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Objetivo: refletir se a hierarquia das normas jurídicas deve ser usada como método de solução infalível mesmo quando um conflito aparente entre normas jurídicas que envolva o direito à saúde e, sobretudo, a sua efetividade, puder ser melhor resolvido mediante decisão técnica do órgão regulador competente. Metodologia: estudo descritivo de abordagem qualitativa e análise documental. Foram analisadas as Resolução de Diretoria Colegiada nº 52/2011, Lei nº 13.454/2017 e Ação Direta de Inconstitucionalidade nº 5.779-DF. Buscou-se doutrina jurídica especializada sobre os temas central e periféricos. Para análise dos dados utilizou-se a técnica da revisão crítico-narrativa. Resultados: no Brasil, a adoção das agências reguladoras como agente normativo e regulador de atividades econômicas viabilizou a tomada de decisões pautadas menos em critérios políticos que em critérios técnicos. O legislador, ancorado em critérios políticos, segundo o entendimento do Judiciário, não pode ultrapassar os critérios técnicos. Conclusão: do julgamento da Ação Direta de Inconstitucionalidade nº 5.779 se extrai que o conceito hodierno e a natureza jurídica do direito à saúde impõem novos paradigmas jurídicos que validam o papel das agências reguladoras (tomada de decisões técnicas em prol da máxima efetividade do direito à saúde), ainda que em detrimento de decisões do legislador, legitimadas politicamente. O paradigma formal não pode obstar a materialização do direito.

Objective: To reflect on whether the hierarchy of legal norms should be used as an infallible method of solution even when an apparent conflict between legal norms involving health law can be better resolved through a technical decision by the competent regulatory agency. Methodology: data was collected. In particular, Resolução de Diretoria Colegiada nº 52/2011, Law nº 13.454/2017 and Ação Direta de Inconstitucionalidade nº 5.779-DF. Specialized legal doctrine was sought on the central and peripheral themes. The data collected was analyzed using the critical-narrative review technique. Results: In Brazil, the adoption of regulatory agencies as normative agents and regulators of economic activities has made it possible to make decisions based less on political criteria than on technical criteria. The legislator, anchored in political criteria, according to the judiciary, cannot go beyond technical criteria. Conclusion: the judgment in Ação Direta de Inconstitucionalidade nº 5.779 shows that today's concept and the legal nature of the right to health impose new legal paradigms that validate the role of regulatory agencies (making technical decisions in favor of maximum effectiveness of the right to health), even to the detriment of politically legitimized decisions by the legislature. The formal paradigm cannot prevent the materialization of the right.

Objetivo: reflexionar si la jerarquía de las normas jurídicas debe utilizarse como método infalible de solución, incluso cuando un conflicto aparente entre normas jurídicas que impliquen al Derecho sanitario pueda resolverse mejor mediante una decisión técnica del órgano regulador competente. Metodología: se recopilaron datos. En particular, RDC nº 52/2011, Ley nº 13.454/2017 y ADI nº 5.779-DF. Se buscó doctrina jurídica especializada sobre los temas centrales y periféricos. Los datos recogidos se analizaron mediante la técnica de revisión crítico-narrativa. Resultados: En Brasil, la adopción de las agencias reguladoras como agentes normativos y reguladores de las actividades económicas ha permitido tomar decisiones basadas menos en criterios políticos que en criterios técnicos. El legislador, anclado en criterios políticos, según el poder judicial, no puede ir más allá de los criterios técnicos. Conclusión: la sentencia en el asunto ADI 5.779 demuestra que el concepto actual y la naturaleza jurídica del derecho a la salud imponen nuevos paradigmas jurídicos que validan el papel de las agencias reguladoras (que adoptan decisiones técnicas en favor de la máxima efectividad del derecho a la salud), incluso en detrimento de las decisiones políticamente legitimadas del poder legislativo. El paradigma formal no puede impedir la materialización del derecho.

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Through enviromics, precision breeding leverages innovative geotechnologies to customize crop varieties to specific environments, potentially improving both crop yield and genetic selection gains. In Brazil's four southernmost states, data from 183 distinct geographic field trials (also accounting for 2017-2021) covered information on 164 genotypes: 79 phenotyped maize hybrid genotypes for grain yield and their 85 nonphenotyped parents. Additionally, 1342 envirotypic covariates from weather, soil, sensor-based, and satellite sources were collected to engineer 10 K synthetic enviromic markers via machine learning. Soil, radiation light, and surface temperature variations remarkably affect differential genotype yield, hinting at ecophysiological adjustments including evapotranspiration and photosynthesis. The enviromic ensemble-based random regression model showcases superior predictive performance and efficiency compared to the baseline and kernel models, matching the best genotypes to specific geographic coordinates. Clustering analysis has identified regions that minimize genotype-environment (G × E) interactions. These findings underscore the potential of enviromics in crafting specific parental combinations to breed new, higher-yielding hybrid crops. The adequate use of envirotypic information can enhance the precision and efficiency of maize breeding by providing important inputs about the environmental factors that affect the average crop performance. Generating enviromic markers associated with grain yield can enable a better selection of hybrids for specific environments.

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The Research Ethics Committee (CEP) has become an essential mechanism for social control in Brazilian research involving human subjects, contributing to the development of studies guided by ethical standards and to the protection of research participants. This article analyzes the performance of CEP in Western Amazonian institution, its history, operating conditions, trends, and different aspects between 2018 to 2022. The theoretical framework addresses the history of research involving human subjects, the origins and evolution of bioethics in the international context, bioethics in Brazil, and regulations on the ethical analysis of research. The data were collected through the Brazil Platform and reports from the institution's CEP. The CEP evaluated 865 research protocols, most of which were from Health Sciences. Additionally, it was observed that during 2018 to 2022 the covid-19 pandemic had a negative impact on the number of projects submitted for evaluation to the CEP. The 57% drop in the number of projects registered during 2020/2022 reveals the negative impact of this event on the execution of projects with human participants.

El Comité de Ética en Investigación (CEP) se ha convertido en un mecanismo esencial para el control social en la investigación brasileña con seres humanos, contribuyendo al desarrollo de estudios guiados por normas éticas y a la protección de los participantes en la investigación. Este artículo analiza el desempeño del CEP en la institución amazónica occidental, su historia, condiciones de funcionamiento, tendencias y diferentes aspectos entre 2018 y 2022. El marco teórico aborda la historia de la investigación con seres humanos, los orígenes y la evolución de la bioética en el contexto internacional, la bioética en Brasil y la normativa sobre el análisis ético de la investigación. Los datos se recogieron a través de la Plataforma Brasil y de informes del CEP de la institución. El CEP evaluó 865 protocolos de investigación, la mayoría de los cuales eran de Ciencias de la Salud. Además, se observó que durante 2018 a 2022 la pandemia de covid-19 tuvo un impacto negativo en el número de proyectos presentados para evaluación al CEP. La caída del 57% en el número de proyectos registrados durante 2020/2022 revela el impacto negativo de este evento en la ejecución de proyectos con participantes humanos.

Os Comitês de Ética em Pesquisa (CEPs) tornaram-se um mecanismo essencial para o controle social em pesquisas brasileiras envolvendo sujeitos humanos, contribuindo para o desenvolvimento de estudos regido por padrões éticos e para a proteção de participantes de pesquisas. Esse artigo analisa o desempenho de CEP em instituição da Amazonia Ocidental, sua história, condições operativas, tendências e diferentes aspectos entre 2018 e 2022. O enquadre teórico visa a história da pesquisa envolvendo sujeitos humanos, as origens e evolução da bioética no contexto internacional, bioética no Brasil e regulamentos de análise ética de pesquisa. Os dados foram coletados através da Plataforma Brasil e relatórios do CEP da instituição. O CEP avaliou 865 protocolos de pesquisa, a maioria deles de Ciências da Saúde. Adicionalmente, foi observado que de 2018 a 2022 a pandemia da covid-19 teve um impacto negativo no número de projetos submetidos para avaliação do CEP. A queda de 57% no número de projetos registrados em 2020/2022 revela o impacto negativo desse evento na execução de projetos com participantes humanos.

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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.

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Ethnic enclave residence is associated with decreased risk for drinking and related problems, but less is known about the mechanisms that explain this association. Informed by theories of social control, we used a multilevel framework to examine whether negative attitudes toward drinking mediated associations between ethnic enclave residence (i.e., neighborhood linguistic isolation) and alcohol outcomes among Mexican American young adults (N = 628) in Southern California. Model 1 assessed mediation effects in the pathways from linguistic isolation to current drinking and alcohol use disorder (AUD). Model 2 adjusted for parental drinking attitudes and neighborhood alcohol availability. There were differential associations by gender in direct effects of linguistic isolation and negative drinking attitudes on both drinking and AUD. Among women only, linguistic isolation was related to greater abstinence and decreased AUD after accounting for social control proxies of parent attitudes and alcohol availability. Young adults' own drinking attitudes did not mediate relationships between linguistic isolation and alcohol outcomes. This study offers evidence on the importance of disaggregating Hispanic national groups by gender to uncover social mechanisms within ethnic enclave settings for tailored supports in reducing risk of drinking and alcohol-related harms.

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Brazil is the fourth largest cement consumer in the world and the largest producer in Latin America, around 1.3% of global production. The main inputs in the manufacture of cement are limestone and clay. Few studies have been carried out in the country on the risk of these materials used in civil construction. Therefore, the objective of this present work is to evaluate the radiological danger that they can present to society. Gamma spectrometry analysis on 16 samples of different brands of cement used as construction material in Rio de Janeiro (Brazil) was performed in this study, using an HPGe detector and the Genie 2000 data acquisition software. Samples were set to count for an accumulation time of 14,400 s (4 h) and all measurements were corrected to eliminate background and backscattering. Activity concentrations are determined for 226Ra was from (41.2 ± 1.6 to 174.9 ± 3.9) Bq kg-1, 232Th was from (15.7 ± 0.5 to 43.1 ± 0.7) Bq kg-1 and 40K was from (82.6 ± 7.2 to 254 ± 17) Bq kg-1. To assess radiological health risks: mean values of Radium Activity Equivalent 150.0 ± 3.4 Bq kg-1, Annual Gonadal Dose Equivalent 468 ± 11 µSv year-1 and Lifetime Excess Cancer Risk (ELCR) 2.42 ± 0.06 were calculated. Total Absorbed Dose Rates ranged from 72.2 ± 1.7 to 225.1 ± 5.2 nGy h-1. The damage to collective health was also estimated from the annual effective dose rates with an estimated total cost of damage to health of US$ 130 million. Values are generally within global limits reported by UNSCEAR.

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OBJECTIVE: We conducted two empirical studies (in a cross-sectional and a longitudinal design) with the aim at establishing normative data (including norms for strategy use [i.e., clustering and switching strategies] and performance over time), and examining the convergent validity, the test-retest reliability (3-4 wks interval) and the changes in performance with practice (1 year interval) of the different verbal fluency (VF) quantitative and qualitative scores in Spanish-speaking children and adolescents. METHOD: In S1 (n = 620 6- to 15-year-old Spanish-speaking children and adolescents), MANCOVA and Pearson's correlations were employed. In S2 (n = 148 6- to 12-year-old Spanish-speaking children), intraclass correlation coefficient (ICC), paired t-tests, and Confirmatory Factor Analysis (CFA) were used. RESULTS: S1 results showed an age effect on all VF measures (quantitative and qualitative). The number of switches/clusters was more related to total word productivity and to executive functions (EF) than the mean cluster size. In S2, a significant increase in phonological VF performance was observed on number of switches and word productivity scores from baseline (Time 1) to repeat testing at Time 2. Practice effects were observed at Time 3 on all measures except for semantic and phonological mean cluster size. Test-retest reliability coefficients at Time 2 for number of clusters and switches, but not for mean cluster size, fell in the moderate range, ranging from ICCs .61 to ICCs .81. Test-retest reliability coefficients for total word productivity were higher (ICCs above .80) and stronger when testing as a unity with CFA methods (ϕ=.94, p < .001). CONCLUSIONS: These data may be relevant for informing the neuropsychological assessment of spontaneous cognitive flexibility in children with typical development (TD) and those with developmental or acquired disorders.

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The present research aims to determine whether environmental awareness, green self-identity, and subjective norms influence the attitudes of consumers who identify with environmental issues and have green purchasing intentions for organic products. The research was quantitative, correlational in scope, and cross-sectional in design. It was applied to 710 Peruvian millennials. A questionnaire consisting of 20 questions was applied, which was quantified through a five-point Likert scale. The results were processed through an Exploratory Factor Analysis (EFA), a Confirmatory Factor Analysis (CFA), and Structural Equation Modeling (SEM). Statistical analyses were developed using SPSS 24 and AMOS 24. The study identified that the personal variables influencing the environmental attitudes of millennials who intend to buy green organic products are green self-identity and subjective norms. While environmental awareness does not influence environmental attitudes, it does influence the green self-identity of Peruvian millennials. This study is one of the first to identify the personal variables influencing the environmental attitudes of Peruvian millennials who intend to buy green organic products.

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This study investigated the association between gender role beliefs and the prevalence and likelihood of experiencing pregnancy among 8525 young women and girls aged 13-19 years in Colombia. The primary outcome of interest was adolescent pregnancy. Retrospective cross-sectional analysis utilised data from the 2015 Demographic and Health Survey (DHS) in Colombia, which included an add-on questionnaire on gender relations. Our analysis measured both pregnancy prevalence and pregnancy likelihood in relation to gender role beliefs. With one exception, young women who disagreed with traditionally conforming gender roles had a lower prevalence of pregnancy and were less likely to experience pregnancy than those who agreed with them. The highest likelihood of pregnancy prevalence and likelihood was found among those who agreed with statements suggesting male dominance and those who agreed with women's homemaking responsibilities. The greater the adherence to traditionally conforming gender role beliefs, the higher the likelihood of experiencing pregnancy during adolescence. Girls' and young women's adherence to traditional gender role beliefs appeared to be a risk factor for adolescent pregnancy. Our findings support Colombia's current sex education policies and practices within the framework of gender equity, and evidence the link between gender equity and girls' and young women's reproductive health.

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Sentence-final completion tasks serve as valuable tools in studying language processing and the associated predictive mechanisms. There are several established sentence-completion norms for languages like English, Portuguese, French, and Spanish, each tailored to the language it was designed for and evaluated in. Yet, cultural variations among native speakers of the same language complicate the claim of a universal application of these norms. In this study, we developed a corpus of 2925 sentence-completion norms specifically for Mexican Spanish. This corpus is distinctive for several reasons: Firstly, it is the most comprehensive set of sentence-completion norms for Mexican Spanish to date. Secondly, it offers a substantial range of experimental stimuli with considerable variability in terms of the predictability of word sentence completion (cloze probability/surprisal) and the level of uncertainty inherent in the sentence context (entropy). Thirdly, the syntactic complexity of the sentences in the corpus is varied, as are the characteristics of the final word nouns (including aspects of concreteness/abstractness, length, and frequency). This paper details the generation of the sentence contexts, explains the methodology employed for data collection from a total of 1470 participants, and outlines the approach to data analysis for the establishment of sentence-completion norms. These norms provide a significant contribution to fields such as linguistics, cognitive science, and machine learning, among others, by enhancing our understanding of language, predictive mechanisms, knowledge representation, and context representation. The collected data is accessible through the Open Science Framework (OSF) at the following link: https://osf.io/js359/?view_only=bb1b328d37d643df903ed69bb2405ac0 .

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Teenage pregnancy carries adverse consequences for health and well-being. In this article, we investigate the perceived causes, consequences and cycles of violence and disadvantage associated with teenage pregnancy in Tambogrande, Peru using an applied anthropological approach. Data were drawn from a larger project investigating the relationship between water insecurity and gender-based violence in Indonesia and Peru. The analysis presented here is derived from 49 semi-structured interviews and 5 focus groups with local community members and stakeholders in Peru. Study participants highlighted two main factors contributing to teenage pregnancy in Tambogrande: machismo and religious deterrents to contraceptive use. Participants described how these factors overlapped, resulting in gendered power imbalances that increased the risk of violence, decreased educational opportunities, and reduced the economic independence of women. However, study participants stated that educational interventions targeting machismo could reduce teenage pregnancy and break the associated cycle of disadvantage. Future research will further investigate local social and gender norms to inform the design of a rights-based educational intervention, targeting upstream factors associated with teenage pregnancy in this area.

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To study linguistically coded concepts, researchers often resort to the Property Listing Task (PLT). In a PLT, participants are asked to list properties that describe a concept (e.g., for DOG, subjects may list "is a pet", "has four legs", etc.). When PLT data is collected for many concepts, researchers obtain Conceptual Properties Norms (CPNs), which are used to study semantic content and as a source of control variables. Though the PLT and CPNs are widely used across psychology, only recently a model that describes the listing course of a PLT has been developed and validated. That original model describes the listing course using order of production of properties. Here we go a step beyond and validate the model using response times (RT), i.e., the time from cue onset to property listing. Our results show that RT data exhibits the same regularities observed in the previous model, but now we can also analyze the time course, i.e., dynamics of the PLT. As such, the RT validated model may be applied to study several similar memory retrieval tasks, such as the Free Listing Task, Verbal Fluidity Task, and to research related cognitive processes. To illustrate those kinds of analyses, we present a brief example of the difference in PLT's dynamics between listing properties for abstract versus concrete concepts, which shows that the model may be fruitfully applied to study concepts.

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Resumo Este artigo de opinião consiste em uma entrevista realizada com Leonardo Peçanha, um homem negro trans, ativista no campo dos direitos humanos e dos direitos das pessoas trans e pesquisador do campo da Saúde Coletiva. Na conversa que se segue Leonardo Peçanha, de forma interseccional, reflete sobre o lugar da beleza, modificações corporais e atividade física no processo de transição de gênero de sujeitos homens trans e transmasculinos, como também toca no tema das (im)possibilidades das pessoas trans no campo dos esportes de alto rendimento e nos conta sobre o concurso de beleza Mister Trans Brasil.

Abstract This opinion article consists of an interview with Leonardo Peçanha, a Black trans man, a human rights and trans people rights activist and a researcher in Collective Health. In this interview, he reflects intersectionally on the place of beauty, body changes, and physical activity in the gender transition process of trans and transmasculine men. He discusses the (im)possibilities of trans people in high-performance sports and tells us about the Mister Trans Brazil beauty pageant contest.

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Resumo Objetivou-se compreender as experiências de dupla maternidade na atenção à saúde durante o pré-natal, parto e puerpério a partir de um método qualitativo, utilizando entrevistas individuais on-line e grupo focal on-line assíncrono com mulheres cisgêneros, a maioria em relacionamentos homoafetivos. Os resultados revelaram a marginalização das vivências parentais dessas mulheres, destacando a violência institucional presente nos serviços de saúde brasileiros, sendo apresentados em dois eixos temáticos: 1) Cisheteronormatividade e seu impacto nas experiências de dupla maternidade e 2) Violência institucional nos serviços de saúde: da curiosidade à LGBTQIA+fobia. Conclui-se que a cisheteronormatividade prejudica a atenção à saúde para essas experiências, especialmente ao invisibilizar a mãe não gestante, destacando a urgência de capacitar profissionais de saúde, repensar e desafiar as normas cisgênero e heterossexuais e promover políticas inclusivas para garantir cuidados equitativos e combater a violência institucional.

Abstract The objective was to understand experiences of double motherhood during antenatal, childbirth and postpartum healthcare, using a qualitative method involving individual online interviews and asynchronous, online focus groups of cisgender women, mostly in same-sex relationships. The results revealed how these women's experiences of parenting were marginalised, highlighting institutional violence in Brazilian healthcare services, which are presented here in two thematic dimensions: 1) Cisheteronormativity and its impact on experiences of double motherhood; and 2) Institutional violence in healthcare services: from curiosity to LGBTQIA+phobia. It was concluded that cisheteronormativity hinders healthcare for these experiences, especially by rendering the non-gestational mother invisible. This underscores the urgent need to train healthcare personnel, rethink and challenge cisgender and heterosexual norms and promote inclusive policies to ensure equitable care and combat institutional violence.

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Resumo Objetivo Analisar o estigma evidenciado nas percepções de médicas e enfermeiras sobre o pré-natal de homens transexuais. Métodos Estudo qualitativo desenvolvido com nove profissionais de saúde (seis enfermeiras e três médicas) atuantes em Unidades de Saúde da Família em um município na Bahia. Foram realizadas entrevistas em profundidade, submetidas à Análise Temática Reflexiva e interpretação baseada na teoria do estigma e do conceito de cisheteronormatividade. Resultados Foram derivados dois temas que explicitaram o estabelecimento de rótulos e estereótipos ao corpo, mente e identidade de gênero do homem trans grávido: (des)preparo profissional e distanciamento das demandas e perspectivas cisheteronormativas para o cuidado pré-natal de homens trans. Elementos do estigma evidenciados: afastamento, rótulos, estereótipo, descrédito e discriminação. Tais elementos (percepções estigmatizantes) se manifestaram dentro da lógica da normalidade e equiparação cisgênero das necessidades de saúde dos homens trans no contexto pré-natal. Conclusão Há estigma na percepção de médicas e enfermeiras sobre o pré-natal de homens trans. A estigmatização pode impactar negativamente a qualidade do pré-natal e da saúde e segurança de homens trans no ciclo gravídico puerperal, antecipando pensamentos, atitudes e práticas que contribuem para a deteriorar a identidade transmasculina na gestação.

Resumen Objetivo Analizar el estigma constatado en las percepciones de médicas y enfermeras sobre el control prenatal de hombres transexuales. Métodos Estudio cualitativo llevado a cabo con nueve profesionales de la salud (seis enfermeras y tres médicas) que trabajan en Unidades de Salud de la familia en un municipio del estado de Bahia. Se realizaron entrevistas en profundidad, que fueron sometidas al análisis temático reflexivo e interpretación con base en la teoría del estigma y del concepto de cisheteronormatividad. Resultados Se derivaron dos temas que explicitaron el establecimiento de rótulos y estereotipos del cuerpo, mente e identidad de género de hombres trans embarazados: (falta de) preparación profesional y distanciamiento de las demandas y perspectivas cisheteronormativas para el cuidado prenatal de hombres trans. Se constataron los siguientes elementos del estigma: distanciamiento, rótulos, estereotipos, descrédito y discriminación. Tales elementos (las percepciones estigmatizantes) se manifestaron dentro de la lógica de la normalidad y equivalencia cisgénero de las necesidades de salud de los hombres trans en el contexto del control prenatal. Conclusión Existe un estigma en la percepción de médicas y enfermeras sobre el control prenatal de hombres trans. La estigmatización puede impactar negativamente en la calidad del control prenatal y de la salud y seguridad de hombres trans durante el embarazo y el puerperio, y puede anticipar pensamientos, actitudes y prácticas que contribuyen al deterioro de la identidad transmasculina en el embarazo.

Abstract Objective To analyze the stigma evidenced in doctors' and nurses' perception regarding prenatal care for transgender men. Methods A qualitative study developed with nine health professionals (six nurses and three doctors) working in Family Health Units in a municipality in Bahia. In-depth interviews were carried out, subjected to reflective thematic analysis and interpretation based on the theory of social stigma and the concept of cisheteronormativity. Results Two topics were derived that explained the establishment of labels and stereotypes on the body, mind and gender identity of pregnant trans men: professional (un)preparedness and distancing from cisheteronormative demands and perspectives for prenatal care for trans men. Elements of stigma observed were distance, labels, stereotype, discredit and discrimination. Such elements (stigmatizing perceptions) manifested themselves within the logic of normality and cisgender equality of trans men's health needs in the prenatal context. Conclusion There is stigma in doctors' and nurses' perception regarding prenatal care for trans men. Stigmatization can negatively impact the quality of prenatal care and trans men's health and safety in the pregnancy and puerperal cycle, anticipating thoughts, attitudes and practices that contribute to the deterioration of transmasculine identity during pregnancy.

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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.

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ABSTRACTFollowing landmark legislation in 2013, Uruguay became the first country to regulate the legal production, distribution and sale of recreational cannabis. While broader debates anticipated the significance of the UN drug conventions, the extent to which Uruguay's drug treaty obligations shaped regulation is unclear and the relevance of finance norms has been neglected. Drawing on institutionalist and governance theories, this study explores how international drug and finance regulations limited Uruguay's policy space to implement cannabis regulation, and how this was perceived by policy actors. Policy documents and 43 semi-structured interviews were thematically analysed. The analysis demonstrates how Uruguay's drug treaty obligations were less directly constraining to policy space compared to international finance norms, including the US Patriot Act, anti-money laundering standards and financial inclusion practices. Such norms exerted powerful influence over Uruguay's ability to implement aspects of cannabis supply that interact with broader financial systems, allowing banks to terminate business relationships with clients deemed as high risks for money laundering. The Uruguayan case suggests that financial regulations at diverse levels are likely to constrain policy space in other contexts where the market-based policies of cannabis regulation raise tensions with a narrowly constructed risk management principle in approaches to financial supply.

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Introduction: Phenotypic plasticity (PP) could be an important short-term mechanism to modify physiological and morphological traits in response to climate change and global warming, particularly for high-mountain tree species. The objective was to evaluate PP response of growth ring traits to temperature and precipitation in Pinus hartwegii Lindl. populations located at the ends of its elevational gradient on two volcanic mountains in central Mexico (La Malinche and Nevado de Toluca). Methods: Increment cores collected from 274 P. hartwegii trees were used to estimate their PP through reaction norms (RN), which relate the ring width and density traits with climate variables (temperature and precipitation). We estimated the trees' sensitivity (significant RN) to climatic variables, as well as the relative proportion of RN with positive and negative slope. We also estimated the relationship between the PP of ring width and density traits using correlation and Principal Component (PC) analyses. Results: Over 70% of all trees showed significant RN to growing season and winter temperatures for at least one growth ring trait, with a similar proportion of significant RN at both ends of the gradient on both mountains. Ring width traits had mostly negative RN, while ring density traits tended to have positive RN. Frequency of negative RN decreased from lower to higher elevation for most traits. Average PP was higher at the lower end of the gradient, especially on LM, both for ring width and ring density traits, although high intrapopulation variation in PP was found on both mountains. Discussion: Results indicate that P. hartwegii presents spatially differentiated plastic responses in width and density components of radial growth. PP was particularly strong at the lower elevation, which has higher temperature and water stress conditions, putting these populations at risk from the continuing global warming driven by climate change.

RESUMO

Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examined using paired data from parents and adolescents. We aimed to examine the relative influence of these correlates among dyads (N=349) of mothers and adolescent daughters. Using multiple logistic regression, daughters' past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers' disapproval about use, mothers' past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers' inclination for NMUPD were risk factors for daughters' NMUPD, while a closer mother-daughter relationship and mothers' disapproving attitudes towards NMUPD were protective factors. The three analysis approaches were corroborative. Results suggest friend descriptive norms, mother-daughter relationship quality, and mothers' attitudes about NMUPD are important prevention targets.

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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.

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