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1.
Nutrients ; 13(10)2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34684504

RESUMO

Comprehensive food lists and databases are a critical input for programs aiming to alleviate undernutrition. However, standard methods for developing them may produce databases that are irrelevant for marginalised groups where nutritional needs are highest. Our study provides a method for identifying critical contextual information required to build relevant food lists for Indigenous populations. For our study, we used mixed-methods study design with a community-based approach. Between July and October 2019, we interviewed 74 participants among Batwa and Bakiga communities in south-western Uganda. We conducted focus groups discussions (FGDs), individual dietary surveys and markets and shops assessment. Locally validated information on foods consumed among Indigenous populations can provide results that differ from foods listed in the national food composition tables; in fact, the construction of food lists is influenced by multiple factors such as food culture and meaning of food, environmental changes, dietary transition, and social context. Without using a community-based approach to understanding socio-environmental contexts, we would have missed 33 commonly consumed recipes and foods, and we would not have known the variety of ingredients' quantity in each recipe, and traditional foraged foods. The food culture, food systems and nutrition of Indigenous and vulnerable communities are unique, and need to be considered when developing food lists.


Assuntos
Gerenciamento de Dados/métodos , Bases de Dados Factuais , Dieta/etnologia , Abastecimento de Alimentos , Grupo com Ancestrais do Continente Africano/etnologia , Cultura , Inquéritos sobre Dietas , Grupos Focais , Assistência Alimentar , Humanos , Povos Indígenas , População Rural , Meio Social , Uganda
2.
Res Nurs Health ; 44(5): 767-775, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34227136

RESUMO

The COVID-19 pandemic has had devastating effects on Black and rural populations with a mortality rate among Blacks three times that of Whites and both rural and Black populations experiencing limited access to COVID-19 resources. The primary purpose of this study was to explore the health, financial, and psychological impact of COVID-19 among rural White Appalachian and Black nonrural central Kentucky church congregants. Secondarily we sought to examine the association between sociodemographics and behaviors, attitudes, and beliefs regarding COVID-19 and intent to vaccinate. We used a cross sectional survey design developed with the constructs of the Health Belief and Theory of Planned Behavior models. The majority of the 942 respondents were ≥36 years. A total of 54% were from central Kentucky, while 47.5% were from Appalachia. Among all participants, the pandemic worsened anxiety and depression and delayed access to medical care. There were no associations between sociodemographics and practicing COVID-19 prevention behaviors. Appalachian region was associated with financial burden and delay in medical care (p = 0.03). Appalachian respondents had lower perceived benefit and attitude for COVID-19 prevention behaviors (p = 0.004 and <0.001, respectively). Among all respondents, the perceived risk of contracting COVID was high (54%), yet 33.2% indicated unlikeliness to receive the COVID-19 vaccine if offered. The COVID-19 pandemic had a differential impact on White rural and Black nonrural populations. Nurses and public health officials should assess knowledge and explore patient's attitudes regarding COVID-19 prevention behaviors, as well as advocate for public health resources to reduce the differential impact of COVID-19 on these at-risk populations.


Assuntos
COVID-19/prevenção & controle , Protestantismo/psicologia , População Rural/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , COVID-19/etnologia , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Kentucky , Masculino , Pessoa de Meia-Idade , População Rural/tendências , Inquéritos e Questionários
3.
Nurs Res ; 70(5S Suppl 1): S3-S12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34074961

RESUMO

BACKGROUND: Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States. OBJECTIVES: The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women. METHODS: We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants' addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention's Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships. RESULTS: Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk. DISCUSSION: We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Fatores de Risco de Doenças Cardíacas , Segregação Social/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Ohio , Fatores Socioeconômicos
4.
Nutrients ; 13(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800575

RESUMO

In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Anemia/etnologia , Anemia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Antropometria , Botsuana/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etnologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Gestantes/etnologia , Prevalência , Magreza/epidemiologia , Magreza/etnologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etnologia , Adulto Jovem
5.
Int J Equity Health ; 20(1): 108, 2021 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902594

RESUMO

BACKGROUND: We assessed the prevalence and trends in racial discrimination among African Canadian adolescents in British Columbia. The association between racial discrimination and self-rated health, access to mental health services, substance use, suicidal thoughts and attempts, experience of extreme stress, among others were examined within the 2018 dataset. METHODS: Secondary analysis used the data collected from African Canadian adolescents (n = 2448) as part of the British Columbia Adolescent Health Surveys (2003-2018). We examined whether racial discrimination increased, decreased, or remained stable over time. We evaluated experiences of racial discrimination for all adolescents, and then disaggregated analyses for boys, girls, immigrant, and Canadian-born African adolescents. We used Rao-Scott's adjusted chi-square to test differences in racial discrimination and adjusted logistic regressions to test trends across survey years, widening or narrowing gaps in racial discrimination, as well as the link to health outcomes. RESULTS: Racial discrimination was significantly different across the survey years (Adjusted F = 4.60, p < .01), with the highest percentage of adolescents reporting past year racial discrimination in 2018 (29.9%) and the lowest percentage in 2013 (21.3%). Girls and immigrant African Canadian adolescents were more likely to have experienced racial discrimination. However, girls and Canadian-born adolescents had the highest odds of reporting racial discrimination in 2018 compared to 2003, AOR = 1.85, and 1.58, respectively. The findings reveal significant differences in the experiences of racial discrimination for boys and girls, as well as for immigrant and Canadian-born African adolescents. Significant differences were noted in the link between racial discrimination and self-rated health and engaging in behaviours that might expose them to health risks. The worst negative health outcomes were found for boys and immigrant African Canadian adolescents. CONCLUSION: The study suggests that more than 1 in 4 African Canadian adolescents in British Columbia report racial discrimination, which is an increasing trend in recent years. Those who reported racial discrimination also had the worst adverse health outcomes. There is a need for more public health action to reduce racism, create awareness about the negative health impacts, and provide better support for African Canadian adolescents.


Assuntos
Comportamento do Adolescente/etnologia , Grupo com Ancestrais do Continente Africano/psicologia , Emigrantes e Imigrantes/psicologia , Racismo/tendências , Adolescente , Grupo com Ancestrais do Continente Africano/etnologia , Colúmbia Britânica , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Acesso aos Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Autorrelato
6.
JAMA Netw Open ; 4(2): e2037640, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33606033

RESUMO

Importance: Medical research has not equitably included members of racial/ethnic minority groups or female and older individuals. There are limited data on participant demographic characteristics in vaccine trials despite the importance of these data to current trials aimed at preventing coronavirus disease 2019. Objective: To investigate whether racial/ethnic minority groups and female and older adults are underrepresented among participants in vaccine clinical trials. Design, Setting, and Participants: This cross-sectional study examined data from completed US-based vaccine trials registered on ClinicalTrials.gov from July 1, 2011, through June 30, 2020. The terms vaccine, vaccination, immunization, and inoculation were used to identify trials. Only those addressing vaccine immunogenicity or efficacy of preventative vaccines were included. Main Outcomes and Measures: The numbers and percentages of racial/ethnic minority, female, and older individuals compared with US census data from 2011 and 2018. Secondary outcome measures were inclusion by trial phase and year of completion. Results: A total of 230 US-based trials with 219 555 participants were included in the study. Most trials were randomized (180 [78.3%]), included viral vaccinations (159 [69.1%]), and represented all trial phases. Every trial reported age and sex; 134 (58.3%) reported race and 79 (34.3%) reported ethnicity. Overall, among adult study participants, White individuals were overrepresented (77.9%; 95% CI, 77.4%-78.4%), and Black or African American individuals (10.6%; 95% CI, 10.2%-11.0%) and American Indian or Alaska Native individuals (0.4%; 95% CI, 0.3%-0.5%) were underrepresented compared with US census data; enrollment of Asian individuals was similar (5.7%; 95% CI, 5.5%-6.0%). Enrollment of Hispanic or Latino individuals (11.6%; 95% CI, 11.1%-12.0%) was also low even among the limited number of adult trials reporting ethnicity. Adult trials were composed of more female participants (75 325 [56.0%]), but among those reporting age as a percentage, enrollment of participants who were aged 65 years or older was low (12.1%; 95% CI, 12.0%-12.3%). Black or African American participants (10.1%; 95% CI, 9.7%-10.6%) and Hispanic or Latino participants (22.5%; 95% CI, 21.6%-23.4%) were also underrepresented in pediatric trials. Among trials reporting race/ethnicity, 65 (48.5%) did not include American Indian or Alaska Native participants and 81 (60.4%) did not include Hawaiian or Pacific Islander participants. Conclusions and Relevance: This cross-sectional study found that among US-based vaccine clinical trials, members of racial/ethnic minority groups and older adults were underrepresented, whereas female adults were overrepresented. These findings suggest that diversity enrollment targets should be included for all vaccine trials targeting epidemiologically important infections.


Assuntos
Ensaios Clínicos como Assunto/normas , Grupos Étnicos/estatística & dados numéricos , Seleção de Pacientes , Sexismo/estatística & dados numéricos , Vacinas , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Ensaios Clínicos como Assunto/estatística & dados numéricos , Grupos de Populações Continentais/etnologia , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/etnologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Sexismo/etnologia
7.
Sci Rep ; 11(1): 1039, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33441574

RESUMO

Inferences from genetic association studies rely largely on the definition and description of the underlying populations that highlight their genetic similarities and differences. The clustering of human populations into subgroups (population structure) can significantly confound disease associations. This study investigated the fine-scale genetic structure within Cameroon that may underlie disparities observed with Cameroonian ethnicities in malaria genome-wide association studies in sub-Saharan Africa. Genotype data of 1073 individuals from three regions and three ethnic groups in Cameroon were analyzed using measures of genetic proximity to ascertain fine-scale genetic structure. Model-based clustering revealed distinct ancestral proportions among the Bantu, Semi-Bantu and Foulbe ethnic groups, while haplotype-based coancestry estimation revealed possible longstanding and ongoing sympatric differentiation among individuals of the Foulbe ethnic group, and their Bantu and Semi-Bantu counterparts. A genome scan found strong selection signatures in the HLA gene region, confirming longstanding knowledge of natural selection on this genomic region in African populations following immense disease pressure. Signatures of selection were also observed in the HBB gene cluster, a genomic region known to be under strong balancing selection in sub-Saharan Africa due to its co-evolution with malaria. This study further supports the role of evolution in shaping genomes of Cameroonian populations and reveals fine-scale hierarchical structure among and within Cameroonian ethnicities that may impact genetic association studies in the country.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Grupo com Ancestrais do Continente Africano/etnologia , Camarões , Grupos Étnicos/genética , Frequência do Gene , Variação Genética/genética , Genética Populacional , Genoma Humano/genética , Antígenos HLA/genética , Haplótipos/genética , Humanos , Malária/genética , Polimorfismo de Nucleotídeo Único/genética , Análise de Componente Principal , Seleção Genética/genética
8.
Ann Diagn Pathol ; 51: 151696, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33460998

RESUMO

Aldehyde dehydrogenase 1 member A1 (ALDH1A1) is one of the most well studied breast cancer stem cells. Its expression has been associated with poor clinicopathological features and clinical outcomes in several studies. This paper studies the expression of ALDH1A1 and its combination with CD44+/CD24-/low breast cancer stem cell and their association with clinicopathological parameters and molecular subtypes. METHOD: Tissue Microarray was constructed from 222 Formalin Fixed Paraffin Embedded (FFPE) breast cancer tissues. The expression of ALDH1A1, CD44 and CD24 were assessed by Immunohistochemistry (IHC). The association of ALDH1A1 and its association with clinicopathological parameters, molecular subtypes, CD44 and CD24 were studied in an African population. The association between CD44+/CD24-/low/ALDH1+ and the clinicopathological phenotypes were also studied. RESULTS: A high ALDH1A1 expression of 90% was recorded in this study. No association was found between ALDH1A1 and clinicopathological parameters. ALDH1A1 was positively associated with CD24 (r = 0.228, OR-4.599 95% CI- 1.751-12.076, p = 0.001) and CD44 (r = 0.228, OR-5.538 95%CI- 1.841-16.662, p = 0.001) but not associated with CD44+/CD24-/low (r = 0.134, OR- 2.720 95%CI- 0.959-7.710, p = 0.052). CD44+/CD24-/ALDH1+ however had significant associations with Age (p- 0.020, r = 0.161, OR- 2.771, 95%CI 1.147-6.697), Gender (p = 0.004, OR- 15.333 95%CI 1.339-175.54), Tumour grade (p = 0.005, r = 0.197, OR-3.913 95%CI 1.421-10.776) and clinical prognostic staging (p = 0.014, r = 0.182, OR-3.028 95%CI- 1.217-7.536). There was no association between CD44+/CD24-/ALDH1+ and the molecular subtypes. CONCLUSION: The high expression of ALDH1A1 in breast cancer makes it an important target for targeted therapy. This study further confirms the increased tumourigenicity of CD44+/CD24-/ALDH1+ combination phenotype and its association with increased tumour grade and clinical prognostic stage. Survival studies of ALDH1A1 and other breast cancer stem cells in African populations are strongly recommended to help further understand their effect on tumour aggressiveness.


Assuntos
Família Aldeído Desidrogenase 1/metabolismo , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Invasividade Neoplásica/patologia , Células-Tronco Neoplásicas/metabolismo , Retinal Desidrogenase/metabolismo , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/genética , Antígeno CD24/metabolismo , Feminino , Gana/epidemiologia , Humanos , Receptores de Hialuronatos/metabolismo , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores/métodos , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise Serial de Tecidos/métodos
12.
Med Sci Law ; 61(3): 180-185, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33270504

RESUMO

PURPOSE: This study aimed to validate the Willems Belgian Caucasian (Willems BC) age estimation model in a Kenyan sample, to develop and validate a Kenyan-specific (Willems KB) age estimation model and to compare the age prediction performances of both models. METHODS: Panoramic radiographs of 1038 (523 female, 515 male) Kenyan children without missing permanent teeth and without all permanent teeth fully developed (except third molars) were retrospectively selected. Tooth development of the seven lower-left permanent teeth was staged according to Demirjian et al. The Willems BC model, performed on a Belgian Caucasian sample and a constructed Kenyan-specific model (Willems KB) were validated on the Kenyan sample. Their age prediction performances were quantified and compared using the mean error (ME), mean absolute error (MAE) and root-mean-square error (RMSE). RESULTS: The ME with Willems BC method equalled zero. Hence, there was no systematic under- or overestimation of the age. For males and females separately, the ME with Willems BC was significantly different from zero, but negligible in magnitude (-0.04 and 0.04, respectively). Willems KB was found not to outperform Willems BC, since the MAE and RMSE were comparable (0.98 vs 0.97 and 1.31 vs 1.29, respectively). Although Willems BC resulted in a higher percentage of subjects with predicted age within a one-year difference of the true age (63.3% vs 60.4%, p=0.018), this cannot be considered as clinically relevant. CONCLUSION: There is no reason to use a country-specific (Willems KB) model in children from Kenya instead of the original Willems (BC) model.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Determinação da Idade pelos Dentes/métodos , Adolescente , Criança , Pré-Escolar , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Quênia/etnologia , Masculino , Radiografia Panorâmica , Reprodutibilidade dos Testes
13.
Home Health Care Serv Q ; 40(1): 75-92, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32799762

RESUMO

Using Andersen's behavioral model of service utilization, this study aimed to understand how predisposing, enabling, and need factors were associated with two types of service utilization among caregivers of people with dementia. Caregiver participants (N = 637) were from the Resources for Enhancing Alzheimer's Caregivers Health (REACH II) study. Binary logistic and linear regression analyses were conducted to predict whether participants used services and the frequency of such service utilization. Results showed that some enabling and need factors were significantly associated with both discretionary and non-discretionary service utilization. Results also indicated some need factors were significant factors of the frequency of use for both discretionary and non-discretionary services. In addition, being Hispanic or African American moderated the association between some enabling or needs factors and service utilization. Practice attention needs to be paid on several enabling and needs factors among Hispanic and African American caregivers of people with dementia.


Assuntos
Cuidadores/psicologia , Grupos de Populações Continentais/etnologia , Demência/complicações , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Cuidadores/estatística & dados numéricos , Grupos de Populações Continentais/estatística & dados numéricos , Demência/psicologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
14.
Artigo em Inglês | MEDLINE | ID: mdl-33003622

RESUMO

Infant feeding among mothers of African descent living with Human Immunodeficiency Virus (HIV) is a critical practice that is influenced by policies, cultural expectations, and the resultant psychosocial state of the mother. Hence, this paper draws insights from a broader infant feeding study. It provides insights into how guidelines on infant feeding practices, cultural expectations, migration, or geographic status intersect to influence the psychosocial experiences of mothers living with HIV. We compared psychosocial experiences of Black mothers of African descent living with HIV in Nigeria versus those in high-income countries (Canada and USA), in the context of contrasting national infant feeding guidelines, cultural beliefs about breastfeeding, and geographic locations. Survey was conducted in venue-based convenience samples in two comparative groups: (Ottawa, Canada and Miami-FL, USA combined [n = 290]), and (Port Harcourt, Nigeria [n = 400]). Using independent samples t-statistics, we compared the means and distributions of six psychosocial attributes between Black mothers in two distinct: Infant feeding groups (IFGs), cultural, and geographical contexts at p < 0.05. Psychosocial attributes, such as discrimination and stigma, were greater in women who exclusively formula feed (EFF) than in women who exclusively breastfeed (EBF) at p < 0.01. Heightened vigilance, discrimination, and stigma scores were greater in women whose infant feeding practices were informed by cultural beliefs (CBs) compared to those not informed by CBs at p < 0.001. Discrimination and stigma scores were greater among mothers in Canada and the USA than in Nigeria at p < 0.001. Heightened vigilance and perceived stress scores were less among women in Canada and the USA than in Nigeria at p < 0.001. The guidelines on infant feeding practices for mothers with HIV should consider cultural expectations and migration/locational status of mothers.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Aleitamento Materno/etnologia , Infecções por HIV/psicologia , Transmissão Vertical de Doenças Infecciosas , Mães/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Canadá/epidemiologia , Comparação Transcultural , Discriminação Psicológica , Feminino , Guias como Assunto , Infecções por HIV/etnologia , Infecções por HIV/transmissão , Humanos , Lactente , Nigéria/etnologia , Estigma Social , Estados Unidos/epidemiologia
15.
Hum Nat ; 31(3): 203-221, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32915412

RESUMO

Although subsistence hunting is cross-culturally an activity led and practiced mostly by men, a rich body of literature shows that in many small-scale societies women also engage in hunting in varied and often inconspicuous ways. Using data collected among two contemporary forager-horticulturalist societies facing rapid change (the Tsimane' of Bolivia and the Baka of Cameroon), we compare the technological and social characteristics of hunting trips led by women and men and analyze the specific socioeconomic characteristics that facilitate or constrain women's engagement in hunting. Results from interviews on daily activities with 121 Tsimane' (63 women and 58 men) and 159 Baka (83 women and 76 men) show that Tsimane' and Baka women participate in subsistence hunting, albeit using different techniques and in different social contexts than men. We also found differences in the individual and household socioeconomic profiles of Tsimane' and Baka women who hunt and those who do not hunt. Moreover, the characteristics that differentiate hunter and non-hunter women vary from one society to the other, suggesting that gender roles in relation to hunting are fluid and likely to change, not only across societies, but also as societies change.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Atividades Humanas , Índios Sul-Americanos/etnologia , Adulto , Bolívia/etnologia , Camarões/etnologia , Feminino , Humanos , Pesquisa Qualitativa , Fatores Socioeconômicos
16.
Drug Alcohol Depend ; 217: 108266, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32956976

RESUMO

BACKGROUND: Fetal Alcohol Spectrum Disorders (FASD) are a global health concern. Early intervention mitigates deficits, yet early diagnosis remains challenging. We examined whether children can be screened and meet diagnoses for FASD at 1.5 years compared to 5 years post-birth. METHODS: A population cohort of pregnant women in 24 neighborhoods (N = 1258) was recruited and 84.5 %-96 % were reassessed at two weeks post-birth, 0.5 years, 1.5 years, 3 years, and 5 years later. A two-step process was followed to diagnose FASD; first, a paraprofessional screened the children and then a physician evaluated the child. We evaluated FASD symptoms at 1.5 vs. 5 years. We also examined maternal differences in children receiving a positive FASD screening (n = 160) with those who received a negative FASD screening. RESULTS: Screening positive for FASD more than doubled from 1.5 years to 5 years (from 6.8 % to 14.8 %). About one quarter of children who screened positive and were evaluated by a physician, were diagnosed as having a FASD. However, half did not complete the 2nd stage screening. Compared to mothers of children with a negative FASD screening, mothers of children with a positive FASD screening were less likely to have a high school education and more likely to have lower incomes, have experienced interpersonal partner violence, and have a depressed mood. Mothers of children who did not follow up for a 2nd stage physician evaluation were more like to live in informal housing compared to those who followed-up (81.3 % vs. 62.5 %, p = 0.014). CONCLUSIONS: We found that children can be screened and diagnosed for FASD at 1.5 and 5 years. As FASD characteristics develop over time, repeated screenings are necessary to identify all affected children and launch preventive interventions. Referrals for children to see a physician to confirm diagnosis and link children to care remains a challenge. Integration with the primary healthcare system might mitigate some of those difficulties.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Transtornos do Espectro Alcoólico Fetal/diagnóstico , Transtornos do Espectro Alcoólico Fetal/etnologia , Programas de Rastreamento/métodos , Adulto , Fatores Etários , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Programas de Rastreamento/tendências , Gravidez , África do Sul/etnologia
17.
Diabetes Care ; 43(10): 2607-2613, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32801129

RESUMO

OBJECTIVE: In African-born Blacks living in America, we determined by BMI category 1) prevalence of abnormal glucose tolerance (Abnl-GT) and 2) diagnostic value and reproducibility of hemoglobin A1c (HbA1c), fructosamine, and glycated albumin (GA). RESEARCH DESIGN AND METHODS: Participants (n = 416; male, 66%; BMI 27.7 ± 4.5 kg/m2 [mean ± SD]) had an oral glucose tolerance test with HbA1c, GA, and fructosamine assayed. These glycemic markers were repeated 11 ± 7 days later. Abnl-GT diagnosis required 0 h ≥5.6 mmol/L (≥100 mg/dL) and/or 2 h ≥7.8 mmol/L (≥140 mg/dL). Thresholds for HbA1c, GA, and fructosamine were the values at the 75th percentile for the population (39 mmol/mol [5.7%], 14.2%, and 234 µmol/L, respectively). RESULTS: Abnl-GT prevalence in the nonobese was 34% versus 42% in the obese (P = 0.124). Reproducibility was excellent for HbA1c and GA (both κ ≥ 0.8), but moderate for fructosamine (κ = 0.6). Focusing on HbA1c and GA in the nonobese, we found as single tests the sensitivities of HbA1c and GA were 36% versus 37% (P = 0.529). Combining HbA1c and GA, sensitivity increased to 58% because GA identified 37% of Africans with Abnl-GT not detected by HbA1c (P value for both tests vs. HbA1c alone was <0.001). For the obese, sensitivities for HbA1c, GA, and the combined tests were 60%, 27%, and 67%, respectively. Combined test sensitivity did not differ from HbA1c alone (P = 0.25) because GA detected only 10% of obese Africans with Abnl-GT not detected by HbA1c. CONCLUSIONS: Adding GA to HbA1c improves detection of Abnl-GT in nonobese Africans.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Intolerância à Glucose/diagnóstico , Intolerância à Glucose/etnologia , Hemoglobina A Glicada/análise , Albumina Sérica/análise , Adulto , África/etnologia , Idoso , Biomarcadores/análise , Biomarcadores/sangue , Glicemia/análise , Feminino , Frutosamina/análise , Frutosamina/sangue , Intolerância à Glucose/epidemiologia , Teste de Tolerância a Glucose/métodos , Teste de Tolerância a Glucose/normas , Hemoglobina Falciforme/análise , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/etnologia , Valor Preditivo dos Testes , Melhoria de Qualidade , Reprodutibilidade dos Testes , Estados Unidos/epidemiologia , Adulto Jovem
18.
J Hosp Palliat Nurs ; 22(5): 392-400, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32740304

RESUMO

Developing solid communication-based partnerships through obtaining illness narratives allows for an understanding of patients' social resources, values, and beliefs and allows an opportunity to provide person-centered care. This study aimed to elicit cocreated illness narratives from persons of color who have serious illness. Twenty patients receiving care for serious illness were interviewed at a large academic medical center. The interviews focused on how illness affected patients' lives and were followed by formation of illness narratives. From the persons living with serious illness, 3 main themes emerged: (1) time, (2) life changes, and (3) family. Participants described how illness did influence their lifestyles and identities but did not define their personhood. Family influence had a lasting effect on participants' values and beliefs, and family presence was viewed as valuable in their current lives. Narratives from persons of color with serious illness can provide an intimate account informing nurses' understanding of patients' illness experiences and may enhance communication between nurses and patients.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Nativos Estadunidenses/psicologia , Grupo com Ancestrais do Continente Asiático/psicologia , Hispano-Americanos/psicologia , Narração , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Nativos Estadunidenses/etnologia , Nativos Estadunidenses/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Centrada no Paciente/métodos , Pesquisa Qualitativa
19.
Med Health Care Philos ; 23(4): 611-620, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32857245

RESUMO

One of the major concerns of advocates of common morality is that respect for cultural diversity may result in moral relativism. On their part, proponents of culturally responsive bioethics are concerned that common morality may result in moral imperialism because of the asymmetry of power in the world. It is in this context that critics argue that global bioethics is impossible because of the difficulties to address these two theoretical concerns. In this paper, I argue that global bioethics is possible if we adopt a culturally responsive and self-critical attitude towards our moral values and those of others. I use the example of women's reproductive autonomy in indigenous African culture to show that the difference between the leading Euro-American and indigenous African construal of autonomy is that the former ascribes greater weight on individual self-determination while the latter emphasizes responsibilities towards the community. One develops dignity in virtue of their capacity for communing with others. Hence, women have rights, but as members of the community, they also have obligations including the duty to procreate. The involvement of the family in reproductive decisions does not contravene women's dignity and human rights. In applying the principle of autonomy in this communitarian context, one has to be sensitive to these ontological and moral specificities. The aim of global bioethics should not be to reach common grounds at all costs; any common norms should be the result of a negotiated democratic dialogue between cultures and not the result of imposition by the preponderant culture(s).


Assuntos
Bioética , Diversidade Cultural , Relativismo Ético , Internacionalidade , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Direitos Humanos , Humanos , Princípios Morais , Autonomia Pessoal , Filosofia Médica
20.
PLoS One ; 15(7): e0233808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673320

RESUMO

Similarly to other populations across the Americas, Argentinean populations trace back their genetic ancestry into African, European and Native American ancestors, reflecting a complex demographic history with multiple migration and admixture events in pre- and post-colonial times. However, little is known about the sub-continental origins of these three main ancestries. We present new high-throughput genotyping data for 87 admixed individuals across Argentina. This data was combined to previously published data for admixed individuals in the region and then compared to different reference panels specifically built to perform population structure analyses at a sub-continental level. Concerning the Native American ancestry, we could identify four Native American components segregating in modern Argentinean populations. Three of them are also found in modern South American populations and are specifically represented in Central Andes, Central Chile/Patagonia, and Subtropical and Tropical Forests geographic areas. The fourth component might be specific to the Central Western region of Argentina, and it is not well represented in any genomic data from the literature. As for the European and African ancestries, we confirmed previous results about origins from Southern Europe, Western and Central Western Africa, and we provide evidences for the presence of Northern European and Eastern African ancestries.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Grupo com Ancestrais do Continente Europeu/genética , Genoma Humano , Índios Sul-Americanos/genética , Casamento , Linhagem , Grupo com Ancestrais do Continente Africano/etnologia , Argentina , Colonialismo , DNA/genética , Escravização , Grupo com Ancestrais do Continente Europeu/etnologia , Marcadores Genéticos , Variação Genética , Genética Populacional , Genótipo , Migração Humana , Humanos , Índios Sul-Americanos/etnologia , Modelos Genéticos
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