How pervasive is joint attention? Mother-child dyads from a Wichi community reveal a different form of "togetherness".

Theories of early development have emphasized the power of caregivers as active agents in infant socialization and learning. However, there is variability, across communities, in the tendency of caregivers to engage with their infants directly. This raises the possibility that infants and children in some communities spend more time engaged in solitary activities than in dyadic or triadic interactions. Here, we focus on one such community (indigenous Wichi living in Argentina's Chaco Forest) to test this possibility. We examine naturally occurring attentional activity involving the mother and child among the Wichi and among Eurodescendant Spanish-speaking families living in Argentina. We engaged 16 families-8 Wichi and 8 Eurodescendant-in an observational study of interactions between caregivers and their 1- to 2-year-olds. A mixed-analytic approach revealed no differences between communities in the proportion of time infants spent alone, or in mother-child interaction. What does differ, however, is how mothers engage in these interactions: Wichi mothers spend a greater proportion of their time observing their infants than do Eurodescendant mothers. Moreover, when infants in both groups are alone, they focus their 'solitary' activities differently: Wichi infants engaged primarily in observation alone, whereas Eurodescendant infants were more focused on the object. Finally, all mother-child pairs engaged in dyadic and triadic (object-infant-caregiver) patterns of attention, but the triadic patterns differed considerably between cultures: Among Wichi, mothers actively "watched" infants as they engaged with objects, whereas Eurodescendant mothers actively engaged with their infants in joint attentional episodes. This work illustrates how attention and socialization, key mechanisms of early development, are culturally organized. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=SwsOCLXubKQ. RESEARCH HIGHLIGHTS: Longitudinal, observational investigation of mother-infant interaction in two distinct Argentine cultural groups (Wichi and Eurodescendants) reveals both commonalities and clear community-based differences in interactions between mothers and their 1- to 2-year-olds. Wichi mother-infant dyads engaged primarily in visual observation of one another, but their Eurodescendant counterparts tended to engage in more verbal or physical interaction. We identify a new form of triadic interaction-lateral joint attention-among the Wichi dyads. This work underscores that attention and socialization, key mechanisms of early development, are culturally organized.

Early lexical acquisition in the Wichi language.

This research brings new evidence on early lexical acquisition in Wichi, an under-studied indigenous language in which verbs occupy a privileged position in the input and in conjunction with nouns are characterized by a complex and rich morphology. Focusing on infants ranging from one- to three-year-olds, we analyzed the parental report of infants' vocabulary (Study 1) and naturalistic speech samples of children and their caregivers (Study 2). Results reveal that: (1) although verbs predominate in the linguistic input, children's lexicons favor nouns over verbs; (2) children's early noun-advantage decreases, coming into closer alignment with the patterns in the linguistic input at a MLU of 1.5; and (3) this early transition is temporally related to children's increasing productive command over the grammatical categories that characterize the morphology of both nouns and verbs. These findings emphasize the early effects of language-specific properties of the input, broadening the vantage point from which to view the lexical acquisition process.

A time to be born: Variation in the hour of birth in a rural population of Northern Argentina.

OBJECTIVES: The present study aimed at investigating the timing of birth across the day in a rural population of indigenous and nonindigenous women in the province of Formosa, Argentina in order to explore the variation in patterns in a non-Western setting. MATERIALS AND METHODS: This study utilized birth record data transcribed from delivery room records at a rural hospital in the province of Formosa, northern Argentina. The sample included data for Criollo, Wichí, and Toba/Qom women (n = 2421). Statistical analysis was conducted using directional statistics to identify a mean sample direction. Chi-square tests for homogeneity were also used to test for statistical significant differences between hours of the day. RESULTS: The mean sample direction was 81.04°, which equates to 5:24 AM when calculated as time on a 24-hr clock. Chi-squared analyses showed a statistically significant peak in births between 12:00 and 4:00 AM. Birth counts generally declined throughout the day until a statistically significant trough around 5:00 PM. DISCUSSION: This pattern may be associated with the circadian rhythms of hormone release, particularly melatonin, on a proximate level. At the ultimate level, giving birth in the early hours of the morning may have been selected to time births when the mother could benefit from the predator protection and support provided by her social group as well as increased mother-infant bonding from a more peaceful environment.

Prevalence of musculoskeletal disorders and rheumatic diseases in an Argentinean indigenous Wichi community.

OBJECTIVE: To estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in an indigenous Wichi population in Argentina. METHODS: This is a cross-sectional, community-based study using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology in ≥ 18-year-old subjects. Validated surveys were conducted by trained interviewers. Subjects with MSK pain (positive cases) were evaluated by internists and rheumatologists for diagnosis and treatment. RESULTS: A total of 648 interviews were performed (90.4% of the census population). Mean age was 37.5 years (SD 14.8), and 379 (58.5%) were female. The mean years of education was 7.0 (SD 3.7); 552 subjects (85.2%) were covered by the public health care system. A total of 216 (33.3%) subjects had MSK pain in the last 7 days. Rheumatic disease prevalence was as follows: mechanical back pain (19.0%), rheumatic regional pain syndrome (5.2%), osteoarthritis (3.2%), rheumatoid arthritis (RA) (3.2%), inflammatory back pain (1.2%), undifferentiated arthritis (0.3%), Sjögren syndrome (0.15%), and fibromyalgia (0.15%). RA patients included 19 (90.5%) women and 9 (42.9%) with RA family history. One hundred percent were seropositive and 66.7% showed radiologic erosions. The mean of Disease Activity Score [DAS-28 (ESR)] at the time of diagnosis was 5.1 (SD 1.5) and the Health Assessment Questionnaire Disability Index (HAQ-DI) was 0.8 (SD 0.4). CONCLUSION: RA prevalence was 3.2%, one of the highest reported using the COPCORD methodology in indigenous and non-indigenous peoples in Latin America, with a high percentage of family cases. Pain and functional capacity were the variables allowing patients' early referral to a specialist. Key Points • The RA prevalence was 3.2%, one of the highest reported using COPCORD methodology in indigenous and non-indigenous peoples in Latin America. • The patients with RA had high percentage of familiar history of RA. • The pain and functional capacity were the variables associated with a diagnosis of any rheumatic disease and should be considered for early referral. • The mean of the delay in the diagnosis was 5.8 years. In this community, the lack of the "migration health" phenomenon may be a social determinant that negatively impacts their health.

Height, weight and body mass index of Wichí children from Formosa, Argentina. / Talla, peso e índice de masa corporal en niños y niñas wichí de Formosa, Argentina.

This study provides the descriptive, anthropometric data of 194 children (aged 0-18 years) from a Wichi population located in the province of Formosa, Argentina. The objective of this study was to document growth and nutritional status in this indigenous people. Weight, height, and body mass index data were collected and the corresponding Z-scores were estimated using national and international reference standards. Most analyzed parameters were within the normal range. However, it is concerning that a significant percentage of children are overweight, which may indicate that this population is going through a process of westernization that promotes the consumption of high-calorie, highly-processed foods and a lower level of physical activity.

Este trabajo presenta datos antropométricos descriptivos de 194 niños y niñas (0-18 años) de una población wichí de la provincia de Formosa, Argentina. El objetivo fue documentar el crecimiento y el estado nutricional de este pueblo originario. Se tomaron datos de peso, talla e índice de masa corporal y se calcularon los respectivos puntajes Z utilizando referencias nacionales e internacionales. La mayoría de los parámetros analizados caen dentro de los rangos de la normalidad. Sin embargo, es preocupante la presencia de un porcentaje significativo de niñas y niños con sobrepeso, lo cual indicaría que esta población se encuentra atravesando un proceso de occidentalización que promueve el consumo de alimentos procesados hipercalóricos y una menor actividad física.

La importancia de la participación y la colaboración intercultural en la formación de enfermeras/os en las comunidades wichí del Chaco salteño / The importance of intercultural participation and collaboration in the training of nurses in the wichí communities of the Chaco salteño / A importância da participação intercultural e da colaboração na formação de enfermeiros nas comunidades wichí do Chaco de Salta

Resumen El artículo aborda la importancia de la colaboración intercultural en la formación de enfermeras/os para garantizar el derecho a la salud en comunidades del pueblo wichí. Describe y analiza debates que fueron desarrollados entre profesionales, de diversas disciplinas, a cargo de la elaboración del currículo del primer curso de Enfermería Intercultural impartido en territorio indígena de la provincia de Salta (Argentina). El estudio de estos debates muestra que los espacios de colaboración intercultural, donde se reconocen, valoran y respetan los diversos sistemas de conocimientos, son un recurso útil para la formación de enfermeras/os. Estos espacios contribuyen a garantizar la participación reconocida en marcos internacionales para los pueblos indígenas y valorada por la Organización Mundial de la Salud y la Organización Panamericana de la Salud para la construcción de respuestas en salud. Sin embargo, la normativa establecida para la aprobación del plan de estudio, en Argentina, limita el desarrollo de este tipo de espacios, restringiendo a su vez los alcances de las políticas y programas de salud focalizados en esta población.

Abstract The article addresses the importance of intercultural collaboration in the training of nurses to guarantee the right to health in communities of the Wichí people. It describes and analyzes debates that were developed among professionals, from different disciplines, in charge of the elaboration of the curriculum of the first Intercultural Nursing course taught in the indigenous territory of the province of Salta (Argentina). The analysis of these debates shows that spaces for intercultural collaboration, oriented towards recognition, appreciation and mutual respect among diverse knowledge systems, are a valuable resource for the training of nurses. These spaces contribute to guarantee the participation recognized in international frameworks for indigenous peoples and valued by World Health Organization and Pan American Health Organization for the construction of health responses. However, the regulations established for the approval of study plans in Argentina limit the development of this type of space, thereby restricting in turn the scope of health policies and programs focused on this population.

Resumo O artigo aborda a importância da colaboração intercultural na formação de enfermeiros para garantir o direito à saúde nas comunidades do povo wichí. Descreve e analisa debates que foram desenvolvidos entre profissionais de diferentes disciplinas encarregados de desenvolver o currículo do primeiro curso de Enfermagem Intercultural ministrado no território indígena da província de Salta (Argentina). A análise desses debates mostra que os espaços de colaboração intercultural, orientados para o reconhecimento, apreciação e respeito mútuo entre diferentes sistemas de conhecimento, são um recurso valioso para a formação de enfermeiros. Esses espaços contribuem para garantir a participação reconhecida nos quadros internacionais dos povos indígenas e valorizada pela Organização Mundial da Saúde e pela Organização Pan-Americana da Saúde para a construção de respostas sanitárias. No entanto, os regulamentos estabelecidos para a aprovação do currículo na Argentina limitam o desenvolvimento desse tipo de espaços, restringindo o âmbito das políticas e programas de saúde centrados nesta população.

Experiencia sobre el proceso de salud-enfermedad-atención en pacientes con artritis reumatoidea pertenecientes a la comunidad Wichí de Misión Chaqueña "El Algarrobal", Salta / Experience on the health-disease-care process in patients with rheumatoid arthritis belonging to the Wichí community of Mission Chaqueña "El Algarrobal", Salta

Introducción: se ha reportado que la prevalencia de artritis reumatoidea (AR) en la comunidad Wichí representa la más alta informada por el Grupo Latinoamericano para el Estudio de las Enfermedades Reumáticas en los Pueblos Originarios (GLADERPO). El objetivo de este estudio fue describir la experiencia sobre el proceso de salud-enfermedad-atención de pacientes con AR de la comunidad Wichí de Misión Chaqueña "El Algarrobal", Salta. Materiales y métodos: estudio narrativo. Diseño de corte etnográfico. Se realizaron entrevistas semi-estructuradas y observaciones registradas. Se utilizaron guías de entrevistas y observación. Los aspectos incluidos fueron: concepción del proceso salud-enfermedad, percepción de la AR en la vida diaria, el acceso al sistema de salud, utilización de recursos tradicionales y de medicina tradicional. Resultados: se realizaron 10 entrevistas. Los aspectos más relevantes fueron la concepción del proceso salud-enfermedad asociado al trauma social pasado y al concepto de voluntad Wichí. Se evidenció la combinación de estrategias para mejorar el dolor (biomedicina, medicina tradicional y acompañamiento religioso). Además, se observó una relación unidireccional con el sistema de salud. Conclusiones: la AR es una enfermedad con un impacto negativo en la comunidad Wichí. Se requieren otras actividades, desde otras disciplinas, para mejorar el acceso al sistema de salud y la continuidad de los tratamientos.

Introduction: the prevalence of rheumatoid arthritis (RA) in the Wichí community has already been published, representing the highest reported by the Grupo Latinoamericano para el Estudio de las Enfermedades Reumáticas en los Pueblos Originarios (GLADERPO). The objective was to describe the experience of the health-disease-care process of patients with RA from the Wichí community of Misión Chaqueña "El Algarrobal", Salta. Materials and methods: study with ethnographic design. Semi-structured interviews and recorded observations were conducted. Interview and observation guides were used. The aspects included were: conception of the health-disease process; perception of RA in daily life, access to the health system, use of traditional resources and traditional medicine. Results: ten interviews were conducted. The most relevant aspects were the conception of the health-disease process, associated with past social trauma and the concept of "Wichí good will". The combination of strategies to improve pain (biomedicine, traditional medicine and religious accompaniment) was evidenced. In addition, a unidirectional relationship with the health system was observed. Conclusions: RA is a disease with a negative impact on the Wichí community. Other activities from other disciplines are necessary to improve access to the health system and continuity of treatment.

Factores de riesgo cardiovascular y renal, y perfil socioeconómico en individuos de la etnia wichi de "el impenetrable", chaco, argentina / Cardiovascular and renal risk factors and socioeconomics profile in individuals of the wichi ethnia group from "el impenetrable", chaco, argentina

Resumen Introducción: Varios estudios han demostrado en poblaciones indígenas alta prevalencia de obesidad, diabetes mellitus, hipertensión arterial, proteinuria y enfermedad renal crónica. Objetivo: Detectar factores de riesgo cardiovascular y renal, hipertensión arterial, sobrepeso y obesidad, obesidad central, diabetes y proteinuria, y evaluar nivel educativo, situación laboral, nivel socioeconómico y cobertura de salud en sujetos de la etnia wichi, habitantes de "El Impenetrable" chaqueño. Material y métodos: Se realizó un estudio descriptivo observacional, de corte transversal, con muestra aleatoria de sujetos mayores de 18 años. La encuesta semiestructurada, y traducida a lengua wichi, incluyó: edad, sexo, sedentarismo, tabaquismo, nivel educativo, situación laboral, cobertura de salud y nivel socioeconómico. Se midió peso, talla, circunferencia de cintura, presión arterial sistólica y diastólica, glucemia y proteinuria. Se calculó el índice de masa corporal. Resultados: Se evaluaron 156 personas (el 58,3% varones, edad 34 ± 12 años). El índice de masa corporal fue de 27,9 ± 5,3, sin diferencia entre sexos. Presentó hipertensión arterial el 10,8%, sobrepeso el 34,0%, obesidad el 30,9%, obesidad central el 40,1% (mayor en mujeres, p= 0,03), tabaquismo el 17,4%, sedentarismo el 83,3%, y proteinuria el 14,5%. Se registró un único caso de diabetes. Solo 6,4% refirió trabajar, el 49,3% no había finalizado estudios primarios, el 61,7% calificó como marginal en el nivel socioeconómico, y solo el 3,8% tenía cobertura de salud. Conclusión: Este grupo poblacional evidencia un alto grado de vulnerabilidad alimentaria, educativa, laboral, social y sanitaria, reflejado en la alta prevalencia de factores de riesgo cardiovascular y renal (en particular exceso de peso y obesidad central), en el bajo nivel educativo, laboral y socioeconómico, y en la falta de cobertura de salud.

Abstract Introduction: Several studies have shown a high prevalence of obesity, diabetes mellitus, hypertension, proteinuria and chronic kidney disease in indigenous populations. Aim: To detect cardiovascular and renal risk factors, hypertension, overweight and obesity, truncal obesity, diabetes and proteinuria, and to evaluate educational level, employment situation, socioeconomic level and health care coverage in subjects from the Wichi ethnic group who inhabit in "El Impenetrable" in Chaco. Methods: An observational, descriptive, cross-sectional study was carried out, with a random sample of subjects over 18 years of age. The semi-structured survey, translated into the Wichi language, included: age, sex, sedentary lifestyle, smoking habit, educational level, employment situation, health care coverage and socioeconomic level. Weight, height, waist circumference, systolic and diastolic blood pressure, blood glucose and proteinuria were measured. Body mass index was calculated. Results: 156 people were evaluated (58.3% men; age: 34 ± 12 years). The body mass index was 27.9 ± 5.3, with no difference between the sexes. Hypertension was present in 10.8% of individuals; overweight in 34.0%; obesity in 30.9%; truncal obesity in 40.1% (higher in women, p = 0.03); smoking habit in 17.4%; sedentary lifestyle in 83.3%, and proteinuria in 14.5%. A single case of diabetes was registered. Only 6.4% reported having a job, 49.3% had not completed primary studies, 61.7% qualified as marginal in terms of socioeconomic status, and only 3.8% had health care coverage. Conclusion: This population group shows a high degree of food, educational, occupational, social and health vulnerability, reflected in the high prevalence of cardiovascular and renal risk factors (particularly excess weight and truncal obesity), in the low educational, employment and socioeconomic levels, and in the lack of health coverage.

Talla, peso e índice de masa corporal en niños y niñas wichí de Formosa, Argentina / Height, weight and body mass index of Wichí children from Formosa, Argentina

Este trabajo presenta datos antropométricos descriptivos de 194 niños y niñas (0-18 años) de una población wichí de la provincia de Formosa, Argentina. El objetivo fue documentar el crecimiento y el estado nutricional de este pueblo originario. Se tomaron datos de peso, talla e índice de masa corporal y se calcularon los respectivos puntajes Z utilizando referencias nacionales e internacionales. La mayoría de los parámetros analizados caen dentro de los rangos de la normalidad. Sin embargo, es preocupante la presencia de un porcentaje significativo de niñas y niños con sobrepeso, lo cual indicaría que esta población se encuentra atravesando un proceso de occidentalización que promueve el consumo de alimentos procesados hipercalóricos y una menor actividad física.

This study provides the descriptive, anthropometric data of 194 children (aged 0-18 years) from a Wichi population located in the province of Formosa, Argentina. The objective of this study was to document growth and nutritional status in this indigenous people. Weight, height, and body mass index data were collected and the corresponding Z-scores were estimated using national and international reference standards. Most analyzed parameters were within the normal range. However, it is concerning that a significant percentage of children are overweight, which may indicate that this population is going through a process of westernization that promotes the consumption of high-calorie, highly-processed foods and a lower level of physical activity.

Chagas disease: serological and electrocardiographic studies in Wichi and Creole communities of Misión Nueva Pompeya, Chaco, Argentina

Chagas disease, which is caused by Trypanosoma cruzi, affects nearly 16 million people in Latin America and causes 75-90 million people to be at risk of infection. The disease is urbanizing and globalizing due to frequent migrations. There are regions of high prevalence of infection, including the north-eastern provinces of Argentina and the entire phytogeographic region known as the Gran Chaco. In the province of Chaco, Argentina, there are places inhabited by native populations such as the Wichi and Toba communities, among others. Many Creole populations resulting from miscegenation with European colonists and immigrants coexist within these communities. It has been widely accepted that in the chronic phase of the disease, between 25-30 percent of individuals develop some form of cardiac disease, with the right bundle-branch block being the most typical condition described so far. The aim of this work was to study the prevalence of Chagas infection and its electrocardiographic profile in the Wichi and Creole populations of Misión Nueva Pompeya, in the area known as Monte Impenetrable in Chaco, to determine the prevalence and the pattern of heart diseases produced by Chagas disease in this region.

Prevalencia de malnutrición y factores asociados en mujeres del pueblo wichí de General Ballivián, Provincia de Salta / Prevalence of Malnutrition and Associated Factors in Women of the Wichí People in General Ballivián, Province of Salta

INTRODUCCIÓN: La malnutrición (MN) es un problema mundial. Sus causas, mecanismos y consecuencias presentan particularidades económicas, biológicas y socioculturales. En la población indígena se han demostrado prevalencias de MN infantil más altas que en la población no indígena, aunque el estado nutricional de mujeres en edad reproductiva no ha sido estudiado. OBJETIVOS: Conocer la prevalencia de MN por déficit (MND) o exceso (MNE) y los factores asociados en mujeres wichí de General Ballivián, Salta. MÉTODOS: Se determinó la prevalencia de MN por antropometría. Se consideraron variables socioeconómicas, biosanitarias y alimentarias. Se estudió a 141 mujeres (wichí, de 12 años o más, no gestantes, sin discapacidad física/mental). Se hizo un estudio de casos y controles no pareados con grupo de casos 1 MNE (80), grupo de casos 2 MND (4) y grupo control: eutróficas (Eu) (57). Los datos se procesaron con SPSS Statistics 20.0. RESULTADOS: Se registró 3% de MND, 40% de Eu y 57% de MNE, con asociación estadísticamente significativa entre MND y adolescencia y entre MNE y multiparidad, ausencia de piezas dentarias, adultez y escolaridad inadecuada. Según OR (odds ratio), el riesgo de MNE es mayor en multíparas y monolingües, la MNE aumenta el riesgo de pérdida de piezas dentarias y una escolaridad inadecuada aumenta casi 13 veces el riesgo de MNE. CONCLUSIONES: La prevalencia de MNE es alta, asociada a edad, multiparidad, educación inadecuada, monolingüismo y carencia de micronutrientes