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1.
J Perinatol ; 44(2): 179-186, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38233581

RESUMO

OBJECTIVES: Among US-born preterm infants of Hispanic mothers, we analyzed the unadjusted and adjusted infant mortality rate (IMR) by country/region of origin and maternal nativity status. STUDY DESIGN: Using linked national US birth and death certificate data (2005-2014), we examined preterm infants of Hispanic mothers by subgroup and nativity. Clinical and sociodemographic covariates were included and the main outcome was death in the first year of life. RESULTS: In our cohort of 891,216 preterm Hispanic infants, we demonstrated different rates of infant mortality by country and region of origin, but no difference between infants of Hispanic mothers who were US vs. foreign-born. CONCLUSION: These findings highlight the need to disaggregate the heterogenous Hispanic birthing population into regional and national origin groups to better understand unique factors associated with adverse perinatal outcomes in order to develop more targeted interventions for these subgroups.


Assuntos
Hispânico ou Latino , Saúde do Lactente , Mortalidade Infantil , Recém-Nascido Prematuro , Mães , Feminino , Humanos , Recém-Nascido , Gravidez , Hispânico ou Latino/etnologia , Hispânico ou Latino/estatística & dados numéricos , Mortalidade Infantil/etnologia , Mães/estatística & dados numéricos , Saúde do Lactente/etnologia , Saúde do Lactente/estatística & dados numéricos , Estados Unidos/epidemiologia , Etnicidade/estatística & dados numéricos , México/etnologia , Porto Rico/etnologia , Cuba/etnologia , América Central/etnologia , América do Sul/etnologia
2.
Nature ; 624(7990): 122-129, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37993721

RESUMO

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.


Assuntos
Variação Genética , Povos Indígenas , Humanos , Agricultura/história , California/etnologia , Região do Caribe/etnologia , Etnicidade/genética , Etnicidade/história , Europa (Continente)/etnologia , Variação Genética/genética , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História Antiga , História Medieval , Migração Humana/história , Povos Indígenas/genética , Povos Indígenas/história , Ilhas , Idioma/história , México/etnologia , Zea mays , Genoma Humano/genética , Genômica , Alelos
3.
Int J Equity Health ; 22(1): 212, 2023 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-37817208

RESUMO

OBJECTIVE: We describe awareness about the modified "public charge" rule among Oregon's Mexican-origin Latino/a population and whether concerns about the rule influenced disenrollment from state-funded programs, which do not fall under the public charge. METHODS: We conducted a cross-sectional survey of adults (ages 18-59) recruited at the Mexican consulate and living in the state of Oregon. Our outcomes were awareness (of the public charge, source of knowledge, and confidence in knowledge of the public charge) and disenrolling self or family members from state-funded public healthcare programs due to concerns about the rule. We described outcomes and used logistic regression and calculated adjusted probabilities to identify factors associated with awareness of the public charge. RESULTS: Of 498 Latino/a respondents, 48% reported awareness of the public charge. Among those who knew about the public charge, 14.6% had disenrolled themselves or family members from public healthcare programs and 12.1% were hesitant to seek care due to concerns about the public charge. Younger respondents had a lower adjusted probability of awareness of the public charge (18-24 years: 15.6% (95% CI 3.1-28.2); 30-39 years 54.9% (95% CI 47.7-62.0). Higher education was associated with a higher adjusted probability of awareness of the public charge; ability to speak English was not associated with awareness of the public charge. CONCLUSION: Our study reveals limited awareness about the public charge among Mexican-origin Oregon Latino/as. Outreach and advocacy are essential to ensure Latino/as know their rights to access available state-funded healthcare programs.


Assuntos
Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Prática de Saúde Pública , Adulto , Humanos , Estudos Transversais , Atenção à Saúde/etnologia , Família , Oregon , México/etnologia , Conscientização , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Acesso aos Serviços de Saúde , Programas Governamentais
4.
J Womens Health (Larchmt) ; 32(12): 1320-1327, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37672570

RESUMO

Objective: To describe pregnancy-related mortality among Hispanic people by place of origin (country or region of Hispanic ancestry), 2009-2018. Materials and Methods: We conducted a cross-sectional descriptive study of pregnancy-related deaths among Hispanic people, stratified by place of origin (Central or South America, Cuba, Dominican Republic, Mexico, Puerto Rico, Other and Unknown Hispanic), using Pregnancy Mortality Surveillance System data, 2009-2018. We describe distributions of pregnancy-related deaths and pregnancy-related mortality ratios (number of pregnancy-related deaths per 100,000 live births) overall and by place of origin for select demographic and clinical characteristics. Results: For 2009-2018, the overall pregnancy-related mortality ratio among Hispanic people was 11.5 pregnancy-related deaths per 100,000 live births (95% confidence intervals [CI]: 10.8-12.2). In general, pregnancy-related mortality ratios were higher among older age groups (i.e., 35 years and older) and lower among those with higher educational attainment (i.e., college degree or higher). Approximately two in five pregnancy-related deaths among Hispanic people occurred on the day of delivery through 6 days postpartum. Place of origin-specific pregnancy-related mortality ratios ranged from 9.6 (95% CI: 5.8-15.0) among people of Cuban origin to 15.3 (95% CI: 12.4-18.3) among people of Puerto Rican origin. Hemorrhage and infection were the most frequent causes of pregnancy-related deaths overall among Hispanic people. People of Puerto Rican origin had a higher proportion of deaths because of cardiomyopathy. Conclusions: We identified differences in pregnancy-related mortality by place of origin among Hispanic people that can help inform prevention of pregnancy-related deaths.


Assuntos
Hispânico ou Latino , Mortalidade Materna , Gravidez , Feminino , Humanos , Gravidez/etnologia , Gravidez/estatística & dados numéricos , Estudos Transversais , Cuba/etnologia , Hispânico ou Latino/etnologia , Hispânico ou Latino/estatística & dados numéricos , Período Pós-Parto/etnologia , Porto Rico/etnologia , Estados Unidos/epidemiologia , Mortalidade Materna/etnologia , Mortalidade Materna/tendências , América Central/etnologia , América do Sul/etnologia , República Dominicana/etnologia , México/etnologia , Adulto
5.
Artigo em Inglês | MEDLINE | ID: mdl-37372712

RESUMO

Diabetes is the seventh leading cause of death in the United States, and it is particularly problematic among the Latine population. This study employed multivariable logistic regression models to examine how hypertension, depression, and sociodemographics were associated with diabetes in a cross-sectional sample of Mexican-origin adults living in three counties of Southern Arizona. The overall prevalence of diabetes from this primary care sample was 39.4%. Holding covariates at fixed values, individuals having hypertension were 2.36 (95% CI: 1.15, 4.83) times more likely to have diabetes, when compared to individuals not having hypertension. The odds of having diabetes for individuals with ≥12 years of educational attainment were 0.29 (95% CI: 0.14, 0.61) times the corresponding odds of individuals with <12 years of educational attainment. For individuals with depression, the odds of having diabetes for those who were born in Mexico and had <30 years living in the US were 0.04 (95% CI: 0, 0.42) times the corresponding odds of individuals without depression and who were born in the US. Findings suggest clinical and public health systems should be aware of the potential increased risk of diabetes among Mexican-origin adults with hypertension and lower educational attainment.


Assuntos
Diabetes Mellitus , Adulto , Humanos , Arizona/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Diabetes Mellitus/etiologia , Hipertensão/complicações , Hipertensão/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Fatores de Risco , Estados Unidos/epidemiologia , Depressão/complicações , Depressão/epidemiologia , Escolaridade
6.
Artigo em Inglês | MEDLINE | ID: mdl-37297621

RESUMO

Using baseline data from three partnering federally qualified health centers, we examined factors associated with depressive symptoms among Mexican-origin adults at risk of chronic disease living in three counties in Southern Arizona (i.e., Pima, Yuma, and Santa Cruz). Multivariable linear regression models identified correlates of depressive symptoms for this population controlling for sociodemographic characteristics. Among 206 participants, 85.9% were female and 49% were between 45 and 64 years of age. The proportion of depressive symptoms was 26.8%. Low levels of physical pain and high levels of hope and social support were also reported. Physical pain was positively and significantly related to depressive symptoms (ß = 0.22; 95% CI = 0.13, 0.30). Conversely, hope was negatively and significantly associated with depressive symptoms (ß = -0.53; 95% CI = -0.78, -0.29). A better understanding of factors related to depressive symptoms among Mexican-origin adults is necessary to fulfill their mental health needs, as well as to achieve health equity and to eliminate health disparities in the US-Mexico border region.


Assuntos
Depressão , Americanos Mexicanos , Dor , Adulto , Feminino , Humanos , Masculino , Arizona/epidemiologia , Depressão/epidemiologia , Depressão/etnologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Dor/epidemiologia , Dor/etnologia , Dor/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-37297627

RESUMO

This research investigated Latinx and Indigenous Mexican caregivers' perspectives of the Salton Sea's environment (e.g., dust concentrations and other toxins) on child health conditions. The Salton Sea is a highly saline drying lakebed located in the Inland Southern California desert borderland region and is surrounded by agricultural fields. Children of Latinx and Indigenous Mexican immigrant families are especially vulnerable to the Salton Sea's environmental impact on chronic health conditions due to their proximity to the Salton Sea and structural vulnerability. From September 2020 to February 2021, we conducted semi-structured interviews and focus groups with a total of 36 Latinx and Indigenous Mexican caregivers of children with asthma or respiratory distress living along the Salton Sea. A community investigator trained in qualitative research conducted interviews in Spanish or Purépecha, an indigenous language spoken by immigrants from Michoacán, Mexico. Template and matrix analysis was used to identify themes and patterns across interviews and focus groups. Participants characterized the Salton Sea's environment as toxic, marked by exposure to sulfuric smells, dust storms, chemicals, and fires, all of which contribute to children's chronic health conditions (e.g., respiratory illnesses such as asthma, bronchitis, and pneumonia, co-presenting with allergies and nosebleeds). The findings have important environmental public health significance for structurally vulnerable child populations in the United States and globally.


Assuntos
Asma , Cuidadores , Hispânico ou Latino , Criança , Humanos , Asma/epidemiologia , Asma/etnologia , Asma/etiologia , Poeira , México/etnologia , California/epidemiologia , Índios Norte-Americanos
8.
Clin Lung Cancer ; 24(6): e219-e225, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37271715

RESUMO

BACKGROUND: Social determinants of health thoroughly explored in the literature include insurance status, race, and ethnicity. There are over 50 million self-identifying Hispanics in the United States. This, however, represents a heterogeneous population. We used a national registry to investigate for significant differences in outcomes of Hispanic patients with non-small cell lung cancer (NSCLC) in the Unites states, by geographic region of origin. MATERIALS AND METHODS: We identified a cohort of Hispanic patients in the Unites states with NSCLC for which region of origin was documented within the 2004 to 2016 National Cancer Database (NCDB) registry. This included patients from Cuba, Puerto Rico, Mexico, South and Central America, and the Dominican Republic. We performed multivariate logistic regression modeling to determine whether origin was a significant predictor of cancer staging at diagnosis, adjusting for age, sex, histology, grade, insurance status, and facility type. Race was not included due to a nonsignificant association with stage at diagnosis at the bivariate level in this cohort. Subsequently, we used Kaplan-Meier modeling to identify whether overall survival (OS) of Hispanic patients differed by origin. RESULTS: A total of 12,557 Hispanic patients with NSCLC were included in this analysis. The breakdown by origin was as follows: n = 2071 (16.5%) Cuban, n = 2360 (18.8%) Puerto Rican, n = 4950 (39.4%) Mexican, n = 2329 (18.5%) from South or Central America, and n = 847 (6.7%) from the Dominican Republic. After controlling for age, sex, histology, grade, insurance status and treating facility type, we found that geographic origin was a significant predictor of advanced stage at diagnosis (P = .015). Compared to Cubans, patients of Puerto Rican origin were less likely to present with advanced disease (68.4% vs. 71.9%; OR: 0.82; 95%CI: 0.69-0.98; P = .026). We also identified a significant (log-rank P-value<.001) difference in OS by geographic origin, even at early-stages of diagnosis. Dominican patients with NSCLC exhibited the highest 5-year OS rate (63.3%), followed by patients from South/Central America (59.7%), Puerto Rico (52.3%), Mexico (45.9%), and Cuba (43.8%). CONCLUSION: This study showed that for Hispanic individuals living in the Unites states, region/country of origin is significantly associated with outcomes, even after accounting for other known determinants of health. We suggest that region of origin should be studied further as a potential determinant of outcomes in patients with cancer.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Hispânico ou Latino , Neoplasias Pulmonares , Determinantes Sociais da Saúde , Humanos , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/etnologia , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , América Central/etnologia , Cuba/etnologia , República Dominicana/etnologia , Hispânico ou Latino/estatística & dados numéricos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , México/etnologia , Porto Rico/etnologia , Determinantes Sociais da Saúde/etnologia , Determinantes Sociais da Saúde/estatística & dados numéricos , América do Sul/etnologia , Estados Unidos/epidemiologia
9.
J Am Heart Assoc ; 12(10): e027433, 2023 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-37158060

RESUMO

Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.


Assuntos
Doenças Cardiovasculares , Fatores de Risco de Doenças Cardíacas , Hispânico ou Latino , Adulto , Humanos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Colesterol , Estudos Transversais , Diabetes Mellitus/epidemiologia , Hispânico ou Latino/etnologia , Hispânico ou Latino/estatística & dados numéricos , Hipercolesterolemia , Hiperlipidemias , Obesidade/epidemiologia , Sobrepeso , Prevalência , Porto Rico/etnologia , Fatores de Risco , Estados Unidos/epidemiologia , Cuba/etnologia , América Central/etnologia , México/etnologia , América do Sul/etnologia , República Dominicana/etnologia , Brancos/estatística & dados numéricos
10.
Health Educ Res ; 38(3): 204-219, 2023 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-36848036

RESUMO

Peer support is effective in improving self-management behaviors and health outcomes among individuals with Type 2 diabetes. Volunteer peer support programs offer a cost-effective resource for diabetes self-management support; however, factors affecting the retention of volunteer peer leaders remain understudied. Herein, we examined factors associated with volunteer retention and satisfaction among 34 predominantly Mexican-origin peer leaders who assisted patients from a Federally Qualified Health Center located on the US/Mexico border with their diabetes management. Peer leaders completed surveys with open- and close-ended questions at baseline, 6 months and 12 months. Quantitative and qualitative data analyses were guided by the Volunteer Process Model. Using nonparametric Mann-Whitney U tests, self-efficacy as a peer leader at 6 months was most associated with interest to continue volunteering (P = 0.01), and satisfaction with support from the program at 12 months was most associated with interest to continue volunteering (P = 0.01). The qualitative data indicated that the relationship between the peer leaders and their patients was the primary factor for a satisfying volunteer experience. Future research should focus on increasing peer leaders' self-efficacy and satisfaction with program support and examine how organizations can support the development of the patient-peer relationship. Practitioners should consider appealing to volunteer peers' motivations to promote their retention.


Assuntos
Diabetes Mellitus Tipo 2 , Hispânico ou Latino , Humanos , Aconselhamento , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/terapia , México/etnologia , Grupo Associado , Estados Unidos/epidemiologia , Liderança , Voluntários , Motivação
11.
Am J Med Genet A ; 191(5): 1378-1383, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36718996

RESUMO

Pre-mRNA splicing factors are crucial in regulating transcript diversity, by removing introns from eukaryotic transcripts, an essential step in gene expression. Splicing of pre-mRNA is catalyzed by spliceosomes. CWC27 is a cyclophilin associated with spliceosome, in which genetic defects of its components have been linked to spliceosomopathies with clinical phenotypes including skeletal developmental defects, retinitis pigmentosa (RP), short stature, skeletal anomalies, and neurological disorders. We report two siblings (male and female) of Mexican descent with a novel homozygous frameshift variant in CWC27 and aim to highlight the cardinal features among the previously described 12 cases as well as expand the currently recognized phenotypic spectrum. Both siblings presented with a range of ocular and extraocular manifestations including novel features such as solitary kidney and tarsal coalition in the male sibling, together with gait abnormalities, and Hashimoto's thyroiditis in the female sibling. Finally, we highlight ectodermal involvement including sparse scalp hair, eyebrows and lashes, pigmentary differences, nail dysplasia, and dental anomalies as a core phenotype associated with the CWC27 spliceosomopathy.


Assuntos
Precursores de RNA , Retinite Pigmentosa , Feminino , Humanos , Masculino , Ciclofilinas/genética , Ciclofilinas/metabolismo , Peptidilprolil Isomerase/genética , Retinite Pigmentosa/genética , Precursores de RNA/genética , Splicing de RNA/genética , Spliceossomos/genética , México/etnologia
12.
Med Anthropol Q ; 36(4): 497-514, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36121921

RESUMO

Based on longitudinal research conducted with 21 Mexican immigrants between 2018 and 2021, this article examines the challenges the COVID-19 pandemic posed to undocumented immigrants in the United States attempting to provide care for aging parents in Mexico. As the United States excluded undocumented immigrants from pandemic support, the pandemic undermined their ability to provide health care for their parents even as the Mexican public health care system crumbled. Meanwhile, as the pandemic hastened their parents' demise, it thwarted immigrants' ability to time returns to see their parents before they died. While scholars have amply documented how spatial disparities exacerbated the impact of the pandemic among marginalized groups, few have examined the temporal disruptions caused by the pandemic. This article suggests that the pandemic provoked particular distress by desynchronizing the temporalities of family life across borders and preventing immigrants' abilities to coordinate care for their parents in time. [COVID-19, transnational families, eldercare, death, time].


Assuntos
COVID-19 , Emigrantes e Imigrantes , Humanos , Antropologia Médica , México/etnologia , Pandemias , Estados Unidos
13.
J Empir Res Hum Res Ethics ; 17(4): 461-470, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35585705

RESUMO

Study designs involving randomization can be difficult to communicate to participants, especially those with low literacy. The literature on strategies to explain research concepts is limited, especially for non-English speakers. We measured the effectiveness of a culturally and contextually situated multimedia approach to recruit a cohort of 60 female Mexican immigrants (FMI) to a randomized control trial (RCT) to reduce social isolation and depression. This strategy was designed to explain the concept of randomization, explain what participating in the research study entailed, and ensure informed consent. Potential participants viewed a presentation explaining the study and a video including animation with voice-over explaining the concept of randomization. We administered a pre/post survey. Respondents (N = 59) reported an increase in their understanding of randomization, intention to enroll, and attitude towards participating in research. We conclude that a culturally and contextually situated multimedia approach is an effective model when recruiting underrepresented populations with low literacy for RCTs.


Assuntos
Consentimento Livre e Esclarecido , Multimídia , Feminino , Humanos , Hispânico ou Latino , Intenção , Inquéritos e Questionários , Ensaios Clínicos Controlados Aleatórios como Assunto , Competência Cultural , Seleção de Pacientes , Emigrantes e Imigrantes , México/etnologia , New Mexico
14.
Rev. esp. nutr. comunitaria ; 28(supl. 2): 32-35, 20/03/2022.
Artigo em Espanhol | IBECS | ID: ibc-221771

RESUMO

En México son altas las prevalencias de obesidad y de diabetes mellitus tipo 2 (DM2), y es alto también el consumo de bebidas azucaradas embotelladas (BAE) y también de bebidas azucaradas de venta libre en las calles. Partiendo de la premisa en la que el consumo regular de BAE podría contribuir con la prevalencia de obesidad y de DM2, a partir de 2014 se instituyó en México el Impuesto Especial sobre Productos y Servicios (IEPS) a alimentos y bebidas de densidad energética alta, incluidas las BAE. Sin embargo, la aplicación del IEPS no ha disminuido ni el consumo de BAE ni las prevalencias de obesidad y DM2, puesto que —además del consumo de BAE— participan en la etiofisiopatología de la obesidad y la DM2 en México factores genéticos idiosincráticos y un patrón de inestabilidad alimentaria asociado con alto consumo de alimentos de gran densidad energética, sumado a índices particularmente elevados de sedentarismo. Para frenar la obesidad y laDM2, hacen falta estrategias basadas en la educación eficaz de la población y en el abatimiento social y económico de lapobre calidad alimentaria hasta ahora prevalente. (AU)


In Mexico, the prevalence of obesity and type 2 diabetes mellitus (DM2) is high, and the consumption of bottled sugar-sweetened beverages (BSSB), as well as sugar sweetened beverages sold over the counter on the streets, is also high. Based on the premise that regular consumption of BSSB could contribute to the prevalence of obesity and DM2, as of 2014, the Special Tax on Products and Services (IEPS) was instituted in Mexico on foods and beverages with high energy density, including BSSB. However, the application of the IEPS has not reduced either the consumption of BSSB or the prevalence of obesity and DM2, since —in addition to the consumption of BSSB— idiosyncratic genetic factors and a pattern of food instability associated with high consumption of energy dense foods, coupled with particularly high rates of sedentary lifestyle. To curb obesity and DM2, strategies based on the effective education of the population and the social and economic abatement of the poor food quality that has prevailed up to now are needed. (AU)


Assuntos
Humanos , Obesidade/diagnóstico , Obesidade/etiologia , Obesidade/prevenção & controle , Bebidas Gaseificadas/efeitos adversos , Diabetes Mellitus Tipo 2/fisiopatologia , 57924 , México/etnologia , México/epidemiologia
15.
BMC Pregnancy Childbirth ; 22(1): 43, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35038990

RESUMO

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.


Assuntos
Entorno do Parto , Assistência à Saúde Culturalmente Competente , Povos Indígenas , Tocologia , Parto/etnologia , Complicações na Gravidez/epidemiologia , Adulto , Análise por Conglomerados , Feminino , Instalações de Saúde , Parto Domiciliar , Humanos , Saúde Materna/etnologia , México/etnologia , Segurança do Paciente , Gravidez , Inquéritos e Questionários
16.
Nutrients ; 13(11)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34836126

RESUMO

Unhealthy diets are recognized as a major risk factor for many diseases. The decrease in costs of industrialized products, as well as the possible misinformation about a healthy diet, has led to new behaviors in the dietary patterns of the pediatric population. The costs of dietary patterns have not been estimated in our population, so the objective of this study was to determine the cost associated with dietary patterns in Mexican children and adolescents, hypothesizing that a healthy diet is not necessarily more economically expensive. This study analyzed data from a population-based cross-sectional study of healthy children and adolescents in Mexico City. Data were collected from a food frequency questionnaire and the meal cost of habitual food shopping. Eating patterns were obtained by using principal component analysis. A micro-costing technique was performed to obtain the direct costs of each pattern. When comparing the healthy pattern with the transition and non-healthy patterns, it was observed that there were no statistically significant differences between the dietary patterns (p = 0.8293). The cost of the healthy pattern only takes up 16.6% of the total biweekly income of a salaried Mexican. In this study, no differences were observed between the costs of a healthy and a less healthy diet.


Assuntos
Comportamento do Consumidor/economia , Dieta Saudável/economia , Dieta Saudável/etnologia , Comportamento Alimentar/etnologia , Abastecimento de Alimentos/economia , Adolescente , Criança , Custos e Análise de Custo , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Humanos , Renda , Masculino , México/etnologia , Análise de Componente Principal
17.
Nutrients ; 13(11)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34836148

RESUMO

Dietary fiber (DF) is a major substrate for the gut microbiota that contributes to metabolic health. Recent studies have shown that diet-metabolic phenotype effect might be related to individual gut microbial profiles or enterotypes. Thus, the aim of this study was to examine whether microbial enterotypes modify the association between DF intake and metabolic traits. This cross-sectional study included 204 children (6-12 years old) and 75 adults (18-60 years old). Habitual DF intake was estimated with a Food Frequency Questionnaire and biochemical, clinical and anthropometric data were obtained. Gut microbiota was assessed through 16S sequencing and participants were stratified by enterotypes. Correlations adjusting for age and sex were performed to test the associations between dietary fiber components intake and metabolic traits. In children and adults from the Prevotella enterotype, a nominal negative correlation of hemicellulose intake with insulin and HOMA-IR levels was observed (p < 0.05), while in individuals of the other enterotypes, these associations were not observed. Interestingly, the latter effect was not related to the fecal short-chain-fatty acids profile. Our results contribute to understanding the enterotype influence on the diet-phenotype interaction, which ultimate could provide evidence for their use as potential biomarkers for future precision nutrition strategies.


Assuntos
Fibras na Dieta/análise , Ingestão de Alimentos/fisiologia , Microbioma Gastrointestinal/fisiologia , Resistência à Insulina/fisiologia , Adolescente , Adulto , Biomarcadores/sangue , Criança , Estudos Transversais , Inquéritos sobre Dietas , Ingestão de Alimentos/etnologia , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Humanos , Resistência à Insulina/etnologia , Masculino , México/etnologia , Pessoa de Meia-Idade , Fenótipo , RNA Ribossômico 16S/análise , Adulto Jovem
18.
Eur Rev Med Pharmacol Sci ; 25(21): 6454-6464, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34787849

RESUMO

OBJECTIVE: Polymorphisms of the KRAS gene have been shown to be associated with cancer. However, their association with breast cancer (BC) has been inconsistent. The purpose of this study was to determine the frequency with which the rs61764370, rs9266, and rs140080026 polymorphisms of the KRAS gene are associated with BC in patients of the Mexican population. PATIENTS AND METHODS: The rs61764370 A>C or T>G and rs140080026 A>G polymorphisms were determined by Polymerase Chain Reaction (PCR), and the rs9266 A>G polymorphism was determined by DNA sequencing of healthy Mexican subjects and BC patients. RESULTS: We observed that 78% of BC patients are overweight and/or obese, 57% have metastatic lymph nodes, 64% have luminal A/B cancer subtypes, and 61% have stage III-IV cancer. The rs61764370 polymorphism was associated with BC susceptibility when the BC patients and the control group were compared for the AC genotype (p = 0.020), AC vs. AA genotypes (heterozygous model: p = 0.016), AC/CC genotype (dominant model: p = 0.002), and the C allele (p = 0.007). The AC/CC genotype (p = 0.018; rs61764370) and AG/GG genotype (p = 0.005; rs9266) were associated with age in BC patients ≥50 years old. The AC/CC (rs61764370) and AG/GG (rs9266) genotypes were classified by molecular subtype, TNM stage, miscarriage, lymph node metastasis, ductal type, and Ki-67. These classifications were also associated with BC patients, indicating that these factors may significantly contribute to BC risk. The AAA (OR 0.65, 95% CI 0.43-0.98, p = 0.039) and CAA (OR 3.25, 95% CI 1.13-9.36, p = 0.021) haplotypes were also associated with BC susceptibility. In addition, 94 polymorphisms were identified on the 3'UTR of the KRAS gene GRCh 38/hg3 (25,209,490-25,209,122) in BC (n = 112) and control (n = 113) samples. However, 92 of these polymorphisms have only expressed the major allele (wild-type allele). CONCLUSIONS: The rs61764370 polymorphism in the KRAS gene was associated with BC susceptibility in the Mexican population. The dominant model of the rs61764370 and rs9266 polymorphisms (classified by molecular subtype, miscarriage, TNM stage, lymph node metastasis, and Ki-67) could significantly contribute to BC risk in patients ≥50 years. The CAA haplotype could significantly contribute to BC risk in the Mexican population analyzed.


Assuntos
Neoplasias da Mama/genética , Hispânico ou Latino/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Adulto , Neoplasias da Mama/patologia , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , México/etnologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Polimorfismo de Nucleotídeo Único , Risco
19.
Sci Rep ; 11(1): 18117, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518570

RESUMO

COVID-19 vaccination is being rapidly rolled out in the US and many other countries, and it is crucial to provide fast and accurate assessment of vaccination coverage and vaccination gaps to make strategic adjustments promoting vaccine coverage. We reported the effective use of real-time geospatial analysis to identify barriers and gaps in COVID-19 vaccination in a minority population living in South Texas on the US-Mexico Border, to inform vaccination campaign strategies. We developed 4 rank-based approaches to evaluate the vaccination gap at the census tract level, which considered both population vulnerability and vaccination priority and eligibility. We identified areas with the highest vaccination gaps using different assessment approaches. Real-time geospatial analysis to identify vaccination gaps is critical to rapidly increase vaccination uptake, and to reach herd immunity in the vulnerable and the vaccine hesitant groups. Our results assisted the City of Brownsville Public Health Department in adjusting real-time targeting of vaccination, gathering coverage assessment, and deploying services to areas identified as high vaccination gap. The analyses and responses can be adopted in other locations.


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/imunologia , Programas de Imunização/estatística & dados numéricos , SARS-CoV-2/imunologia , Cobertura Vacinal/estatística & dados numéricos , Vacinação/estatística & dados numéricos , COVID-19/prevenção & controle , COVID-19/virologia , Vacinas contra COVID-19/administração & dosagem , Geografia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Programas de Imunização/métodos , México/etnologia , Grupos Minoritários/estatística & dados numéricos , Saúde das Minorias/estatística & dados numéricos , SARS-CoV-2/fisiologia , Fatores Socioeconômicos , Texas/etnologia , Vacinação/métodos , Cobertura Vacinal/métodos , Populações Vulneráveis/etnologia , Populações Vulneráveis/estatística & dados numéricos
20.
Int J Legal Med ; 135(6): 2457-2467, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34477923

RESUMO

Cross-population applicability of osteological and dental methods is a known issue in forensic anthropology, but very little is known about whether differences between populations are due to ancestry, environment effects, or even the statistical approach utilized for developing the methods. This study wishes to add to the discussion of population-specificity of dental age estimation methods and examine the impact of their statistical basis on their accuracy and precision. These parameters were estimated by testing 12 different dental age estimation techniques on a sample of 182 panoramic radiographs of children between the ages of 6 and 15 years (110 girls and 72 boys) from the city of Mérida in Yucatán, México. None of the 12 methods selected is based on Mexican samples. Dental maturation was scored following and methods tested employed two dental scoring schemes: Moorrees, Fanning, and Hunt's (MFH) 13-/14-stage system and Demirjian's 8-stage system. Results show that methods derived from more geographically specific groups do not fare better or worse than methods developed on more diverse and inclusive international samples, even if no methods specific to Mexicans were tested. While some of the methods performed very well, and they were not based on a Mexican sample, this suggests that population-specific dental age estimation methods may be relatively unimportant or that population differences in dental maturation are very small. Other issues seemed to have a greater impact on accuracy and precision, such as age dependency, inclusion of the third molar in age assessments, age truncation and age heaping in reference samples, the dental scoring scheme used, and how predicted age is calculated mathematically. As such, findings in this study suggest that validation tests of age estimation methods may not be a useful or reliable means to assess population differences and that these differences need to be more systematically assessed if an argument is to be made for the increased accuracy and precision of population-specific methods. The statistical basis of dental prediction methods seems to have a more significant role in their accuracy and precision outside of their reference sample.


Assuntos
Determinação da Idade pelos Dentes/métodos , Odontologia Legal/métodos , Adolescente , Variação Biológica da População , Criança , Feminino , Humanos , Masculino , México/etnologia , Radiografia Panorâmica , Valores de Referência , Reprodutibilidade dos Testes
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