido hacia el consumo de tabaco y alcohol. Se realizaron modelos de regresión logística de la actitud, norma subjetiva y control conductual percibido sobre el consumo de tabaco y alcohol. Material y Métodos: Se realizó un estudio correlacional predictivo en 735 adolescentes estudiantes de preparatorias públicas, ubicadas en 14 complementos urbanos pertenecientes al Estado de Nuevo León, México. Los datos se obtuvieron mediante cuestionarios autoadministrados, para variables sociodemográficas, consumo de tabaco y alcohol, actitud, norma subjetiva y control conductual percibido hacia el consumo de tabaco y alcohol. Se realizaron modelos de regresión logística de la actitud, norma subjetiva y control conductual percibido sobre el consumo de tabaco y alcohol. Resultados: La norma subjetiva (OR=1.02, p=0.028) y el control conductual percibido (OR=1.084, p=0.001), se mostraron significativos para predecir el consumo de tabaco alguna vez en la vida, mientras que la actitud (OR=0.980, p=0.017), norma subjetiva (OR=1.034, p=0.025) y control conductual percibido (OR=1.080, p=0.001), se mostraron significativos para predecir el consumo de alcohol alguna vez en la vida. Conclusiones: Con base a los resultados se puede determinar la aplicabilidad y pertinencia de la Teoría de la Conducta Planeada para la generación de nuevos conocimientos científicos, que permitan el diseño e implementación de programas específicos para enfrentar las situaciones que los adolescentes perciben como facilitadores para el consumo de tabaco y alcohol.

Abstract: Objective: To know the effect of the determinants of planned behavior on tobacco and alcohol consumption in high school adolescents. Material and Methods: A predictive correlational study was carried out in 735 adolescent students of public high schools, located in 14 urban complements belonging to the State of Nuevo León, Mexico. Data were obtained through self-administered questionnaires for sociodemographic variables, tobacco and alcohol consumption, attitude, subjective norm and perceived behavioral control towards tobacco and alcohol consumption. Logistic regression models of attitude, subjective norm and perceived behavioral control over tobacco and alcohol consumption were performed. Results: The subjective norm (OR = 1.02, p = .028) and the perceived behavioral control (OR = 1.084, p = .001), were found to be significant in predicting tobacco use sometime in life, while the attitude (OR = .980, p = .017), subjective norm (OR = 1.034, p= .025) and perceived behavioral control (OR = 1.080, p = .001), were found to be significant in predicting alcohol consumption at some time in the life. Conclusions: Based on the results, the applicability and relevance of the Theory of Planned Behavior can be determined for the generation of new scientific knowledge, which allows the design and implementation of specific programs to face the situations that adolescents perceive as facilitators for the tobacco and alcohol consumption.

Social norms and dishonesty across societies.

Social norms have long been recognized as an important factor in curtailing antisocial behavior, and stricter prosocial norms are commonly associated with increased prosocial behavior. In this study, we provide evidence that very strict prosocial norms can have a perverse negative relationship with prosocial behavior. In laboratory experiments conducted in 10 countries across 5 continents, we measured the level of honest behavior and elicited injunctive norms of honesty. We find that individuals who hold very strict norms (i.e., those who perceive a small lie to be as socially unacceptable as a large lie) are more likely to lie to the maximal extent possible. This finding is consistent with a simple behavioral rationale. If the perceived norm does not differentiate between the severity of a lie, lying to the full extent is optimal for a norm violator since it maximizes the financial gain, while the perceived costs of the norm violation are unchanged. We show that the relation between very strict prosocial norms and high levels of rule violations generalizes to civic norms related to common moral dilemmas, such as tax evasion, cheating on government benefits, and fare dodging on public transportation. Those with very strict attitudes toward civic norms are more likely to lie to the maximal extent possible. A similar relation holds across countries. Countries with a larger fraction of people with very strict attitudes toward civic norms have a higher society-level prevalence of rule violations.

Functions of social networks in maternal food choice for children in Mexico.

Food choice for children has important implications in establishing early-life dietary habits and preferences. Food choice for children has been studied as parent-child dyad dynamics, but little is known about the extended system of relationships in maternal food choice for children. The objective of this study was to understand the functions of mothers' social networks in the food choices that mothers make for their children ages 1 to 5 years old in rural Mexico. In-depth interviews were conducted with 46 participants in three rural communities. The interviews inquired about participants' child-feeding practices, personal and local beliefs about child feeding and the individuals with whom they had conversations about food and child feeding. All interviews were conducted in Spanish, audio-recorded, transcribed verbatim, verified for quality and analysed using the constant comparative method. Five interconnected networks emerged, consisting of household family, non-household family, community, children's initial school and health and nutritional programme personnel. Each network had functions in food choice that ranged from shared food decision-making in the household family network to imparting formal dietary guidance in the health and nutritional programme personnel network. Across the networks, professionals, participants' mothers and mothers-in-law, community senior women and other women with children emerged as prominent figures whom participants would turn to for child-feeding advice. These findings provide empirical evidence that social networks, as an organized system of interconnected relationships, have vital functions in establishing social norms for food choices made for children that can be leveraged to promote healthy food choices.

Construção e validação de instrumento sobre intenção de uso de preservativos entre mulheres de aglomerado subnormal / Construction and validation of an instrument on the intended use of condoms among socially vulnerable women

Resumo O objetivo deste artigo é construir e validar um instrumento de medida da intenção de uso de preservativos entre mulheres em contexto de vulnerabilidade social. Pesquisa metodológica cuja etapa de construção envolveu 111 mulheres em estudo prévio e a validação do conteúdo e face contou com 166 participantes, entre usuárias de um serviço de saúde, juízes especialistas e docentes. No processo de validação foram utilizados o Índice de Validade de Conteúdo por Item, Índice de Validade de Conteúdo Geral e Alfa de Cronbach. O instrumento constou de 29 itens, com Índice de Validade de Conteúdo Geral 0,99. A validação semântica resultou na inserção de sinais pictóricos nas escalas de resposta. O estudo piloto gerou Alfa de Cronbach 0,61 (IC: 0,48-0,72). O instrumento validado constitui-se ferramenta que pode auxiliar trabalhadores da saúde e pesquisadores na predição do uso de preservativos, guiando intervenções preventivas na direção de práticas sexuais seguras entre mulheres em situação de vulnerabilidade social.

Abstract The scope of this article is to build and validate an instrument to measure the intention to use condoms among women in a context of social vulnerability. It involved methodological research, the elaboration stage of which involved 111 women from a previous study, and the content validation stage had 166 participants, including female frequenters of a healthcare service, specialized referees and teachers. In the validation process, the Content Validity Index per Item, General Content Validity Index and Cronbach's Alpha were used. The instrument included 29 items and had a General Content Validity Index of 0.99. The semantic validation resulted in the insertion of pictorial signs in the response scales. The pilot study generated Cronbach's alpha of 0.61 (CI: 0.48-0.72). The validated instrument is a tool that can assist health workers and researchers in predicting condom use, providing input for preventive interventions towards safe sexual practices among women in situations of social vulnerability.

Taking Care of Each Other: How Can We Increase Compliance with Personal Protective Measures During the COVID-19 Pandemic in Chile?

In the context of the COVID-19 pandemic, personal protective measures (e.g., social distancing, handwashing, and mask wearing) have been adopted as a cornerstone to limit the spread of the disease. Yet, the effectiveness of these measures depends on people's levels of adherence. In this article, we apply social-psychological research to the study of compliance with personal protective measures during the COVID-19 pandemic in Chile. We consider three possible models underlying adherence: (1) sociodemographic and socioeconomic factors, (2) instrumental factors, and (3) normative factors. We draw on data from a longitudinal nonrepresentative panel study (Study 1, n = 32,304) and a cross-sectional representative survey (Study 2, n = 1,078) to explore the impact of these different factors on personal protective measures compliance. Findings show the strongest support for the role of instrumental and normative factors, in that people who comply with protective measures report to a greater extent that relatives and friends comply too and tend to perceive high risk of COVID-19. We finish by proposing policy recommendations to promote effective strategies to contain the spread of the virus.

Socio-cultural factors for breastfeeding cessation and their relationship with child diarrhoea in the rural high-altitude Peruvian Andes - a qualitative study.

BACKGROUND: In some areas of the world, breast milk is seen as a potential source of child diarrhoea. While this belief has been explored in African and Southeast Asian countries, it remains vastly understudied in Latin American contexts. We investigate socio-cultural factors contributing to breastfeeding cessation in rural high-altitude populations of the Peruvian Andes. The role of socio- cultural factors in the local explanatory model of child diarrhoea, and whether these perceptions were integrated in the local healthcare system were assessed. METHODS: Within the framework of a randomised controlled trial, we conducted semi-structured interviews with 40 mothers and 15 health personnel from local healthcare centres involved in the trial. RESULTS: Cultural beliefs on breastfeeding cessation included the perception that breast milk turned into "blood" after six months and that breastfeeding caused child diarrhoea. We identified eight local types of child diarrhoea, and women linked six of them with breastfeeding practices. "Infection" was the only diarrhoea mothers linked to hygiene and the germ disease concept and perceived as treatable through drug therapy. Women believed that other types of diarrhoea could not be treated within the formal healthcare sector. Interviews with health personnel revealed no protocol for, or consensus about, the integration of the local explanatory model of child diarrhoea in local healthcare and service provision. CONCLUSIONS: The local explanatory model in rural Andean Peru connected breastfeeding with child diarrhoeas. Cultural beliefs regarding diarrhoea management may increase home treatments, even in cases of severe diarrhoeal episodes. Future national breastfeeding support programmes should promote peer-counselling approaches to reduce negative attitudes towards breastfeeding and health practitioners. Local explanatory models should be incorporated into provincial and regional strategies for child diarrhoea management to promote equity in health and improve provider-patient relationships.

RESUMEN: ANTECEDENTES: En diferentes partes del mundo, la leche materna es percibida como una fuente potencial de diarreas infantiles. Mientras que estas creencias se han estudiado en África o el Sudeste Asiático, su análisis en el contexto latinoamericano es limitado. Esta investigación se centra en el estudio de los factores culturales que contribuyen al cese de la lactancia materna en poblaciones rurales de los Andes peruanos. Al mismo tiempo, también se analiza el papel de estos factores culturales en el modelo explicativo local de diarreas infantiles y la integración de las creencias en los servicios locales de salud. MéTODOS: Dentro de un ensayo clínico aleatorizado, se llevaron a cabo entrevistas semi-estructuradas con 40 mujeres y 15 trabajadores de salud de centros participantes en el ensayo. RESULTADOS: Las creencias culturales en torno a la lactancia maternal incluían la percepción de que la leche materna se convierten en "sangre" a los seis meses del parto y que la leche materna causaba diarreas en los niños lactantes. Identificamos ocho tipos de diarreas locales, seis de las cuales fueron asociadas con la lactancia por las madres participantes. "Infección" resultó ser el único tipo de diarrea que las madres asociaron con los principios de la higiene y la teoría microbiana de la enfermedad y percibían como curable por medio de medicamentos. Las mujeres creían que el resto de diarreas locales no podían ser tratadas dentro del sistema de salud. Las entrevistas con el personal sanitario indicaron una falta de protocolos y consenso sobre cómo integrar el sistema de creencias locales en torno a las diarreas infantiles en los servicios de salud. CONCLUSIONES: El modelo explicativo local en zonas rurales de los Andes peruanos asocia la lactancia con las diarreas infantiles. Estas creencias culturales dan lugar a prácticas de manejo de diarreas infantiles que pueden incrementar los tratamientos domiciliarios, incluso en episodios de diarrea severos. Futuros programas nacionales de apoyo a la lactancia materna deben promover la consejería y apoyo de pares y profesionales de salud con la finalidad de reducir las actitudes negativas hacia la lactancia materna y el personal de salud. Los modelos explicativos locales de las diarreas infantiles deberían incorporarse a las estrategias provinciales y regionales con la finalidad de promover la equidad en salud y mejorar las relaciones médico-paciente.

Do advertising pieces that portray brazilian jeitinho influence dishonest behavior? / Peças publicitárias que retratam jeitinho brasileiro Iinfluenciam o comportamento desonesto? / ¿ Los anuncios publicitarios que retratan al jeitinho brasileño influyen en el comportamiento deshonesto?

This research aimed at investigating whether watching Brazilian advertising pieces that portray a sociocultural behavioral pattern called Brazilian jeitinho would influence participant's subsequent behavior. One carried out an experiment in which 200 subjects watched and assessed three advertisement pieces. Upon recruitment, participants were informed that they would be taking part in a raffle for a gift card. The number of tickets received per participant was defined by a die-under-cup task. The more tickets they obtained, the higher the chance to receive the prize, providing an incentive to cheat. Afterwards, respondents took part in a task that defined the number of tickets that each would receive to participate in the raffle. Independent variables consisted in the manipulation of priming of jeitinho (video content: jeitinho or neutral) and privacy of the task (with or without privacy). On the other hand, the dependent variable consisted in the result obtained when participants rolled the dices that defined the number of tickets. One found a significant difference between the groups in which privacy was manipulated, indicating that the groups that performed the task aimed at measuring dishonesty with privacy actually tended to report lower values than the ones actually obtained, entailing an effect of contrast. This finding suggests that the implementation of public policies that utilize propaganda that portrays Brazilian jeitinho could reduce engagement in dishonest behavior among Brazilians. (AU)

Esta pesquisa objetivou investigar se assistir a peças publicitárias nacionais representativas de um padrão de comportamento sociocultural do Brasil, o jeitinho brasileiro, influenciaria o comportamento subsequente dos participantes. Realizou-se um experimento no qual 200 participantes assistiram e avaliariam três anúncios publicitários. Ao serem recrutados, os participantes foram informados de que estariam concorrendo a um sorteio de um vale-presente. O número de tickets do sorteio foi definido por uma tarefa que consistiu em jogar um dado dentro de um copo. Quanto mais tickets obtivessem, maior a chance de ganhar o prêmio, criando-se um incentivo para trapacear. As variáveis independentes constituíram a manipulação da pré-ativação (priming) de jeitinho (conteúdo das peças: jeitinho ou neutro) e da privacidade da tarefa (com ou sem privacidade). Já a variável dependente consistiu no resultado obtido ao jogar dados para definir o número de tickets. Encontrou-se diferença significativa entre os grupos para manipulação de privacidade, indicando que os participantes que realizaram a tarefa de mensuração de desonestidade com privacidade tenderam a reportar valores menores do que os que realmente obtiveram no sorteio, ocasionando um efeito de contraste. Esse achado sugere que a implementação de políticas públicas utilizando propagandas que retratem o jeitinho brasileiro podem reduzir o engajamento em comportamento desonesto entre os brasileiros. (AU)

Este estudio tuvo como objetivo investigar si ver anuncios publicitarios brasileños que retratan a un patrón de comportamiento sociocultural denominado jeitinho brasileño influiría en el comportamiento posterior de los participantes. Se realizó un experimento donde 200 individuos vieron y evaluaron tres anuncios publicitarios. Al ser reclutados, se les informó a los participantes que se realizaría un sorteo de una tarjeta de regalo. El número de boletos de cada participante fue definido mediante una tarea que consistía en lanzar un dado a una taza. Cuantos más boletos obtuvieron, mayor fue la posibilidad de recibir el premio, lo que ofreció un incentivo para hacer posibles trampas. Posteriormente, los encuestados participaron en una tarea que definió la cantidad de boletos que cada uno recibiría para participar en el sorteo del premio. Las variables independientes consistieron en la manipulación de la preactivación (priming) de jeitinho (contenido de los videos: jeitinho o neutro) y de la privacidad de la tarea (con o sin privacidad). Por otro lado, la variable dependiente consistió en el resultado obtenido cuando los participantes lanzaron los dados que definían el número de boletos. Se encontró una diferencia significativa entre los grupos en los que se manipuló la privacidad, lo que indica que en los grupos que realizaron la tarea dirigida a medir la deshonestidad con privacidad, en realidad tendían a informar valores más bajos que los que realmente obtuvieron, lo que conlleva un efecto de contraste. Este resultado sugiere que la implementación de políticas públicas utilizando propaganda que retrata al jeitinho brasileño podría reducir la participación en conductas deshonestas entre los brasileños. (AU)

Exploring Psychosocial Determinants of Eating Behavior: Fruit and Vegetable Intake Among Brazilian Adolescents.

In most Western countries, children and adolescents do not eat the recommended amount of fruits and vegetables (FVs). Theoretical frameworks on social psychology of eating, such as the Reason Action Approach, Social Cognitive Theory, and Theory of Normal Conduct have been applied to understand how psychosocial variables can explain FV intake. However, considering those predictors is still rare on the understanding of FV intake among adolescents (particularly in Brazil) despite its importance within eating behavior. Therefore, this study explored important psychosocial determinants of weekly frequency of FV intake among Brazilian adolescents in a model testing socioeconomic status (SES) and body mass index (BMI). A cross-sectional design was performed with 429 students (58% female), mean age 14.45 (SD 1.86). Key variables of theoretical framework on social psychology of food were investigated by structural equation modeling. The model included self-efficacy, attitudes, and social norms (with its subcomponents descriptive and injunctive) as psychosocial predictors of weekly frequency of FV intake along with SES and BMI. An instrument developed for Brazilian Portuguese was used to collect psychosocial variables as well as to verify FV reported intake. The total model explained 45.5% of weekly frequency of FV intake, and self-efficacy was the only significant psychosocial determinant (λ = 0.51, p = 0.001). SES also showed an important effect on the model (λ = 0.21, p = 0.001), while for BMI no significance was observed. In conclusion, the model was adequate to understand psychosocial determinants of weekly frequency of FV intake for Brazilian adolescents, with self-efficacy and SES as the major determinants of this eating behavior.

Women's Empowerment as It Relates to Attitudes Towards and Practice of Female Genital Mutilation/Cutting of Daughters: An Ecological Analysis of Demographic and Health Surveys From 12 African Countries.

Background: Women's empowerment may play a role in shaping attitudes towards female genital mutilation/cutting (FGM/C) practices. We aimed to investigate how empowerment may affect women's intention to perpetuate FGM/C and the practice of FGM/C on their daughters in African countries. Materials and methods: We used data from Demographic and Health Surveys carried out from 2010 to 2018. The countries included in our study were Benin, Burkina Faso, Chad, Côte d´Ivoire, Ethiopia, Guinea, Kenya, Mali, Nigeria, Senegal, Tanzania, and Togo. This study included 77,191 women aged 15-49 years with at least one daughter between zero and 14 years of age. The proportion of women who reported having at least one daughter who had undergone FGM/C as well as the mother's opinion towards FGM/C continuation were stratified by empowerment levels in three different domains (decision-making, attitude to violence, and social independence) for each country. We also performed double stratification to investigate how the interaction between both indicators would affect daughter's FGM/C. Results: The prevalence of women who had at least one daughter who had undergone FGM/C was consistently higher among low empowered women. Tanzania, Benin, and Togo were exceptions for which no differences in having at least one daughter subjected to FGM/C was found for any of the three domains of women's empowerment. In most countries, the double stratification pointed to a lower proportion of daughters' FGM/C among women who reported being opposed to the continuation of FGM/C and had a high empowerment level while a higher proportion was observed among women who reported being in favor of the continuation of FGM/C and had a low empowerment level. This pattern was particularly evident for the social independence domain of empowerment. In a few countries, however, a higher empowerment level coupled to a favorable opinion towards FGM/C was related to a higher proportion of daughters' FGM/C. Conclusion: Women's empowerment and opinion towards FGM/C seems to be important factors related to the practice of FGM/C in daughters. Strategies to improve women's empowerment combined with shifts in the wider norms that support FGM/C may be important for achieving significant reductions in the practice.

Normas sociales y consumo de alcohol en mujeres embarazadas de la Argentina / Social norms and alcohol consumption in pregnant women of Argentina

Resumen La exposición prenatal al alcohol puede derivar en un espectro de trastornos congénitos, dentro de los cuales el Síndrome Alcohólico Fetal (SAF) es el más severo. Esto es 100 % prevenible si no se consume alcohol durante la gestación, por lo que conocer los factores que determinan que una mujer consuma alcohol estando embarazada es fundamental. El objetivo de este trabajo es evaluar si características del entorno (como son las normas sociales prescriptivas o NSP) se relacionan con el consumo de alcohol durante la gestación en mujeres de la ciudad de Mar del Plata, Argentina. Para ello, se realizó un muestro probabilístico de 852 mujeres gestantes durante el año 2016 en los principales centros de atención primaria a la salud de la ciudad. Se evaluó el consumo de alcohol antes y durante la gestación a través del Test de Identificación de Trastornos por Consumo de Alcohol y las NSP con preguntas construidas ad hoc. El 87 % consideró que las otras gestantes consumen alcohol; de ellas, 53 % cree que el consumo es igual, 10 % cree que es mayor y el resto menor. El 90 % reconoció que las personas importantes para ellas desaprobarían el consumo durante la gestación. Las mujeres con un entorno favorable hacia el consumo se correspondieron con ingesta de alcohol en el embarazo, mientras que se observó lo contrario en los casos en los que el entorno era desfavorable. Estos resultados indican que podría ser beneficioso diseñar estrategias preventivas que se focalicen no solo en la gestante, sino en el entorno cercano.

Abstract Prenatal alcohol exposure can lead to a spectrum of congenital disorders for the fetus with permanent consequences, known as fetal alcohol spectrum disorders (FASD), within which Fetal Alcohol Syndrome (SAF) is its most severe extreme. All FASD are 100 % preventable if no alcohol is consumed during pregnancy, so knowing the factors that determine that a woman decides to drink while pregnant is essential to develop effective prevention plans. Among these factors are the phenomena of social influence such as perceived social norms (PSN), both descriptive and prescriptive. The PSN are transmitted by social interaction and produced based on the perception of the beliefs or behaviors of others, beyond their real actions. It has been identified that PSN predict alcohol consumption in various populations, such as university students, but research is almost non-existent with pregnant women. The aim of this study is to assess whether environmental characteristics (such as PSN) are related to alcohol consumption during pregnancy in pregnant women in the city of Mar del Plata, Argentina. Method: a probabilistic sample of 852 pregnant women was carried out during 2016 in the main primary health care centers of the city of Mar del Plata. Alcohol consumption was assessed before and during pregnancy through the AUDIT and the PSN was assessed with five questions constructed ad hoc by specialists in the area of alcohol consumption. Descriptive analyses were performed to categorized social norms and the prescriptive ones were re-categorized into four groups: 1. It is bad for the health of the baby or the mother; 2. It is wrong for cultural or moral reasons; 3. consumption is accepted; 4. It does not know/does not matter. To describe them based on alcohol consumption, latent class analyses were performed. Models of two to four classes were estimated, reproduced 50 times to avoid local maximums, with the software R. Results: 87 % of pregnant women believed that others in their same condition consume alcohol. 53 % of them believed they consume the same as before pregnancy, 10 % believed they consume more and the rest that they reduced their consumption. The belief about the average amount that other pregnant women would consume is more than three drinks, the equivalent of one bottle of beer per occasion of consumption. 90 % recognized that people important to them would disapprove consumption during pregnancy because doing so would cause harm to the baby, the mother, pregnancy in general or because alcohol is considered harmful to health. 6 % considered that people important to them would approve consumption because few amounts are tolerated or because alcohol is good for breastfeeding. The latent class analysis indicated a better fit for the two-class model. Class 1 was made up of women who claimed that for their people, alcohol consumption during pregnancy was acceptable and they themselves consumed alcohol during pregnancy. Class 2 conglomerated women who thought that others would see their consumption as bad at this stage and there was a low probability that they themselves consumed during pregnancy. Conclusions: These results indicate that it could be beneficial to design preventive strategies that focus not only on the future mother, but on the nearby environment (couple, family, friends), and even throughout the community, where social norms are established and reproduced.

MECHANISMS Study: Using Game Theory to Assess the Effects of Social Norms and Social Networks on Adolescent Smoking in Schools-Study Protocol.

This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) intervention harnesses peer influence, while the Dead Cool intervention uses classroom pedagogy. Both interventions were originally developed in the UK but culturally adapted for a Colombian setting. In a before and after design, we will obtain psychosocial, friendship, and behavioral data (e.g., attitudes and intentions toward smoking and vaping) from ~300 students in three schools for each intervention in the UK and the same number in Colombia (i.e., ~1,200 participants in total). Pre-intervention, participants take part in a Rule Following task, and in Coordination Games that allow us to assess their judgments about the social appropriateness of a range of smoking-related and unrelated behaviors, and elicit individual sensitivity to social norms. After the interventions, these behavioral economic experiments are repeated, so we can assess how social norms related to smoking have changed, how sensitivity to classroom and school year group norms have changed and how individual changes are related to changes among friends. This Game Theoretic approach allows us to estimate proxies for norms and norm sensitivity parameters and to test for the influence of individual student attributes and their social networks within a Markov Chain Monte Carlo modeling framework. We identify hypothesized mechanisms by triangulating results with qualitative data from participants. The MECHANISMS study is innovative in the interplay of Game Theory and longitudinal social network analytical approaches, and in its transdisciplinary research approach. This study will help us to better understand the mechanisms of smoking prevention interventions in high and middle income settings.

Las creencias que justifican la corrupción disminuyen la disposición y el apoyo percibido para combatirla / Beliefs that justify corruption decrease willingness and perceived support to combat it

Resumen La participación cívica es fundamental para abstenerse y sancionar a quienes se benefician de la corrupción. Experimentos muestran que el castigo altruista (pagar para castigar a quienes no cooperan), mantiene cooperando a los transgresores, pero en la vida real se les sanciona poco, siendo necesario identificar los factores que disminuyen esa disposición. Se encuestaron 622 ciudadanos mexicanos, población general, para analizar los efectos de creencias que justifican la corrupción y el apoyo percibido sobre la disposición a actuar contra la corrupción sancionando y absteniéndose de ella. Un modelo de ecuaciones estructurales confirma efectos negativos de las creencias de justificación de la corrupción y positivos del apoyo percibido, además de un efecto negativo indirecto de las creencias de justificación de la corrupción a través de un efecto negativo sobre el apoyo percibido, explicando en conjunto el 47% de la varianza de la disposición a actuar contra la corrupción en un modelo que muestra indicadores que reflejan una adecuada bondad de ajuste.

Abstract Civic participation is essential to abstain and punish the corrupt people. Experimental studies that show altruistic punishment, paying for those who do not cooperate to be punished, keep offenders cooperating, but in real life they are little penalized, being necessary to identify the factors that diminish that disposition. 622 Mexican citizens were surveyed to analyze the effects of beliefs that justify corruption and perceived support on willingness to act against cor ruption by sanctioning and abstaining from it. A model of structural equations confirmed negative effects of corruption justification beliefs and positive perceived support effects, in addition to an indirect negative effect of corruption justification beliefs through a negative effect on perceived support, together explaining for 47% of the variance of the willingness to act against corruption in a model that shows indices of adequate goodness of fit.