No abstract

BackgroundChagas disease is a vector-borne parasitic disease of major public health importance. Current prevention efforts are based on triatomine vector control to reduce transmission to humans. Success of vector control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to improved vector control strategies in the Yucatan peninsula, Mexico.Methodology/principal findingsWe employed a sequence of qualitative and quantitative research methods to investigate knowledge, attitudes and practices surrounding Chagas disease, triatomines and vector control in three rural communities. Our combined data show that community members are well aware of triatomines and are knowledgeable about their habits. However, most have a limited understanding of the transmission dynamics and clinical manifestations of Chagas disease. While triatomine control is not a priority for community members, they frequently use domestic insecticide products including insecticide spray, mosquito coils and plug-in repellents. Families spend about $32 US per year on these products. Alternative methods such as yard cleaning and window screens are perceived as desirable and potentially more effective. Screens are nonetheless described as unaffordable, in spite of a cost comparable to the average annual spending on insecticide products.Conclusion/SignificanceFurther education campaigns and possibly financing schemes may lead families to redirect their current vector control spending from insecticide products to window screens. Also, synergism with mosquito control efforts should be further explored to motivate community involvement and ensure sustainability of Chagas disease vector control.

No abstract

Recent research on the relationship between borderline personality disorder (BPD) and suicidal behavior is reviewed. Risk factors for attempted and completed suicide as well as the effect of the comorbidity of BPD with other Axis I and II disorders are considered. Explanations for suicidality in BPD are discussed. General assessment strategies are offered, along with treatment recommendations. Specifically, research has shown that borderline patients improve in the long-term, decreasing in suicidality, self-destructiveness, and interpersonal maladjustment, if survival is effectively managed during the turbulent years of youth. Clinical lore at times can lead clinicians to disregard the danger of suicide completion among chronically parasuicidal patients, which can prevent effective intervention during suicidal crises and result in unfortunate outcomes.