Calidad global de la alimentación en la poblacion migrante residente en Chile / Global food quality in the migrant population residing in Chile

Introducción: el proceso de migración involucra cambio, modificación o adquisición de nuevos patrones y formas de alimentación, los cuales no siempre impactan de manera positiva en la salud de los migrantes, siendo frecuentemente asociadas a un mayor riesgo de enfermedades metabólicas y malnutrición por exceso cuando la calidad de la alimentación no es la adecuada. Objetivo: analizar el índice de calidad global de la alimentación (ICGA) en la población migrante colombiana en Chile, comparándola con la población chilena y la colombiana no migrante. Material y métodos: el total de la muestra fue de 834 individuos mayores de 18 años: 206 migrantes colombianos residiendo en Chile, 266 colombianos residentes en Colombia y 362 chilenos. Se les aplicó una encuesta de índice de calidad global de la alimentación para categorizar cuán saludable es el patrón alimentario de los participantes. Resultados: existen diferencias significativas en todos los puntajes analizados del ICGA en cuanto a alimentos saludables, no saludables y por tiempos de comidas. Se observó que los colombianos residentes en Colombia cuentan con el mayor puntaje de clasificación saludable mientras que los colombianos migrantes presentan las más altas cifras dentro de la condición poco saludable. En cuanto a los tiempos de comida, los chilenos son los que menos cumplen con los horarios. No obstante, destacan otras influencias relacionadas con los grupos de alimentos. Conclusión: es necesario ahondar en las variables vinculadas al contexto sociodemográfico, analizar los potenciales cambios en el tiempo y replicar la investigación en migrantes de otras nacionalidades para contar con mayores antecedentes sobre la relación entre la calidad de la alimentación y el proceso migratorio. (AU)

Introduction: the migration process involves change, modification, or acquisition of new eating patterns and ways of eating, which do not always positively impact the health of migrants, being frequently associated with a higher risk of metabolic diseases and excess malnutrition when the quality of food is not adequate. Objective: to analyze the global food quality index (GQI) in the Colombian migrant population in Chile, comparing it with the Chilean population and non-migrant Colombians. Material and methods: the total sample consisted of 834 individuals over 18 years of age — 206 Colombian migrants residing in Chile, 266 Colombians residing in Colombia, and 362 Chileans. A global food quality index survey was applied to categorize the healthiness of the participants' dietary patterns. Results: there were significant differences in all the ICGA scores analyzed regarding healthy foods, unhealthy foods, and mealtimes. It was observed that Colombians residing in Colombia have the highest score in the healthy classification, while Colombian migrants have the highest figures in the unhealthy condition. Regarding meal times, Chileans are the least compliant with meal times. However, other influences related to food groups stand out. Conclusion: it is necessary to delve deeper into variables linked to the sociodemographic context, analyze potential changes over time, and replicate in migrants of other nationalities to have more information on the relationship between food quality and the migration process. (AU)

[Global food quality in the migrant population residing in Chile]. / Calidad global de la alimentación en la poblacion migrante residente en Chile.

INTRODUCTION: Introduction: the migration process involves change, modification, or acquisition of new eating patterns and ways of eating, which do not always positively impact the health of migrants, being frequently associated with a higher risk of metabolic diseases and excess malnutrition when the quality of food is not adequate. Objective: to analyze the global food quality index (GQI) in the Colombian migrant population in Chile, comparing it with the Chilean population and non-migrant Colombians. Methods: the total sample consisted of 834 individuals over 18 years of age - 206 Colombian migrants residing in Chile, 266 Colombians residing in Colombia, and 362 Chileans. A global food quality index survey was applied to categorize the healthiness of the participants' dietary patterns. Results: there were significant differences in all the ICGA scores analyzed regarding healthy foods, unhealthy foods, and mealtimes. It was observed that Colombians residing in Colombia have the highest score in the healthy classification, while Colombian migrants have the highest figures in the unhealthy condition. Regarding meal times, Chileans are the least compliant with meal times. However, other influences related to food groups stand out. Conclusion: it is necessary to delve deeper into variables linked to the sociodemographic context, analyze potential changes over time, and replicate in migrants of other nationalities to have more information on the relationship between food quality and the migration process.

INTRODUCCIÓN: Introducción: el proceso de migración involucra cambio, modificación o adquisición de nuevos patrones y formas de alimentación, los cuales no siempre impactan de manera positiva en la salud de los migrantes, siendo frecuentemente asociadas a un mayor riesgo de enfermedades metabólicas y malnutrición por exceso cuando la calidad de la alimentación no es la adecuada. Objetivo: analizar el índice de calidad global de la alimentación (ICGA) en la población migrante colombiana en Chile, comparándola con la población chilena y la colombiana no migrante. Material y método: el total de la muestra fue de 834 individuos mayores de 18 años: 206 migrantes colombianos residiendo en Chile, 266 colombianos residentes en Colombia y 362 chilenos. Se les aplicó una encuesta de índice de calidad global de la alimentación para categorizar cuán saludable es el patrón alimentario de los participantes. Resultados: existen diferencias significativas en todos los puntajes analizados del ICGA en cuanto a alimentos saludables, no saludables y por tiempos de comidas. Se observó que los colombianos residentes en Colombia cuentan con el mayor puntaje de clasificación saludable mientras que los colombianos migrantes presentan las más altas cifras dentro de la condición poco saludable. En cuanto a los tiempos de comida, los chilenos son los que menos cumplen con los horarios. No obstante, destacan otras influencias relacionadas con los grupos de alimentos. Conclusión: es necesario ahondar en las variables vinculadas al contexto sociodemográfico, analizar los potenciales cambios en el tiempo y replicar la investigación en migrantes de otras nacionalidades para contar con mayores antecedentes sobre la relación entre la calidad de la alimentación y el proceso migratorio.

Gateway to Global Aging Data: Resources for Cross-National Comparisons of Family, Social Environment, and Healthy Aging.

OBJECTIVES: The Gateway to Global Aging Data (Gateway; g2aging.org) is a data and information platform developed to facilitate cross-country analyses on aging, especially those using the international family of Health and Retirement studies. We provide a brief introduction to the Gateway to Global Aging Data, discussing its potential for cross-national comparisons of family, social environment, and healthy aging. METHODS: We summarize the survey metadata, study characteristics, and harmonized data available from the Gateway, describing the population represented in each study. We portray cohort characteristics and key measures of health and social environment from 37 countries in North America, Europe, and Asia using harmonized data. RESULTS: Significant cross-country heterogeneity was observed in many measures of family, social environment, and healthy aging indicators. For example, there was a threefold difference in coresidence with children, ranging from 14% in Sweden to over 46% in Spain and Korea in 2014. From 2002 to 2014, the difference between informal care receipt in individuals of low and high wealth decreased by 6% in the United States and remained unchanged in England. The percentage of individuals aged 50-59 living alone in 2012 varied 15-fold, from a low of 2% in China to a high of 30% in Mexico. DISCUSSION: By partnering with nationally representative studies around the globe, the Gateway to Global Aging Data facilitates comparative research on aging through the provision of easy-to-use harmonized data files and other valuable tools.

Expanding Opportunities for American Descendants of Slavery to Build a More Inclusive and Diverse Global Health Workforce.

Historically, the terms African American and Black have been used interchangeably to describe any person with African ancestry living in the United States. However, Black Americans are not a monolith, and legitimate differences exist between those with generational roots in the United States and either African or Caribbean immigrants. American descendants of slavery (ADOS) are underrepresented in many fields, but I have noticed during my decades long career in global health that they are acutely absent in this field. Here, I offer seven recommendations to improve recruitment, retention, and advancement of ADOS in the global health field. Immediate implementation of these recommendations will not only bring diverse perspectives and immense capacity to the field but also allow ADOS an opportunity to engage in compelling and meaningful work and to collaborate with those from their ancestral homelands.

Comparative risks and predictors of preeclamptic pregnancy in the Eastern, Western and developing world.

Preeclampsia (PE) is a complication of pregnancy characterized by hypertension (HTN-Preg), and often proteinuria. If not managed promptly, PE could lead to eclampsia and seizures. PE could also lead to intrauterine growth restriction (IUGR) and prematurity at birth. Although PE is a major cause of maternal and fetal morbidity and mortality, the underlying mechanisms are unclear. Also, there is a wide variability in the incidence of PE, ranging between 2 and 8% of pregnancies in the Eastern, Western and Developing world, suggesting regional differences in the risk factors and predictors of the pregnancy-related disorder. Several demographic, genetic, dietary and environmental factors, as well as maternal circulating biomarkers have been associated with PE. Demographic factors such as maternal race and ethnicity could play a role in PE. Specific genetic polymorphisms have been identified in PE. Maternal age, parity, education and socioeconomic status could be involved in PE. Dietary fat, protein, calcium and vitamins, body weight, and environmental factors including climate changes and air pollutants could also play a role in PE. Several circulating cytoactive factors including anti-angiogenic factors and cytokines have also been associated with PE. Traditional midwifery care is a common practice in local maternity care units, while advanced perinatal care and new diagnostic tools such as uterine artery Doppler velocimetry have been useful in predicting early PE in major medical centers. These PE risk factors, early predictors and diagnostic tools vary vastly in different regions of the Eastern, Western and Developing world. Further understanding of the differences in the demographic, genetic, dietary and environmental factors among pregnant women in different world regions should help in designing a region-specific cluster of risk factors and predictors of PE, and in turn provide better guidance for region-specific tools for early detection and management of PE.

Incidence of childhood renal tumours: An international population-based study.

Malignant renal tumours represent 5% of childhood cancers and include types with likely different aetiology: Wilms tumour (WT), rhabdoid renal tumour, kidney sarcomas and renal carcinomas. WT is the most common renal tumour in children, previously shown to vary internationally and with ethnicity. Using the comprehensive database of the International Incidence of Childhood Cancer study (IICC), we analysed global variations and time trends in incidence of renal tumour types in children (age 0-14 years) and adolescents (age 15-19 years). The results were presented by 14 world regions, and five ethnic groups in the US. We included 15 320 renal tumours in children and 800 in adolescents reported to the 163 contributing registries during 2001-2010. In children, age-standardised incidence rate (ASR) of renal tumours was 8.3 per million (95% confidence interval, CI = 8.1, 8.4); it was the highest in North America and Europe (9-10 per million) and the lowest in most Asian regions (4-5 per million). In the US, Blacks had the highest ASR (10.9 per million, 95% CI = 10.2, 11.6) and Asian and Pacific Islanders the lowest (4.4 per million, 95% CI = 3.6, 5.1). In adolescents, age-specific incidence rate of renal tumours was 1.4 per million (95% CI = 1.3, 1.5). WT accounted for over 90% of all renal tumours in each age from 1 to 7 years and the proportion of renal carcinomas increased gradually with age. From 1996 to 2010, incidence remained mostly stable for WT (average annual percent change, AAPC = 0.1) and increased for renal carcinomas in children (AAPC = 3.7) and adolescents (AAPC = 3.2). Our findings warrant further monitoring.

Global Health Education and Mediatization of Care in Costa Rica.

Costa Rica has become a destination for global health education courses, while funding for global health has increased dramatically over the past thirty years. An examination of one Costa Rican group's efforts to market humanitarian discourses, focusing on website design, provides a window into the workings of global health education and details the sometimes-uncomfortable position of non-US health professionals in educational programming. This contributes to theorizations of the intersection of mediatization and care, and suggests links between the legitimation of global health as a discipline, on the one hand, and the reproduction of inequities, on the other.

Humanitarianism from Below: Sowa Rigpa, the Traditional Pharmaceutical Industry, and Global Health.

In this article I explore, for the first time, the relationship between Sowa Rigpa (Tibetan medicine) and global health, tracing "the global" in ethical discourses and pharmaceutical innovation practices of Tibetan medical practitioners. I argue that Sowa Rigpa's engagement with the world and its global health activities outside China can be understood as a form of "humanitarianism from below," while its industrialization in China aligns with global health in different ways. In providing new insights into recent developments of Sowa Rigpa, I aim to decenter the notion of humanitarianism and contribute to a broader understanding of global health.

Living with HIV as Donor Aid Declines in Tanzania.

Fluctuations in global health funding can significantly impact the lives of people who depend on donor-funded programs for life-long care. In this article, I examine shifting HIV policies that expanded antiretroviral therapy (ART) while reducing "care" services meant to improve ART access and adherence. I describe how these changes were experienced by HIV+ women accessing ART at a hospital in Tanzania in 2011-2012, highlighting their increasing precarity and uncertainty for care amidst donor instability and eroding program services. This research suggests that stable funding in support of long-term care services is important to help HIV+ people maintain life-long ART.

Comparison of clinical baseline characteristics between Asian and Western COPD patients in a prospective, international, multicenter study.

We aimed to compare clinical characteristics between Asian and Western chronic obstructive pulmonary disease (COPD) patients. This was a sub-analysis of an international, multicenter, prospective cohort study. Asian patients were enrolled in Singapore and South Korea. Western patients were enrolled in Spain, Poland, Ireland, the United Kingdom, and Malta. A total of 349 patients were analyzed. Among them, 110 (32%) patients were Asian and 239 (68%) Western. Male sex was more predominant in Asian than in Western (95% versus 63%, respectively; P<0.01). Body mass index was significantly lower in Asian (23.5 versus 27.1; P<0.01). The proportion of patients with a history of exacerbation was lower in Asian (12% versus 64%; P<0.01). Although patients were enrolled by same inclusion criteria, there were several differences between Asian and Western COPD patients. Our study has shown unbiased real-world differences between Asian and Western COPD patients. Since prospective follow-up study is currently ongoing, the result of this study can be fundamental base of future analysis.

Assessing social recovery of vulnerable youth in global mental health settings: a pilot study of clinical research tools in Malaysia.

BACKGROUND: A social recovery approach to youth mental health focuses on increasing the time spent in valuable and meaningful structured activities, with a view to preventing enduring mental health problems and social disability. In Malaysia, access to mental health care is particularly limited and little research has focused on identifying young people at risk of serious socially disabling mental health problems such as psychosis. We provide preliminary evidence for the feasibility and acceptability of core social recovery assessment tools in a Malaysian context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. METHODS: Nine vulnerable young people from low-income backgrounds were recruited from a non-government social enterprise and partner organisations in Peninsular Malaysia. Participants completed a battery of social recovery assessment tools (including time use, unusual experiences, self-schematic beliefs and values). Time for completion and completion rates were used as indices of feasibility. Acceptability was examined using qualitative interviews in which participants were asked to reflect on the experience of completing the assessment tools. Following a deductive approach, the themes were examined for fit with previous UK qualitative accounts of social recovery assessments. RESULTS: Feasibility was indicated by relatively efficient completion time and high completion rates. Qualitative interviews highlighted the perceived benefits of social recovery assessments, such as providing psychoeducation, aiding in self-reflection and stimulating goal setting, in line with findings from UK youth samples. CONCLUSIONS: We provide preliminary evidence for the feasibility and acceptability of social recovery assessment tools in a low-resource context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. We also suggest that respondents may derive some personal and psychoeducational benefits from participating in assessments (e.g. of their time use and mental health) within a social recovery framework.

Into the Machine: Economic Tools, Sovereignty, and Joy in a Global Health Institution.

Since the early 1990s, the World Bank and Inter-American Development Bank have led efforts advocating the use of economic tools in setting priorities for health spending in poor countries. But while these powerful global health institutions present economic management as the key to improving health, they often fail to implement even their own policies requiring the use of economic tools for health project planning. In these institutions, economic tools operate beyond application for decision-making, becoming simultaneously a site of tensions regarding sovereignty and sites of enjoyment for economists at development bank headquarters. This article traces the ways that economic tools are both deployed and left aside across development bank networks, and in the process are productive of both affect and power. Attention to frictions in the use of economic tools ought to help motivate more just global health governance, taking into account political considerations that are built into expert practice.

The Anthropology of Plastics: An Agenda for Local Studies of a Global Matter of Concern.

Anthropology has largely ignored plastics, even as they have emerged as the paradigmatic material-and problem-of our times. In this article, we make the case for an anthropology of plastics as a priority for environmental and medical anthropological research. Drawing from exploratory fieldwork in India, we briefly highlight the benefits and risks of different types of plastics, identify areas for anthropological investigations of human-plastic entanglements, and unpack major debates about plastic control. We recommend analyses that take into account the social life of plastics and the life cycle of plastic production, consumption, circulation, disposal, retrieval, and decomposition. We propose a facilitator role for anthropologists in bringing environmental NGOs and the plastic industry to the table to reduce the human and environmental health risks related to widespread reliance on plastics. Overall, we argue that anthropological analyses are urgently needed to address environmental and global health concerns related to plastics.