RESUMEN
BACKGROUND: The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach. METHODS: Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks. RESULTS: Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient. CONCLUSION: Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.
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Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Adulto , Australia , Estudios Transversales , Interpretación Estadística de Datos , Femenino , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Nativos de Hawái y Otras Islas del Pacífico/psicología , Factores Socioeconómicos , Adulto JovenRESUMEN
BACKGROUND: Benefits of breastfeeding are well-established. Few studies have examined initiation and duration of breastfeeding of Aboriginal infants. METHODS: Population-based study of women giving birth to an Aboriginal infant in South Australia, July 2011-June 2013. FINDINGS: 344 women took part. Participants were representative in relation to maternal age, infant birthweight and gestation. Eighty-six percent initiated breastfeeding, declining to 54% at 12 weeks postpartum. Women living in remote areas were more likely to be breastfeeding at 12 weeks than women living in Adelaide (Odds Ratio=2.6, 95% Confidence Interval 1.5-4.7). Two-thirds of women (67%) attending standard public antenatal care in regional areas and 61% attending regional Aboriginal Family Birthing Program Services were breastfeeding at 12 weeks, compared to one third of women (36%) attending standard metropolitan public antenatal care and 49% of women attending metropolitan Aboriginal Family Birthing Program Services. Less than half of women (45%) described their postnatal care as 'very good', and 40% were not always able to access support with infant feeding when needed. The most common reasons for switching to formula before 6 weeks were: low milk supply/baby not gaining weight, mastitis/sore breasts or other feeding problems. Mothers also identified their own health as a factor. CONCLUSION: While the findings must be treated with caution due to small numbers, they suggest benefits for women attending Aboriginal Family Birthing Program services in the urban environment where rates of initiation and continued breastfeeding are lowest. Provision of culturally appropriate support to Aboriginal women during and after pregnancy is key to improving outcomes.
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Lactancia Materna/estadística & datos numéricos , Madres/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Factores de Tiempo , Adulto , Peso al Nacer , Lactancia Materna/etnología , Lactancia Materna/psicología , Femenino , Humanos , Lactante , Recién Nacido , Edad Materna , Madres/psicología , Oportunidad Relativa , Embarazo , Atención Prenatal/estadística & datos numéricos , Australia del SurRESUMEN
OBJECTIVE: To determine if recently found disparities in prostate cancer-specific mortality (PCSM) among Mexican and Puerto Rican men remained true in patients undergoing radical prostatectomy (RP), where the true grade and extent of cancer are known and can be accounted for. MATERIALS AND METHODS: Men diagnosed with localized-regional prostate cancer who had undergone RP as primary treatment were identified (N = 180,794). Patients were divided into the following racial and ethnic groups: non-Hispanic white (NHW) (n = 135,358), non-Hispanic black (NHB) (n = 21,882), Hispanic or Latino (n = 15,559), and Asian American or Pacific Islander (n = 7995). Hispanic or Latino men were further categorized into the following subgroups: Mexican (n = 3323) and South or Central American, excluding Brazilian (n = 1296), Puerto Rican (n = 409), and Cuban (n = 218). A multivariable analysis was conducted using competing risk regression in the prediction of PCSM. RESULTS: This analysis revealed hidden disparities in surgical outcomes for prostate cancer. In the multivariable analysis, Hispanic or Latino men (hazard ratio [HR] = 0.88, P = .207) did not show a significant difference in PCSM compared with NHW men. When breaking Hispanic or Latino men into their country of origin or ancestry, Puerto Rican men were found to have significantly worse PCSM than NHW men (HR = 2.55, P = .004) and NHB men (HR = 2.33, P = .016). CONCLUSION: Our findings reveal higher rates of PCSM for Puerto Rican men after RP than for both NHW and NHB men. At a minimum, these findings need further validation and should be considered in the screening and management of these men.
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Hispánicos o Latinos/estadística & datos numéricos , Neoplasias de la Próstata/etnología , Neoplasias de la Próstata/mortalidad , Negro o Afroamericano/estadística & datos numéricos , Anciano , Asiático/estadística & datos numéricos , América Central/etnología , Cuba/etnología , Humanos , Masculino , México/etnología , Persona de Mediana Edad , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Prostatectomía , Neoplasias de la Próstata/cirugía , Puerto Rico/etnología , América del Sur/etnología , Población Blanca/estadística & datos numéricosRESUMEN
OBJECTIVE: To compare the magnitude of relative oral health inequalities between Indigenous and non-Indigenous persons from Brazil, New Zealand and Australia. METHODS: Data were from surveys in Brazil (2010), New Zealand (2009) and Australia (2004-06 and 2012). Participants were aged 35-44 years and 65-74 years. Indigenous and non-Indigenous inequalities were estimated by prevalence ratios (PR) and their corresponding 95% confidence intervals (CI), adjusting for sex, age and income. Outcomes included inadequate dentition, untreated dental caries, periodontal disease and the prevalence of "fair" or "poor" self-rated oral health in Australia and New Zealand, and satisfaction with mouth/teeth in Brazil (SROH). RESULTS: Irrespective of country, Indigenous persons had worse oral health than their non-Indigenous counterparts in all indicators. The magnitude of these ratios was greatest among Indigenous and non-Indigenous Australians, who, after adjustments, had 2.77 times the prevalence of untreated dental caries (95% CI 1.76, 4.37), 5.14 times the prevalence of fair/poor SROH (95% CI 2.53, 10.43). CONCLUSION: Indigenous people had poorer oral health than their non-Indigenous counterparts, regardless of setting. The magnitude of the relative inequalities was greatest among Indigenous Australians for untreated dental decay and poor SROH.
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Disparidades en el Estado de Salud , Indígenas Sudamericanos/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Salud Bucal , Adulto , Anciano , Australia/epidemiología , Brasil/epidemiología , Femenino , Humanos , Masculino , Nueva Zelanda/epidemiología , PrevalenciaRESUMEN
The objective of this paper was to evaluate the association between eligibility for a conditional cash transfer program, based on household income, and dental caries in 12-year-old children from three Indigenous ethnic groups living in Mato Grosso do Sul state, Central Brazil. A population-based cross-sectional study was performed in three ethnic groups: Kaiwoá, Guarani, and Terena. The study population was drawn by stratified sampling according to each ethnic group with a probability proportional to the village size. The number of untreated decayed permanent teeth as a count variable was the outcome measure. Ethnic group and eligibility for the conditional cash transfer program showed significant association with untreated caries. Children from Guarani and Terena presented respectively two-fold and 2.8-fold higher caries rate (p<.001) compared with Kaiwoá in the adjusted model, while children from no eligible cash transfer program households had a 40% lower caries rate (p=.034).
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Caries Dental/etnología , Renta/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Brasil , Niño , Estudios Transversales , Caries Dental/prevención & control , Femenino , Humanos , Masculino , Factores ProtectoresRESUMEN
ResumoA devolução, restituição ou compartilhamento pode significar, dentre outras possibilidades, entregar produtos aos partícipes de um empreendimento de pesquisa/extensão. A entrega de resultados não é uma prática nova na antropologia, embora ainda seja pouco usual, sistematizada e valorizada. Neste artigo, relato e discuto uma experiência de devolução de materiais de um projeto de extensão da antropologia, que foi desenvolvido dentro de um centro de saúde, na região periférica do Distrito Federal. As reações aos materiais foram muito diferentes do esperado pela equipe do projeto, mas ainda assim permitiu fazer avançar o diálogo entre os envolvidos e, mais do que isso, permitiu que o conhecimento sobre as relações de trabalho dentro dessa instituição de saúde fosse aprofundado. Não é somente porque foi logrado o aval de comitês de ética que as negociações sobre a entrada e permanência em projetos acadêmicos estão garantidas continuamente. As relações de subjetividade, poder e autoria permeiam qualquer iniciativa antropológica, antes de começá-la e muito depois de, supostamente, terminá-la.
AbstractDevolution, restitution or sharing can mean, within other possibilities, to offer products to participants of a research or an extension project. Far from a new practice in Anthropology, returning results is still unusual, little organized and valued. This paper presents and discusses a devolution experience by an extension project in Anthropology that was developed in a primary care unit in the outskirts of Distrito Federal (Brazil). Local reactions were very different from what was expected by the project's staff, but still permitted dialogue with the health professionals and, more important, deepened our knowledge about work relations in this health institution. Even though IRB approval has been granted, negotiations about starting and continuing academic projects have to be negotiated continuously. Subjectivity, power and authority permeate any anthropological initiative from its beginning and much after it supposedly has been concluded.
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Femenino , Humanos , Masculino , Persona de Mediana Edad , Aculturación , Asiático/estadística & datos numéricos , Trastorno Depresivo/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Infecciones por VIH/etnología , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Percepción Social , Estudios Transversales , Seropositividad para VIH/etnología , New York/epidemiología , Prevalencia , Calidad de Vida , Factores de Riesgo , Asunción de Riesgos , San Francisco/epidemiología , Encuestas y CuestionariosRESUMEN
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
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Servicios de Salud Dental/estadística & datos numéricos , Adolescente , Distribución por Edad , Niño , Índice CPO , Atención Dental para Niños/estadística & datos numéricos , Femenino , Servicios de Salud del Indígena/estadística & datos numéricos , Humanos , Masculino , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Factores Socioeconómicos , VictoriaRESUMEN
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
O objetivo deste estudo foi investigar as características sociodemográficas de usuários do serviço público de saúde bucal no Estado de Vitória, Austrália, com até 17 anos de idade. O presente estudo é uma análise de dados secundários de 45.728 sujeitos que recorreram ao serviço público de saúde bucal entre julho de 2008 a junho de 2009. A idade média da amostra foi 8,9 (DP: 3,5) anos. A maioria dos sujeitos (82,7%) apresentava entre 6 e 17 anos de idade e 50,3% eram do gênero masculino. A maioria (76,6%) havia nascido na Austrália e falava inglês em casa (89,1%). O índice CPOD médio foi 1,0 (DP: 2,1) e o ceod 3,16 (DP: 5,79). Os dados indicam que entre as crianças de 6 anos categorizadas no Significant Caries Index (SiC), o índice ceod médio foi 6,82. Os achados demonstram desigualdade social nos desfechos de saúde bucal e fornecem sugestões para que os serviços de saúde bucal desenvolvam estratégias e prioridades para reduzir tais desigualdades na saúde e bem-estar, de forma a adequar os serviços às necessidades locais.
El objetivo de este estudio fue describir las características sociodemográficas de la población de usuarios de los servicios públicos de atención odontológica, de 17 o menos años de edad, en el estado australiano de Victoria. El estudio realiza un análisis secundario de los datos de 45.728 pacientes que asistieron a los servicios de atención odontológica públicos entre julio 2008 y junio 2009. El promedio de edad de la muestra fue 8,9 (s.d. 3,5) años. La mayoría (82,7 %) tenía entre 6 y 17 años de edad, y el 50,3 % fue de sexo masculino. La mayoría (76,6%) nació en Australia y hablaba inglés en casa (89,1%). El COPD promedio fue 1.0 (s.d. 2.1) dientes, con un ceod promedio de 3,16 (s.d. 5,79) dientes. A los 6 años de edad en la categoría de Índice de Caries Significativo, el dmft promedio fue de 6.82 dientes. Los resultados confirman desigualdades sociales en salud bucodental y proporcionan sugerencias para los servicios de salud bucodental, con el fin de desarrollar estrategias y prioridades tendientes a la reducción de desigualdades en salud y bienestar.
Asunto(s)
Adolescente , Niño , Femenino , Humanos , Masculino , Servicios de Salud Dental/estadística & datos numéricos , Distribución por Edad , Índice CPO , Atención Dental para Niños/estadística & datos numéricos , Servicios de Salud del Indígena/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Factores Socioeconómicos , VictoriaRESUMEN
OBJECTIVES: The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. DESIGN: Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). PARTICIPANTS: Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. METHODS: Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities' graduation and enrollment between nursing schools with and without diversity pipeline programs RESULTS: Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%-10.4%, p = .001), but they decreased among Black (6.8%-5.0%, p = .004) and Native American/Pacific Islander students (2.1 %-0.3%, p ≥ .001). CONCLUSIONS: Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students.
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Bachillerato en Enfermería/estadística & datos numéricos , Grupos Minoritarios/educación , Grupos Minoritarios/estadística & datos numéricos , Selección de Personal/estadística & datos numéricos , Criterios de Admisión Escolar/estadística & datos numéricos , Facultades de Enfermería/estadística & datos numéricos , Estudiantes de Enfermería/estadística & datos numéricos , Adulto , Negro o Afroamericano/educación , Negro o Afroamericano/estadística & datos numéricos , Asiático/educación , Asiático/estadística & datos numéricos , Diversidad Cultural , Femenino , Hispánicos o Latinos/educación , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Masculino , Nativos de Hawái y Otras Islas del Pacífico/educación , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Vigilancia de la Población , Puerto Rico , Estados UnidosRESUMEN
In recent decades there has been an increasing interest in understanding the role of social and physical contexts in influencing health behaviors and outcomes. This is especially true for weight, which is considered to be highly dependent on environmental factors. The evidence linking neighborhood characteristics to weight in the United States, however, is mixed. Many studies in this area are hampered by cross sectional designs and a limited scope, insofar as they investigate only one dimension of neighborhood context. It is also unclear to what extent neighborhood characteristics account for racial/ethnic disparities in weight. Using longitudinal data from the Los Angeles Family and Neighborhood Survey (L.A. FANS), we compare patterns of weight change between Hispanics and other racial and ethnic groups in order to evaluate whether we observe a pattern of unhealthy assimilation in weight among Hispanic immigrants and to identify differences in the rate at which different groups gain weight over time. We also explore the extent to which patterns of weight change are related to a wider range of community characteristics. We find that weight increases across all groups between the two study waves of L.A. FANS and that the increases are significant except for Asians/Pacific Islanders. With respect to differences in the pace of weight change, second and higher generation Hispanic women and black men gain weight more rapidly than their first generation Hispanic counterparts. Although the evidence presented indicates that first generation Hispanics gain weight, we do not find evidence for convergence in weight since the U.S.-born gain weight at a more rapid rate. The inclusion of community-level variables does not alter the relationships between the race, ethnicity, and immigrant generation categories and weight change. Of the six types of community characteristics considered, only collective efficacy is consistently and significantly associated with weight change, although the protective effect of neighborhood collective efficacy is seen only among women.
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Índice de Masa Corporal , Hispánicos o Latinos/estadística & datos numéricos , Sobrepeso/etnología , Grupos de Población/estadística & datos numéricos , Aculturación , Adulto , Negro o Afroamericano/estadística & datos numéricos , Asiático/estadística & datos numéricos , Emigración e Inmigración/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Características de la Residencia/estadística & datos numéricos , Factores de Riesgo , Factores Socioeconómicos , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
This overview revealed that substantial oral health inequalities exist between Indigenous and non-Indigenous child and adult populations in the United States, Canada, Brazil, Australia and New Zealand, with evidence suggesting that these inequalities are increasing. Despite the marked differences in geography, culture, language and history experienced by these groups, it is notable how similar the oral health inequalities were. A number of reasons are discussed in the paper.
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Disparidades en el Estado de Salud , Salud Bucal , Australia , Brasil , Canadá , Índice CPO , Humanos , Indígenas Norteamericanos/estadística & datos numéricos , Indígenas Sudamericanos/estadística & datos numéricos , Inuk/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Nueva Zelanda , Estados UnidosRESUMEN
OBJECTIVE: To describe the prevalence and clinical characteristics of the metabolic syndrome (MetS) in a cohort of Australian Aboriginal children. STUDY DESIGN: Body mass index (BMI), waist circumference, skin fold thickness, body fat percentage, insulin resistance, and the prevalence of MetS were evaluated in 486 children age 9 to 14 years from the Darwin Health Region, Northern Territory, Australia. RESULTS: Using an age- and sex- specific definition, 14% of the children in the cohort had MetS, 6.4% were overweight, 4.9% were obese, and 26.2% had an elevated waist circumference. The mean percentage of body fat was 30.2%. The children with MetS had higher BMI and waist z-scores, percent body fat, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) score, and skin fold thickness compared with those without MetS (P < .001); however, >50% of those with MetS were neither overweight nor obese. Waist circumference was significantly associated with insulin resistance as measured by the HOMA-IR (P < .001). CONCLUSIONS: MetS is common in our cohort despite low rates of overweight and obesity. A tendency for central adiposity is already evident in these young children. Measurement of waist circumference may help identify Aboriginal children at high risk for MetS.
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Índice de Masa Corporal , Tamaño Corporal , Síndrome Metabólico/epidemiología , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Australia/epidemiología , Composición Corporal , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Síndrome Metabólico/diagnóstico , Prevalencia , Grosor de los Pliegues CutáneosRESUMEN
OBJECTIVES: Asthma prevalence for different ethnic groups in the United States, beyond white, black and Hispanic, is seldom reported. We compared the prevalence of asthma diagnosis among various Hispanic and Asian American ethnic subgroups using data collected from the school-based California Healthy Kids Survey. METHODS: The California Healthy Kids Survey was administered to 462 147 public school students in the seventh, ninth, and 11th grades throughout California during the 2001-2002 and 2002-2003 school years. Prevalence of lifetime asthma diagnosis was calculated for 11 Asian American Pacific Islander subgroups and 8 Hispanic subgroups. RESULTS: Asthma prevalence among Hispanic subgroups ranged from 13.2% for Mexican American students to 22.8% for Puerto Rican students and 23.0% among Cuban American students. Lifetime asthma diagnosis among the 11 Asian American Pacific Islander subgroups ranged from 10.9% among Korean American students to 23.8% among Filipino American students. CONCLUSIONS: The survey revealed substantial variation in asthma prevalence between the different Hispanic and Asian American Pacific Islander subgroups and that Pacific Islanders, Filipinos, Cubans, and Puerto Ricans are at elevated risk for asthma. Differences in the distributions of characteristics related to country of birth, residential history, generational status, and/or degree of acculturation might account for much of the observed differences in asthma prevalence between ethnic subgroups. Previous asthma prevalence estimates for Asians or Hispanics are in part a function of the particular ethnic composition of the population under investigation. We suggest that asthma studies that include a substantial number of Asian Pacific Islander and Hispanic persons use a more detailed categorization of race/ethnicity.
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Asiático/estadística & datos numéricos , Asma/etnología , Hispánicos o Latinos/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Adolescente , Asiático/clasificación , California/epidemiología , Cambodia/etnología , América Central/etnología , Niño , China/etnología , Cuba/etnología , Femenino , Encuestas Epidemiológicas , Hispánicos o Latinos/clasificación , Humanos , India/etnología , Japón/etnología , Corea (Geográfico)/etnología , Laos/etnología , Masculino , México/etnología , Nativos de Hawái y Otras Islas del Pacífico/clasificación , Islas del Pacífico/etnología , Filipinas/etnología , Prevalencia , Puerto Rico/etnología , Riesgo , América del Sur/etnología , Vietnam/etnologíaRESUMEN
Latin America is undergoing a rapid demographic and nutritional transition. A recent WHO/PAHO survey on obesity in the region revealed an increasing trend in obesity as countries emerge from poverty, especially in urban areas. In contrast, in middle income countries, obesity tends to decline as income increases; this is especially so in women. Dietary changes and increasing inactivity are considered the crucial contributory factors that explain this rise. The end result is a progressive rise in overweight and obesity, especially in low income groups who improve their income and buy high fat/high carbohydrate energy-dense foods. Intake of these foods increases to the detriment of grains, fruits and vegetables. Most aboriginal populations of the Americas have changed their diet and physical activity patterns to fit an industrialized country model. They now derive most of their diet from Western foods and live sedentary and physically inactive lives. Under these circumstances they develop high rates of obesity, insulin resistance and type 2 diabetes. Supplementary feeding programs are common in the region; the number of beneficiaries significantly exceeds the malnourished. Weight-for-age definition of undernutrition without assessment of length will overestimate the dimension of malnutrition and neglect the identification of stunted overweight children. Providing food to low income stunted populations may be beneficial for some, although it may be detrimental for others, inducing obesity especially in urban areas. Defining the right combination of foods/nutrients, education and lifestyle interventions that are required to optimize nutrition and health is a present imperative.
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Dieta/tendencias , Trastornos Nutricionales/complicaciones , Obesidad/epidemiología , Adolescente , Adulto , Anciano , Estatura , Índice de Masa Corporal , Niño , Preescolar , Diabetes Mellitus/epidemiología , Diabetes Mellitus/prevención & control , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Ejercicio Físico , Femenino , Servicios de Alimentación , Promoción de la Salud , Humanos , Renta , Lactante , Resistencia a la Insulina , América Latina/epidemiología , Estilo de Vida , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Obesidad/complicaciones , Obesidad/prevención & control , Grupos Raciales , Población UrbanaRESUMEN
BACKGROUND & AIMS: The etiology of cholesterol gallstones is multifactorial, with interactions of genes and the environment. The hypothesis that aborigine cholesterol lithogenic genes are widely spread among Chileans, a population with a high prevalence of gallstones, was tested. METHODS: Medical history and anthropometric measurements were obtained and abdominal ultrasonography was performed in 182 Mapuche Indians, 225 Maoris of Easter Island, and 1584 Hispanics. Blood groups, DNA, lipids, and glucose were analyzed. The Amerindian Admixture Index and mitochondrial DNA (mtDNA) assessed the ethnicity and degree of racial admixture. RESULTS: Amerindian Admixture Index was 0.8 in Mapuches and 0.4 in Hispanics. All Mapuches, 88% of Hispanics, but none of Maoris had Amerindian mtDNA haplotypes. Age- and sex-adjusted global prevalence of gallstone disease was higher in Mapuches (35%) than in Hispanics (27%) and Maoris (21%). Compared with Hispanics, the youngest group of Mapuches had the greatest corrected risk of gallstones: odds ratios of 6.0 in women and 2.3 in men. In contrast, the gallstone risk in Maoris was lower compared with Hispanics: odds ratios of 0.6 for women and 0.5 for men. CONCLUSIONS: Cholesterol lithogenic genes appear widely spread among Chilean Indians and Hispanics. They could determine the early formation of gallstones and explain the high prevalence of gallbladder diseases among some South American populations.
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Colelitiasis/etnología , Colelitiasis/genética , Colesterol/metabolismo , Hispánicos o Latinos/estadística & datos numéricos , Indígenas Sudamericanos/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Adulto , Chile/epidemiología , Colelitiasis/metabolismo , Femenino , Hispánicos o Latinos/genética , Humanos , Indígenas Sudamericanos/genética , Masculino , Persona de Mediana Edad , Nativos de Hawái y Otras Islas del Pacífico/genética , Polinesia/epidemiologíaRESUMEN
El objetivo de la presente investigación fue determinar la prevalencia de las parasitosis intestinales en dos comunidades indígenas de la Sierra de Perijá, Estado Zulia: los pobladores de Santa Ana de Wasana y los de Kasmera. Se les dió instrucción para la adecuada recolección de la muestra fecal, obteniéndose un total, entre las dos comunidades de 70 muestras de heces, mediante métodos coproparasitológicos del examen directo, coloración temporal con lugol y por concentración (formol-etil acetato). Se encontró una alta prevalencia de enteroparasitosis en ambas comunidades; las especies de enteroparásitos más frecuentes en Santa Ana de Wasama y Kasmera fueron: Ascaris lumbricoides (36.6 por ciento y 62.1 por ciento), Trichuris trichiura (31.7 por ciento y 44.8 por ciento) y Entamoeba histolytica (26.8 por ciento y 37.9 por ciento respectivamente). Se evidenció un alto poliparasitismo en ambas comunidades
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Niño , Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Factores Epidemiológicos , Métodos Epidemiológicos , Epidemiología/métodos , Educación en Salud , Parasitosis Intestinales/etiología , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Factores SocioeconómicosRESUMEN
HTLV-I seroprevalences of 3.63% (02/55), 12.19% (10/82) and 13.88% (10/72) were demonstrated among Tiryio, Mekranoiti and Xicrin Amazonian Indians, respectively, by the Western blotting enzyme assay (WBEI). By indirect immunoelectron microscopy (IIEM), 2 Tiriyo, 9 Mekranoiti and 6 Xicrin Amerindians were reactive. Of 44 serum samples from Japanese immigrants, none reacted by any of the techniques before mentioned. One, 8 and 6 serum samples from Tiryio, Mekranoiti and Xicrin Indians, respectively, were both WBEI and IIEM positive. Our results strongly suggest that HTLV-I and/or an HTLV-I antigenic variant circulate (s) among populations living in the Amazon region of Brazil
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Humanos , Anticuerpos Anti-HTLV-I/sangre , Infecciones por HTLV-I/etnología , Infecciones por HTLV-I/inmunología , Indígenas Sudamericanos , Nativos de Hawái y Otras Islas del Pacífico , Western Blotting , Brasil/epidemiología , Inmunohistoquímica , Indígenas Sudamericanos/estadística & datos numéricos , Japón/etnología , Microscopía Inmunoelectrónica , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Prevalencia , Estudios SeroepidemiológicosRESUMEN
Blood pressure, weight, height and cardiovascular risk factors were evaluated in 73 adults of Easter Island (mean age 49 +/- 12.9 (SD) years) in January 1989 and 1990. Their mean blood pressure (BP) was 129 +/- 24/81 +/- 14, significantly higher by 7/5 mm Hg than in 1979 (p < 0.05). Of the population studied 30% of subjects were hypertensives. Both systolic (S) and diastolic blood pressure (DBP) correlated with age (r = 0.40, p < 0.005 and r = 24, p < 0.05 respectively). In males body mass index correlated strongly with SBP and DBP (r = 0.55, p < 0.005 and r = 0.52, p < 0.01). Forty eight % of subjects were obese, 60% smoked (14 cigarettes/day), 38% drank alcohol and 70% lead sedentary lives; their level of stress was considered average. In 23 normotensives or undiagnosed hypertensives 24 hour urine was collected for sodium, potassium, creatinine and kallikrein; mean urinary sodium excretion was 121 +/- 39 mmol/day; potassium excretion 59 +/- 29 mmol/day, creatinine excretion 1383 +/- 489 mg/day and kallikrein excretion 682 +/- 355 mU/day; of these, only urinary sodium was significantly lower than values determined in a group of 29 continental volunteers. Eleven natives that had never left the island had similar BP and risk factors than a sex and age paired sample, who has spent 10.9 +/- 7.8 years in the continent. The present study demonstrates that Easter Island natives have increased their mean BP in 10 years, elevated their BP with age and have lost the protection previously associated to staying in the island.(ABSTRACT TRUNCATED AT 250 WORDS)