What do indigenous communities want from their surgeons and surgical services: A systematic review.

BACKGROUND: This investigation was undertaken to define the factors determining the optimal and most productive relationship among indigenous communities, surgeons, and providers of surgical services. METHODS: A systematic literature review was conducted to identify studies reporting on the experience of indigenous communities with surgeons, medical practitioners, and the providers of surgical and other health services. The databases searched were MEDLINE, EMBASE, PubMed, Web of Science, and Google Scholar, including all literature available until the search date of April 3, 2019. The reference lists of all included articles and related review articles were searched manually to identify further relevant studies. An inductive approach was used to identify common themes. RESULTS: Thirty-three publications discussed the experiences of New Zealand Maori (n = 2), Aboriginal and Torres Strait Islanders (n = 20), North American First Nation (n = 10), and Indigenous Latin Americans (n = 1). Across all indigenous peoples, 6 themes emerged: accessible health services, community participation and community governance, continuous quality improvement, a culturally appropriate and clinically skilled workforce, a flexible approach to care, and holistic healthcare. CONCLUSION: To provide medical and surgical services in indigenous communities successfully requires a diverse range of skills and core technical and academic competencies. Many skills lie within the definition of professionalism and advocacy as well as the ability to undertake and operationalize community consultation and empowerment. If surgical services serving Indigenous communities are to be successful in addressing health disparity, specific training in these skills will need to be developed and made available.

Curando dentro, cuidando fuera: mujeres latinoamericanas y prácticas terapéuticas en el contexto migratorio transnacional / Healing inside, caring outside: Latin American women and therapeutic practices in the transnational migration context / Curando dentro, cuidando fora: mulheres latino-americanas e práticas terapêuticas no contexto migratório transnacional

Resumen El siguiente artículo intenta reflexionar acerca de la relación que se construye entre las mujeres latinas migrantes y las prácticas terapéuticas, atendiendo a los roles designados o asumidos por ellas en los procesos de salud/enfermedad/atención. Se realizó una investigación etnográfica con mujeres caribeñas establecidas en España, con el fin de indagar acerca de determinadas actividades curativas y de cuidado ejercidas por ellas, tanto al interior del hogar como hacia afuera. Además del componente descriptivo, se trabajó con las narrativas y significados específicos elaborados en torno a dichas ocupaciones. Su análisis permitió identificar facetas contradictorias y conflictivas en el desarrollo de la identidad y la experiencia migratoria femenina. Por un lado, las actividades de cuidado como principal alternativa laboral evidencian la desigualdad de oportunidades y ámbitos de incidencia social accesibles a las latinoamericanas. Al mismo tiempo reflejan mecanismos de reproducción de esquemas esencialistas, que naturalizan la división del trabajo en función de "cualidades" étnicas y de género. Por otro lado, el manejo de conocimientos específicos sobre curación, tratamiento y asistencia supone para las mujeres la posesión de un papel distintivo y potencialmente empoderador al interior de la comunidad como continuadoras de determinados saberes tradicionales.

Abstract The article attempts to reflect on the relationship between Latin American immigrant women and therapeutic practices, according to the roles designated or assumed by them in healthcare processes. An ethnographic research was carried out with Caribbean women settled in Spain, in order to inquire about certain curative and care activities exercised by them, both inside and outside their homes. In addition to the descriptive component, we worked specifically with the narratives and meanings elaborated around these occupations. Their analysis allowed us to identify conflicting facets in the development of female identity and migratory experience. Being a caregiver as their main job alternative evidence the inequality of opportunities and social impact areas accessible to Latin women; at the same time, they reproduce essentialist schemes, which naturalize the division of labour according to ethnic and gender "qualities". On the other hand, the management of specific knowledge about healing, treatment and assistance allow women to possess a distinctive and potentially empowering role within the community as continuators of certain traditional knowledge.

Resumo O presente trabalho procura refletir sobre a relação que se constrói entre as mulheres latinas migrantes e as práticas terapêuticas, de acordo com os papéis designados ou assumidos por elas nos processos de saúde/doença/cuidado. Uma pesquisa etnográfica foi realizada com mulheres caribenhas instaladas na Espanha, a fim de indagar sobre certas atividades curativas e cuidados exercidos por elas, tanto dentro como fora de casa. Além do componente descritivo, trabalhamos com narrativas e significados específicos elaborados em torno dessas ocupações. Sua análise permitiu identificar facetas conflitantes no desenvolvimento da identidade feminina e da experiência de migração. As atividades de cuidado como principal alternativa de trabalho evidenciam a desigualdade de oportunidades e áreas de impacto social acessíveis aos latino-americanos; ao mesmo tempo, refletem mecanismos de reprodução de esquemas essencialistas, que naturalizam a divisão do trabalho de acordo com "qualidades" étnicas e de gênero. Por outro lado, a gestão de conhecimentos específicos sobre cura, tratamento e assistência supõe para as mulheres a posse de um papel distintivo e potencialmente empoderador dentro da comunidade como continuadores de certos conhecimentos tradicionais.

Integrating hepatitis B, hepatitis C and HIV screening into tuberculosis entry screening for migrants in the Netherlands, 2013 to 2015.

We evaluated uptake and diagnostic outcomes of voluntary hepatitis B (HBV) and C virus (HCV) screening offered during routine tuberculosis entry screening to migrants in Gelderland and Amsterdam, the Netherlands, between 2013 and 2015. In Amsterdam, HIV screening was also offered. Overall, 54% (461/859) accepted screening. Prevalence of chronic HBV infection (HBsAg-positive) and HCV exposure (anti-HCV-positive) in Gelderland was 4.48% (9/201; 95% confidence interval (CI): 2.37-8.29) and 0.99% (2/203; 95% CI: 0.27-3.52), respectively, all infections were newly diagnosed. Prevalence of chronic HBV infection, HCV exposure and chronic HCV infection (HCV RNA-positive) in Amsterdam was 0.39% (1/256; 95% CI: 0.07-2.18), 1.17% (3/256; 95% CI: 0.40-3.39) and 0.39% (1/256; 95% CI: 0.07-2.18), respectively, with all chronic HBV/HCV infections previously diagnosed. No HIV infections were found. In univariate analyses, newly diagnosed chronic HBV infection was more likely in participants migrating for reasons other than work or study (4.35% vs 0.83%; odds ratio (OR) = 5.45; 95% CI: 1.12-26.60) and was less likely in participants in Amsterdam than Gelderland (0.00% vs 4.48%; OR = 0.04; 95% CI: 0.00-0.69). Regional differences in HBV prevalence might be explained by differences in the populations entering compulsory tuberculosis screening. Prescreening selection of migrants based on risk factors merits further exploration.

Plan de salud para la juventud indígena de América Latina y el Caribe 2017 / Health plan for indigenous youth in Latin America and the Caribbean 2017

América Latina y el Caribe es una de las regiones más diversas del mundo. Al mismo tiempo, es una región en donde se evidencian las mayores disparidades socio-económicas en términos de clase. La OPS reconoce la necesidad de hacer frente a las diversidades étnicas, sociales y culturales que existen a lo interno de los Estados Miembros y las unidades técnicas para crear políticas y servicios de salud accesibles a poblaciones enteras. Existe una amplia evidencia sobre las desventajas y discriminación que los hombres y especialmente las mujeres de estas poblaciones experimentan con respecto a su bienestar. Los sistemas de información en salud también fallan al momento de reconocer las particularidades y necesidades de estos grupos, lo cual afecta la propia definición de intervenciones e indicadores que buscan evaluar la efectividad en el mejoramiento de la salud de estas poblaciones. El proceso de formulación, implementación, seguimiento y evaluación de las políticas públicas debe asegurar la participación de las poblaciones involucradas, el respeto de los derechos humanos, la interculturalidad y la igualdad de género.

The Role of Faith-Based Organizations in the Depression Care of African Americans and Hispanics in Los Angeles.

OBJECTIVE: This study examined use of depression care provided by faith-based organizations (FBOs) by African Americans and Hispanics and factors associated with the receipt of such care, including mental illness severity and use of traditional mental health services. METHODS: The study used baseline data from the Community Partners in Care study, a group-randomized trial comparing a community-partnered approach with a technical-assistance approach to improving depression care in underresourced communities in Los Angeles. A sample of 947 individuals (48% African American, 27% non-U.S.-born Hispanic, 15% U.S.-born Hispanic, and 10% non-Hispanic white) were surveyed about recent visits to a religious or spiritual place and receipt of FBO depression care. Descriptive analyses compared racial-ethnic, sociodemographic, and health service use variables for three groups: those who did not attend a religious place, those who attended a religious place and did not receive FBO depression services, and those who received FBO depression services. Multinomial logistic regression was used to identify predictors of receipt of FBO depression care. RESULTS: A larger proportion of African Americans and non-U.S.-born Hispanics received FBO faith-based depression services compared with non-Hispanic whites and with U.S.-born Hispanics. Receipt of FBO depression services was associated with younger age, lifetime diagnosis of mania, use of primary care depression services, and receipt of a mental health service from a substance abuse agency. CONCLUSIONS: FBO depression services were used in the community, especially by persons from racial-ethnic minority groups. Collaborative efforts between FBOs and traditional health services may increase access to depression services for African Americans and Latinos.

Collaborative depression care among Latino patients in diabetes disease management, Los Angeles, 2011-2013.

INTRODUCTION: The prevalence of comorbid diabetes and depression is high, especially in low-income Hispanic or Latino patients. The complex mix of factors in safety-net care systems impedes the adoption of evidence-based collaborative depression care and results in persistent disparities in depression outcomes. The Diabetes-Depression Care-Management Adoption Trial examined whether the collaborative depression care model is an effective approach in safety-net clinics to improve clinical care outcomes of depression and diabetes. METHODS: A sample of 964 patients with diabetes from 5 safety-net clinics were enrolled in a quasi-experimental study that included 2 arms: usual care, in which primary medical providers and staff translated and adopted evidence-based depression care; and supportive care, in which providers of a disease management program delivered protocol-driven depression care. Because the study design established individual treatment centers as separate arms, we calculated propensity scores that interpreted the probability of treatment assignment conditional on observed baseline characteristics. Primary outcomes were 5 depression care outcomes and 7 diabetes care measures. Regression models with propensity score covariate adjustment were applied to analyze 6-month outcomes. RESULTS: Compared with usual care, supportive care significantly decreased Patient Health Questionnaire-9 scores, reduced the number of patients with moderate or severe depression, improved depression remission, increased satisfaction in care for patients with emotional problems, and significantly reduced functional impairment. CONCLUSION: Implementing collaborative depression care in a diabetes disease management program is a scalable approach to improve depression outcomes and patient care satisfaction among patients with diabetes in a safety-net care system.

Factors associated with not using folic acid supplements preconceptionally.

OBJECTIVE: Neural tube defects are among the most common birth defects worldwide. Folic acid intake from one month before to three months after conception reduces the likelihood of neural tube defects by at least 50%. Since 1995, several campaigns have been organised in the Netherlands which resulted in 51% of pregnant women using folic acid supplements during the entire recommended period in the northern part of the Netherlands in 2005. Our research question was to gain insight into the current prevalence and factors associated with inadequate pregnancy-related use of folic acid supplements. DESIGN: Data from the DELIVER study were used, which is a population-based cohort study. SETTING: Twenty midwifery practices across the Netherlands in 2009 and 2010. SUBJECTS: In total 5975 pregnant women completed a questionnaire covering items on sociodemographic and lifestyle factors, including folic acid intake. RESULTS: Of our study population, 55·5% (3318/5975) used folic acid supplements before conception. Several sociodemographic and lifestyle factors were associated with no preconception use of folic acid, of which non-Western ethnicity and not having a partner had the largest effect size. CONCLUSIONS: In the Netherlands, the folic acid intake before conception is suboptimal and has not improved over recent years. Fortification of staple foods with folic acid should be reconsidered as it would provide a more effective means of ensuring an adequate intake, especially for those groups of women who are unlikely to plan their pregnancies or to receive or respond to health promotion messages.

[Assessing the profile and nutritional intake of an Ibero-American group of nutrition postgraduate students]. / Valoración del perfil e ingesta de nutrientes de un grupo de estudiantes iberoamericanos de postgrados en nutrición.

INTRODUCTION: Dietary habits have a great influence on people health of, and its study is extremely important to proof adaptation to current recommendations in order to develop nutritional education and/or supplementation policies adjusted to reality. MATERIAL AND METHODS: A descriptive cross study with the participation of postgraduate students. Participants were selected using non-probability accidental sampling accidental. Information was sent by e-mail, including a questionnaire on socio-demographic characteristics and a 3-day dietary record. We obtained a sample of n = 50 participants. The 3-day dietary records were evaluated with NutrIber software and the data obtained were treated using the statistical software SPSS 15. RESULTS AND DISCUSSION: The profile of the students was 80% females and 20% males, mean age 33.7 ± 9.32 years, and body mass index of 22.91 ± 4.07. All groups have an excessive consumption of proteins and lipids and carbohydrates deficit. At the macro-story is remarkable that no group covers iodine recommended nutrient intake, and that no group of women covers the recommendations for fiber, folic acid and iron intake. CONCLUSIONS: Further studies are needed to confirm the results found. However, it can be concluded that urban populations in Latin America are increasingly closer to the model of Western diet, rich in protein and fat and low in carbohydrates, fiber and micronutrients, which is indicative of poor diets in whole grains, fruits and vegetables.

Introducción: Los hábitos alimentarios tienen una gran influencia sobre la salud de las personas, por ello es de suma importancia profundizar en su estudio para comprobar su adaptación a las recomendaciones actuales y poder realizar políticas de educación nutricional y/o suplementación ajustadas a la realidad. Material y métodos: Estudio transversal descriptivo con la colaboración de estudiantes de postgrado. Los participantes se seleccionaron mediante muestreo no probabilístico accidental enviando vía mail la información del estudio, realizado mediante un cuestionario sobre sus características socio-demográficas y un registro dietético de 3 días. La muestra estuvo formada por n = 50 participantes. Los registros dietéticos de 3 días se valoraron con el software NutrIber y los datos obtenidos fueron tratados mediante el software estadístico SPSS 15. Resultados y discusión: El perfil de los estudiantes es de 80% mujeres y 20% hombres, con edad media de 33,7 ± 9,32 AÑOs, e índice de masa corporal de 22,91 ± 4,07. Todos los grupos presentan un consumo excesivo de proteínas y lípidos y deficitario en glúcidos. En cuanto a los micronutrientes es destacable que ningún grupo cubre las ingestas recomendadas de yodo, y que ningún grupo de mujeres cubre las recomendaciones de ingesta de fibra, ácido fólico ni hierro. Conclusiones: Son necesarios más estudios para confirmar los resultados hallado, sin embargo, se puede concluir que las poblaciones urbanas de Latinoamérica cada vez se acercan más al modelo de dieta occidental, rica en proteínas y grasas y pobre en glúcidos, fibra y micronutrientes, lo que es indicativo de dietas pobres en cereales integrales, frutas y verduras.

Retrospective epidemiological study of Latin American patients with transfusional hemosiderosis: the first Latin American epidemiological study in iron overload--the RELATH study.

The retrospective epidemiological study of Latin Americans with transfusional hemosiderosis is the first regional patient registry to gather data regarding the burden of transfusional hemosiderosis and patterns of care in these patients. Retrospective and cross-sectional data were collected on patients ≥2 years with selected chronic anemias and minimum 20 transfusions. In the 960 patients analyzed, sickle-cell disease (48·3%) and thalassemias (24·0%) were the most frequent underlying diagnoses. The registry enrolled 355 pediatric patients (187 with sickle-cell disease/94 with thalassemia). Serum ferritin was the most frequent method used to detect iron overload. Complications from transfusional hemosiderosis were reported in ~80% of patients; hepatic (65·3%), endocrine (27·5%), and cardiac (18·2%) being the most frequent. These data indicate that hemoglobinopathies and complications due to transfusional hemosiderosis are a significant clinical problem in the Latin American population with iron overload. Chelation therapy is used insufficiently and has a high rate of discontinuation.

[Vitamin D intoxication in infants born from Latin-American immigrants. Series of 3 cases]. / Intoxicación por vitamina D en hijos de inmigrantes latinoamericanos. Serie de 3 casos.

Vitamin D intoxication is a well-known cause of hypercalcemia in children and can have serious consequences (renal, cardiac and neurologic mainly). The use of the so-called over-the-counter (OTC) supplements involves a high risk in this taking place. The clinical expression of hypercalcaemia is unspecific, and, together with the fact that the administration of such supplements is frequently denied, the diagnosis of vitamin D intoxication is often delayed and the number of complementary tests performed is high. We here-for expose a series of 3 cases all of which are infants born from Latin-American immigrants who were receiving supplements that came from their parents originary countries. All 3 cases were admitted in our hospital within a period of 5 months. After the first preceding case, the diagnosis of the 2 latter ones was performed promptly and so was the instauration of the treatment for hypercalcemia. The initial levels of serum calcium and of 25-hydroxy vitamin D where, respectively for each case: 17.9 mg/dl and 504 ng/ml; 14.46 mg/dl and 505 ng/ml; 14.2mg/dl and 530 ng/ml. All 3 patients received intravenous treatment with serum, furosemide and corticoids and in one case with subcutaneous calcitonine as well. The clinical outcome was optimal for them all, with normalization of the calcium levels and of the renal function.

Gastro-intestinal Chagas disease in migrants to Spain: prevalence and methods for early diagnosis.

Each year in Spain, the number of Latin American immigrants who present with chronic Trypanosoma cruzi infection increases. Although gastro-intestinal abnormalities are not as common as cardiomyopathy in such infection, they can still lead to an impaired quality of life. In a recent study based in Madrid, the frequencies of gastro-intestinal involvement in a cohort of Latin American immigrants infected with T. cruzi, and the role of early diagnostic techniques in the detection of such involvement, were explored. Between January 2003 and April 2009, all Latin Americans who attended the Tropical Medicine Unit of the Hospital Universitario Ramón y Cajal were tested for T. cruzi infection, in IFAT and ELISA. Each subject found both IFAT- and ELISA-positive was considered to be infected (chronically) and checked for symptoms indicative of Chagas disease. Each infected subject giving informed consent was investigated further, using an electrocardiogram, an echocardiogram and oesophageal manometry. Between January 2003 and June 2008, every infected subject who consented was also explored using a barium swallow and barium enema. After July 2008, however, only subjects showing oesophageal and/or colonic symptoms were investigated in this manner. Of the 248 patients found infected with T. cruzi, 118 underwent oesophageal manometry, 75 a barium enema and 48 a barium swallow. Thirteen (11%) showed evidence of oesophageal involvement (incomplete relaxation of the lower oesophageal sphincter; three cases) or bowel involvement (five cases of dolichosigma, three of dolichocolon and two of megacolon). Only six of these 13 had any gastro-intestinal symptoms (all six were suffering from constipation). None of the barium swallows revealed any pathology. It appears that oesophageal manometry can reveal mild abnormalities not detected by barium swallow, even in asymptomatic patients, while barium enemas are useful in the detection of colonic involvement.

Comparison of clinical features and drug therapies among European and Latin American patients with juvenile dermatomyositis.

OBJECTIVES: To compare the demographic features, presenting manifestations, diagnostic investigations, disease course, and drug therapies of children with juvenile dermatomyositis (JDM) followed in Europe and Latin America. METHODS: Patients were inception cohorts seen between 1980 and 2004 in 27 paediatric rheumatology centres. The following information was collected through the review of patient charts: sex; age at disease onset; date of disease onset and diagnosis; onset type; presenting clinical features; diagnostic investigations; course type; and medications received during disease course. RESULTS: Four hundred and ninety patients (65.5% females, mean onset age 7.0 years, mean disease duration 7.7 years) were included. Disease presentation was acute or insidious in 57.1% and 42.9% of the patients, respectively. The course type was monophasic in 41.3% of patients and chronic polycyclic or continuous in 58.6% of patients. The more common presenting manifestations were muscle weakness (84.9%), Gottron's papules (72.9%), heliotrope rash (62%), and malar rash (56.7%). Overall, the demographic and clinical features of the 2 continental cohorts were comparable. European patients received more frequently high-dose intravenous methylprednisolone, cyclosporine, cyclophosphamide, and azathioprine, while methotrexate and antimalarials medications were used more commonly by Latin American physicians. CONCLUSIONS: The demographic and clinical characteristics of JDM are similar in European and Latin American patients. We found, however, several differences in the use of medications between European and Latin American paediatric rheumatologists.

Epidemiología de la infección por VIH en inmigrantes en España: fuentes de información, características, magnitud y tendencias / Epidemiology of HIV infection in immigrants in Spain: information sources, characteristics, magnitude and tendencies

En España, la proporción de inmigrantes en la población general y entre las personas con infección por VIH es creciente en los últimos años. Sin embargo, la información sobre las tendencias temporales de la epidemia en inmigrantes y sobre sus características sociodemográficas, epidemiológicas y clínicas es escasa, y está fraccionada en diversas fuentes de información que cubren aspectos complementarios. Los objetivos de este trabajo fueron analizar las fuentes de información disponibles que permiten caracterizar la epidemiología de la infección por VIH en los inmigrantes en España, y describir la situación actual de la epidemia en este grupo de población a partir de la información disponible en dichas fuentes (AU)

Lately Spain, the proportion of immigrants has increased in both general and HIV-infected populations. Nevertheles, data on the temporal trends of the epidemic in immigrants and on their sociodemographic, epidemiologic and clinical characteristics are scarce and are scattered in various information sources that cover complementary aspects of this issue. The objectives of the present study were to analyze the available information sources that allow the epidemiology of HIV infection in immigrants in Spain to be studied, and to describe the current situation of HIV infection in immigrants, based on the available information sources (AU)

[Epidemiology of HIV infection in immigrants in Spain: information sources, characteristics, magnitude and tendencies]. / Epidemiología de la infección por VIH en inmigrantes en España: fuentes de información, características, magnitud y tendencias.

Lately Spain, the proportion of immigrants has increased in both general and HIV-infected populations. Nevertheles, data on the temporal trends of the epidemic in immigrants and on their sociodemographic, epidemiologic and clinical characteristics are scarce and are scattered in various information sources that cover complementary aspects of this issue. The objectives of the present study were to analyze the available information sources that allow the epidemiology of HIV infection in immigrants in Spain to be studied, and to describe the current situation of HIV infection in immigrants, based on the available information sources.

Abordaje homeopático en comunidades carenciadas ii / Homeopathic approach in deprived communities ii

Más de 1,000,000 de niños, la mitad de la población infantilvive por debajo de la línea de pobreza, 1 de cada 2 niños.Estos niños tienen grandes carencias a nivel de: nutrición,agua potable y saneamiento, salud, educación, vivienda einformación. En Uruguay, 50 por ciento de los niños se encuentranpor debajo de la línea de pobreza. Por esto, a nivelsalud, no podemos dejar de pensar en estos niños.En cuanto al extracto social. La Homeopatía es unapráctica privada que les llega a los extractos sociales más altosde la población. En un estudio que realizamos en el 2005,a propósito de nuestros pacientes pediátricos, en donde recibimospacientes de bajos recursos a demanda, vimos queestudiando la procedencia socioeconómica, el 68 por cientocorrespondió a extractos técnico-profesional y altos, el19 por ciento corresponden a padres obreros y solamenteel 6 por ciento provienen de comunidades carenciadas.A este amplio número de personas en situación depobreza, con sus necesidades básicas insatisfechas, que tienenmucho más riesgo de enfermar y/o morir y cuyas vidasse desarrollan en un marco social sumamente agresivo, laHomeopatía no llega.Por lo que junto con un grupo de colegas que trabajanhace varios años en policlínicos descentralizados concomunidades carenciadas resolvimos llevar la Homeopatía ala comunidad de menores recursos.

Abordaje homeopático en comunidades carenciadas ii / Homeopathic approach in deprived communities ii

Más de 1,000,000 de niños, la mitad de la población infantilvive por debajo de la línea de pobreza, 1 de cada 2 niños.Estos niños tienen grandes carencias a nivel de: nutrición,agua potable y saneamiento, salud, educación, vivienda einformación. En Uruguay, 50 por ciento de los niños se encuentranpor debajo de la línea de pobreza. Por esto, a nivelsalud, no podemos dejar de pensar en estos niños.En cuanto al extracto social. La Homeopatía es unapráctica privada que les llega a los extractos sociales más altosde la población. En un estudio que realizamos en el 2005,a propósito de nuestros pacientes pediátricos, en donde recibimospacientes de bajos recursos a demanda, vimos queestudiando la procedencia socioeconómica, el 68 por cientocorrespondió a extractos técnico-profesional y altos, el19 por ciento corresponden a padres obreros y solamenteel 6 por ciento provienen de comunidades carenciadas.A este amplio número de personas en situación depobreza, con sus necesidades básicas insatisfechas, que tienenmucho más riesgo de enfermar y/o morir y cuyas vidasse desarrollan en un marco social sumamente agresivo, laHomeopatía no llega.Por lo que junto con un grupo de colegas que trabajanhace varios años en policlínicos descentralizados concomunidades carenciadas resolvimos llevar la Homeopatía ala comunidad de menores recursos.

Cuerpo y representación: la imagen del hombre en la eugenesia latina / Body and representation: the image of man in Latin eugenics

Trata del cuestión relativas la cuerpo y representación.

Cuerpo y representación: la imagen del hombre en la eugenesia latina / Body and representation: the image of man in Latin eugenics

Trata del cuestión relativas la cuerpo y representación. (AU)

Weight, diet, and physical activity-related beliefs and practices among pregnant and postpartum Latino women: the role of social support.

OBJECTIVES: Eating and physical activity patterns may contribute to excessive pregnancy weight gain and postpartum retention that increase the risks of obesity and diabetes for both Latino mothers and their children. Social support is an important health determinant and may affect health-related beliefs and behaviors. The objective of this study was to investigate the influence of social support on weight, diet, and physical activity-related beliefs and behaviors among pregnant and postpartum Latinas. METHODS: A community-based participatory project, Promoting Healthy Lifestyles among Women, was conducted in southwest Detroit to plan interventions aimed at reducing risks of obesity and type 2 diabetes. Qualitative analyses of in-depth semistructured interviews with dyads of 10 pregnant and postpartum Latinas, and 10 people who influenced them were conducted. RESULTS: Husbands and some female relatives were primary sources of emotional, instrumental, and informational support for weight, diet, and physical activity-related beliefs and behaviors for Latina participants. Holistic health beliefs and the opinions of others consistently influenced Latinas' motivation and beliefs about the need to remain healthy and the links between behavior and health. Absence of mothers, other female relatives, and friends to provide childcare, companionship for exercise, and advice about food were prominent barriers that limited women's ability to maintain healthy practices during and after pregnancy. CONCLUSION: The findings support evidence that low-income, recently immigrated pregnant and postpartum Latinas could benefit from community-based, family-oriented interventions that provide social support necessary to promote and sustain healthy lifestyles.