Salud mental y estrés por aculturación en inmigrantes sudamericanos en el norte de Chile / Mental health and stress by acculturation in immigrants from South America in northern Chile

Background: Coping with changes brought about by immigration and social circumstances that often characterize this process may cause mental health problems. Aim: To analyze the relationship between acculturation stress and mental health symptoms in South American immigrants residing in Antofagasta, Chile. Material and Methods: The OQ questionnaire, which assesses mental health and the acculturation stress questionnaire from Ruiz, were answered by 431 immigrants (53.8% Colombian and 46.2% Peruvian) aged between 18 and 65 years old. Results: The major source of acculturation stress was distance from origin, followed by difficulties in social relationships and perceived discrimination and rejection. About 50% of respondents had elevated levels of discomfort in their life, with mental health problems derived from their adjustment to social roles and relationships. There was a high correlation between acculturation stress levels and severity of mental health symptoms. Conclusions: Immigrants are exposed to high levels of stress resulting in a negative impact on their mental health.

Inequidad en la utilización de servicios de salud reproductiva en Colombia en mujeres indígenas y afrodescendientes / Ethnic disparities in the use of reproductive health services by indigenous and African-descendant Colombian women / Disparidades étnicas no uso de serviços de saúde reprodutiva por mulheres colombianas indígenas e afrodescendentes

Resumen Se analizó la utilización de servicios de salud reproductiva (atención prenatal, parto y posparto), según la etnia de las mujeres, a partir de la Encuesta Nacional de Demografía y Salud 2010 de Colombia. La etnia fue medida por auto- reconocimiento (indígenas, afrodescendientes y ninguna) y se estimaron modelos logísticos para cada servicio. Encontramos que, respecto a quienes no pertenecen a ninguna etnia, la utilización de servicios de salud reproductiva es menor en las mujeres indígenas y afrodescendientes. En los modelos de regresión se encontró que mujeres indígenas tienen menores posibilidades de un número adecuado de controles prenatales (OR = 0,61), así como también afrodescendientes. Igual situación para la atención institucional del parto: indígenas (OR = 0,33), afrodescendientes (OR = 0,60); y en control posparto: indígenas (OR = 0,80), afrodescendientes (OR = 0,80). En conclusión, existen inequidades en la utilización de servicios de salud reproductiva en las mujeres de grupos étnicos de Colombia que deben ser atendidas con estrategias gubernamentales que garanticen el derecho a la salud.

Abstract The aim of this study in Colombia was to analyze the use of reproductive health services (prenatal care, childbirth, and postpartum) according to women’s ethnicity, based on the National Demographic and Health Survey for 2010. Ethnicity was self-reported (indigenous, African-descendant, or neither), and logistic models were performed for each service. The use of reproductive health services was lower among indigenous and African-descendant Colombian women when compared to those that did not declare their ethnicity. According to the regression models, indigenous women showed lower odds of having an adequate number of prenatal visits (OR = 0.61), and the same was true for African-descendant women. The same situation prevailed for institutional childbirth care: indigenous women (OR = 0.33) and African-descendant women (OR = 0.60); and postpartum follow-up: indigenous (OR = 0.80), African-descendant (OR = 0.80). In conclusion, there are inequities in the use of reproductive health services by women belonging to ethnic groups in Colombia, who should be targeted with government strategies to guarantee their right to health.

Resumo O objetivo deste estudo na Colômbia foi analisar o uso de serviços de saúde reprodutiva (pré-natal, parto e pós-parto) de acordo com a identidade étnica das mulheres, com base na Pesquisa Nacional sobre Demografia e Saúde de 2010. A identidade étnica era autorreferida (indígena, afrodescendente ou nenhuma das duas), e modelos logísticos foram aplicados a cada serviço de saúde. As mulheres colombianas indígenas e afrodescendentes usavam menos os serviços de saúde reprodutiva, quando comparadas àquelas que não informaram a identidade étnica. De acordo com os modelos de regressão, as mulheres indígenas mostravam menores chances de ter um número adequado de consultas de pré-natal (OR = 0,61), o mesmo valendo para as afrodescendentes. As mesmas disparidades apareciam em relação ao parto hospitalar: parturientes indígenas (OR = 0,33) e afrodescendentes (OR = 0,60); e atendimento puerperal: indígenas (OR = 0,80) e afrodescendentes (OR = 0,80). O estudo concluiu que há desigualdades no uso de serviços de saúde reprodutiva por mulheres pertencentes a grupos étnicos na Colômbia, e que estas devem ser alvo de estratégias públicas para garantir seu direito à saúde.

Pigmentocracia dei deseo en el mercado sexual Trans de Cali, Colombia / Pigmentocracy of desire in the trans sexual market in Cali, Colombia / Pigmentocracia do desejo no mercado sexual Trans de Cali, Colômbia

Este artículo analiza el efecto de la condición étnico/racial para las mujeres negras Trans en el mercado sexual Trans femenino en Cali, Colombia. Se trata de un estudio sobre el trabajo sexual desde una perspectiva interseccional, a través de los aportes del black feminism, articulando raza como color de piel, auto-identidad de sexo/género, clase social y grupo etario, en la producción y consumo de servicios sexuales ofrecidos por mujeres no biológicas, que realizan en determinados casos el trabajo de peluquería. La hipótesis indica, como efecto más importante que el "exotismo de los cuerpos negros", en el juego de los capitales eróticos, valoriza sobremanera las "mujeres masculinas" o "activas" dotadas con "pene potente". Ello, debido a la confluencia entre clientes cuya fantasia sexual se recrea en una mujer fálica, y hombres biológicos, jóvenes de clases populares, en su mayoría negros, que reconstruyen sus identidades de sexo/género y encuentran en el mercado sexual un espacio laboral.

This article analyzes the effect of black trans women's ethnic/racial condition in the female trans sex market in the city of Cali, Colombia. The study looked at sex work from an intersectional perspective, with the contributions of Black Feminism, articulating race as skin color, sex/gender self-identity, social class and age group in the production and consumption of sex services offered by not-biologically-born women who sometimes work as hairdressers. We argue that the "exoticism of black bodies" as erotic capital gives a high value to the "wellendowed male" or "active" black woman with a "potent penis", in the confluence of clients whose sexual fantasy valorizes a phallic woman, and lower class male-born black youths who reconstruct their sex/gender identities and find a labor niche in the sex market.

Este artigo analisa o efeito da condição étnico/racial para as mulheres negras trans no mercado sexual trans feminino em Cali, Colômbia. Trata-se de um estudo sobre o trabalho sexual a partir de uma perspectiva interseccional, através das contribuições do black feminism, articulando raça como cor de pele, autoidentidade de sexo/gênero, classe social e grupo etário na produção e no consumo de serviços sexuais oferecidos por mulheres não biológicas, que realizam, em determinados casos, o trabalho de cabeleireiras. A hipótese indica que o "exotismo dos corpos negros", no jogo dos capitais eróticos, valoriza sobremaneira as "mulheres masculinas" ou "ativas" dotadas de "pênis potente". Isto devido à convergência entre clientes cuja fantasia sexual se recria em uma mulher fálica e em homens biológicos, jovens de classes populares, em sua maioria negros, que reconstroem suas identidades de sexo/ gênero e encontram no mercado sexual um espaço de trabalho.

Factores asociados con la seguridad alimentaria en un Municipio Rural del norte del Cauca, Colombia

La seguridad alimentaria (SA) es el acceso suficiente a alimentos inocuos y nutritivos para satisfacer las necesidades alimentarias y preferencias personales, y llevar una vida sana y activa. En el presente estudio se determinó la seguridad alimentaria de 302 familias de escolares de un municipio rural del departamento de Cauca, Colombia; y los factores asociados a la misma. Los hogares seleccionados hacían parte de un proyecto de impacto nutricional de maíz con mayores nutrientes realizado en esta zona. En estos hogares se aplicó una escala de SA compuesta por 12 ítems y un cuestionario sociodemográfico. Los hogares se clasificaron con seguridad e inseguridad alimentaria leve, moderada y severa. El 44,37% de los hogares se encontró en SA y el 55,63% con inseguridad alimentaria (IA), (41,39% presentó inseguridad leve, 12,25% inseguridad moderada y 1,99% inseguridad severa). Las familias que se encontraron en IA tenían hogares en donde el número de personas que trabajaban es relativamente menor al número de personas que allí vivían, contaban con menos de 4 bienes o servicios y el (los) niño (s) tenían menos apetito en comparación con las familias que se encontraban con SA. En conclusión más de la mitad de las familias encuestadas se encontraron en IA y los factores que la influencian están asociados al ingreso familiar.

Factors associated with food security in a rural Municipality in northern Cauca, Colombia. Food security is sufficient access to safe and nutritious foods to satisfy nutritional needs and personal preferences, and to lead a healthy and active life. The current study evaluated food security in 302 families with school-age children living in a rural municipality in Cauca, Colombia, and factors associated with food security. Families were participating in an evaluation of the nutrition impact of an intervention with nutritionally improved maize. A12-item food security scale was applied to the household head, as well as a sociodemographic survey. Families were classified as food secure, or mildly, moderately or severely food insecure. Among households, 44,37% were classified as food secure and 55,63% as food insecure (with 41,39% as mildly insecure, 12,25% as moderately insecure and 1,99% as severely insecure). Food-insecure families had fewer persons working relative to the total individuals in the home, 4 or fewer services or assets, and children with a reduced appetite, in comparison with food-secure households. In conclusion, more than half of the sample was food insecure; the factors associated with food insecurity relate to family income.

Asociación de los polimorfismos IL-1B-511 e IL-1RN y Helicobacter pylori CagA positivo con cáncer gástrico en una zona de riesgo alto en Colombia / Association of interleukin-1 genetic polymorphism and CagA positive Helicobacter pylori with gastric cancer in Colombia

Background: There is an association of interleukin (IL)1B polymorphism with gastric cancer risk. However systematic reviews of the existing evidence have shown that such association varies across populations with different genetic ancestry. Aim: To evaluate the association of IL-1B-511 and IL-1RN polymorphism and Helicobacter pylori IgG antibodies CagA, with gastric cancer in two Colombian cities located in a high risk area for gastric cancer. Material and Methods: A case-control study including 46 gastric cancer cases and 99 controls with non-atrophic gastritis from a high risk zone for gastric cancer. Polymorphism genotyping was carried out by polymerase chain reaction (PCR) and IgG CagA status by ELISA. Results: IgG CagA seropositive individuals had an increased gastric cancer risk (odds ratio (OR) = 11.56; 95 percent confidence intervals (CI) 2.62-50.91 in Tunja and OR = 19.66, 95 percentCI 0.98-395 in Bogotá). IL-1B-511TT carriers in Tunja had increased risk of gastric cancer (OR = 11.31; 95 percentCI 1.20-106.54)), while IL-1RN*2 alelle carriers in Bogotá showed an inverse association with gastric cancer risk (OR = 0.03; 95 percentCI 0.01-0.65). Conclusions: This study adds evidence to the positive association of Helicobacter pylori CagA positive strains with non-cardial gastric cancer etiology. There is a possible heterogeneity in the association of IL-1B gene polymorphism with cancer, in populations of similar ethnic background and settled in the same risk area.

Estado nutricional y hábitos alimentarios en indígenas embera de Colombia / Nutritional status and food patterns in embera indigenous people from Colombia

Objective: To analyze food habits and nutritional status in indigenous people. Methodology: Study of prevalence of two communities with different patterns of food acquisition: dependency of rainforest resources (Tausig) and farmers with a degree of acculturation (Nusidó). The usual daily intake (24 hours recall and nutrient analysis) and nutritional status by anthropometry (height-age, height-weight andIMC) were studied. Ethnography of foods was undertaken. Results: the traditional dietary ideal (hunting, fishing and harvesting), is not sustainable due to the low productivity and the socio-economic conditions. The prevalence of deficiency in daily intake (Atausí> Nusidó) is high: energy 73,2 percent, roteins 36,6 percent, folic acid 34,2percent,calcium 93,0 percent, vitamin A 61,4 percent and zinc 75,7 percent. Chronic under-nutrition appeared in 68,9 percent (0-10 years), and short stature in 77,1 percent (10-19 years),overweight in 45 percent (adults). Both communities have greater under-nutrition than the national level and the community more dependent on forest (Atausí) has worse nutrition outcomes. Conclusion: Current dietary habits do not guarantee the coverage of food requirements and have influence on under nutrition, along with other factors that increase food insecurity of Embera indigenous compared to the general Colombian population.

Objetivo: analizarlos hábitos alimentarios y el estado nutricional en indígenas. Metodología: estudio de preval encías en dos comunidades con patrones diferenciales para conseguir alimentos: con recursos de selva (Atausí) y campesinos más aculturados (Nusidó). Se estudió la ingesta (por recordatorio de 24 horas) y el estado nutricional por antropometría (estatura-edad, peso-estatura e IMC). Se realizó etnografía sobre la alimentación. Resultados: el ideal dietario (caza, pesca y recolección) tradicional, es insostenible por la baja productividad y las condiciones socioeconómicas. La prevalencia de deficiencia en la ingesta diaria (Atausf>Nusidó) es alta: energía 73,2 por ciento, proteínas 36,6 por ciento, ácido fólico 34,2 por ciento, calcio 93 por ciento, vitamina A 61,4 por ciento y cinc 75,7 por ciento. La desnutrición crónica se presentó en el 68,9 por ciento (0-10 años), y talla baja en 77,1 por ciento (10-19 años), el sobrepeso en el 45 por ciento (adultos) y a otras edades se asoció con el patrón alimentario y la baja estatura. Ambas comunidades poseen mayor desnutrición que el nivel nacional y la más dependiente de la selva (Atausí) presenta mayores problemas nutricionales. Conclusión: los actuales hábitos alimentarios no cubren los requerimientos nutricionales e influyen en la desnutrición crónica encontrada, junto con otros factores que incrementan la inseguridad alimentaria en indígenas embera, en relación a la población general colombiana.