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1.
RNA ; 25(7): 857-868, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31010885

RESUMO

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.


Assuntos
Doença/etnologia , Doença/genética , Grupos Étnicos/genética , Genoma Humano , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Polimorfismo de Nucleotídeo Único , Marcadores Genéticos , Genética Populacional , Genômica , Humanos , Padrões de Herança
2.
BMC Genomics ; 19(Suppl 8): 861, 2018 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-30537949

RESUMO

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.


Assuntos
Doença/etnologia , Doença/genética , Genética Populacional , Genoma Humano , Genômica/métodos , Polimorfismo de Nucleotídeo Único , Grupo com Ancestrais do Continente Africano , Grupos Étnicos/genética , Grupo com Ancestrais do Continente Europeu , Nível de Saúde , Humanos , América Latina
3.
Arch. Health Sci. (Online) ; 25(3): 36-40, 21/12/2018.
Artigo em Português | LILACS | ID: biblio-1046415

RESUMO

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


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso/estatística & dados numéricos , Exercício Físico , Doença/etnologia , Academias de Ginástica/estatística & dados numéricos
4.
J Community Health Nurs ; 35(3): 148-161, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30024284

RESUMO

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.


Assuntos
Hispano-Americanos , Medicina Tradicional/métodos , Competência Cultural , Cultura , Doença/etnologia , Hispano-Americanos/psicologia , Humanos , Medicina Tradicional/psicologia , Cura Mental/psicologia , Saúde Mental/etnologia , Religião e Medicina , Espiritualidade
5.
Sci Rep ; 8(1): 1853, 2018 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-29382849

RESUMO

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.


Assuntos
Doença/etnologia , Doença/genética , Genética Populacional , Medicina de Precisão , Saúde Pública , Regionalização/organização & administração , Adolescente , Adulto , Idoso , Assistência à Saúde , Estudos de Viabilidade , Feminino , Estudo de Associação Genômica Ampla , Humanos , Macau/epidemiologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Risco , Adulto Jovem
6.
Qual Health Res ; 28(3): 433-445, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29313465

RESUMO

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.


Assuntos
Doença/etnologia , Linguística , Adulto , Cultura , Doença/psicologia , Grupos Étnicos/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Entrevistas como Assunto , Quênia , Masculino , Pesquisa Qualitativa
7.
Qual Life Res ; 26(12): 3439-3447, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28712003

RESUMO

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.


Assuntos
Doença/etnologia , Qualidade de Vida/psicologia , Urbanização/tendências , Adulto , Doença Crônica , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Peru , Inquéritos e Questionários
9.
J Health Psychol ; 22(4): 515-525, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-26349612

RESUMO

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.


Assuntos
Americanos Asiáticos , Características Culturais , Doença/psicologia , Nível de Saúde , Violência por Parceiro Íntimo/etnologia , Trauma Psicológico/complicações , Meio Social , Adulto , Ásia Sudeste/etnologia , Americanos Asiáticos/psicologia , Doença/etnologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Modelos Biológicos , Modelos Psicológicos , Prevalência , Trauma Psicológico/fisiopatologia , Trauma Psicológico/psicologia
10.
Salud Colect ; 11(3): 301-30, 2015 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-26418090

RESUMO

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.


Assuntos
Capitalismo , Assistência à Saúde Culturalmente Competente , Doença , Serviços de Saúde do Indígena , Medicina Tradicional , Poder Psicológico , Socialismo , Comparação Transcultural , Características Culturais , Assistência à Saúde Culturalmente Competente/ética , Assistência à Saúde Culturalmente Competente/organização & administração , Doença/etnologia , Doença/psicologia , Serviços de Saúde do Indígena/ética , Serviços de Saúde do Indígena/organização & administração , Direitos Humanos , Humanos , Índios Centro-Americanos/psicologia , Índios Sul-Americanos/psicologia , América Latina , Medicina Tradicional/psicologia , México , Ocidente
11.
MMWR Morb Mortal Wkly Rep ; 64(17): 469-78, 2015 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-25950254

RESUMO

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.


Assuntos
Causas de Morte , Doença/etnologia , Serviços de Saúde/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
12.
PLoS One ; 10(5): e0125865, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25965382

RESUMO

BACKGROUND: To control the double burden of communicable and non-communicable diseases (NCDs), in the developing world, understanding the patterns of morbidity and healthcare-seeking is critical. The objective of this cross-sectional study was to determine the distribution, predictors and inter-relationship of perceived morbidity and related healthcare-seeking behavior in a poor-resource setting. METHODS: Between October 2013 and July 2014, 43999 consenting subjects were recruited from 10107 households in Malda district of West Bengal state in India, through multistage random sampling, using probability proportional-to-size. Information on socio-demographics, behaviors, recent ailments, perceived severity and healthcare-seeking were analyzed in SAS-9.3.2. RESULTS: Recent illnesses were reported by 55.91% (n=24,600) participants. Among diagnosed ailments (n=23,626), 50.92% (n=12,031) were NCDs. Respiratory (17.28%, n=7605)), gastrointestinal (13.48%, n=5929) and musculoskeletal (6.25%, n=2749) problems were predominant. Non-qualified practitioners treated 53.16% (n=13,074) episodes. Older children/adolescents [adjusted odds ratio for private healthcare providers (AORPri)=0.76, 95% confidence interval=0.71-0.83) and for Govt. healthcare provider (AORGovt)=0.80(0.68-0.95)], females [AORGovt=0.80(0.73-0.88)], Muslims [AORPri=0.85(0.69-0.76) and AORGovt=0.92(0.87-0.96)], backward castes [AORGovt=0.93(0.91-0.96)] and rural residents [AORPri=0.82(0.75-0.89) and AORGovt=0.72(0.64-0.81)] had lower odds of visiting qualified practitioners. Apparently less severe NCDs [acid-peptic disorders: AORPri=0.41(0.37-0.46) & AORGovt=0.41(0.37-0.46), osteoarthritis: AORPri=0.72(0.59-0.68) & AORGovt=0.58(0.43-0.78)], gastrointestinal [AORPri=0.28(0.24-0.33) & AORGovt=0.69(0.58-0.81)], respiratory [AORPri=0.35(0.32-0.39) & AORGovt=0.46(0.41-0.52)] and skin infections [AORPri=0.65(0.55-0.77)] were also less often treated by qualified practitioners. Better education [AORPri=1.91(1.65-2.22) for ≥graduation], sanitation [AORPri=1.58(1.42-1.75)] and access to safe water [AORPri=1.33(1.05-1.67)] were associated with healthcare-seeking from qualified private practitioners. Longstanding NCDs [chronic obstructive pulmonary diseases: AORPri=1.80(1.46-2.23), hypertension: AORPri=1.94(1.60-2.36), diabetes: AORPri=4.94(3.55-6.87)] and serious infections [typhoid: AORPri=2.86(2.04-4.03)] were also more commonly treated by qualified private practitioners. Potential limitations included temporal ambiguity, reverse causation, generalizability issues and misclassification. CONCLUSION: In this poor-resource setting with high morbidity, ailments and their perceived severity were important predictors for healthcare-seeking. Interventions to improve awareness and healthcare-seeking among under-privileged and vulnerable population with efforts to improve the knowledge and practice of non-qualified practitioners probably required urgently.


Assuntos
Doença/classificação , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Doença/etnologia , Doença/psicologia , Feminino , Humanos , Índia/etnologia , Lactente , Masculino , Pessoa de Meia-Idade , Morbidade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Pobreza/psicologia , População Rural , Fatores Socioeconômicos , Adulto Jovem
13.
Hum Biol ; 87(4): 361-371, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27737584

RESUMO

Despite major public health initiatives, significant disparities persist among racially and ethnically defined groups in the prevalence of disease, access to medical care, quality of medical care, and health outcomes for common causes of morbidity and mortality in the United States. It is critical that we develop new and creative strategies to address such inequities; mitigate the social, environmental, institutional, and genetic determinants of poor health; and combat the persistence of racial profiling in clinical contexts that further exacerbates racial/ethnic health disparities. This article argues that medical education is a prime target for intervention and that anthropologists and human population geneticists should play a role in efforts to reform US medical curricula. Medical education would benefit greatly by incorporating anthropological and genetic perspectives on the complexities of race, human genetic variation, epigenetics, and the causes of racial/ethnic disparities. Medical students and practicing physicians should also receive training on how to use this knowledge to improve clinical practice, diagnosis, and treatment for racially diverse populations.


Assuntos
Dor Abdominal/etnologia , Anemia Falciforme/etnologia , Educação Médica/organização & administração , Variação Genética/genética , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Anemia Falciforme/diagnóstico , Antropologia , Criança , Grupos de Populações Continentais , Currículo , Doença/etnologia , Epigenômica , Grupos Étnicos , Humanos , Masculino , Morbidade , Mortalidade/etnologia , Segregação Social , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Adulto Jovem
14.
Anthropol Med ; 21(2): 107-12, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25175289

RESUMO

While social scientists often highlight the way medical technologies mediate biomedical hegemony, this special issue focuses on the creative and often unexpected ways in which medical technologies are appropriated by diverse actors in homes, clinics and communities. The authors highlight key insights from twelve ethnographic case studies conducted in North and South America, Western Europe, Sub-Saharan Africa and Southeast Asia. The case studies focus on, among other issues, how sperm donors in Denmark, despite being subjugated to medical surveillance, experience the act of donating sperm as liberating; how sex workers in Indonesia turn to psychoactive painkillers to feel confident when approaching clients; why some anorexic patients in the United States resist prescribed antidepressant drugs; and how adolescent sex education workshops in Ecuador are appropriated by mothers to monitor their daughters and shame their 'lying husbands'. Hardon and Moyer conclude that studies of medical technology need to be sensitive to the micro-dynamics of power, the specificities of local markets in which medical technologies generate value, the social and intergenerational relations in which they are embedded, and their intersections with class hierarchies.


Assuntos
Antropologia Cultural , Antropologia Médica , Doença/etnologia , Doença/psicologia , Assistência à Saúde/etnologia , Feminino , Humanos , Masculino
16.
Mayo Clin Proc ; 89(10): 1336-49, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25220409

RESUMO

OBJECTIVE: To describe the prevalence of multimorbidity involving 20 selected chronic conditions in a geographically defined US population, emphasizing age, sex, and racial/ethnic differences. PATIENTS AND METHODS: Using the Rochester Epidemiology Project records linkage system, we identified all residents of Olmsted County, Minnesota, on April 1, 2010, and electronically extracted the International Classification of Diseases, Ninth Revision codes associated with all health care visits made between April 1, 2005, and March 31, 2010 (5-year capture frame). Using these codes, we defined the 20 common chronic conditions recommended by the US Department of Health and Human Services. We counted only persons who received at least 2 codes for a given condition separated by more than 30 days, and we calculated the age-, sex-, and race/ethnicity-specific prevalence of multimorbidity. RESULTS: Of the 138,858 study participants, 52.4% were women (n=72,732) and 38.9% had 1 or more conditions (n=54,012), 22.6% had 2 or more conditions (n=31,444), and 4.9% had 5 or more conditions (n=6853). The prevalence of multimorbidity (≥2 conditions) increased steeply with older age and reached 77.3% at 65 years and older. However, the absolute number of people affected by multimorbidity was higher in those younger than 65 years. Although the prevalence of multimorbidity was similar in men and women overall, the most common dyads and triads of conditions varied by sex. Compared with white persons, the prevalence of multimorbidity was slightly higher in black persons and slightly lower in Asian persons. CONCLUSION: Multimorbidity is common in the general population; it increases steeply with older age, has different patterns in men and women, and varies by race/ethnicity.


Assuntos
Doença/etnologia , Grupos Étnicos/etnologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Comorbidade/tendências , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Minnesota/epidemiologia , Prevalência , Prognóstico , Distribuição por Sexo , Adulto Jovem
17.
Med Anthropol Q ; 28(3): 419-39, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24474448

RESUMO

Highland agriculturalists complain of the cultural syndrome chucaque in the Peruvian Andes. The first aim of this research was to ethnographically document cases of a cultural syndrome utilizing theoretical elements borrowed from cognitive anthropology. Another aim was to use case-control sampling to determine if there was a relationship between higher social stress levels and the development of a cultural syndrome. The research reported here integrated qualitative and quantitative methods. The social stress gauge developed by Rubel et al. () was adapted to the Andean cultural environment and utilized to assess highland social stressors. Chucaque was found to be locally defined as a specific type of head pain commonly associated with the episode of a traumatic event. Chucaque and household social stress levels were found to be significantly related, especially when the ratio of males to females, which often was imbalanced, was included in the analysis.


Assuntos
Doença/etnologia , Estresse Psicológico/etnologia , Antropologia Médica , Feminino , Pesar , Cefaleia/etnologia , Humanos , Masculino , Peru/etnologia , Fatores Socioeconômicos
18.
SADJ ; 69(6): 272-4, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26548202

RESUMO

There is ongoing debate as to whether persons of different racial/ethnic groups are biologically significantly different, and, if such differences exist, whether they are relevant in relation to disease susceptibility and to treatment outcomes. There is also debate about the benefits of using race/ethnicity as a factor in clinical decision making, and as a variable in biomedical or public health research, because of the emotional sensitivities attached to race/ethnic categorisation. Such categorisation may also divert attention from underlying issues such as socioeconomic status and lack of access to modern health care. In this short article we will discuss these controversies, and will emphasize the importance of responsible and sensitive use of race/ethnicity as a variable in biomedical research and in clinical practice.


Assuntos
Pesquisa Biomédica , Grupos de Populações Continentais , Doença/etnologia , Grupos Étnicos , Grupos de Populações Continentais/genética , Suscetibilidade a Doenças/etnologia , Escolaridade , Grupos Étnicos/genética , Interação Gene-Ambiente , Predisposição Genética para Doença/etnologia , Predisposição Genética para Doença/genética , Variação Genética/genética , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde/etnologia , Humanos , Preconceito/etnologia , Classe Social , Resultado do Tratamento
20.
PLoS One ; 8(4): e59494, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23577066

RESUMO

Whole genome sequencing studies are essential to obtain a comprehensive understanding of the vast pattern of human genomic variations. Here we report the results of a high-coverage whole genome sequencing study for 44 unrelated healthy Caucasian adults, each sequenced to over 50-fold coverage (averaging 65.8×). We identified approximately 11 million single nucleotide polymorphisms (SNPs), 2.8 million short insertions and deletions, and over 500,000 block substitutions. We showed that, although previous studies, including the 1000 Genomes Project Phase 1 study, have catalogued the vast majority of common SNPs, many of the low-frequency and rare variants remain undiscovered. For instance, approximately 1.4 million SNPs and 1.3 million short indels that we found were novel to both the dbSNP and the 1000 Genomes Project Phase 1 data sets, and the majority of which (∼96%) have a minor allele frequency less than 5%. On average, each individual genome carried ∼3.3 million SNPs and ∼492,000 indels/block substitutions, including approximately 179 variants that were predicted to cause loss of function of the gene products. Moreover, each individual genome carried an average of 44 such loss-of-function variants in a homozygous state, which would completely "knock out" the corresponding genes. Across all the 44 genomes, a total of 182 genes were "knocked-out" in at least one individual genome, among which 46 genes were "knocked out" in over 30% of our samples, suggesting that a number of genes are commonly "knocked-out" in general populations. Gene ontology analysis suggested that these commonly "knocked-out" genes are enriched in biological process related to antigen processing and immune response. Our results contribute towards a comprehensive characterization of human genomic variation, especially for less-common and rare variants, and provide an invaluable resource for future genetic studies of human variation and diseases.


Assuntos
Grupo com Ancestrais do Continente Europeu/genética , Genoma Humano/genética , Análise de Sequência de DNA/métodos , Adulto , Cromossomos Humanos Y/genética , Variações do Número de Cópias de DNA/genética , DNA Mitocondrial/genética , Doença/etnologia , Doença/genética , Feminino , Genômica , Humanos , Mutação INDEL/genética , Masculino , Taxa de Mutação , Polimorfismo de Nucleotídeo Único/genética
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