Itinerários terapêuticos para cuidados em saúde bucal de adultos quilombolas de um distrito rural da Bahia, Brasil / Therapeutic itineraries of quilombola adults for oral health care in a rural district of Bahia, Brazil

Resumo O estudo analisou os itinerários terapêuticos relacionados à saúde bucal de adultos quilombolas de um distrito rural de Vitória da Conquista, Bahia. Trata-se de uma pesquisa qualitativa, na qual foram realizadas dez entrevistas semiestruturadas com adultos quilombolas em maio de 2021, transcritas e analisadas por meio da análise de conteúdo. Os resultados evidenciaram ausência e/ou precariedade na higiene bucal em alguma fase da vida, especialmente infância e adolescência; utilização de práticas populares para cuidado a saúde bucal e experiências de cuidado profissional marcados pela exodontia. A utilização de serviços de saúde foi relatada, em sua maioria, apenas no período anterior à pandemia de COVID-19, os entrevistados divergiram quanto à percepção de facilidade do acesso aos serviços de saúde em sua comunidade. Os relatos sobre a satisfação da saúde bucal destacaram a necessidade de uso ou substituição de próteses dentárias. À guisa de conclusão, entende-se que é necessária a promoção de saúde bucal de forma articulada com ações que possibilitem a prevenção de agravos, a reabilitação odontológica e a valorização do conhecimento e da visão de mundo da população quilombola.

Abstract This study examined the oral health-related therapeutic itineraries of quilombola adults in a rural district of Vitória da Conquista, Bahia. This qualitative study involved ten semi-structured interviews of adult members of the quilombola community, in May 2021, which were then transcribed and analysed using content analysis. The results showed little or poor oral hygiene at some stage of life, especially in childhood and adolescence, the use of popular oral health care practices, and experiences of professional care featuring tooth extraction. Use of health services was mostly reported only in the period prior to the COVID-19 pandemic. Responses as to perceived ease of access to health services in the community varied. One common complaint as to satisfaction with oral health was the need to use or replace dental prostheses. This study concluded that oral health must be promoted jointly with disease prevention, dental rehabilitation and recognition for the knowledge and worldview of the quilombola population.

Anos Potenciais de Vida Perdidos devido à COVID-19, segundo a raça/cor e gênero, no Brasil, entre 2020 e 2021 / Years of Potential Life Lost due to COVID-19 according to race/color and gender in Brazil between 2020 and 2021

Resumo A mortalidade provocada pela pandemia da COVID-19 tem produzido impactos aos indicadores de Anos Potenciais de Vida Perdidos (APVP) em nível mundial. Objetiva-se estimar os APVP devido à mortalidade por COVID-19, segundo sexo, faixa etária e raça/cor, no período de março de 2020 a dezembro de 2021, no Brasil. Foram caracterizadas as mortes por COVID-19, estimadas e comparadas as taxas e razão de taxas padronizadas de APVP, a média de anos potenciais de vida não vividos (APVNV) e a idade média do óbito (IMO). No geral, foram perdidos 13.776.969,50 anos potenciais de vida, o que determinou uma perda média de 22,5 anos potenciais não vividos. Houve maior perda de anos potenciais de vida nos homens (58,12%) e nas faixas etárias de 0 a 59 anos nas populações negra (58,92%) e indígena (63,35%), enquanto nas faixas etárias de 60 anos e mais foi observada maior perda de APVP nas populações branca (45,89%) e amarela (53,22%). As mulheres registraram as maiores IMO, com exceção das mulheres indígenas. Homens brancos (1,63), pardos (1,59) e pretos (1,61) tiveram as maiores taxas em comparação às mulheres brancas. Apesar da COVID-19 ter tido maior impacto em idosos, foram as populações negra e indígena na faixa de menos de 60 anos quem teve maior perda de anos potenciais de vida.

Abstract Mortality caused by the COVID-19 pandemic has impacted indicators of Years of Potential Life Lost (YPLL) worldwide. This study aimed to estimate the YPLL due to mortality caused by COVID-19, according to sex, age group, and race/color in Brazil, from March 2020 to December 2021. Deaths caused by COVID-19 were characterized, in which the rates and ratios of standardized YPLL rates, the average number of years of potential life lost (ANYPLL), and the average age at death (AAD) were estimated and compared. Overall, 13,776,969.50 potential years of life were lost, which resulted in an average loss of 22.5 potential years not lived. A greater loss of potential years of life was identified in men (58.12%) and in the age groups from 0 to 59 years in the black (58.92%) and indigenous (63.35%) populations, while in the age groups of 60 years and over, a greater loss of YPLL was observed in the white (45.89%) and yellow (53.22%) populations. Women recorded the highest ADD, with the exception of indigenous women. White men (1.63), brown men (1.59), and black men (1.61) had the highest rates when compared to white women. Although COVID-19 has a greater impact on the elderly, it was the black and indigenous populations under the age of 60 who had the greatest loss of potential years of life.

Racial and ethnic disparities in premature births among pregnant women in the NISAMI cohort, Brazil / Disparidades étnicas e raciais nos partos prematuros entre gestantes da coorte NISAMI, Brasil

Abstract The incidence of premature birth has increased worldwide, unequally distributed by race/ethnicity. Racism generates economic inequalities, educational disparities, and differential access to health care, which increases the risk of preterm birth. Thus, this study aimed to evaluate the factors associated with preterm birth and racial and ethnic disparities in premature birth among pregnant women attending prenatal care at the Brazilian Unified Health System health units in the urban area of Santo Antônio de Jesus, Bahia, Brazil. This study used data from 938 pregnant women aged between 18 to 45 years within the NISAMI prospective cohort. Premature birth prevalence was 11.8%, with a higher prevalence among black than non-black women (12.9% versus 6.0%, respectively). Maternal age between 18 and 24 years was the only factor associated with premature birth. A higher risk of premature birth was found among black women than non-black women (RR 3.22; 95%CI 1.42-7.32). These results reveal the existence of racial and social inequalities in the occurrence of premature birth.

Resumo A incidência de parto prematuro tem aumentado em todo o mundo, distribuída de forma desigual por raça/etnia. O racismo gera desigualdades econômicas, disparidades educacionais e acesso diferenciado à saúde, o que aumenta o risco de parto prematuro. Assim, este estudo teve como objetivo avaliar os fatores associados à prematuridade e disparidades raciais e étnicas no parto prematuro entre gestantes atendidas durante o pré-natal em unidades de saúde do Sistema Único de Saúde na zona urbana de Santo Antônio de Jesus, Bahia, Brasil. Este estudo utilizou dados de 938 mulheres grávidas com idade entre 18 e 45 anos dentro da coorte prospectiva do NISAMI. A prevalência de prematuridade foi de 11,8%, sendo maior entre as negras do que entre as não negras (12,9% versus 6,0%, respectivamente). A idade materna entre 18 e 24 anos foi o único fator associado ao parto prematuro. Foi encontrado maior risco de prematuridade entre as mulheres negras do que entre as não negras (RR 3,22; IC95% 1,42-7,32). Esses resultados revelam a existência de desigualdades raciais e sociais na ocorrência do parto prematuro.

Ethnically distinct populations and coping with violence against children in the COVID-19 pandemic / Poblaciones étnicamente diversas y la lucha contra la violencia infantil en la pandemia de COVID-19 / Populações etnicamente distintas e o enfrentamento da violência contra crianças na pandemia da COVID-19

ABSTRACT Objective: To identify policies and programs adopted by a Brazilian municipality to address violence against children during the COVID-19 pandemic. Method: A qualitative documentary study. The study setting was the municipality of Ananindeua, Pará, Brazil. Data was collected from official websites between November 2021 and February 2022. Thematic content analysis was used with the support of webQDA software. Results: Three empirical categories emerged: a) Impacts of the COVID-19 pandemic on violence against children; b) Action strategies for tackling violence against children in the COVID-19 pandemic; c) Evaluation indicators and targets for action strategies for tackling violence against children. Final considerations: The documents revealed few direct mentions of children, especially traditional populations; they presented superficial and ineffective evaluations of the policies and programs adopted, using exclusively quantitative indicators.

RESUMEN Objetivo: Identificar políticas y programas adoptados por un municipio brasileño para hacer frente a la violencia infantil durante la pandemia de COVID-19. Método: Se trata de un estudio cualitativo documental. El escenario fue el municipio de Ananindeua, Pará, Brasil. Los datos se recogieron de sitios de internet oficiales entre noviembre de 2021 y febrero de 2022. Se utilizó el análisis temático de contenido con el apoyo del software webQDA. Resultados: Surgieron tres categorías empíricas: a) Impactos de la pandemia de COVID-19 en la violencia contra los niños; b) Estrategias de acción para abordar esta violencia; c) Indicadores de evaluación y metas de las estrategias de acción para este afrontamiento. Consideraciones finales: Los documentos revelaron pocas menciones sobre los niños de las poblaciones tradicionales en especial y presentaron evaluaciones superficiales de las políticas y programas adoptados, utilizando exclusivamente indicadores cuantitativos.

RESUMO Objetivo: Identificar políticas e programas adotados por um município brasileiro para o enfrentamento da violência contra crianças durante a pandemia de COVID-19. Método: Estudo qualitativo do tipo documental. O cenário de estudo foi Ananindeua, Pará, Brasil. A coleta de dados foi realizada em sites oficiais, de novembro de 2021 a fevereiro de 2022. Utilizou-se a análise de conteúdo temática apoiada pelo software webQDA. Resultados: Emergiram três categorias empíricas: a) Impactos da pandemia de COVID-19 na violência contra crianças; b) Estratégias de enfrentamento desta violência; c) Indicadores de avaliação e metas das estratégias para este enfrentamento Considerações finais: Há poucas menções diretas às crianças, especialmente às de populações tradicionais; apresentaram avaliações ineficazes das políticas, apenas qualitativamente.

Selenium-rich food potentially useful to control mercury levels among Afro-Colombians: Towards an intercultural intervention

Introduction. Diet-based interventions may be a culturally acceptable option to decrease mercury levels and thus prevent the adverse effects of this metal on population health. Selenium is an element present in Colombian geology that can act as a chelator, decreasing mercury concentrations in the human body. Objective. To identify potentially useful selenium-rich foods to control the effects of mercury exposure among Afro-Colombians. Materials and methods. A cross-sectional study was carried out with 320 individuals from five municipalities of Chocó. They were asked about the frequency of consumption of selenium-rich foods, and their association with mercury concentrations in hair was estimated with multiple robust regression. Results. Guava, whole wheat flour, strawberries, cow liver, spinach and yeast extract were the foods with higher consumption. Walnuts, whole wheat flour, and yeast extract were identified in multiple robust regression as foods to consider in future interventions. Conclusion. It is proposed that the banana juice, the pineapple colada, the borojó (Borojoa patinoi) sorbet, the cucas, and the enyucado are basic elements for a culturally acceptable intervention.

Introducción. Las intervenciones basadas en la dieta pueden ser una opción culturalmente aceptable para disminuir los niveles de mercurio y prevenir los efectos adversos de este metal en la salud de la población. El selenio es un elemento presente en la geología colombiana que puede actuar como quelante, disminuyendo las concentraciones de mercurio en el cuerpo humano. Objetivo. Identificar los alimentos ricos en selenio potencialmente útiles para controlar los efectos de la exposición a mercurio entre afrocolombianos. Materiales y métodos. Se realizó un estudio transversal con 320 individuos de cinco municipios del departamento del Chocó. Se les preguntó sobre la frecuencia de consumo de alimentos ricos en selenio y su asociación con las concentraciones de mercurio en cabello fue estimada con regresión múltiple robusta. Resultados. La guayaba, la harina de trigo integral, las fresas, el hígado de vaca, la espinaca y el extracto de levadura fueron los alimentos de mayor consumo. Las nueces, la harina de trigo integral y el extracto de levadura fueron identificados en regresión múltiple robusta como alimentos por considerar en futuras intervenciones. Conclusiones. Se propone que el jugo de plátano, la piña colada, el sorbete de borojó (Borojoa patinoi), las cucas, el enyucado y la sábida de plátano primitivo maduro son elementos básicos para una intervención culturalmente aceptable.

Anthropometric Similarities and Differences in Children of Aymara and Non-Aymara Descent in Northern Chile: Implications for Health and Development / Similitudes y Diferencias Antropométricas en Niños de Etnia Aymara y Ascendencia No-Aymara en el Norte de Chile: Implicaciones para la Salud y el Desarrollo

SUMMARY: This study aims to assess the nutritional status of Aymara and non-Aymara children in Arica, comparing anthropometric measurements of boys and girls aged 4-10 to inform interventions for child health and development. We conducted a non-experimental, quantitative, cross-sectional study in Arica, Chile. The sample included 458 children, with equal representation of Aymara and non-Aymara children from diverse socioeconomic backgrounds. Trained research assistants collected anthropometric data using standardized techniques. IBM SPSS statistical software was used for data analysis, including Student's t-test and the Levene test. Both Aymara and non-Aymara children showed high prevalence of overweight and obesity. Boys had a meso-endomorph somatotype, while girls had an endomorph somatotype. Among 8-year-olds, non-Aymara children had a slightly higher mean body weight (35.87, SD 4.50) compared to Aymara children (32.27, SD 4.31), but the difference was not statistically significant (p>0.05). However, 10-year-old Aymara girls had a significantly higher mean body mass index (22.34, SD 4.21) than non-Aymara girls (20.10, SD 3.58) (p=0.05). Regarding body fat percentage, 10-year- old non-Aymara girls had a slightly higher mean (31.01, SD 5.64) than Aymara girls (26.12, SD 5.63), but the difference was not statistically significant (p>0.05). The study found high levels of overweight and obesity in children from northern Chile, increasing with age for both Aymara and non-Aymara groups. The somatotype patterns were consistent across both groups. Although the differences between Aymara and non-Aymara children were not statistically significant, the Aymara group showed slightly higher levels of overweight and obesity. Further research with a larger sample size is needed to confirm these results and identify potential trends. Efforts should focus on promoting healthy nutrition and physical activity to address the growing problem of overweight and obesity in this region.

Este estudio tiene como objetivo evaluar el estado nutricional de los niños Aymaras y no Aymaras en Arica, comparando las medidas antropométricas de niños y niñas de 4 a 10 años para informar las intervenciones para la salud y el desarrollo infantil. Realizamos un estudio no experimental, cuantitativo, de corte transversal en Arica, Chile. La muestra incluyó a 458 niños, con igual representación de niños Aymaras y no Aymaras de diversos estratos socioeconómicos. Asistentes de investigación capacitados recolectaron datos antropométricos utilizando técnicas estandarizadas. Se utilizó el software estadístico IBM SPSS para el análisis de datos, incluyendo la prueba t de Student y la prueba de Levene. Tanto los niños Aymaras como los no Aymaras presentaron una alta prevalencia de sobrepeso y obesidad. Los niños tenían un somatotipo meso-endomorfo, mientras que las niñas tenían un somatotipo endomorfo. Entre los niños de 8 años, los niños no Aymaras tenían un peso corporal medio ligeramente superior (35,87, DE 4,50) en comparación con los niños Aymaras (32,27, DE 4,31), pero la diferencia no fue estadísticamente significativa (p>0,05). Sin embargo, las niñas Aymaras de 10 años tenían un índice de masa corporal medio significativamente mayor (22,34, SD 4,21) que las niñas no Aymaras (20,10, SD 3,58) (p=0,05). En cuanto al porcentaje de grasa corporal, las niñas no Aymaras de 10 años tuvieron una media ligeramente superior (31,01, DE 5,64) que las niñas Aymaras (26,12, DE 5,63), pero la diferencia no fue estadísticamente significativa (p>0,05). El estudio encontró altos niveles de sobrepeso y obesidad en niños del norte de Chile, aumentando con la edad tanto para los grupos Aymaras como para los no Aymaras. Los patrones de somatotipo fueron consistentes en ambos grupos. Aunque las diferencias entre los niños Aymaras y no Aymaras no fueron estadísticamente significativas, el grupo Aymara mostró niveles ligeramente más altos de sobrepeso y obesidad. Se necesita más investigación con un tamaño de muestra más grande para confirmar estos resultados e identificar tendencias potenciales. Los esfuerzos deben centrarse en promover una nutrición saludable y la actividad física para abordar el creciente problema del sobrepeso y la obesidad en esta región.

Conceptualización y usos de las categorías etnia y raza en el análisis de salud para población afrocolombiana

Objetivo: El propósito del estudio fue analizar la conceptualización y el uso que se hace, desde el sector de la salud, de las categorías etnia y raza para esta población en Colombia. Metodología: Estudio de tipo cualitativo. El corpus estuvo constituido por el apartado "2.3. Marco estratégico intercultural con las comunidades negras, afrocolombianas, raizales y palenqueras" del capítulo 8 del Plan Decenal de Salud Pública 2022-2031 de Colombia y un texto en una revista médica. De los documentos seleccionados se analizaron puntos de vista y argumentos. Resultados: El estudio encontró que para la población afro en el sector salud hay, por lo menos, cuatro usos y conceptualizaciones de su etnia y raza: una considera esta como un determinante social, otra como un gradiente biológico, mientras los otros dos pueden ser complementarios, al considerar, la tercera, a la etnia afro como un hecho político, legal, que favorece un enfoque diferencial en salud; y la última, como una cultura con huella ancestral africana. Conclusión: En cuanto se considere la etnia y raza de los afrodescendientes como un gradiente biológico, se fortalecerán intervenciones individuales y biológicas; si, por el contrario, se asume un determinante social, se hará énfasis en aspectos que mejoren su calidad de vida, la afirmación de su ancestralidad en salud o el hecho político. Además, sin que se reconozcan las condiciones históricas y actuales de exclusión de esta población, no se podrá comprender e incidir en su situación de salud.

Objective: The objective of the study was to analyze the conceptualization and use (from the health sector) of the ethnicity and race variables for this population in Colombia. Methodology: This is a qualitative-type study. The corpus consisted of the section "2.3. Intercultural strategic framework with black, Afro-Colombian, Raizal and Palenquera communities" from chapter 8 of the Colombian Ten-Year Public Health Plan 2022-2031 and a text in a medical journal. Points of view and arguments were analyzed from the selected documents. Results: The study found that, for the Afro population in the health sector, there are at least four uses and conceptualizations of their ethnicity and race: one considers this as a social determinant, another as a biological gradient, while the other two may be complementary, when considering the third, the Afro ethnic group as a political, legal fact, which favors a differential approach in health; and the last one, as a culture with African ancestral traces Conclusion: As soon as the ethnicity and race of Afro-descendants is considered as a biological gradient, individual and biological interventions will be strengthened. If, on the contrary, a social determinant is assumed, the focus will be placed on aspects that improve their quality of life, the affirmation of their ancestry in health or the political fact. In addition, without acknowledging the historical and current conditions of exclusion of this population, it will not be possible to understand and influence their health situation.

Objetivo: O propósito do estudo foi analisar a conceptualização e o uso que se faz, desde o setor da saúde, das categorias etnia e raça para essa população na Colômbia. Metodologia: Estudo de tipo qualitativo. O corpus constituiu-se pelo parágrafo "2.3. Quadro estratégico intercultural com as comunidades negras, afro-colombianas, raizales e palenqueras" do capítulo 8 do Plano Decenal de Saúde Pública 2022-2031 da Colômbia e um texto em uma revista médica. Nos documentos selecionados foram analisados pontos de vista e argumentos. Resultados: O estudo encontrou que para a população afro no setor saúde há, pelo menos, quatro usos e conceptualizações de sua etnia e raça: um deles a considera como um determinante social; outro como um gradiente biológico; já os outros dois podem ser complementários, pois o terceiro considera a etnia afro como um fato político, legal, que favorece um enfoque diferencial em saúde; e, o último, como uma cultura com uma impronta ancestral africana. Conclusão: Sempre que a etnia e a raça dos afrodescendentes se considerem um gradiente biológico, serão fortalecidas intervenções individuais e biológicas; pelo contrário, se é compreendida como determinante social, haverá atenção especial em aspectos que melhorem sua qualidade de vida, a afirmação de sua ancestralidade em saúde ou o fato político. Além disso, sem o reconhecimento das condições históricas e atuais de exclusão dessa população, sua situação de saúde não poderá ser compreendida nem modificada.

Associação entre saúde bucal, variáveis sociais, culturais e de acesso em indivíduos de uma população quilombola / Association between oral health, social, cultural and access variables in individuals from a quilombola population

Avaliar as condições de saúde bucal e sua relação com os aspectos socioculturais e de acesso a serviços odontológicos em quilombolas do Município de Cachoeira (BA). Realizou-se um estudo transversal, examinando 128 indiíduos. A análise estatística foi conduzida através da distribuição das frequências das variáveis demográficas e socioeconômicas. O cálculo de associação entre as variáveis e os desfechos foi obtido pelas Razões de Prevalências e respectivos intervalos de confiança. Constatou-se que há significância estatística (IC 95%) entre a doença periodontal e dieta cariogênica, plantas medicinais e bochecho com chá ou enxaguante bucal, assim como existiu associação entre a cárie dentária e a dificuldade de acesso a serviços odontológicos, odontalgia e o edentulismo. A maior prevalência dos agravos bucais investigados foi em indivíduos adultos e predominantemente em mulheres, sendo que a maior parte dos indivíduos possuía apenas o ensino fundamental e renda inferior a um salário-mínimo.

To evaluate oral health conditions and their relationship with sociocultural aspects and access to dental services in quilombolas in the municipality of Cachoeira, Bahia. A cross-sectional study was carried out, examining 128 individuals. Statistical analysis was conducted through the frequency distribution of demographic and socioeconomic variables. The calculation of the association between variables and outcomes was obtained using Prevalence Ratios and respective confidence intervals. It was found that there is statistical significance (CI 95%) between periodontal disease and cariogenic diet, medicinal plants and mouthwash with tea or mouthwash, as well as an association between dental caries and difficulty in accessing dental services, toothache and edentulism. The highest prevalence of oral diseases investigated was in adult individuals and predominantly in women, and most individuals had only elementary education and income below the minimum wage.

Efecto de determinantes sociales en salud: racismo en enfermedad cardiovascular

La alta morbilidad y mortalidad por Enfermedad Cardiovascular (ECV), la reafirma como un problema de salud pública a nivel mundial; son bien conocidos los factores de riesgo cardiovascular clásicos como: Hipertension, diabetes, dislipidemia, tabaco. Y los no clásicos, como: Los determinantes sociales en salud (DSS) y el racismo; que juegan un rol fundamental. Mediante la presente revisión narrativa, se detalla literatura actualizada puntual, acerca de cómo DSS ejercen influencia y su fisiopatología en ECV. Se seleccionaron en el lapso de un año, 10 artículos que cumplieron criterios de inclusión cuya temática es: DSS, racismo y ECV. Concluye, que los DSS y el racismo juegan un papel de alta envergadura para la generación, evolución, y hasta desenlace fatal de las diferentes enfermedades cardiovasculares; cuya influencia empeoro por la pandemia COVID19.

The high morbidity and mortality from Cardiovascular Disease (CVD), reaffirms it as a public health problem worldwide; The classic cardiovascular risk factors are well known, such as: Hypertension, diabetes, dyslipidemia, tobacco. And the non-classical ones, such as: Social determinants of health (DSS) and racism; that play a fundamental role. Through the present narrative review, updated literature is detailed about how DSS exert influence and its pathophysiology in CVD. In the period of one year, 10 articles that met inclusion criteria whose theme is: DSS, racism and CVD were selected. It concludes that the DSS and racism play a major role for the generation, evolution, and even fatal outcome of different cardiovascular diseases; whose influence worsened by the COVID19 pandemic.

Psychometric Properties of Trilingual Versions of HBC-HBP HillBone Compliance to High Blood Pressure (9-Items) in Divergent Ethnic Groups of Older Adults in Iran

@#Introduction: The HBC-HBP Scale is the most common scale for measuring adherence to medication in the elderly with hypertension, its Persian version has never been tested in Iran. Methods: 281 older adults with hypertension were randomly selected from health care centers in Iran during the second half-year of 2019. The demographic questionnaire and Persian, Turkmen, and Kazak versions of HBC-HBP were completed by participants. The scale structure was evaluated using goodness of fit by Exploratory and Confirmatory Factor Analysis using IBM-SPSS v.26 and AMOS v.24. Results: The mean of CVI was 0.94, indicating good content validity for HBC-HBP. Exploratory Factor Analysis revealed two subscales for HBC-HBP, collectively explaining 70% of the adherence medication variance in three versions. All item loadings were “moderate” to “excellent”, ranging from 0.38 (Moderate) to 0.95(excellent). Confirmatory Factor Analysis indicated the goodness of fit for the HBC-HBP based on the trilingual version. A high goodness of fit was sown for Turkmen, Persian, and Kazak versions of HBC-HBP. (Chi-Square=8.213, 8.354, 8.210, RMSEA=0.016, 0.013, 0.010, GFI=0.90, 0.90, 0.91, CFI=0.91, 0.90, 0.91, and AGFI=0.90, 0.91, 0.90). Cronbach’s alpha was 0.90 for the whole scale (p<0.001). The optimal cut-off point that best distinguished between adherent and non-adherent patients was 26.5. Conclusion: Results showed the validity and reliability of the trilingual versions of the HBMA for measuring adherence medication in the elderly with hypertension.

Variables censales vinculadas al proceso de vacunación contra COVID-19 en Chile / Census variables linked to the vaccination process against COVID-19 in Chile

La pandemia por COVID-19 generó una crisis de salud pública sin precedentes a nivel mundial, provocando la muerte directa o indirecta de alrededor de 14,9 millones de personas en un período de 2 años. Ante esto, el desarrollo de vacunas para evitar la muerte, cuadros graves y cortar la cadena de propagación del virus, se estableció como prioridad mundial. El proceso de vacunación ha demostrado su efectividad, pero ha existido reticencia a vacunarse dentro de la población. El objetivo de la presente investigación fue analizar la relación de variables censales con respecto a la frecuencia de vacunación para la semana del 24 de mayo de 2021 en Chile. Para ello, se recurrió a datos secundarios del censo del 2017 y del Ministerio de Salud y, a través de una regresión lineal múltiple, se determinó que la escolaridad, la vivienda de residencia y la etnicidad son variables que impactan en la cantidad de personas vacunadas por comuna. Los hallazgos obtenidos aportan información relevante para la generación de políticas públicas(AU)

The COVID-19 pandemic generated an unprecedented public health crisis worldwide, which caused the direct or indirect death of about 14.9 million people in a period of two years. In view of this, the development of vaccines to prevent death and serious illnesses and to cut the chain of spread of the virus was established as a global priority. Although the vaccination process has demonstrated the effectiveness of vaccination, there has been reluctance within the population. Therefore, the objective of this research was to identify the relation of census variables with respect to the frequency of vaccination for the week of May 24, 2021 in Chile. For this purpose, secondary data from the 2017 Census and the Ministry of Health were used and, through a multiple linear regression, it was determined that schooling, residence dwelling and ethnicity are variables that impact the number of people vaccinated per commune. The findings obtained provide relevant information for the generation of public policies(AU)

El concepto de etnia en un país pluriétnico y multicultural: una representación desde un grupo de estudiantes de odontología / The concept of ethnicity in a multi-ethnic and multicultural country: a representation from a group of dental students

Objetivo: explorar el concepto de <<etnias>>, en un grupo de estudiantes de Odontología de una universidad privada. Métodos: Se realizó un estudio cualitativo con 11 estudiantes entre 18 y 21 años en una Facultad de Odontología de una Universidad de Bogotá, en el curso de Socio Humanística I. Se efectuó una entrevista semiestructurada a cada estudiante; se obtuvo el consentimiento informado, el estudio fue clasificado como sin riesgo. Se aplicó en una sesión una entrevista semiestructurada, organizada en forma de historia donde el estudiante se involucra al leer el relato y contestar los interrogantes a medida que transcurría la lectura, lo que sirvió como base para el análisis de contenido. Resultados: Se determinaron tres categorías a saber: concepto de etnia, grupos étnicos en Colombia y enfoque diferencial étnico en salud, encontrándose que la etnia para los estudiantes es el reconocimiento de multietnicidad y pluriculturalidad del país, acompañado de diversidad. Conclusión: Con relación al concepto de etnia, se resalta que para algunos de los encuestados hay una confusión con representar los grupos étnicos como: madres cabeza de hogar, desplazados y población LGBTI. Los estudiantes respondieron "Raizales, negritudes, indígenas, Rom, desplazados, adultez, vejez, niñez, LGTBI." Que, aunque tienen relación con el enfoque diferencial, no corresponden al interrogante planteado en la historia.

Objective: to explore the concept of ethnicity in a group of odontology students of a private university. Methods: A qualitative study was carried out with 11 students between 18 and 21 years of age in an odontology faculty of a university in Bogota, in the course of socio-humanistic I. A semi-structured interview was conducted with each student, aninformed consent was obtained, and the study was classified as risk-free. A semi-structured interview was applied in one session, organized in the form of a story where the student was involved by reading the story and answering the questions as the reading progressed, which served as a basis for the content analysis. Results: Three categories were determined: concept of ethnicity, ethnic groups in Colombia and ethnic differential approach in health, finding that ethnicity for students is the recognition of multiethnicity and multiculturalism of the country, accompanied by diversity. Conclusion: In relation to the concept of ethnicity, a highlight is that for some of the participants there is confusion with representing ethnic groups such as: single mothers, displaced people and LGBTI population. The students answered "Raizal, black people, indigenous people, Rom, displaced, adults, elders, children, LGTBI". Although they are related to the differential approach, they do not correspond to the question raised in the story.

Momentos clave en el camino hacia la equidad en salud en la Organización Panamericana de la Salud / Milestones on the road to health equity at the Pan American Health Organization / Momentos-chave no caminho rumo à equidade em saúde na Organização Pan-Americana da Saúde

RESUMEN Hoy en día la equidad es un objetivo central para la Organización Panamericana de la Salud (OPS). Este objetivo es el resultado de movimientos multidimensionales que tienen una historia y que sólo pueden comprenderse a la luz de las relaciones sociales que estructuran los procesos que llamamos de "salud". De una preocupación por el comercio marítimo a un interés por los determinantes sociales de la salud, la OPS ha fortalecido sus esfuerzos por poner en el centro de sus acciones la idea de la equidad en salud como fin último. Se ha pasado de una idea de salud enfocada en el individuo, a una idea de salud para todas las personas, que contemple las diferencias de ser y hacer en el mundo. Estos cambios han producido políticas, análisis y estudios donde el género y la diversidad cultural son ejes transversales que deben ser contemplados en toda planificación y ejecución de políticas de salud en la Región de las Américas. En este artículo se analizan momentos clave en el camino hacia la equidad en salud en la Región desde una perspectiva histórica.

ABSTRACT Equity has become a key objective for the Pan American Health Organization (PAHO). This is the result of multidimensional movements with a history that can only be understood in the light of social relations that structure the processes we refer to as "health". From an initial concern for maritime trade to a current interest in the social determinants of health, PAHO has strengthened its efforts to make the concept of health equity the ultimate goal of its actions. The idea of health focused on the individual has given way to the idea of health for all people, which considers the differences between being and doing in the world. These changes have produced policies, analyses, and studies in which gender and cultural diversity are cross-cutting themes that must be considered in all planning and implementation of health policies in the Region of the Americas. This article discusses milestones on the road to health equity in the Region from a historical perspective.

RESUMO Hoje, a equidade é um objetivo central para a Organização Pan-Americana da Saúde (OPAS). Esse objetivo é fruto de movimentos multidimensionais que têm uma história e que só podem ser compreendidos à luz das relações sociais que estruturam os processos que chamamos de "saúde". Da preocupação com o comércio marítimo ao interesse pelos determinantes sociais da saúde, a OPAS tem intensificado seus esforços para colocar no cerne de suas ações a ideia da equidade em saúde como objetivo final. Passou de uma ideia de saúde centrada no indivíduo a uma ideia de saúde para todas as pessoas, que contempla as diferenças entre o ser e o fazer no mundo. Essas mudanças produziram políticas, análises e estudos onde o gênero e a diversidade cultural são eixos transversais que devem ser considerados em todo planejamento e execução de políticas de saúde na Região das Américas. Este artigo analisa momentos-chave no caminho rumo à equidade em saúde na região, a partir de uma perspectiva histórica.

Persistent bilateral atypical femoral fractures in an antiresorptive-naïve Singaporean Chinese patient with Graves’ Disease / Journal of the ASEAN Federation of Endocrine Societies

@#Atypical femoral fractures (AFFs) are rare adverse effects of bisphosphonate therapy. We report an unusual case of bilateral diaphyseal AFFs in an antiresorptive-naïve Singaporean Chinese female with Graves’ disease. She presented with complete right AFF requiring surgical fixation, and persistent left incomplete AFF for over four years. Femoral bowing, varus femoral geometry, and ethnic influence likely contributed to the AFFs’ formation. This case may provide insights into the pathogenesis of AFFs in high-risk Asian populations.

Necesidad de apoyo psicológico y etnicidad en personas diagnosticadas con Esquizofrenia: La importancia del componente subjetivo en el abordaje del estigma internalizado / Need for psychological support and ethnicity in people diagnosed with Schizophrenia: The importance of the subjective component in addressing internalized stigma

Objetivo Comparar las características socio-demográficas, la calidad de vida, el malestar psicológico y los niveles de estigma internalizado en una muestra de pacientes con Esquizofrenia pertenecientes a la región de Arica y Parinacota que reciben tratamiento en el mismo sistema de salud mental. Método Participaron 209 pacientes con un diagnóstico de Esquizofrenia usuarios de los servicios públicos ambulatorios de salud mental. Resultados La pertenencia a la etnia Aymara no determinó diferencias en las características sociodemográficas. Por otra parte, el grupo de pacientes Aymara presentó mayores niveles de Alienación en la escala de Estigma Internalizado en comparación al grupo de pacientes No-Aymara. La necesidad de apoyo psicológico es convergente a los niveles de malestar psicológico, la calidad de vida y el estigma internalizado. Conclusiones Los hallazgos refuerzan la adecuada capacidad de los usuarios con Esquizofrenia para valorar sus necesidades de apoyo psicológico durante el tratamiento en función de sus niveles de calidad de vida y malestar psicológico.

Objective The aim of this study was to compare the socio-demographic characteristics, quality of life, psychological distress and levels of internalized stigma in a sample of patients with Schizophrenia belonging to the region of Arica and Parinacota who receive treatment in the same mental health system. Methods 209 patients with a diagnosis of schizophrenia, users of public outpatient mental health services, participated in the study. Results Aymara ethnicity did not determine differences in sociodemographic characteristics. On the other hand, the group of Aymara patients had higher levels of Alienation on the Internalized Stigma Scale compared to the group of Non-Aymara patients. Need for psychological support are convergent to levels of psychological distress, quality of life and internalized stigma. Conclusions The findings emphasize the adequate capacity of users with schizophrenia to assess their psychological support needs during treatment based on their levels of quality of life and psychological distress.

Saúde de populações da Amazônia: análise de produções de um programa de pós-graduação em enfermagem stricto sensu / Health of populations in the Amazon: analysis of productions of a stricto sensu postgraduate program in nursing / Salud de las poblaciones amazónicas: análisis de las producciones de un programa de posgrado en enfermería stricto sensu

Objetivo: caracterizar os resultados das produções acadêmicas de programas stricto sensu quanto à atenção à saúde de povos e comunidades tradicionais da Amazônia. Método: estudo descritivo, quantitativo, com base documental. A coleta foi realizada por meio do banco de dados da Coordenação de Aperfeiçoamento Pessoal de Nível Superior e repositórios abertos de uma Universidade Pública, a partir de um Programa de Pós-graduação em Enfermagem da região norte, no intervalo de 2013 a 2020. Resultados: o ano de 2020 foi o de maior número de publicações, com 13 no total, vinculadas à linha de pesquisa Políticas de Saúde no Cuidado de Enfermagem Amazônico com 36 trabalhos. Na disposição geográfica, o município de Belém contou 58 produções realizadas, e o descritor/palavra-chave mais utilizado foi Enfermagem, contido em 37 estudos. Considerações finais: a área de políticas de saúde revela maior dedicação aos estudos com populações tradicionais da Amazônia, ampliando a responsabilidade na continuidade dos estudos e envolvimento social.

Objective: to characterize the results of academic productions of stricto sensu programs as regards health care for traditional Amazon peoples and communities. Method: in this quantitative, descriptive, document-based study, data were collected using the Coordination for the Improvement of Higher Education Personnel database and open repositories of a public university, from a postgraduate program in Nursing in the North region, from 2013 to 2020. Results: 2020 was the year with the highest number of publications (13 in total), connected with the research line Health Policies in Nursing Care in the Amazon (36 studies). Geographically, 58 productions were from the municipality of Belém, and the descriptor/keyword most used was Nursing (in 37 studies). Final considerations: the health policy field displays greatest dedication to studies of traditional populations in the Amazon, and is taking increasing responsibility for continuing studies and social involvement.

Objetivo: caracterizar los resultados de las producciones académicas de programas stricto sensu sobre el cuidado de la salud de los pueblos y comunidades tradicionales de la Amazonía. Método: estudio descriptivo, cuantitativo, cuya base es documental. La recolección se realizó utilizando la base de datos de la Coordinación para el Perfeccionamiento del Personal de Educación Superior y repositorios abiertos de una Universidad Pública de un Programa de Posgrado en Enfermería de la región norte, desde 2013 hasta 2020. Resultados: 2020 fue el año con mayor número de publicaciones, - 13 en total -, vinculadas a la línea de investigación Políticas de Salud en la Atención de Enfermería en la Amazonía, con 36 trabajos. Desde el punto de vista geográfico, el municipio de Belém tuvo 58 producciones realizadas, y el descriptor/palabra clave más utilizado fue Enfermería, presente en 37 estudios. Consideraciones finales: el área de políticas de salud revela una mayor dedicación a los estudios sobre poblaciones tradicionales de la Amazonía, aumentando la responsabilidad por la continuidad de esos estudios y la participación social.

Ethnicity, Urbanization And Agricultural Growth In Benin

In order to promote agricultural growth and urbanization of rural areas, ethnicity poses many dysfunctions in land governance concerning the rules, processes and structures mediating decisions on access, use and control of land, as well as the technique of managing conflicting land decisions and interests. The objective of this paper is to analyze the effects of urbanization and ethnicity on agricultural growth in Benin. Using VAR modeling on data covering the period 1995-2019, the results show that agricultural population negatively affects agricultural growth and ethnicity positively and significantly affects agricultural growth. Thus, it would be very interesting to take into account the evolution of agricultural population and ethnicity in the design and implementation of reforms in the agricultural sector in Benin.

Cáncer de vesícula en colecistectomías de la región de Tarapacá. Análisis según pertenencia étnica / Prevalence of gallbladder cancer in a Northern Chilean region

BACKGROUND: Gallbladder Cancer (GBC) prevalence varies among countries, associated with different geographical and genetic factors. The Mapuche ethnicity (Ethnia mostly located between the VIII and X Chilean regions) stands out in Chile due to its high GBC prevalence. Aim: To estimate the GBC prevalence in patients undergoing cholecystectomy at a public hospital in the Northern region of Chile (Tarapaca), where other ethnical groups are common. MATERIAL AND METHODS: Pathological reports of 3270 patients (72% women) who underwent cholecystectomy between January 2016 and December 2019 were revised. Subsequently, the accreditation of ethnic belonging for each patient to one of the ten native communities in Chile was requested to the National Corporation for Native Communities Development (CONADI). RESULTS: According to the analysis of pathological reports, the global GBC prevalence was 0.3 %. The prevalence in Aymaras was 0.4% and 0% in Mapuches. The distribution of ethnic origins among analyzed patients was Aymara in 14.3, Mapuche in 2.7%, Diaguita in 1.7%, Quechua in 1.3%, Atacameña in 0.2%, and Colla in 0.2%. No specific ethnic origin was found in 79% of patients. Conclusions: There was a low GBC prevalence rate in Northern Chile and among the Aymara population.

Correlation of obesity profile and blood pressure among ethnic and immigrant young adult students in Gangtok, Sikkim

Background: Several studies support the influence of ethnicity on the relationship between body mass index (BMI) and risk factors for cardiovascular disease. Aim and Objectives: This study aims to investigate the difference in correlation between obesity profile and blood pressure (BP) between Sikkimese and immigrant students in Gangtok. Materials and Methods: A cross-sectional study was conducted in the Department of Physiology, Sikkim Manipal Institute of Medical Sciences, Sikkim, Gangtok. A total of 274 students aged 18–25 years were included in the study. The anthropometric parameters (Height, weight, BMI, and Waist Circumference [WC]), systolic and diastolic BP (DBP) of the ethnic and immigrant group, were recorded. Two-tail Students’ test was performed to compare two groups and Pearson product-moment correlation coefficient was used to measure the linear correlation. Results: Mean value of all variables-BMI, WC, Systolic BP (SBP), and DBP was higher in the immigrant group as compared to the ethnic group, but the differences were not statistically significant. Lower prevalence of general obesity, abdominal obesity, elevated BP., and hypertension was found among Sikkimese compared to non-Sikkimese young adults. A stronger positive correlation was found between BP and WC and between BP and BMI in immigrants compared to the ethnic group. Conclusion: Higher incidence of different cardiovascular risk factors in young immigrant adults as compared to the ethnic Sikkimese group in this study points toward ethnicity-dependent differences in the relationship between obesity profile and BP.