Diseases of Africans, an African disease: transformations of quijila between Central West Africa and Minas Gerais, in Brazil, in the seventeenth and eighteenth centuries. / Doenças de africanos, doença africana: transformações da quijila, entre a África centro-ocidental e as Minas Gerais, Brasil, séculos XVII e XVIII.

This article discusses the origin of quijila/kijila in Central West African culture, more particularly in the cultural universe of the Imbangala (Jaga) and the Ambundu and Kimbundu populations who lived in the Portuguese regions of Angola and the Congo in the seventeenth and eighteenth centuries. Following this, it investigates how the concept of quijila was structured, comprehended, and transformed, both in Africa, where it was basically a food prohibition, but whose applications and meanings varied; and in Brazil, to where it was transported in the 1700s, and where it transformed into a disease which attacked blacks, especially Africans of various origins, being framed as such in the Hippocratic-Galen universe characteristic of that time.

Este artigo discute a origem da quijila/kijila na cultura centro-ocidental africana, mais particularmente no universo cultural dos imbangalas (jagas) e das populações ambundos e kimbundos, que viviam nas regiões portuguesas de Angola e do Congo, nos séculos XVII e XVIII. Em seguida, investiga como foi estruturado, compreendido e transformado o conceito de quijila tanto na África, basicamente um interdito alimentar, mas cujos significados e aplicações variam, quanto no Brasil, para onde foi transportado nos Setecentos, transformando-se numa doença que atacava os negros, especialmente os africanos de diversas origens, sendo enquadrada pelos médicos locais no universo da medicina hipocrática-galena vigente na época.

Racial/Ethnic disparities in the chains of morbid events leading to death: network analysis of US multiple cause of death data.

Multiple-cause-of-death data have not yet been applied to the study of racial/ethnic differences in causal chains of events leading to death, nor they have been used to examine racial/ethnic disparities in cause-of-death certification. We use publicly available 2019 US death certificate data to reassemble chains of morbid events leading to death. From them, we construct and analyze directed multiple cause of death networks by race and sex of deaths aged 60+. Three perspectives to measure disparities are employed: (i) relative prevalence of cause-of-death-pairs, (ii) strength of associations between diseases, (iii) similarities in transition matrices. Non-Hispanic Blacks (NHB) had overall lower prevalence of cause of death pairs, Hispanics (HIS) were burdened more by alcohol-related mortality and Asian and Pacific Islanders (API) exceeded in transitions to cerebrovascular diseases. Lower similarity was observed in transitions to external causes of death, dementia and Alzheimer's disease, pulmonary heart diseases, interstitial respiratory diseases, and diseases of the liver. After excluding rare diseases, the similarity further decreased for ill-defined conditions, diabetes mellitus, other cardiovascular diseases, diseases of the pleura, and anemia. To sum up, races/ethnicities not only vary in structure and timing of death but they differ in morbid processes leading to death as well.

Alcohol consumption and risks of more than 200 diseases in Chinese men.

Alcohol consumption accounts for ~3 million annual deaths worldwide, but uncertainty persists about its relationships with many diseases. We investigated the associations of alcohol consumption with 207 diseases in the 12-year China Kadoorie Biobank of >512,000 adults (41% men), including 168,050 genotyped for ALDH2- rs671 and ADH1B- rs1229984 , with >1.1 million ICD-10 coded hospitalized events. At baseline, 33% of men drank alcohol regularly. Among men, alcohol intake was positively associated with 61 diseases, including 33 not defined by the World Health Organization as alcohol-related, such as cataract (n = 2,028; hazard ratio 1.21; 95% confidence interval 1.09-1.33, per 280 g per week) and gout (n = 402; 1.57, 1.33-1.86). Genotype-predicted mean alcohol intake was positively associated with established (n = 28,564; 1.14, 1.09-1.20) and new alcohol-associated (n = 16,138; 1.06, 1.01-1.12) diseases, and with specific diseases such as liver cirrhosis (n = 499; 2.30, 1.58-3.35), stroke (n = 12,176; 1.38, 1.27-1.49) and gout (n = 338; 2.33, 1.49-3.62), but not ischemic heart disease (n = 8,408; 1.04, 0.94-1.14). Among women, 2% drank alcohol resulting in low power to assess associations of self-reported alcohol intake with disease risks, but genetic findings in women suggested the excess male risks were not due to pleiotropic genotypic effects. Among Chinese men, alcohol consumption increased multiple disease risks, highlighting the need to strengthen preventive measures to reduce alcohol intake.

Self-loving in the epidemic years: Carmen Machado's rhetoric of woundedness.

This article explores Carmen Machado's Her Body and Other Parties (2017) as articulating generative unmaking of bodies. Mobilizing that which I examine as rhetoric of woundedness, a thread of Latina rhetoric wherein wounds are strategically positioned to emphasize flesh as space of conflict, Machado writes body horrors to provoke dis-ease in audiences. Specifically, Machado highlights pervasive discursive discomforts that decentralize narratives about women's body (un)wellness. It is important to note, however, that Machado's attention to the corporal becomes, in part, rejection of body, a de-composition of physicality-sometimes reached through sexual ecstasy, other times through violence and epidemics-to re-compose self. Such a tactic recalls conversations advanced in Cherríe Moraga's writings and Yvonne Yarbro-Bejarano's embodied theories, both included in Carla Trujillo's landmark anthology, Chicana Lesbians: The Girls Our Mothers Warned Us About (1991). Moraga and Yarbro-Bejarano investigate textual dismemberment of female physique to re-imagine and reclaim body for enactments of Chicana desire. What marks Machado as distinct is her resistance to reclaim body. Often, Machado's characters manifest phantom states that quarantine body from toxic physical and social spaces. Concurrently, characters lose rights to body due to self-hate within that toxicity. Machado's characters find clarity only when freed from physicality, at which point they may re-compose themselves according to their testified truths. I see this distinction as a progression of works contained in Trujillo's anthology as Machado envisions a worldmaking process that one composes through autonomous self-love and self-partnership to nurture female narrative and solidarity.

Paleopathology and children in the Andes: Local/situated biologies and future directions.

In the decades since Verano (1997) published his foundational piece on Andean paleopathology, scholars have recognized the importance of the bioarchaeology of childhood. Yet, scholarship on ancient childhood in the Andes deemphasizes paleopathology. Nonadult paleopathological data are often employed in large-scale, biocultural studies focused on environmental or political adaptations; however, they can also elucidate children's individual lived experiences and roles in society. To generate culturally-meaningful paleopathological data, we must take a contextualized approach to our analyses and interpretations. Disparate use of chronological age in published datasets makes synthesis across studies problematic, and ethnohistorical and ethnographic data on Andean children demonstrate that developmental age categories, rather than chronological age ranges, are most appropriate. Further, paleopathological data can best inform our investigations when they are combined with related datasets such as those on sex, diet, activity, and mobility. With that in mind, we use the theoretical framework of "local biologies" (and the related "situated biologies"), where biology is viewed as heavily contingent on culturally-specific beliefs and practices and local physical, sociocultural, and political environments (Lock, 1993, 2001; Niewöhner and Lock, 2018). Local biologies approaches can enrich social bioarchaeology and paleopathology to by specifically situating children and their experiences within the ancient Andean world.

Cranial modification and the shapes of heads across the Andes.

This broad literature review considers advances in the study of cranial vault modification with an emphasis on investigations of Andean skeletal remains over the last two decades. I delimit three broad categories of research, building on Verano's synthesis of the state of Andean paleopathology in 1997. These are associations with skeletal pathological conditions, classification and morphology, and social identity. Progress is noted in each of these areas with a particular emphasis on methodological advances in studying morphology as well as the growth of contextualized bioarchaeology and the incorporation of social theory in the consideration of cranial modification as a cultural practice. The article concludes with avenues for future research on head shaping in the Andes specifically and paleopathology more broadly.

Advances in regional paleopathology of the Southern Coast of the Central Andes.

Because of a rich cultural history and excellent preservation of archaeological materials the south coast of the Central Andes is a region where many anthropological questions can be explored, using the latest methods and techniques. Over the last 20 years, multidisciplinary paleopathological studies have revealed interesting and unanticipated perspectives regarding the lives and cultures of the peoples who inhabited this region in pre-Hispanic times. This paper presents a panorama of these recent investigations, beginning with a review of the data sources - the collections of human remains - available for study, their numbers, preservation, accessibility, strengths and weaknesses. Then follows a revision of recent investigations, presenting new knowledge about temporal trends in human health in the region, including mortality curves, stature achieved in adulthood, porotic hyperososis, cribra orbitalia, linear enamel hypoplasias, dental caries, biochemical analysis, trauma, and violence. This review shows how the knowledge of the history of this region has increased but also the many new questions that have emerged. Hopefully this paper will encourage more investigation, as the collections of human remains from this region are abundant, well documented and well preserved.

A systematic literature review on the European, African and Amerindian genetic ancestry components on Brazilian health outcomes.

The variables such as race, skin colour and ethnicity have become intensely discussed in medicine research, as a response to the rising debate over the importance of the ethnic-racial dimension in the scope of health-disease processes. The aim of this study was to identify the European (EUR), African (AFR) and Amerindian (AMR) ancestries on Brazilian health outcomes through a systematic literature review. This study was carried out by searching in three electronic databases, for studies published between 2005 and 2017. A total of 13 papers were eligible. The search identified the following health outcomes: visceral leishmaniosis, malaria, Alzheimer's disease, neuromyelitis optica, multiple sclerosis, prostate cancer, non-syndromic cleft lip/palate, chronic heart failure, sickle cell disease, primary congenital glaucoma, preterm labour, preterm premature rupture of membranes, systemic lupus erythematosus and type 1 diabetes mellitus. Research paper assessments were guided by the STROBE instrument, and agreements between results were determined by comparing the points attributed by two authors. Increased EUR ancestry was identified from preterm labour (PTL), type 1 diabetes (T1D) and non-syndromic cleft lip with or without cleft palate (NSCL), as well as in patients presenting aggressive prostate cancer prognoses. On the other hand, the highest AFR ancestral component was verified from systemic lupus erythematosus (SLE) and primary congenital glaucoma (PCG) cases, presenting worse prognoses. AMR ancestry may be a protective factor in the development of Alzheimer's disease (AD). The worst hemodynamic parameters in cases of heart failure (HF) were identified among individuals with greater AMR and AFR ancestry indices.

Ancestry patterns inferred from massive RNA-seq data.

There is a growing body of evidence suggesting that patterns of gene expression vary within and between human populations. However, the impact of this variation in human diseases has been poorly explored, in part owing to the lack of a standardized protocol to estimate biogeographical ancestry from gene expression studies. Here we examine several studies that provide new solid evidence indicating that the ancestral background of individuals impacts gene expression patterns. Next, we test a procedure to infer genetic ancestry from RNA-seq data in 25 data sets where information on ethnicity was reported. Genome data of reference continental populations retrieved from The 1000 Genomes Project were used for comparisons. Remarkably, only eight out of 25 data sets passed FastQC default filters. We demonstrate that, for these eight population sets, the ancestral background of donors could be inferred very efficiently, even in data sets including samples with complex patterns of admixture (e.g., American-admixed populations). For most of the gene expression data sets of suboptimal quality, ancestral inference yielded odd patterns. The present study thus brings a cautionary note for gene expression studies highlighting the importance to control for the potential confounding effect of ancestral genetic background.

Genetic ancestry, admixture and health determinants in Latin America.

BACKGROUND: Modern Latin American populations were formed via genetic admixture among ancestral source populations from Africa, the Americas and Europe. We are interested in studying how combinations of genetic ancestry in admixed Latin American populations may impact genomic determinants of health and disease. For this study, we characterized the impact of ancestry and admixture on genetic variants that underlie health- and disease-related phenotypes in population genomic samples from Colombia, Mexico, Peru, and Puerto Rico. RESULTS: We analyzed a total of 347 admixed Latin American genomes along with 1102 putative ancestral source genomes from Africans, Europeans, and Native Americans. We characterized the genetic ancestry, relatedness, and admixture patterns for each of the admixed Latin American genomes, finding a spectrum of ancestry proportions within and between populations. We then identified single nucleotide polymorphisms (SNPs) with anomalous ancestry-enrichment patterns, i.e. SNPs that exist in any given Latin American population at a higher frequency than expected based on the population's genetic ancestry profile. For this set of ancestry-enriched SNPs, we inspected their phenotypic impact on disease, metabolism, and the immune system. All four of the Latin American populations show ancestry-enrichment for a number of shared pathways, yielding evidence of similar selection pressures on these populations during their evolution. For example, all four populations show ancestry-enriched SNPs in multiple genes from immune system pathways, such as the cytokine receptor interaction, T cell receptor signaling, and antigen presentation pathways. We also found SNPs with excess African or European ancestry that are associated with ancestry-specific gene expression patterns and play crucial roles in the immune system and infectious disease responses. Genes from both the innate and adaptive immune system were found to be regulated by ancestry-enriched SNPs with population-specific regulatory effects. CONCLUSIONS: Ancestry-enriched SNPs in Latin American populations have a substantial effect on health- and disease-related phenotypes. The concordant impact observed for same phenotypes across populations points to a process of adaptive introgression, whereby ancestry-enriched SNPs with specific functional utility appear to have been retained in modern populations by virtue of their effects on health and fitness.

Doenças associadas à dificuldade de realizar atividade física em academias públicas de uma amostra de idosos do sul do Brasil / Diseases associated with the difficulty of performing physical activity in public academies of a sample of the elderly in the south of Brazil

Introdução:Observando um aumento da população e a criação de programas públicos de atividade física, torna-se interessante identificar as doenças que dificultam a prática de exercício físico dos idosos nesses programas, de modo que esses indicadores sirvam para promover maior adesão ao programa e melhor desenvolvimento das atividades realizadas com os participantes. Objetivo:identificar as doenças crônicas associadas à dificuldade de idosos para realizar atividade física nas Academias da Melhor Idade (AMI). Casuística e Métodos estudo transversal observacional, realizado em uma amostra de 255 idosos, durante o ano de 2011, na cidade de Joinville, do Sul do Brasil. Foi utilizado um questionário sobre características e de condições de saúde (doenças diagnosticadas pelo médico, percepção subjetiva de saúde, se o estado de saúde atual dificulta a prática de atividades físicas e satisfação com a mesma), aplicados em forma de entrevista. Para a análise de dados utilizou-se testes de associação e identificando a razão de chance por meio da regressão logística binária. Resultados: Dentre as doenças relatadas, 47,4% dos idosos disseram apresentar hipertensão arterial, 20,3% diabetes, 10,9% artrose, 8,6% dores lombares e 7,8% dislipidemia. Verificou-se também que os idosos acometidos por dores lombares e artrose apresentam, significativamente, mais chances de possuírem dificuldade da realização de atividade física. Conclusão: Idosos com dores lombares e artrose manifestam mais chances de apresentar dificuldade na prática de atividadefísica. Além disso, há associaçãodessa dificuldade com a presença de artrite e osteoporose. Os indicadores apontados permitirão a realização de programas de atividade física ajustados às necessidades dos praticantes, e por sua vez, produzirão maior aderência permitindo um ciclo de contínua evolução.

Introduction: By observing an increase of the population, and the establishment of public programs for physical activity, it is interesting to identify diseases that hindered the practice of physical exercises by elders in these programs. These indicators contribute to a better development of the activities carried out with the participants, along with the promotion of a greater adhesion to the program. Objective: Identify the chronic diseases associated with the difficulty of the elderly to perform physical activity in the Best Age Academies (BAA). Patients and Methods: An observational cross-sectional study was conducted in a sample of 255 elderly people in the city of Joinville, southern Brazil, in 2011. A questionnaire was used on sociodemographic characteristics and health conditions (diseases diagnosed by the physician, subjective perception of health, if the current health condition makes it difficult to practice physical activities and satisfaction with the same), applied for an interview. For data analysis, we used association tests, identifying the odds ratio applying binary logistic regression. Results: Among the diseases reported, 47.4% of the elderly reported having hypertension, 20.3% diabetes, 10.9% arthrosis, 8.6% lower-back pain and 7.8% dyslipidemia. It was also verified that the elderly affected by lumbar pain and arthrosis is significantly more likely to have difficulty performing physical activity. Conclusion: Elderly people with back pain and arthrosis are more likely to present difficulties in the practice of physical activity. In addition, there is an association of this difficulty in the presence of arthritis and osteoporosis. The indicated indicators will allow the achievement of physical activity programs adjusted to the needs of the practitioners, and in turn, will produce greater adherence allowing a cycle of continuous evolution

An Examination of the Folk Healing Practice of Curanderismo in the Hispanic Community.

Curanderismo is a system of traditional folk practices and beliefs that address health and healing in the Hispanic community. Curanderismo serves a function in the daily lives of Hispanics worldwide, providing them access to culturally appropriate healthcare, and agency over their own, and their family's health. Cultural competency in the area of curanderismo is invaluable, as curanderismo is a folk resource that if acknowledged and embraced by nurses and healthcare practitioners can aid in healthcare delivery and increased healthcare utilization among Hispanic populations.

Population-Wide Genetic Risk Prediction of Complex Diseases: A Pilot Feasibility Study in Macau Population for Precision Public Healthcare Planning.

The genetic bases of many common diseases have been identified through genome-wide association studies in the past decade. However, the application of this approach on public healthcare planning has not been well established. Using Macau with population of around 650,000 as a basis, we conducted a pilot study to evaluate the feasibility of population genomic research and its potential on public health decisions. By performing genome-wide SNP genotyping of over a thousand Macau individuals, we evaluated the population genetic risk profiles of 47 non-communicable diseases and traits, as well as two traits associated with influenza infection. We found that for most of the diseases, the genetic risks of Macau population were different from those of Caucasian, but with similar profile with mainland Chinese. We also identified a panel of diseases that Macau population may have a high or elevated genetic risks. This pilot study showed that (1) population genomic study is feasible in Asian regions like Macau; (2) Macau may have different profile of population-based genetic risks than Caucasians, (3) the different prevalence of genetic risk profile indicates the importance of Asian-specific studies for Asian populations; and (4) the results generated may have an impact for going forward healthcare planning.

Linguistic Conceptualizations of Disease Among the Luo of Kenya.

The region inhabited by the Luo ethnic group in Kenya is disease endemic. However, disease awareness initiatives register low acceptance due to the sociocultural images of disease and illness conceptualized in the local Dholuo language in ways that may contradict modern biomedical knowledge and practice. This article evaluates the sociocultural basis of encoding descriptions of disease in the Luo indigenous knowledge system and their implications for modern medical practice. The methodology entailed use of qualitative interviews of purposively sampled Dholuo-speaking patient escorts in a provincial referral hospital. Nonparticipant observation was also conducted at funerals to monitor contextualized usage of the discourse of disease, illness, and death. The data were analyzed using qualitative content analysis and categorized into emergent themes and categories. The results revealed that Dholuo is replete with expressions that emphasize the vulnerability and discrimination of the sick. Such attitudes cause rejection of interventions and negatively influence health-seeking behavior. The expressions were relevant and acceptable to cultural insiders; hence, they could determine their understanding of health conditions thereby influencing how they make medical decisions. It emerges that the unique Luo worldview controls their perceptions on the causes of disease and prescribes community-driven remedies which may depart from the expectations of the biomedical model.

Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru.

PURPOSE: To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). METHODS: We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol's EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. RESULTS: We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored -13.7 points on the EQ-VAS in Lima, -7.9 in urban Puno, -11.0 in semi-urban Tumbes, and -2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). CONCLUSION: The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations.

Intimate partner violence and physical health outcomes among Southeast Asian American women.

Although intimate partner violence is prevalent among Southeast Asian American women, little is known about the associations between the experience of intimate partner violence and negative health outcomes in this population. Resnick et al. proposed a model explaining the development of health problems following violent assault. This article assesses the applicability of Resnick et al.'s model to Southeast Asian American women who have experienced intimate partner violence by reviewing cultural, historical, and social factors in this population. Our review indicates that the applicability of Resnick et al.'s model to Southeast Asian American women is mixed, with some components of the model fitting well with this population and others requiring a more nuanced and complex perspective. Future studies should take into consideration cultural, historical, and social factors.

[Is disease merely illness?: Biomedicine, "parallel" forms of care and power]. / Las enfermedades ¿son solo padecimientos?: biomedicina, formas de atención "paralelas" y proyectos de poder.

Following Giovanni Berlinguer's proposal that health/disease processes are one of the primary spies into the contradictions of a system, this article describes cases that occurred in central and peripheral capitalist contexts as well as in the so-called "real socialist" States that allow such a role to be seen. Secondly, we observe the processes and above all the interpretations developed in Latin America and especially Mexico regarding the role attributed to traditional medicine in the identity and sense of belonging of indigenous peoples, which emphasize the incompatibility of indigenous worldviews with biomedicine. To do so we analyze projects that were carried out under the notion of intercultural health, which in large part resulted in failure both in health and political terms. The almost entirely ideological content and perspective of these projects is highlighted, as is the scant relationship they hold with the reality of indigenous people. Lastly, the impact and role that the advance of these conceptualizations and health programs might have had in the disengagement experienced over the last nearly ten years in the ethnic movements of Latin America is considered.

Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States - 2009-2013.

BACKGROUND: Hispanics and Latinos (Hispanics) are estimated to represent 17.7% of the U.S. population. Published national health estimates stratified by Hispanic origin and nativity are lacking. METHODS: Four national data sets were analyzed to compare Hispanics overall, non-Hispanic whites (whites), and Hispanic country/region of origin subgroups (Hispanic origin subgroups) for leading causes of death, prevalence of diseases and associated risk factors, and use of health services. Analyses were generally restricted to ages 18-64 years and were further stratified when possible by sex and nativity. RESULTS: Hispanics were on average nearly 15 years younger than whites; they were more likely to live below the poverty line and not to have completed high school. Hispanics showed a 24% lower all-cause death rate and lower death rates for nine of the 15 leading causes of death, but higher death rates from diabetes (51% higher), chronic liver disease and cirrhosis (48%), essential hypertension and hypertensive renal disease (8%), and homicide (96%) and higher prevalence of diabetes (133%) and obesity (23%) compared with whites. In all, 41.5% of Hispanics lacked health insurance (15.1% of whites), and 15.5% of Hispanics reported delay or nonreceipt of needed medical care because of cost concerns (13.6% of whites). Among Hispanics, self-reported smoking prevalences varied by Hispanic origin and by sex. U.S.-born Hispanics had higher prevalences of obesity, hypertension, smoking, heart disease, and cancer than foreign-born Hispanics: 30% higher, 40%, 72%, 89%, and 93%, respectively. CONCLUSION: Hispanics had better health outcomes than whites for most analyzed health factors, despite facing worse socioeconomic barriers, but they had much higher death rates from diabetes, chronic liver disease/cirrhosis, and homicide, and a higher prevalence of obesity. There were substantial differences among Hispanics by origin, nativity, and sex. IMPLICATIONS FOR PUBLIC HEALTH: Differences by origin, nativity, and sex are important considerations when targeting health programs to specific audiences. Increasing the proportions of Hispanics with health insurance and a medical home (patientcentered, team-based, comprehensive, coordinated health care with enhanced access) is critical. A feasible and systematic data collection strategy is needed to reflect health diversity among Hispanic origin subgroups, including by nativity.