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1.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004606

RESUMO

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Assuntos
Ansiedade/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Depressão/epidemiologia , Cefaleia/epidemiologia , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/psicologia , Traumatismos Craniocerebrais/psicologia , Estudos Transversais , Depressão/psicologia , El Salvador/etnologia , Feminino , Guatemala/etnologia , Haiti/etnologia , Cefaleia/psicologia , Honduras/etnologia , Humanos , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/psicologia , México/etnologia , Nicarágua/etnologia , Razão de Chances , Questionário de Saúde do Paciente , Prevalência , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Refugiados/psicologia , Estudos Retrospectivos , Distribuição por Sexo , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inconsciência/epidemiologia , Inconsciência/psicologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia , Adulto Jovem
2.
Hum Nat ; 31(1): 43-67, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31898017

RESUMO

Variation in the durations of exclusive breastfeeding (exBF) and any breastfeeding (anyBF) is associated with socioecological factors. This plasticity in breastfeeding behavior appears adaptive, but the mechanisms involved are unclear. With this concept in mind, we investigated whether durations of exBF and anyBF in a rural Maya population covary with markers of a form of socioecological change-market integration-and whether individual factors (individual learning, physiological plasticity) and/or learning from others in the community (social learning, norm adherence) mediate these changes. Using data from 419 mother-child pairs from two Guatemalan Maya villages, we fit a bivariate linear mixed model. The model compared exBF and anyBF among children from households of varying degrees of market integration whose mothers follow what we inferred to be local infant-feeding norms. It controlled for other factors expected to affect breastfeeding durations. We found evidence that exBF is associated with whether mothers follow their population's infant feeding norms, but no evidence that exBF is associated with the household's level of market integration. Conversely, anyBF is significantly associated with the household's market integration, but not with the villages' inferred norms. Because deviations from exBF norms are likely to result in infant mortality and reduced fitness, we hypothesize that the incentive to conform is relatively strong. Relatively greater individual plasticity in anyBF allows mother-child pairs to tailor it to socioecological conditions. Deviations from anyBF norms may be tolerated because they may provide later-life health/fitness payoffs, while posing few risks to infant survival.


Assuntos
Aleitamento Materno/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Mães , Aprendizado Social , Adulto , Feminino , Guatemala/etnologia , Humanos , Lactente , Fatores de Tempo
3.
Psychiatry Res ; 286: 112555, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31522891

RESUMO

Immigrant children who faced forced separation from their parents may be at heightened risk of developing mental health disorders, including depression, post-traumatic stress disorder (PTSD), and anxiety disorders. This cross-sectional study assessed the mental health of children being held in U.S. immigration detention who had been previously separated from their mothers. We interviewed 73 mothers about their eldest child age 5-17 using the Parent-Report version of the Strengths and Difficulties Questionnaire (SDQ). Among these children, many had elevated scores for emotional problems (49%), peer problems (21%), and total difficulties (15%). Male children demonstrated significantly higher rates of abnormal peer problems compared to females. Younger children (age 5-11 years) also demonstrated significantly higher rates of abnormal conduct problems, hyperactivity, and total difficulties. Scores did not differ significantly based on length of separation. Results reveal that children who had been separated from their parents experience high levels of mental health distress, which are especially high in younger children. Regardless of length of separation, these children would benefit from comprehensive mental health treatment with a culturally-responsive and trauma-informed lens.


Assuntos
Emigrantes e Imigrantes/psicologia , Transtornos Mentais/diagnóstico , Mães/psicologia , Comportamento Problema/psicologia , Adolescente , Adulto , Transtornos de Ansiedade , Criança , Pré-Escolar , Estudos Transversais , Depressão , El Salvador/etnologia , Feminino , Guatemala/etnologia , Honduras/etnologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , México , Pessoa de Meia-Idade , Pais/psicologia , Transtornos de Estresse Pós-Traumáticos , Inquéritos e Questionários , Estados Unidos/epidemiologia
4.
J Lesbian Stud ; 24(2): 77-93, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31258009

RESUMO

Mainstream research on lesbian, gay, bisexual, transgender Los Angeles (LA) has ignored Latinx queer communities until recently, and lesbian Latinas, particularly those who are migrants and/or refugees, have been especially marginalized. Building on scholarship and creative work by Chicana, Latina, women of color feminist, queer of color, and queer migration activists and scholars, this essay contributes to research on Mexican, Central American, and Latina lesbians in LA. In her research on sexually non-conforming Latinas, Katie L. Acosta argues that to better understand Latinas' sexualities in all their complexities, future scholarly work should address the pleasures and desires of Latina lesbians, as well as the quality and stability of the relationships they nurture in the borderlands. Building on queer migration research and using what Nan Alamilla Boyd and Horacio Roque Ramírez call "queer oral history," this article focuses on two everyday lesbians in LA whose stories add depth to our understandings of LA queer history and to the lives of queer migrants in the city. The narratives of Luna and Dulce, migrant lesbians from Mexico and Guatemala, respectively, provide a context for better understanding diverse experiences of migrant Latina lesbians in LA. Situating their lives within ongoing research on lesbian Latinas, this essay focuses on three themes-migration, leisure spaces, and family-to explore how these inform the women's everyday choices and shape their practices of freedom. Their stories and perspectives have been instrumental in enabling me to develop an interdisciplinary theoretical framework that I call "finding sequins in the rubble," through which we can recognize and understand how queer Latinx communities engage in processes of queer-world making and radical possibility through everyday acts of resilience and self-care in the midst of familial, institutional, and state violence.


Assuntos
Hispano-Americanos , Homossexualidade Feminina/etnologia , Minorias Sexuais e de Gênero , Migrantes , Adulto , Feminino , Guatemala/etnologia , Humanos , Los Angeles/etnologia , México/etnologia
5.
Soc Sci Med ; 242: 112565, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31627080

RESUMO

Guatemala has the fourth highest infant mortality rate in Latin America, which makes the support and protection of breastfeeding especially critical. Traditional health-promoting practices like breastfeeding may be protected by increasing knowledge of its benefits. Yet there is a dearth of research documenting breastfeeding knowledge (i.e., knowledge of its benefits for infant health and development) in communities where breastfeeding is already practiced. OBJECTIVE: Our aim was to assess degree of breastfeeding knowledge among Mayan mothers in the rural highlands of North-Western Guatemala and compare knowledge of breastfeeding - a practice promoted by local health centers - and other traditional yet non-promoted infant care practices. METHOD: We conducted a survey of maternal-infant health knowledge and behavior among mothers in rural Guatemala (N = 300) from six communities with a non-governmental organization (NGO) health program and one comparison community. RESULTS: Overall, mothers displayed more knowledge of the benefits of breastfeeding in comparison with other traditional infant care practices not promoted by a community health program. Mothers in communities with a health program demonstrated increased knowledge of breastfeeding, regardless of whether they personally participated in the program. This health knowledge predicted participation in novel health-promoting behaviors (family planning, prenatal care, exclusive breastfeeding). CONCLUSIONS: Understanding breastfeeding knowledge as a proxy for community health exposure may increase the efficacy and diffusion of community health messaging.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Mães/psicologia , População Rural/tendências , Adulto , Aleitamento Materno/etnologia , Feminino , Guatemala/etnologia , Humanos , Lactente , Recém-Nascido , Mães/estatística & dados numéricos , Gravidez , Inquéritos e Questionários
6.
Am J Ind Med ; 62(12): 1079-1090, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31436849

RESUMO

BACKGROUND: US government child labor policies allow children as young as age 10 to be hired as workers on farms not operated by family members. Children may face substantial health risks in an industry known for high worker morbidity and mortality rates, due to high demands for productivity, and low control and little support because of the organization of the workplace. This paper examines how child farmworkers in North Carolina experience their work situation. METHODS: In-depth interviews conducted in 2016 with 30 Latinx child farmworkers, ages 10 to 17, were analyzed using concepts from the demand-control-support model. All had worked as either migrant or seasonal hired farmworkers within the past year. RESULTS: Children reported planting, cultivating, and harvesting crops including fruits, vegetables, and tobacco. The crew leader supervisory system, piece-rate pay, and coworker pressure produced significant demands to work quickly and take risks including lifting heavy loads, operating mechanical equipment, and working in excessive heat. Children had little control over work to counter demands they experienced; and they labored in a state of fear of firing, wage theft, and other sanctions. Support was variable, with younger children more likely to experience family and coworker support than older children. CONCLUSIONS: The high demands with limited control and, for some, little support, that these children experience place them at risk and show the possibility of injury and exploitation. Future research should systematically document the occupational injury and illness of hired child farmworkers, and consider whether changes in labor policy are warranted.


Assuntos
Agricultura , Trabalho Infantil , Fazendeiros , Carga de Trabalho , Adolescente , Agricultura/economia , Agricultura/métodos , Criança , Feminino , Guatemala/etnologia , Hispano-Americanos , Humanos , Entrevistas como Assunto , Masculino , México/etnologia , North Carolina , Migrantes , Populações Vulneráveis
7.
Leukemia ; 33(11): 2746-2751, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31296947
8.
Harm Reduct J ; 16(1): 44, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288811

RESUMO

BACKGROUND: Compared with Caucasians, Latinxs with the hepatitis C virus (HCV) tend to initiate treatment less often, discontinue treatment, become infected younger, and have higher reinfection rates post-treatment. Little is known about HCV treatment experiences among Latinxs who inject drugs in the Northeastern USA. We assessed knowledge, attitudes, and perceptions tied to HCV, as well as HCV treatment readiness, and explored the overall HCV treatment experience of Latinx people who inject drugs (PWID) in Boston. METHODS: We conducted qualitative interviews with monolingual and bilingual Spanish-speaking Latinx PWID (n = 15) in Boston, Massachusetts, between 2015 and 2016. We used a thematic content analysis approach to code and analyze data to identify knowledge, attitudes, and experiences related to HCV treatment. RESULTS: We identified barriers and facilitators to HCV treatment. Six salient themes emerged from the data. For participants who had not initiated HCV treatment, lack of referral, fear of quitting drugs, and fear of relapse were perceived barriers. Trust in medical providers and a willingness to quit drugs were primary facilitators. Most participants had positive HCV treatment experiences, and several emphasized the need for outreach to Latinxs about the advantages of newer treatment options. Concerns about HCV reinfection were also notable. CONCLUSIONS: We identified a range of experiences tied to HCV treatment among Latinx PWID. HCV care providers play a key role in determining treatment uptake, and more treatment information should be disseminated to Latinx PWID. Healthcare providers should capitalize on treatment facilitators by ensuring referrals to treatment and should continue to address perceived barriers.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Hepatite C/etnologia , Hepatite C/terapia , Hispano-Americanos/estatística & dados numéricos , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/etnologia , População Urbana/estatística & dados numéricos , Adulto , Boston , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Guatemala/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Porto Rico/etnologia , Pesquisa Qualitativa , Venezuela/etnologia
9.
Leg Med (Tokyo) ; 37: 25-27, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30599443

RESUMO

The population of Guatemala includes Mestizos (admixed) and different Mayan groups (Native Americans), which have been poorly studied in regards to short tandem repeat (STR) loci used for human identification (HID) purposes. Therefore, 483 unrelated Guatemalan volunteers from one Mestizo and three Mayan populations (Poqomchi, Ixil, and Achi) were analyzed with an AmpFlSTR Identifiler™ kit. Allele frequencies and forensic parameters were obtained for 15 autosomal STRs in these populations. Hardy-Weinberg equilibrium by locus and equilibrium linkage between pair of loci were demonstrated by exact tests in all the studied populations. Larger genetic differentiation probably due to genetic drift effects was observed among the studied Guatemalan Mayan groups than the neighboring Mexican Mayas. In brief, our results validate to use the Identifiler™ kit for HID in three non-previously studied Mayan groups, and one Mestizo population from Guatemala.


Assuntos
Genética Forense/métodos , Técnicas de Genotipagem/métodos , Repetições de Microssatélites/genética , Kit de Reagentes para Diagnóstico , Feminino , Frequência do Gene , Deriva Genética , Ligação Genética , Loci Gênicos/genética , Guatemala/etnologia , Humanos , Desequilíbrio de Ligação , Masculino
10.
J Transcult Nurs ; 30(3): 242-249, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30122120

RESUMO

INTRODUCTION: Guatemala is the only country in Central America with a majority indigenous population. Most indigenous Mayans prefer to seek health advice from family members. It is important to understand the beliefs of Mayan caregivers. The purpose of this study was to examine indigenous ways of explaining health and illness in the context of one Mayan village. METHOD: We applied a qualitative descriptive design in summer 2017. Interviews were conducted in Spanish with 10 Mayan caregivers, who were primarily female, between ages 19 and 50 years, in Guatemala. The sample was drawn from families who received a water filter the previous year. RESULTS: Health was explained by access to food, including local herbs, and clean water. Illness was explained by bodily symptoms and behavioral changes. DISCUSSION: Findings align with several United Nations 2030 Sustainable Development Goals and suggest a need to strategize with global partners.


Assuntos
Serviços de Saúde da Criança/normas , Saúde da Criança/normas , Grupos Populacionais/psicologia , Adulto , Criança , Saúde da Criança/etnologia , Saúde da Criança/estatística & dados numéricos , Serviços de Saúde da Criança/estatística & dados numéricos , Feminino , Guatemala/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Populacionais/etnologia , Grupos Populacionais/estatística & dados numéricos , Pesquisa Qualitativa
12.
Med Anthropol ; 38(3): 295-310, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30526055

RESUMO

Widespread use of antibiotics is of concern due to the selection for resistant bacterial strains, which render life-saving antimicrobials ineffective. Smallholders in rural Guatemala rely on human antibiotics to treat their poultry, and in this article, I aim to understand why they do so. I incorporate Ethnographic Decision Modeling (EDM) to understand treatment behaviors. Results indicate that access and affordability in opportunity costs are barriers to seeking veterinary medicines for poultry. Access to veterinary medicine and education campaigns on poultry health are necessary to support the appropriate use of antimicrobials for backyard poultry.


Assuntos
Criação de Animais Domésticos , Antibacterianos/uso terapêutico , Prescrição Inadequada/veterinária , Aves Domésticas , Drogas Veterinárias/uso terapêutico , Animais , Antropologia Médica , Guatemala/etnologia , Humanos
13.
Geriatr Nurs ; 40(2): 123-128, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30107949

RESUMO

Access to mental health services for older Hispanic adults is limited and often older Hispanic adults must rely on their own resources in dealing with mental health issues. The aim of this study was to understand how older Hispanic immigrants cope mental health issues (e.g. stress, anxiety, and/or depression). A qualitative, descriptive approach was used to interview 17 older Hispanic immigrants from Guatemala, Dominican Republic and Colombia. Interviews were audio recorded, transcribed and translated verbatim by bilingual research assistants. Data were analyzed using content analysis with a combination of immersion/crystallization, editing and template organizing styles. Ways of coping included spiritual beliefs and religious practices, social support, distraction, medications and professional help. Primary care providers may be more effective if they build upon the cultural constructs that undergird older Hispanic immigrants' ways of coping in addressing emotional distress and mental health issues in this population.


Assuntos
Adaptação Psicológica , Hispano-Americanos/psicologia , Serviços de Saúde Mental , Idoso , Idoso de 80 Anos ou mais , Colômbia/etnologia , Depressão/psicologia , República Dominicana/etnologia , Emigrantes e Imigrantes/psicologia , Feminino , Guatemala/etnologia , Acesso aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Apoio Social , Estresse Psicológico/psicologia , Estados Unidos
14.
Ann Glob Health ; 84(4): 704-709, 2018 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-30779520

RESUMO

BACKGROUND: The civil war between the indigenous Mayans and other Guatemalans lasted for 36 years, killed civilians, decimated villages, and resulted in many refugees. The Guatemalan Peace Agreement of 1996 aimed to alleviate the ongoing conflict. Studies of peace agreements more typically evaluate local political outcomes while neglecting global health outcomes. OBJECTIVE: Our research quantified associations between pre-migration exposure to the peace agreement in Guatemala and the post-migration health status of Guatemalan immigrants in the United States. METHODS: We used chi-square tests to compare the distribution of health status before and after peace. We used ordered probit regressions to estimate associations between peace in Guatemala and health in the United States, conditional on the observed distributions of age, age squared, age cubed, and linear time trends before and after peace. FINDINGS: The study sample included 4,115 female and 5,282 male Guatemalan immigrants between the ages of 15 and 85. The mean age was 38.8 years for females (standard deviation, 14.2) and 35.4 years for males (standard deviation, 12.6). Chi-square tests found statistically significant differences in the distribution of health status before and after the peace agreement, for females (P < .001) and males (P < .001). In unadjusted results, the peace agreement was associated with a 7.3 percentage point increase in excellent post-migration health for females (95% confidence interval, 4.9 to 9.8) and a 6.0 percentage point increase for males (95% confidence interval, 3.8 to 8.2). In adjusted results, we found that the peace agreement was associated with a 6.1 percentage point increase in excellent post-migration health for females (95% confidence interval, 0.8 to 11.4) and a 5.5-percentage point increase for males (95% confidence interval, 1.0 to 10.0). CONCLUSIONS: The peace agreement in Guatemala was associated with statistically significant improvements in the health status of Guatemalan immigrants to the United States.


Assuntos
Emigrantes e Imigrantes , Nível de Saúde , Política , Guerra , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Guatemala/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
15.
Rev. Col. Méd. Cir. Guatem ; 156(2): 67-70, nov. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-986776

RESUMO

PROPÓSITO: Explorar los factores que influyen en la aplicación de la interculturalidad con respecto a la atención del parto y puerperio inmediato en personal médico y paramédico, comadronas y usuarias del Centro de Urgencias Médicas (CUM) de Tecpán, Chimaltenango, abril-mayo 2017. MATERIAL Y MÉTODOS: Estudio cualitativo con diseño etnográfico. Se realizaron entrevistas en profundidad al personal de salud y usuarias del CUM y grupos focales con comadronas. Se evaluó la infraestructura de las salas de parto y posparto. RESULTADOS: En el personal médico y paramédico se evidenciaron saberes limitados acerca de la pertinencia cultural, descrita en las Normas de Atención con Pertinencia Cultural. Se contó con el 65% de los elementos de infraestructura y equipo de la sala de partos culturalmente adecuada. Las comadronas percibieron una atención deficiente y refirieron poco interés y capacitación del personal del servicio de salud. Las usuarias opinaron que existe una buena relación con el personal de salud, sin embargo no se les brindó una atención con adecuación cultural. CONCLUSIONES: Los factores que influyen en la implementación de las prácticas interculturales son de índole económica principalmente, además de aspectos estructurales, organizaciones y socioculturales.


PURPOSE: To explore the factors that influence the implementation of interculturality in regards to care during childbirth and the immediate postpartum period, in medical and paramedical staff, traditional midwives and patients of the Center of Medical Urgencies (CUM), Tecpán, Chimaltenango, April-May 2017. MATERIALS AND METHODS: Qualitative study with an ethnographic design. In-depth interviews with medical staff and patients of the CUM were carried out in addition to focal groups with traditional midwives. The infrastructure of the birthing room and postpartum ward were evaluated. RESULTS: CONCLUSIONS: The medical and paramedical staff showed limited awareness of cultural pertinence, as described in the Norms of Attention with Cultural Pertinence. The birthing room satisfies 65% of the criteria of infrastructure and equipment of a culturally pertinent birthing room. The traditional midwives perceived deficient patient care and identified a lack of interest and training of the health staff. The patients experienced a good relationship with the health staff, but declared a lack of cultural adequacy in the attention. The factors that influence in the implementation of intercultural practices are principally of economic nature, in addition to structural, organizational and sociocultural aspects.


Assuntos
Humanos , Feminino , Parto/etnologia , Período Pós-Parto/etnologia , Atenção à Saúde , Competência Cultural/educação , Tocologia/educação , Estudos de Avaliação como Assunto/etnologia , Guatemala/etnologia
16.
Anthropol Med ; 24(2): 142-158, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28721738

RESUMO

Thirty years ago, Nancy Scheper-Hughes and Margaret Lock outlined a strategy for 'future work in medical anthropology' that focused on three bodies. Their article - a zeitgeist for the field - sought to intervene into the Cartesian dualisms characterizing ethnomedical anthropology at the time. Taking a descriptive and diagnostic approach, they defined 'the mindful body' as a domain of future anthropological inquiry and mapped three analytic concepts that could be used to study it: the individual/phenomenological body, the social body, and the body politic. Three decades later, this paper returns to the 'three bodies'. It analyses ethnographic fieldwork on chronic illness, using a rescriptive, practice-oriented approach to bodies developed by science studies scholars that was not part of the initial three bodies framework. It illustrates how embodiment was a technical achievement in some practices, while in others bodies did not figure as relevant. This leads to the suggestion that an anthropology of health need not be organized around numerable bodies. The paper concludes by suggesting that future work in medical anthropology might embrace translational competency, which does not have the goal of better definitions (better health, better bodies, etc.) but the goal of better engaging with exchanges between medical and non-medical practices. That health professionals are themselves moving away from bodies to embrace 'planetary health' makes a practice-focused orientation especially crucial for medical anthropology today.


Assuntos
Pesquisa Biomédica , Medicina Tradicional , Obesidade/etnologia , Antropologia Médica , Feminino , Guatemala/etnologia , Humanos
17.
BMJ Case Rep ; 20172017 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-28280081

RESUMO

A 43-year-old indigenous Guatemalan woman with achondroplasia presented to our clinic with chronic fatigue and generalised oedema. She had limited contact with the formal healthcare system. However, 1 year prior, she had sought medical evaluation from a private physician. Her symptoms had been attributed to a combination of heart failure and physical disability due to the musculoskeletal complications of her achondroplasia. She was lost to follow-up due to inability to pay for further testing or treatment. On initial laboratory evaluation in our clinic, she was found to have a thyrotropin level greater than assay. With initiation of oral levothyroxine supplementation, her dyspnoea and oedema completely resolved. The case illustrates how indigenous patients in rural Guatemala experience many barriers to accessing high-quality medical care. As a result, presentations of common illnesses are often very advanced and definitive diagnoses and treatments are frequently delayed.


Assuntos
Acondroplasia/complicações , Mixedema/diagnóstico , Adulto , Feminino , Guatemala/etnologia , Serviços de Saúde do Indígena , Humanos , Mixedema/tratamento farmacológico , Saúde da População Rural , Tiroxina/administração & dosagem , Tiroxina/uso terapêutico , Resultado do Tratamento
18.
Fam Community Health ; 40(2): 101-111, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28207673

RESUMO

The purpose of this study was to examine demographic factors associated with health care barriers among Mexican (n = 258) and Guatemalan (n = 143) immigrants in Cincinnati, a nontraditional destination (new migration area). Three primary results emerged: length of US residence was not associated with fewer health care barriers, Mexican women and younger Guatemalans endorsed fewer skills-related barriers, and childless Guatemalans reported more barriers to care the longer they reside in the United States, when compared with Guatemalans with children. Our study highlights the importance of disaggregating data to create more tailored interventions to eliminate health disparities for Latinos.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Demografia , Acesso aos Serviços de Saúde/tendências , Adolescente , Adulto , Idoso , Emigrantes e Imigrantes , Feminino , Guatemala/etnologia , Hispano-Americanos , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
19.
J Hum Lact ; 33(4): 781-789, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28107098

RESUMO

BACKGROUND: Guatemala exhibits the sixth highest rate of child stunting worldwide, and stunting disproportionately affects Guatemala indigenous communities. In a country struggling to combat this result of malnutrition, early child nutrition is especially critical. Specifically, early initiation of breastfeeding is important for the development of newborn infants. Understanding beliefs and practices related to early initiation of breastfeeding in Maya Guatemala may provide an avenue to guide nutrition interventions in indigenous communities. Research aim: This study aimed to determine major beliefs and practices associated with early initiation of breastfeeding among Maya mothers in Lake Atitlán, Guatemala. METHODS: As part of a larger study to assess child nutrition in the Lake Atitlán region, we created a series of semistructured interview questions to document breastfeeding practices and beliefs among mothers. We conducted and audio-recorded in-person interviews that were translated from Kaqchikel, the local language, to Spanish by a community assistant. RESULTS: We conducted 178 interviews with mothers; 76% practiced early initiation. Early initiation was associated with the village and complementary feeding practices. Mothers held a variety of beliefs about the value of colostrum, and these beliefs were associated with the village. Mothers who held negative beliefs toward colostrum were more likely to delay breastfeeding initiation. CONCLUSION: Although most Maya mothers practice early initiation, the intervillage disparity in breastfeeding practices demonstrates a need to geographically focus breastfeeding interventions. Our novel insights into the breastfeeding beliefs among Maya mothers will serve as a guide to structure culturally competent breastfeeding education interventions in indigenous communities.


Assuntos
Aleitamento Materno/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Mães/psicologia , Fatores de Tempo , Adulto , Aleitamento Materno/etnologia , Colostro , Estudos Transversais , Feminino , Transtornos do Crescimento/etiologia , Guatemala/etnologia , Humanos , Lactente , Recém-Nascido , Pesquisa Qualitativa
20.
Am J Phys Anthropol ; 162(4): 616-626, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27808397

RESUMO

OBJECTIVES: The causes of variation in breastfeeding duration in humans are poorly understood, but life history factors related to maternal energetics drive much of the variation in lactation duration in nonhuman animals. With this in mind, we investigated whether four energy-related factors influence variation in breastfeeding duration in a non-industrial human population: (1) mortality risk during mother's development (assessed via mother's adult height), (2) reliance on nutrient-dense weaning foods, (3) access to and need for help with infant feeding and care ("allomaternal care"), and (4) maternal tradeoffs between current and future reproduction (measured via child's birth order). MATERIALS AND METHODS: The data pertain to 51 Kakchiquel-speaking Maya mothers and 283 children from a village in rural Guatemala. We developed a linear mixed model to evaluate the relationships between breastfeeding duration and the energy-related factors. RESULTS: Duration of breastfeeding was associated with two of the energy-related factors in the ways we predicted but not with the other two. Contrary to predictions, taller mothers breastfed for shorter periods and we found no evidence that weanling diet quality impacts breastfeeding duration. As predicted, women who had more help with infants breastfed for shorter periods, and later-born infants breastfed longer than earlier-born ones. DISCUSSION: The results regarding allomaternal care suggest that help reduces mothers' lactation demands. The energy saved may be redirected to increasing fecundity or investment in other children. The birth order result suggests that children born to mothers nearing reproductive senescence receive higher levels of investment, which likely impacts children's fitness.


Assuntos
Aleitamento Materno/etnologia , Índios Centro-Americanos/etnologia , Desmame/etnologia , Antropologia Física , Estatura , Metabolismo Energético , Feminino , Guatemala/etnologia , Humanos , População Rural , Fatores de Tempo
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