Genetic continuity and change among the Indigenous peoples of California.

Before the colonial period, California harboured more language variation than all of Europe, and linguistic and archaeological analyses have led to many hypotheses to explain this diversity1. We report genome-wide data from 79 ancient individuals from California and 40 ancient individuals from Northern Mexico dating to 7,400-200 years before present (BP). Our analyses document long-term genetic continuity between people living on the Northern Channel Islands of California and the adjacent Santa Barbara mainland coast from 7,400 years BP to modern Chumash groups represented by individuals who lived around 200 years BP. The distinctive genetic lineages that characterize present-day and ancient people from Northwest Mexico increased in frequency in Southern and Central California by 5,200 years BP, providing evidence for northward migrations that are candidates for spreading Uto-Aztecan languages before the dispersal of maize agriculture from Mexico2-4. Individuals from Baja California share more alleles with the earliest individual from Central California in the dataset than with later individuals from Central California, potentially reflecting an earlier linguistic substrate, whose impact on local ancestry was diluted by later migrations from inland regions1,5. After 1,600 years BP, ancient individuals from the Channel Islands lived in communities with effective sizes similar to those in pre-agricultural Caribbean and Patagonia, and smaller than those on the California mainland and in sampled regions of Mexico.

Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial.

BACKGROUND: Available research on the contribution of traditional midwifery to safe motherhood focuses on retraining and redefining traditional midwives, assuming cultural prominence of Western ways. Our objective was to test if supporting traditional midwives on their own terms increases cultural safety (respect of Indigenous traditions) without worsening maternal health outcomes. METHODS: Pragmatic parallel-group cluster-randomised controlled non-inferiority trial in four municipalities in Guerrero State, southern Mexico, with Nahua, Na savi, Me'phaa and Nancue ñomndaa Indigenous groups. The study included all pregnant women in 80 communities and 30 traditional midwives in 40 intervention communities. Between July 2015 and April 2017, traditional midwives and their apprentices received a monthly stipend and support from a trained intercultural broker, and local official health personnel attended a workshop for improving attitudes towards traditional midwifery. Forty communities in two control municipalities continued with usual health services. Trained Indigenous female interviewers administered a baseline and follow-up household survey, interviewing all women who reported pregnancy or childbirth in all involved municipalities since January 2016. Primary outcomes included childbirth and neonatal complications, perinatal deaths, and postnatal complications, and secondary outcomes were traditional childbirth (at home, in vertical position, with traditional midwife and family), access and experience in Western healthcare, food intake, reduction of heavy work, and cost of health care. RESULTS: Among 872 completed pregnancies, women in intervention communities had lower rates of primary outcomes (perinatal deaths or childbirth or neonatal complications) (RD -0.06 95%CI - 0.09 to - 0.02) and reported more traditional childbirths (RD 0.10 95%CI 0.02 to 0.18). Among institutional childbirths, women from intervention communities reported more traditional management of placenta (RD 0.34 95%CI 0.21 to 0.48) but also more non-traditional cold-water baths (RD 0.10 95%CI 0.02 to 0.19). Among home-based childbirths, women from intervention communities had fewer postpartum complications (RD -0.12 95%CI - 0.27 to 0.01). CONCLUSIONS: Supporting traditional midwifery increased culturally safe childbirth without worsening health outcomes. The fixed population size restricted our confidence for inference of non-inferiority for mortality outcomes. Traditional midwifery could contribute to safer birth among Indigenous communities if, instead of attempting to replace traditional practices, health authorities promoted intercultural dialogue. TRIAL REGISTRATION: Retrospectively registered ISRCTN12397283 . Trial status: concluded.

In many Indigenous communities, traditional midwives support mothers during pregnancy, childbirth, and some days afterwards. Research involving traditional midwives has focused on training them in Western techniques and redefining their role to support Western care. In Guerrero state, Mexico, Indigenous mothers continue to trust traditional midwives. Almost half of these mothers still prefer traditional childbirths, at home, in the company of their families and following traditional practices. We worked with 30 traditional midwives to see if supporting their practice allowed traditional childbirth without worsening mothers' health. Each traditional midwife received an inexpensive stipend, a scholarship for an apprentice and support from an intercultural broker. The official health personnel participated in a workshop to improve their attitudes towards traditional midwives. We compared 40 communities in two municipalities that received support for traditional midwifery with 40 communities in two municipalities that continued to receive usual services. We interviewed 872 women with childbirth between 2016 and 2017. Mothers in intervention communities suffered fewer complications during childbirth and had fewer complications or deaths of their babies. They had more traditional childbirths and fewer perineal tears or infections across home-based childbirths. Among those who went to Western care, mothers in intervention communities had more traditional management of the placenta but more non-traditional cold-water baths. Supporting traditional midwifery increased traditional childbirth without worsening health outcomes. The small size of participating populations limited our confidence about the size of this difference. Health authorities could promote better health outcomes if they worked with traditional midwives instead of replacing them.

Population diversity of three variants of the SLC47A2 gene (MATE2-K transporter) in Mexican Mestizos and Native Americans.

BACKGROUND: MATE2-K is an efflux transporter protein of organic cation expressed mainly in the kidney and encoded by the SLC47A2 gene. Different variants of this gene have shown an impact on the pharmacokinetics of various drugs, including metformin, which represents one of the most widely used drugs in treating type 2 diabetes. The SLC47A2 gene variants have been scarcely studied in Mexican populations, especially in Native American groups. For this reason, we analyzed the distribution of the variants rs12943590, rs35263947, and rs9900497 within the SLC47A2 gene in 173 Native Americans (Tarahumara, Huichol, Maya, Puerépecha) and 182 Mestizos (admixed) individuals from Mexico. METHODS AND RESULTS: Genotypes were determined through TaqMan probes (qPCR). The Hardy-Weinberg agreement was confirmed for all three SLC47A2 gene variants in all the Mexican populations analyzed. When worldwide populations were included for comparison purposes, for alleles and genotypes a relative interpopulation homogeneity was observed for rs35263947 (T allele; range 23.3-51.1%) and rs9900497 (T allele; range 18.6-40.9%). Conversely, heterogeneity was evident for rs12943590 (A allele, range 22.1-59.1%), where the most differentiated population was the Huichol, with high frequencies of the risk genotype associated with decreased response to metformin treatment (A/A = 40.9%). CONCLUSIONS: Although the SLC47A2 gene variants allow predicting favorable response to the metformin treatment in Mexican populations, the probable high frequency of ineffectiveness should be discarded in Huichols.

"Making Medicine" with Salvia divinorum: Competing Approaches and Their Implications.

The psychoactive plant Salvia divinorum has long been used medicinally by Indigenous people from southern Mexico, the only place where it is endemic, and is now studied by pharmaceutical researchers. I analyze competing ways the two groups "make medicine" with salvia, attending simultaneously to material/embodied and semiotic/linguistic dimensions of those practices. I introduce two concepts - stripping and enrobing - to show that differences in how the groups interact with salvia have ethical and political consequences. Those repercussions matter because salvia is but one of many plants important to marginalized groups whose ties to them are threatened by international medical interests.

Development of a cognitive behavioral therapy with integrated mindfulness for Latinx immigrants with co-occurring disorders: Analysis of intermediary outcomes.

Objectives: Transdiagnostic interventions have been increasingly used in the management of a variety of mental health and substance use conditions, and in the context of chronic stress. We discuss the development and evaluation of the Integrated Intervention for Dual Problems and Early Action (IIDEA), a 10-session manualized intervention that includes cognitive therapy and mindfulness practice designed to improve symptoms of anxiety, depression, posttraumatic stress, and co-occurring substance use problems. Methods: In this secondary analysis of a randomized-controlled trial of IIDEA conducted with an international sample of immigrant Latinx in the United States and Spain, we evaluate intermediate outcomes-mindful awareness, working alliance with clinician and illness self-management-and integrate statistical findings with results from qualitative interviews with participants. Results: The IIDEA intervention group showed higher levels of mindful awareness, illness self-management, and working alliance over an enhanced treatment as usual control group (usual treatment plus scheduled assessments) and qualitative data offer insights into the importance of therapeutic alliance and integration of mindfulness practice with cognitive therapy management skills. Conclusions: Findings suggest that skills related to the studied intermediary outcomes can be helpful for Latinx immigrants experiencing circumstances of ongoing exposure to adversity and traumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Breastfeeding Initiation, Duration, and Supplementation Among Mexican-Origin Women in Texas.

BACKGROUND: Mexican-origin women breastfeed at similar rates as white women in the United States, yet they usually breastfeed for less time. In our study, we seek to identify differences in Mexican-origin women's breastfeeding intentions, initiation, continuation, and supplementation across nativity and country-of-education groups. METHODS: The data are from a prospective cohort study of postpartum women ages 18 to 44 recruited from 8 Texas hospitals. We included 1235 Mexican-origin women who were born and educated in either Texas or Mexico. Women were interviewed at delivery and at 3, 6, 12, 18, and 24 months post partum. Breastfeeding intentions and initiation were reported at baseline, continuation was collected at each interview, and weeks until supplementation was assessed for both solids and formula. Women were classified into 3 categories: born and educated in Mexico, born and educated in the United States, and born in Mexico and educated in the United States. RESULTS: Breastfeeding initiation and continuation varied by nativity and country of birth, although all women reported similar breastfeeding intentions. Women born and educated in Mexico initiated and continued breastfeeding in higher proportions than women born and educated in the United States. Mexican-born and US-educated women formed an intermediate group. Early supplementation with formula and solid foods was similar across groups, and early supplementation with formula negatively impacted duration across all groups. CONCLUSIONS: Nativity and country of education are important predictors of breastfeeding and should be assessed in pediatric and postpartum settings to tailor breastfeeding support. Support is especially warranted among US-born women, and additional educational interventions should be developed to forestall early supplementation with formula across all acculturation groups.

Making Women into Protagonists: Midwives Reimagine the Mexican Childbirth Narrative.

I examine midwives' interpretation of - and efforts to reimagine - the contemporary Mexican birth narrative. Throughout my research, midwives argued that, for birth outcomes to improve, women need to become "the protagonists of their own births". I analyze midwives' creative representations of how birth is and could be, and argue that the counter narrative they promote reveals the conditions within which they believe women can become empowered. By centering women's choice as the measure of success, this counter narrative stands in contrast to development initiatives and contemporary biomedical approaches to care. It also emphasizes the continued need for midwifery in Mexico. Examino los esfuerzos de parteras mexicanas para reinventar la narrativa mexicana sobre el nacimiento. Las parteras dijeron que, para que los resultados del parto mejoren, las mujeres deben convertirse en "las protagonistas de sus propios partos". Analizo las representaciones creativas de las parteras acerca del nacimiento, y sostengo que la contra-narrativa que promueven revela las condiciones dentro de las cuales creen que las mujeres pueden empoderarse. Al centrar el poder de las mujeres como la medida del éxito, esta contra-narrativa contrasta con las iniciativas de desarrollo y los enfoques biomédicos contemporáneos. También enfatiza la necesidad continuada de partería en México.

A Novel School-based Intermittent Delivery System of Iron Supplements for Highly Marginalized Tarahumara Indigenous Women of Reproductive Age of Northern Mexico.

To develop a novel delivery scheme to bridge the Mexican health system with highly isolated indigenous communities by involving naturally occurring social links: households and boarding schools. This was a school-based placebo-controlled trial with a follow-up period of 16 weeks. Children whose mothers fulfilled the inclusion criteria for anemia acted as iron supplement carriers between schools and homes. Adherence was measured based on teachers' and mothers' records. An effectiveness sub-analysis assessed changes in biochemical profiles according to random allocation to either supplementation or placebo groups. There was an overall high adherence in both groups. Analyses revealed that schooling years, literacy, and walking times played a role in high adherence. Logistic regression showed that women had higher adherence odds on the basis of household size, walking times, and previous inclusion in supplement distributions. Adherence significantly decreased the proportion of anemia by 48.2% in the intervention group. The difference at baseline and endpoint significantly reduced the number of iron-deficient anemic women by 67.7% in the supplementation group. This delivery method is a valid alternative to the conventional efforts used to reach Tarahumara indigenous communities, and could also have the potential to be piloted to tackle other health issues hindering these marginalized communities.

Tattoo Removal as a Resettlement Service to Reduce Incarceration Among Mexican Migrants.

In Mexico, tattooed migrants face discrimination and are at high-risk of incarceration, thus, we assessed whether receiving laser tattoo removal affected the likelihood of incarceration. In 2015-2016, 89 adults ages ≥ 18 years with visible tattoos were recruited at a free-clinic to receive laser tattoo removal or assigned to the wait-list; all completed baseline and 6-month questionnaires. Overall, 97.8% of participants ever migrated to the USA. In multivariate analyses restricted to migrants (n = 87), those receiving laser tattoo removal [Adjusted Odds Ratio (AOR) 0.27, 95% CI 0.07-0.89] and possessing a Mexican Voting card (AOR 0.14; 95% CI 0.03-0.58) were significantly less likely than wait-list participants to be incarcerated at 6-months. Previously incarcerated participants were significantly more likely to be incarcerated at follow-up. Tattoo removal may reduce incarceration among Mexican migrants. Future studies can assess other health and social benefits of tattoo removal for migrants/deportees returning to Mexico.

Oral health and diet of a young Late Pleistocene woman from Quintana Roo, Mexico.

OBJECTIVES: To increase understanding of the subsistence practices of the first Americans through analysis of the near-complete dentition of a young woman dating to the terminal Pleistocene of the Yucatan Peninsula, Mexico. MATERIALS AND METHODS: The skeleton is that of "Naia" a 15 to 17-year-old female from the submerged natural trap of Hoyo Negro found in association with remains of numerous extinct species of megafauna. Superbly preserved remains included the skull with 28 teeth, which are analyzed for evidence of caries, periodontal disease, wear patterns, and malocclusion. RESULTS: Naia exhibits a high frequency of dental caries, along with aggressive periodontal disease that threatened all her teeth, particularly her incisors. Dental attrition was extremely light for a hunter-gatherer, reaching to four on the Molnar scale on only one tooth. Lack of wear is associated with severe mandibular retrognathia, and low masticatory forces. DISCUSSION: Naia's dental condition is compared with that of other northern Paleoamericans, mostly females, dating before 11,000 cal BP. These exhibit a high degree of variability in both caries and tooth wear. All, however, exhibit rapid anterior wear owing to technological use of the front teeth. Naia exhibits the highest rate of caries, similar to that of the earliest South Americans, and one of the lowest rates of attrition. This demonstrates that she had a nonabrasive diet that was at least seasonally rich in carbohydrates. This does not mean her diet was low in meat, however, because similarly light dental attrition is seen in the Arch Lake female, a Paleoamerican from a big-game hunting society.

[Difficulties accessing abortion in legal termination contexts: high school students' narratives in a rural community in Mexico]. / Dificultades de acceso al aborto en contextos de interrupción legal del embarazo: narrativa de estudiantes de bachillerato en una comunidad campesina de México.

In this article, we analyze beliefs and practices among young high school students who seek out or consider the possibility of terminating a pregnancy. We selected students from a public school located in a rural, peasant community in México City, México. This is a constructivist ethnographic study based on in-depth interviews with 15 sexually-active women aged between 18 and 24 years. The interviews were recorded with participants' authorization and informed consent. Results indicate that social stigmas persist which affect the dignity of women who have chosen to have an abortion. However, Catholic ideologies do not seem persuasive for participants who chose to carry the unwanted pregnancy to term. In any case, the absence of confidentiality in the clinics may lead young women to opt for clandestine spaces or for self-medication, usually based on natural medicine or abortive pills. Significantly, participants acknowledged that they did not use condoms and that they occasionally use oral contraceptives. The public health system in the community does not always guarantee confidentiality for legal terminations, for this reason participants do not consider it the first option for having an abortion. On the other hand, sexual education projects are indispensable for enabling young women to avoid unwanted pregnancies and to freely exercise their sexual and reproductive rights. Additionally, actions are needed for sensitizing and training education workers.

En este trabajo se analizan las creencias y prácticas entre jóvenes estudiantes de bachillerato que buscan o consideran la posibilidad de interrumpir un embarazo. Se eligieron estudiantes de una escuela pública situada en un una comunidad rural y campesina de la Ciudad de México, México. Es un estudio etnográfico de corte constructivista, basado en entrevistas en profundidad a 15 mujeres de entre 18 y 24 años de edad, con vida sexual activa. Las entrevistas fueron grabadas con autorización y bajo el consentimiento informado de los participantes. Los hallazgos indican que persisten estigmas sociales que afectan la dignidad de las mujeres que eligen abortar. Sin embargo, las ideologías católicas no parecen ser persuasivas para que las informantes decidan continuar con un embarazo que no desean. En todo caso, la falta de confidencia en las clínicas puede llevar a las jóvenes a optar por espacios clandestinos o a la automedicación, generalmente basada en herbolaria y pastillas abortivas. Llama la atención que las informantes reconocieron que no usaban preservativos y que eventualmente emplean anticonceptivos orales. Los sistemas de salud públicos en la comunidad no siempre garantizan la confidencialidad para interrumpir legalmente un embarazo, por eso no son contemplados por las jóvenes entrevistadas como la primera opción para suspender la gestación. Por otro lado, es muy necesaria la consolidación de proyectos educativos en sexualidad que permitan a las jóvenes evitar embarazos que no desean y puedan ejercer plenamente sus derechos sexuales y reproductivos. Además, es importante incluir acciones relativas a la sensibilización y capacitación de profesionales de las instituciones de enseñanza.

Neste trabalho são analisadas as crenças e práticas entre jovens estudantes do Ensino Médio que procuram ou consideram a possibilidade de interromper uma gravidez. Foram selecionados estudantes de uma escola pública localizada em una comunidade rural e camponesa da Cidade do México, México. Estudo etnográfico de caráter construtivista, baseado em entrevistas em profundidade a 15 mulheres entre 18 e 24 anos de idade, com vida sexual ativa. As entrevistas foram gravadas com autorização e com o consentimento informado dos participantes. Os resultados indicam que persistem estigmas sociais que afetam a dignidade das mulheres que escolheram abortar. Entretanto, as ideologias católicas no parecem ser persuasórias para que as informantes resolveram continuar com a gravidez indesejada. De qualquer forma, a ausência de confidencialidade nas clínicas pode levar as jovens a optar por espaços clandestinos o pela automedicação, normalmente baseada em medicina natural ou comprimidos abortivos. Foi significativo que as informantes reconheceram que não fizeram uso de preservativos e que eventualmente usam anticonceptivos orais. O sistema de saúde público na comunidade nem sempre garante o sigilo para interromper legalmente uma gravidez, por isso não é contemplado pelas jovens entrevistadas como a primeira opção para interromper a gestação. Por outro lado, e imprescindível a consolidação de projetos educativos em sexualidade que permitam as jovens evitar gravidezes indesejadas e que possam ser livres para exercer plenamente seus direitos sexuais e reprodutivos. Além disso, é importante incluir ações relativas a sensibilização e capacitação de profissionais das instituições de ensino.

Conventional and Complementary Therapy Use among Mexican Farmworkers in North Carolina: Applying the I-CAM-Q.

Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May-September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies.

Regulating Traditional Mexican Midwifery: Practices of Control, Strategies of Resistance.

The institutionalization of Mexican midwifery has a long history. Despite global recommendations moving away from training traditional midwives, training courses still continue. Based on fieldwork in the State of Chiapas, I argue that while ongoing trainings offered to traditional midwives in Mexico aim at teaching them best practices, they also limit midwives' autonomy and keep poor women's reproductive behaviors under control. I demonstrate how midwives and medical personnel mobilize discourses of reproductive risk, women's rights and indigenous cultural rights to reinforce or contest mechanisms of reproductive governance.

Dificultades de acceso al aborto en contextos de interrupción legal del embarazo: narrativa de estudiantes de bachillerato en una comunidad campesina de México / Difficulties accessing abortion in legal termination contexts: high school students' narratives in a rural community in Mexico / Dificuldades de acesso ao aborto em contextos de interrupção legal da gravidez: narrativa de estudantes do Ensino Médio em uma comunidade rural do México

Resumen: En este trabajo se analizan las creencias y prácticas entre jóvenes estudiantes de bachillerato que buscan o consideran la posibilidad de interrumpir un embarazo. Se eligieron estudiantes de una escuela pública situada en un una comunidad rural y campesina de la Ciudad de México, México. Es un estudio etnográfico de corte constructivista, basado en entrevistas en profundidad a 15 mujeres de entre 18 y 24 años de edad, con vida sexual activa. Las entrevistas fueron grabadas con autorización y bajo el consentimiento informado de los participantes. Los hallazgos indican que persisten estigmas sociales que afectan la dignidad de las mujeres que eligen abortar. Sin embargo, las ideologías católicas no parecen ser persuasivas para que las informantes decidan continuar con un embarazo que no desean. En todo caso, la falta de confidencia en las clínicas puede llevar a las jóvenes a optar por espacios clandestinos o a la automedicación, generalmente basada en herbolaria y pastillas abortivas. Llama la atención que las informantes reconocieron que no usaban preservativos y que eventualmente emplean anticonceptivos orales. Los sistemas de salud públicos en la comunidad no siempre garantizan la confidencialidad para interrumpir legalmente un embarazo, por eso no son contemplados por las jóvenes entrevistadas como la primera opción para suspender la gestación. Por otro lado, es muy necesaria la consolidación de proyectos educativos en sexualidad que permitan a las jóvenes evitar embarazos que no desean y puedan ejercer plenamente sus derechos sexuales y reproductivos. Además, es importante incluir acciones relativas a la sensibilización y capacitación de profesionales de las instituciones de enseñanza.

Abstract: In this article, we analyze beliefs and practices among young high school students who seek out or consider the possibility of terminating a pregnancy. We selected students from a public school located in a rural, peasant community in México City, México. This is a constructivist ethnographic study based on in-depth interviews with 15 sexually-active women aged between 18 and 24 years. The interviews were recorded with participants' authorization and informed consent. Results indicate that social stigmas persist which affect the dignity of women who have chosen to have an abortion. However, Catholic ideologies do not seem persuasive for participants who chose to carry the unwanted pregnancy to term. In any case, the absence of confidentiality in the clinics may lead young women to opt for clandestine spaces or for self-medication, usually based on natural medicine or abortive pills. Significantly, participants acknowledged that they did not use condoms and that they occasionally use oral contraceptives. The public health system in the community does not always guarantee confidentiality for legal terminations, for this reason participants do not consider it the first option for having an abortion. On the other hand, sexual education projects are indispensable for enabling young women to avoid unwanted pregnancies and to freely exercise their sexual and reproductive rights. Additionally, actions are needed for sensitizing and training education workers.

Resumo: Neste trabalho são analisadas as crenças e práticas entre jovens estudantes do Ensino Médio que procuram ou consideram a possibilidade de interromper uma gravidez. Foram selecionados estudantes de uma escola pública localizada em una comunidade rural e camponesa da Cidade do México, México. Estudo etnográfico de caráter construtivista, baseado em entrevistas em profundidade a 15 mulheres entre 18 e 24 anos de idade, com vida sexual ativa. As entrevistas foram gravadas com autorização e com o consentimento informado dos participantes. Os resultados indicam que persistem estigmas sociais que afetam a dignidade das mulheres que escolheram abortar. Entretanto, as ideologias católicas no parecem ser persuasórias para que as informantes resolveram continuar com a gravidez indesejada. De qualquer forma, a ausência de confidencialidade nas clínicas pode levar as jovens a optar por espaços clandestinos o pela automedicação, normalmente baseada em medicina natural ou comprimidos abortivos. Foi significativo que as informantes reconheceram que não fizeram uso de preservativos e que eventualmente usam anticonceptivos orais. O sistema de saúde público na comunidade nem sempre garante o sigilo para interromper legalmente uma gravidez, por isso não é contemplado pelas jovens entrevistadas como a primeira opção para interromper a gestação. Por outro lado, e imprescindível a consolidação de projetos educativos em sexualidade que permitam as jovens evitar gravidezes indesejadas e que possam ser livres para exercer plenamente seus direitos sexuais e reprodutivos. Além disso, é importante incluir ações relativas a sensibilização e capacitação de profissionais das instituições de ensino.

The genus Datura L. (Solanaceae) in Mexico and Spain - Ethnobotanical perspective at the interface of medical and illicit uses.

ETHNOPHARMACOLOGICAL RELEVANCE: The different species of the genus Datura have been used traditionally by some pre-Columbian civilizations, as well as in medieval rituals linked to magic and witchcraft in both Mexico and Europe. It is also noteworthy the use of different alkaloids obtained from the plants for medicinal purposes in the treatment of various groups of diseases, especially of the respiratory and muscularskeletal systems. AIM OF THE STUDY: A review of the ethnobotanical uses of the genus Datura in Mexico and Spain has been conducted. We focus on the medicinal and ritualistic uses included in modern ethnobotanical studies, emphasizing the historical knowledge from post-colonial American Codices and medieval European texts. Datura's current social emergency as a drug of recreation and leisure, as well as its link to crimes of sexual abuse is also considered. The work is completed with some notes about the distribution and ecology of the different species and a phytochemical and pharmacological review of Datura alkaloids, necessary to understand their arrival in Europe and the ethnobotanical uses made since then MATERIALS AND METHODS: A literature review and compilation of information on traditional medicinal uses of the genus has been carried out from the main electronic databases. Traditional volumes (codices) have also been consulted in libraries of different institutions. Consultations have been made with the National Toxicological Services of Spain and Mexico for toxicological data. RESULTS: A total of 118 traditional uses were collected in both territories, 111 medicinal ones to be applied in 76 conditions or symptoms included in 13 pathological groups. Although there are particular medicinal uses in the two countries, we found up to 15 similar uses, of which 80% were previously mentioned in post-Colonial American codices. Applications in the treatment of asthma and rheumatism are also highlighted. Apart from medicinal uses, it is worth noting their cultural and social uses, in the case of Mexico relating to diseases such as being scared, astonishment or falling in love, and in the case of Spain, as a recreational drug and lately, for criminal purposes. CONCLUSIONS: This review highlights the variety of uses traditionally given to the different species in both territories. The fact that most of the coincident or similar uses in both countries also appear in the classical codices can be found an example of the flow, not only of the plants from America to Europe, but also of their associated information. It is also relevant that particular uses have derived in both countries, reflecting the difference in the cultural factors and traditions linked to rituals and cultural practices. Finally, the significant growth of Datura consumption in recent years as a drug of leisure and recreation, as well as in crimes of sexual submission, should be considered as research of maximum relevance in the field of forensic botany and toxicology.

Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California.

This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care.

Oral Histories as Critical Qualitative Inquiry in Community Health Assessment.

Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories center residents' lived experiences, which often reveal more complex social and health phenomena than conventional qualitative inquiry. This article examines an oral history research component of the Little Village Community Health Assessment, a collaborative research effort to promote health equity in an urban, Mexican ethnic enclave. We collected of 32 oral histories from residents to provide deeper, more grounded insight on community needs and assets. We initially used thematic data analysis. After analytic peer debriefings with the analysis team, we found the process inadvertently reductionist and instead opted for community listening events for participatory data analysis, knowledge translation, and dissemination of findings. Oral histories were most meaningful in their original audio form, adding to a holistic understanding of health by giving voice to complex problems while also naming and describing concepts that were culturally unique. Moreover, the oral histories collectively articulated a counternarrative that celebrated community cultural wealth and opposed the mainstream narrative of the community as deprived. We argue for the recognition and practice of oral histories as a more routine form of qualitative inquiry in community health assessment. In the pursuit of health equity and collaboratively working toward social justice, oral histories can push the boundaries of community health assessment research and practice.

Use of traditional herbal medicine as an alternative in dental treatment in Mexican dentistry: a review.

CONTEXT: Herbal therapies are used worldwide to treat health conditions. In Mexico, generations have used them to treat gingivitis, periodontitis, mouth infections, and discoloured teeth. However, few studies have collected scientific evidence on their effects. OBJECTIVE: This study aimed at searching and compiling scientific evidence of alternative oral and dental treatments using medicinal herbs from Mexico. METHODS: We collected various Mexican medicinal plants used in the dental treatment from the database of the Institute of Biology at the National Autonomous University of Mexico. To correlate with existing scientific evidence, we used the PubMed database with the key term '(scientific name) and (oral or dental)'. RESULTS: Mexico has various medical herbs with antibacterial and antimicrobial properties, according to ancestral medicinal books and healers. Despite a paucity of experimental research demonstrating the antibacterial, antimicrobial, and antiplaque effects of these Mexican plants, they could still be useful as an alternative treatment of several periodontal diseases or as anticariogenic agents. However, the number of studies supporting their uses and effects remains insufficient. DISCUSSION AND CONCLUSION: It is important for the health of consumers to scientifically demonstrate the real effects of natural medicine, as well as clarify and establish their possible therapeutic applications. Through this bibliographical revision, we found papers that testify or refute their ancestral uses, and conclude that the use of plants to treat oral conditions or to add to the dental pharmacological arsenal should be based on experimental studies verifying their suitability for dental treatments.

Commodifying Indigeneity: How the Humanization of Birth Reinforces Racialized Inequality in Mexico.

This article examines the humanized birth movement in Mexico and analyzes how the remaking of tradition-the return to traditional birthing arts (home birth, midwife-assisted birth, natural birth)-inadvertently reinscribes racial hierarchies. The great irony of the humanized birth movement lies in parents' perspective of themselves as critics of late capitalism. All the while, their very rejection of consumerism bolsters ongoing commodification of indigenous culture and collapses indigeneity, nature, and tradition onto one another. While the movement is quickly spreading across Mexico, indigenous women and their traditional midwives are largely excluded from the emerging humanized birth community. Through ethnographic examples, the article suggests that indigenous individuals are agentive actors who appropriate cards in decks stacked against them. Examples of resistance emerge within a context of power and political economy that often capitalizes on images of indigeneity while obscuring the lives, experiences, and opinions of indigenous people.

Letting the Air Out: Aire as an Empty Signifier in Oaxacan Understandings of Illness.

"Air (aire, also aigre) in the body" is a frequent explanation of illness according to the traditional medical beliefs in Mexico. Anthropologists have generally scrutinized aire in the context of other common folk illnesses treated by traditional healers (curanderas). However, drawing on my research in the communities of Northern Oaxaca I suggest that aire occupies a more distinct position in the folk medical cosmology than it has usually been credited with. This distinction rests on the notion's exceptional ambivalence and openness to multiple interpretations. "Air" is recurred to as the cause of illness mainly in situations where every other explanation, either "traditional" or "biomedical," seems to be inadequate. The physical properties of air-its transparency, invisibility, apparent immateriality, near omnipresence, and virtual "nothingness"-render it a suitable explanation of the last resort. Local understandings of what aire "is" are often vague and elusive, and in many respects the term functions in folk medical discourse as an "empty signifier."