Freshwater Management Discourses in the Northern Peruvian Andes: The Watershed-Scale Complexity for Integrating Mining, Rural, and Urban Stakeholders.

The Peruvian environmental action plan seeks headwaters protection as one of its integrated watershed management objectives. However, heterogeneous social and environmental conditions shape this freshwater management challenge at subnational scales. We have noticed different interpretations of this challenge. To map the debate, understand the diverse interpretations, and frame political choices, we conducted semi-structured interviews with institutional and non-institutional stakeholders for performing discourse analysis in an Andean watershed where mountaintop gold mining, midstream farmers, and the downstream Cajamarca city coexist. One discourse dominates the debate on protecting the freshwater supply and argues the importance of river impoundment, municipal storage capacity, and institutional leadership. The other two discourses revolve around protecting the mountain aquifer. The second discourse does so with a fatalistic view of headwaters protection and rural support. The third discourse partially shifts the debate towards the need for improving rural capacity building and (ground)water inventories. To understand evolutions in society, it is crucial to understand these three discourses, including the types of knowledge that actors present as legitimate, the attributed roles to all stakeholders, and the kinds of worldviews informing each discourse. The interaction among discourses could hinder integrated watershed management at worst or, at best, help inspire multi-stakeholder collaboration.

How Brazilian Schoolchildren Identify, Classify, and Label Foods and Beverages-A Card Sorting Methodology.

This study examined how Brazilian schoolchildren identified, classified, and labeled foods and beverages. Semi-structured interviews were conducted with 133 schoolchildren aged 7 to 10 years old from a public school located in southern Brazil in 2015. A set of cards with pictures of 32 food and beverage items from the web-based Food Intake and Physical Activity of Schoolchildren tool (Web-CAAFE) were used. Participants identified each item, formed groups for them based on similarity, and assigned labels for those groups. Student's t-tests and analysis of variance (ANOVA) tests were used to verify the mean difference between the groups of items. K-means cluster analysis was applied to identify similar clusters. Schoolchildren made an average of 9.1 piles of foods and beverages that they thought were similar (±2.4) with 3.0 cards (±1.8) each. Five groups were identified: meats, snacks and pasta, sweets, milk and dairy products, and fruits and vegetables. The most frequently used nomenclature for labeling groups was taxonomic-professional (47.4%), followed by the specific food item name (16.4%), do not know/not sure (13.3%), and evaluative (health perception) (8.8%). The taxonomic-professional category could be applied to promote improvements in the identification process of food and beverage items by children in self-reported computerized dietary questionnaires.

Attitudes towards urban howler monkeys (Alouatta caraya) in Paraguay.

Increasing urbanisation is encroaching into natural habitats and sometimes forcing wildlife into urban centres. Whether or not wildlife can thrive in an urban environment is dependent on many factors, one of which is how the species is perceived by local people. This study focuses on the city of Pilar in south-west Paraguay, which is home to a population of urban-dwelling black and gold howler monkeys (Alouatta caraya). Using semi-structured interviews, we assessed peoples' attitudes towards the presence of howlers, whether they perceived the monkeys to cause problems in the city, what they believed were the biggest threats to the monkeys, and whether they felt that the presence of monkeys in the city was compatible with their way of life in the long term. Overall, we found that the majority of interviewees had positive attitudes towards the monkeys, believing that they brought benefits to the city and that they should be protected from potential risks in the urban environment. Our results provide the basis for collaborative, community-based development of management strategies for the long-term survival of these urban monkeys.

Pregnant again? Perspectives of adolescent and young mothers who and do not experience a repeat pregnancy in adolescence.

Introduction: Teen pregnancy remains a major social and public health issue in developing countries. Each additional child compromises the development of both the mother and children. Scarce studies have been performed in Latin America.Purpose: This study explores and analyzes individual and family factors associated with repeat pregnancies during adolescence to better elucidate the phenomenon.Methods: Qualitative-descriptive study. Thirty semi-structured interviews were conducted with mothers 20 years of age or younger from urban areas of Santiago, Chile. Participants were divided into Repeat Pregnancy (RP) and No Repeat Pregnancy (NRP) groups. Qualitative data analysis was based on elements of grounded theory.Results: The RP group generally related life stories reflecting greater psychosocial vulnerability. Most of the RP group dropped out of school after their first pregnancy to focus on parenting and had a passive attitude towards contraception. In contrast, members of the NRP group actively sought long-term contraceptive methods, motivated largely by the desire to continue their education to improve their living conditions and achieve greater personal fulfilment. They tended to have family support networks that facilitated school retention.Conclusion: Key differences between groups included use of contraception, focus on life projects, and motivation to finish school. Prevention strategies should promote long-term contraceptive methods, offer strategies to help young mothers continue their education, facilitate achievement of personal projects, and provide support for parenting.

A Qualitative Exploration of Less Acculturated Mexican Mothers' Safety Perceptions of Herbs, Medicines, and Cleaners in the Home.

Childhood poisoning is a leading public health concern in our society. The death rate from unintentional poisonings among children has increased by 80% from 2000 to 2009. Immigrant children are also at-risk. A qualitative study, consisting of a pile sort, was conducted among immigrant Mexican mothers to determine their safety perceptions of commonly used medicines, herbs, and cleaners. Participants (N = 35) were selected for semi-structured interviews from a pediatric primary care clinic in the Dallas/Fort Worth Metroplex. Some mothers over-estimated their children's ability to discern the dangers of substances, relied heavily on sensory skills of children, and perceived a medicine as safe after successful use in the past. Other mothers were more cognizant of allergic reactions, ingestion, and the need to store substances carefully. Brief interventions that incorporate culturally-appropriate safety messages are needed to assist Mexican mothers in creating a safe home environment.

La evaluación de los trastornos de la personalidad según el DSM-5: recursos y limitaciones / Assessment of personality disorders according to DSM-5: available instruments and limitations

El objetivo de este artículo es hacer una revisión sobre los instrumentos de medida disponibles en español para la evaluación de los trastornos de personalidad (TP) según el DSM-5. El enfoque actual de los TP figura en la Sección II del DSM-5 y no registra cambios respecto al DSM-IV. Sin embargo, se presenta en la Sección III un modelo alternativo dimensional-categorial. Las categorías diagnósticas derivadas de este modelo en la Sección III incluyen sólo los TP antisocial, evitativo, límite, narcisista, obsesivo-compulsivo y esquizotípico y se evalúan con entrevistas clínicas estructuradas, tales como el SCID-II o el IPDE. A su vez, los rasgos de personalidad patológicos se evalúan con autoinformes diseñados específicamente para el sistema clasificatorio del DSM-5, como el PID-5, o con autoinformes más genéricos, como el MMPI-2-RF, el MCMI-III o el PAI. Sin embargo, los autoinformes presentan una tendencia al sobrediagnóstico. Se desarrollan algunas sugerencias para la investigación futura.

This paper aims at reviewing interviews and self-reports avalaible in Spanish for the assessment of personality disorders (PD) according to DSM-5. The current approach to PD appears in Section II of DSM-5 and has not changed from that in DSM-IV, except that they are moved to the main disorder section from Axis II. However, there is an alternative model developed in Section III. PD are characterized by impairments in personality functioning and by pathological personality traits. Diagnostic categories derived from this model include only antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal personality disorders. Diagnostic categories are assessed with structured clinical interviews, such as SCID-II or IPDE. In turn pathological personality traits are assessed with self-reports specifically designed for DSM-5 alternative dimensional model, such as PID-5, or with more general self-reports, such as MMPI-2-RF, MCMI-III or PAI. Self-reports have a tendency to over-diagnose personality disorders. Suggestions for future research are outlined.

"O que vêm da terra não faz mal": relatos de problemas relacionados ao uso de plantas medicinais por raizeiros de Diadema/SP / "Natural and therefore free of risks": adverse effects, poisonings and other problems related to medicinal herbs by "raizeiros" in Diadema/SP

A crença de que medicamentos à base de plantas são isentos de riscos à saúde faz parte da bagagem cultural da população afeita ao seu uso: "o que vêm da terra não faz mal". No entanto, o potencial tóxico, as características específicas do usuário, a possibilidade de contaminação e a falta de regulamentação constituem fatores de risco para a ocorrência de reações adversas, intoxicações e outras complicações decorrentes de seu uso. Foram realizadas entrevistas semi-estruturadas junto a 20 raizeiros (vendedores de ervas "in natura") na cidade de Diadema/SP. Foram relatados 40 casos de problemas relacionados ao uso de 22 espécies de plantas medicinais. As espécies mais citadas foram Luffa operculata - buchinha (7 casos), Senna alexandrina - sene (4 casos) e Paullinia cupana - guaraná (3 casos). Dentre os sinais e sintomas relatados, os mais freqüentes foram relacionados ao sistema nervoso central, problemas gastrointestinais e cardiovasculares. Os entrevistados também relataram um caso de aborto relacionado ao uso de S. alexandrina e três casos de óbito após a ingestão do chá do fruto de L. operculata. O caráter "natural" das plantas medicinais não é sinônimo de ausência de riscos para a população usuária. É necessária a implantação de políticas de fitofarmacovigilância eficientes, a fim de tornar o consumo mais racional e, deste modo, minimizar os riscos à população usuária.

Traditionally, medicinal herbs have been considered gentle and harmless because of their natural origin: "natural and therefore free of risks". However, toxic potential, various consumer-related factors (such as age, disease factors, pregnancy, etc), contamination, and lack of regulation concerning quality control are some of the risk factors deemed to be associated with herbal adverse reactions, poisonings and other complications. Over a 7-month period, semi-structured interviews were carried out with 20 "raizeiros" (traditional healers) in Diadema/SP. We found 40 unexpected events related to 22 species of medicinal herbs. The most frequent species reported were Luffa operculata - "buchinha" (7 reports), Senna alexandrina - "sene" (4 reports) and Paullinia cupana - "guaraná" (3 reports). Among the adverse events, the most frequent signs and symptoms reported involved the central nervous, gastrointestinal and cardiovascular systems. They also reported one case of abortion (related with S. alexandrina) and three deaths related with L. operculata. Adverse events that result from "natural" medicines are relatively uncommon, but they certainly occur more often than acknowledged. Medicinal plants are traditionally considered as innocuous, but as commercially available medicinal products they require sanitary surveillance in order to identify their risks, to give them a legal status, to evaluate their efficacy and to ascertain their safety.