Desafios do processo gestacional de mulheres negras: uma revisão narrativa / Challenges in the gestational process of black women: a narrative review

Esta revisão narrativa procura discutir aspectos concernentes ao processo gestacional de mulheres negras, quais sejam: se existem diferenças de tratamento entre mulheres brancas e negras durante a gravidez e nos momentos do parto e pós-parto, como essas diferenças são influenciadas pelos aspectos fisiológicos de cada grupo étnico e como isso afeta as taxas de morbimortalidade. Para esta revisão, quatro bases de dados foram usadas (SciELO, LILACS, PubMed e MEDLINE) e 23 artigos foram lidos na íntegra, depois de selecionados por data de publicação, língua, país da pesquisa e análise dos títulos e resumos. Como principais resultados, os autores encontraram diferenças claras entre mulheres brancas e negras quanto ao acesso à saúde, sendo as negras mais propensas a usar os sistemas públicos e ter menos consultas pré-natal. Também foi observado que as mulheres negras reportaram maus-tratos mais vezes, tinham maiores chances de serem proibidas de ter um acompanhante durante o parto e recebiam menos anestesia para episiotomias. As características fisiológicas também foram apontadas várias vezes. Nesse sentido, altas taxas de anemia ferropriva e hipertensão durante a gravidez foram mais comuns entre as negras. Além disso, em se tratando de taxas de morbimortalidade, mulheres negras tinham uma chance consideravelmente maior de serem readmitidas pós-parto e maiores taxas de mortalidade, quando comparadas com mulheres brancas.(AU)

This review aims to discuss aspects related to the gestational process of black women, namely: if there is a difference in how black and white women are treated throughout pregnancy, partum and postpartum moments, how this difference is influenced by the physiological aspects of each ethnical group and how it affects their morbidity and mortality rates. For this review, four databases were used (SciELO, LILACS, PubMed and MEDLINE) and 23 articles were fully read, after being selected by publishing date, language, country of research, title and abstract analysis. The authors found as the main results clear differences between black women's and white women's access to health care, as black women are more likely to use public health care systems and have fewer prenatal appointments. It was also noticed that black women reported maltreatment more frequently, had a higher chance of being prohibited from keeping a companion during labor and suffering from less local anesthesia for episiotomy. The physiological characteristics were also pointed out several times, with high rates of iron deficiency anemia and hypertension during pregnancy being more common among black women. Moreover, when it comes to morbidity and mortality rates, black women had an extremely higher chance of being readmitted postpartum, and a higher mortality rate, when compared to white women.(AU)

Assessment of Prognostic Factors of Racial Disparities in Testicular Germ Cell Tumor Survival in the United States (1992-2015) / 生物医学与环境科学（英文）

Objective@#Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but histological type of the diagnosed cancer has not yet been thoroughly assessed.@*Methods@#The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.@*Results@#Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.@*Conclusion@#Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.

Self-reported Hearing Loss Associated with Frailty among Afro-Caribbeans / Pérdida de la audición autoreportada asociada con la fragilidad entre los afrocaribeños

ABSTRACT Objective: Data on ethnic differences in the relationship between hearing loss and frailty are sparse. We investigated the relationship between self-reported hearing loss and frailty in four ethnic groups. Methods: This was a cross-sectional study of a community-dwelling sample of African American, Afro-Caribbean, Hispanic, and European American individuals aged 60 years or older (n = 484). Participants had to be able to ambulate independently or with the help of a device, and had an age- and education-adjusted Mini-Mental State Examination score of > 23 to be enrolled. Self-reported hearing loss was measured by a single question: 'Is your hearing excellent, very good, good, fair or poor?'. Answers of excellent, very good and good were considered as 'no hearing loss', and answers of fair and poor as 'self-reported hearing loss'. Frailty was defined as reporting three or more of the following criteria: weight loss, weakness, exhaustion, slow walking speed, and low physical activity. Results: In unadjusted (odds ratio: 3.075; 95% confidence interval: 1.149, 8.233; p = 0.025) and adjusted (odds ratio: 7.509; 95% confidence interval: 1.797, 31.386; p = 0.006) models, self-reported hearing loss was associated with frailty in Afro-Caribbeans, but not in African Americans, Hispanics and European Americans. Out of the five frailty criteria, only exhaustion was significantly more common in the self-reported hearing loss group among Afro-Caribbeans. Conclusion: Self-reported hearing loss was associated with frailty among Afro-Caribbeans, and this association was largely due to the frailty criterion of exhaustion.

RESUMEN Objetivo: Los datos sobre las diferencias étnicas en la relación entre la pérdida auditiva y la fragilidad son escasos. Investigamos la relación entre la pérdida de la audición autoreportada y la fragilidad en cuatro grupos étnicos. Métodos: Se trató de un estudio transversal de una muestra de una comunidad de residentes afroamericanos, afrocaribeños, hispanos y euroamericanos de 60 años o más (n = 484). Para ser seleccionados, los participantes tenían que ser capaces de deambular independientemente o con la ayuda de un dispositivo, y tener una puntuación de >23 en el Mini Examen del Estado Mental ajustado a la edad y al nivel educacional. La pérdida de audición autoreportada fue medida con una sola pregunta: '¿Es tu audición excelente, muy buena, buena, satisfactoria, o pobre?'. Las respuestas de 'excelente', 'muy buena', y 'buena', se consideraron como 'sin pérdida de la audición', y las respuestas de 'satisfactoria' y 'pobre' como 'pérdida de la audición autoreportada'. La fragilidad se definió a partir de reportar tres o más de los siguientes criterios: pérdida de peso, debilidad, agotamiento, velocidad de marcha lenta, y baja actividad física. Resultados: En los modelos no ajustados (odds ratio: 3.075; 95% intervalo de confianza: 1.149, 8.233; p = 0.025) y ajustados (odds ratio: 7.509; 95% intervalo de confianza: 1.797, 31.386; p = 0.006), la pérdida de audición autoreportada se asoció con la fragilidad en los afrocaribeños, pero no en los afroamericanos, hispanos y euroamericanos. De los cinco criterios de fragilidad, sólo el agotamiento fue significativamente más común en el grupo de pérdida de la audición autoreportada entre afrocaribeños. Conclusión: La pérdida de audición autoreportada estuvo asociada con la fragilidad entre afrocaribeños, y esta asociación se debió en gran parte al criterio de agotamiento como aspecto de la fragilidad.

Topical ophthalmic antimicrobials: unfulfilled demands and possibility of new investments in Brazil and in the United States

In general, topical ophthalmic drug products, especially those used for treating infections, present low effectiveness because of various reasons, from unfavorable drug physicochemical properties to physiological protective mechanisms of the eye. The fact is such group of products holds room for improvement, which could mean the development of better drugs or dosage forms. To achieve this, the knowledge of market composition is essential. The present work studied and compared the antimicrobial ophthalmic markets of Brazil and of the United States (US). Official databank of Brazilian Health Regulatory Agency and of US Food and Drug Administration were assessed for registered antimicrobial topical ophthalmic drug products. Brazilian market has registered greater number of drug products (119) than the US (94), but the latter involves more variety of substances and dosage forms. In both countries, non-innovative products registered as solutions of antibacterials, especially fluoroquinolones and aminoglycosides lead the market. Despite the clinical demand, the US has only one group of antimycotics (polyenes) registered, while in Brazil, there is not any ophthalmic antimycotic product marketed. This study evidences there is not only space for development of newer drugs and formulations but also a demand for already existing technologies and products in both countries.

Project HOPE: American nurses in Brazil (1973) / Proyecto HOPE: actuación de enfermeras norteamericanas en Brasil (1973) / Projeto HOPE: atuação de enfermeiras norte-americanas no Brasil (1973)

ABSTRACT Objective: to describe the reality of nurses of Project HOPE and discuss the repercussion of their performance in relation to the reconfiguration of nursing in Alagoas State. Method: social-historical study, whose primary sources were documents filed in the Laboratory of Documentation and Research in History of Nursing, granted by this project; oral testimonies resulting from the transcription of interviews of US nurses and the VeNeta Masson's'logbook, coordinator nurse of the ship. The discussion of the data was based on Pierre Bourdieu's theory. The project was submitted to the Ethics Committee and approved by it. Results: The actions of the American nurses exposed the shortage of this type of professional in the area, as well as the precarious health conditions in the region. Conclusion: the symbolic capital of these nurses has contributed to the reconfiguration of the nursing field in Alagoas State.

RESUMEN Objetivo: describir las circunstancias de actuación de las enfermeras del proyecto HOPE y discutir las repercusiones de la actuación de esas enfermeras en relación a la reconfiguración de la enfermería del estado de Alagoas, Brasil. Método: el estudio histórico-social, cuyas fuentes primarias fueron documentos archivados en el Laboratorio de Documentación e Investigación en Historia de la Enfermería, documentos cedidos por el proyecto HOPE, testimonios orales resultantes de la transcripción de entrevistas de enfermeras norteamericanas y el diario de a bordo de la enfermera VeNeta Masson, coordinadora de enfermería del buque. La discusión de los datos tuvo como referencia la teoría de Pierre Bourdieu. El proyecto fue sometido al Comité de Ética y fue aprobado. Resultados: las acciones de las enfermeras norteamericanas expusieron la escasez de ese tipo de profesional en el área, así como las precarias condiciones de salud en la región. Conclusión: el capital simbólico de esas enfermeras contribuyó a la reconfiguración del campo de la enfermería en Alagoas.

RESUMO Objetivo: descrever as circusntâncias de atuação das enfermeiras do projeto HOPE e discutir as repercussões da atuação dessas enfermeiras em relação à reconfiguração da enfermagem alagoana. Método: estudo histórico-social, cujas fontes primárias foram documentos arquivados no Laboratório de Documentação e Pesquisa em História da Enfermagem, documentos cedidos pelo projeto HOPE, depoimentos orais resultantes da transcrição de entrevistas de enfermeiras norte-americanas e o diário de bordo da enfermeira VeNeta Masson, coordenadora de enfermagem do navio. A discussão dos dados teve como referencial a teoria de Pierre Bourdieu. O projeto foi submetido ao Comitê de Ética e foi aprovado. Resultados: as ações das enfermeiras norte-americanas expuseram a escassez desse tipo de profissional na área, bem como as precárias condições de saúde na região. Conclusão: o capital simbólico dessas enfermeiras contribuiu para a reconfiguração do campo da enfermagem em Alagoas.

Relações entre atividade física, corpo e imagem corporal entre universitários da Argentina, Brasil, Estados Unidos da América e França / Relation among physical activity, body and body image of college students from Argentina, Brazil, United States and France

Introdução: Ao corpo são atribuídos diversos significados e a imagem corporal é influenciada por múltiplos fatores. Jovens universitários constituem um grupo vulnerável aos ideais de aparência corporal, e podem buscá-los por meio de exercícios físicos, dietas, restrições alimentares e cirurgias plásticas, com consequências adversas. Objetivo: Avaliar a relação entre atividade física, relação com corpo e imagem corporal entre universitários, e verificar como estes construtos se relacionam e se diferenciam entre quatro países em ambos os sexos. Método: A amostra incluiu 1.695 universitários de ambos os sexos, da Argentina (n=304), Brasil (n=583), França (n=441) e EUA (n=367), que responderam a um questionário online com questões sociodemográficas, estado nutricional, atividade física, imagem corporal, cirurgia plástica e atitudes alimentares. Na avaliação do efeito do país, do sexo, da razão para exercício e do estado nutricional sobre as demais variáveis, utilizaram-se modelos lineares generalizados; enquanto a avaliação da associação de variáveis categóricas nominais foi feita por meio de teste de Qui-quadrado (X2) de Pearson. Resultados: A saúde foi apontada como principal razão para exercício entre argentinos (=40,2 por cento ; =52 por cento ), brasileiros (=36,4 por cento ; =29,1 por cento ) e estadunidenses ( = 52,1 por cento ; =48,8 por cento ) de ambos os sexos; entre os franceses, a saúde foi mais frequente para as mulheres (43,4 por cento ), e a diversão para os homens (38,3 por cento ). Independente do país, ser do sexo feminino determinou piores atitudes alimentares, como dietas (p<0,001), vômitos (p<0,001), e maior insatisfação corporal (p<0,001) mais de 80 por cento das mulheres e dos homens apresentaram insatisfação corporal: desejando formas corporais menores (=88,5 por cento ; =52,9 por cento ) ou maiores (=11,5 por cento ; =47,1 por cento ). Ser mulher também determinou maior escore para restrições alimentares (pior na Argentina, p<0,001) e maior preocupação com excesso de peso (pior no Brasil, p<0,05); enquanto ser do sexo masculino determinou desejar peso e imagem corporal maiores. O país foi determinante para a frequência semanal de atividade física, preocupação com a rotina de exercícios (maiores nos EUA, p<0,001), restrições e compulsões alimentares [maiores escores na Argentina (p<0,001) e na França (p<0,001), respectivamente]. No Brasil, houve maior possibilidade de aderir a uma cirurgia plástica (p<0,001), maior média de anos de vida que abria mão por um corpo ideal (p<0,05) e maior preocupação com a comida e a aparência (p<0,05). Discussão: Embora a saúde tenha sido a resposta mais frequente para se exercitar, verificaram-se atitudes disfuncionais para com a alimentação, o corpo e exercício. As atitudes alimentares foram piores entre as mulheres, enquanto a relação com o corpo/aparência e atividade física parece ser mais influenciada pelos países. Conclusão: Houve bastante semelhança quanto às atitudes alimentares disfuncionais e insatisfação corporal para os jovens dos quatro países a maior diferença foi o sexo. Já os significados e importância dados à atividade física e aparência corporal apresentaram mais diferenças culturais, sendo os estadunidenses os que mais valorizam a rotina de exercícios, e os brasileiros os que mais consideram realizar cirurgias plásticas Estes resultados evidenciam a importância de um olhar mais amplo por parte dos nutricionistas e profissionais de saúde quanto à alimentação, atividade física e ao corpo bem como considerar possíveis diferenças entre homens e mulheres, e entre culturas

Introduction: Different meanings are attributed to the body and body image is influenced by multiple factors. Young college students represent a vulnerable group to body appearance ideals, and this group tries to achieve these ideals through physical exercises, diets, food restrictions and plastic surgeries with adverse consequences. Objective: To evaluate the relationship between physical activity, body and body image of college students, and how they relate and differentiate themselves between four countries in both genders. Method: The sample included 1,695 college students, from both genders in Argentina (n=304), Brazil (n= 583), France (n=441) and USA (n=367), that answered to an online questionnaire composed by sociodemographic questions, nutritional status, physical activity data, body image, plastic surgery and eating attitudes. To evaluate the effect of country, gender, reason to exercise and nutritional status over other variables, generalized linear models were used, and the evaluation of categorical nominal variables associations were done by Pearson Chi-square Test (X2). Results: Health was mentioned as the main reason to exercise among Argentinean (=40,2 per cent ; =52 per cent ), Brazilians (=36,4 per cent ; =29,1 per cent ) and Americans ( = 52,1 per cent ; =48,8 per cent ) in both genders; among French, health was more frequent for women (43,4 per cent ), and , the reason fun for men (38,3 per cent ). Despite of the country, the female group showed worst eating attitudes as dieting (p<0,001), vomiting (p<0,001), and a higher body dissatisfaction (p<0,001) more than 80 per cent of woman and men were dissatisfied with their bodies: desired a smaller body size (=88,5 per cent ; =52,9 per cent ) or larger (=11,5 per cent ; =47,1 per cent ). Being a woman also determined greater score to food restriction (worst in Argentina, p<0,001) and more concerns about overweight (worst in Brazil, p<0,05); whereas being a male determined the desire to have a greater weight and larger body image. The country was determinant for the physical activity weekly frequency, concerns about exercises routine (greater in USA, p<0,001), food restriction and binge [greatest scores in Argentina (p<0,001) and France (p<0,001), respectively]. In Brazil, there was the higher adherence possibility to plastic surgery (p<0,001), the highest number of years of life that they are willing to give up for an ideal body (p<0,05) and higher concern about food and appearance (p<0,05). Discussion: Although health was the most frequent reason to exercise, there were also verified dysfunctional attitudes towards food, body and exercises. Eating attitudes were worse in women, whereas the relationship with body/appearance and physical activity seems more influenced by countries. Conclusion: There was considerable similarity regarding dysfunctional eating attitudes and body dissatisfaction among the students of the four countries the greatest was gender. The meaning and importance of physical activity and body appearance presented more cultural differences, the Americans were the ones who most valued the exercise routine, and Brazilians were the ones who most consider going under plastic surgeries. These results emphasize the importance of a deeper understanding to be considered by nutritionists and health professionals regarding eating, physical activity and body as well as to consider the possible differences between men and women and cultures

Factores de riesgo para la adquisición de VIH en mujeres hispanas de 50 años y más / Risk factors for HIV acquisition hmong Hispanic women 50 years and older living in South Florida

Las mujeres Hispanas de 50 años y más (MHC) son una minoría en Estados Unidos, presentan un elevado riesgo de adquirir VIH y son el grupo menos estudiado en lo que respecta a salud, características sociales y de comportamiento sexual. Objetivo: Investigar los factores que incrementan el riesgo de VIH en las MHC con el propósito de desarrollar o adaptar una intervención apropiada para la edad y la cultura de este grupo de mujeres. Metodología: Estudio descriptivo de corte transversal con una muestra de 50 MHC, sexualmente activas y que residían en Miami, Florida, Estados Unidos. Se utilizó un cuestionario estructurado administrado por entrevistadores entrenados y bilingües (inglés/español). Las participantes fueron reclutadas en diferentes lugares en el sur de Florida. Para el análisis de los datos se utilizó estadística descriptiva, tanto medidas de tendencia central como medidas de dispersión. Resultados: La edad promedio de las MHC fue de 55,7 +/- 6 años (rango 5 - 76 años). Todas las MHC estaban en la menopausia. Prevención del VIH: Las MHC reportaron niveles medios de conocimientos sobre VIH y comunicación con la pareja. En la muestra se reportó la presencia de síntomas depresivos, violencia en la pareja, actitudes negativas hacia las personas viviendo con VIH y baja percepción de riesgo de adquirir VIH. Las MHC mencionaron necesidades de aprendizaje en tópicos relacionados con prevención de VIH y cambios de la edad. Conclusión: Las MHC están a riesgo de adquirir VIH y tienen necesidades especiales en términos de educación sobre prevención de VIH.

Introduction: Hispanic women aged 50 and over (OHW) are a minority in the U.S. at high risk of acquiring HIV and the least studied group of population in relation to health, social characteristics and sexual behavior. Objective: To investigate the factors that increase HIV risk among OHW with the purpose of developing or adapting an intervention appropriate for their “age and culture”. Methodology: A cross-sectional descriptive study with a sample of 50 OHW, sexually active and who residing in Miami, Florida, U.S. A structured questionnaire was administered by trained bilingual interviewers (English/Spanish). Participants were recruited from different locations in South Florida. Data were analyzed using descriptive statistics, including central tendency and dispersion measures. Results: OHW’s mean age was 55.7 +/- 6 years old (range 50-76 years old). All the OHW were in the menopause. HIV Prevention: OHW reported average levels of HIV knowledge and partner communication. In the sample OHW reported depression symptoms, intimate partner violence, negative attitudes towards people living with HIV and low perceived risk of acquiring HIV. OHW mentioned learning needs in topics related to HIV prevention and age changes. Conclusion: OHW are at risk of acquiring HIV and they have special needs in terms of HIV prevention.

Relationships as risk for HIV infection: high risk sex, substance abuse, and violence among Hispanic men who have sex with men / Relaciones como riesgo de infección por VIH: sexo de alto riesgo, abuso de sustancias y violencia entre hombres hispánicos que tienen sexo con hombres

Los hombres que se involucran en actividades sexuales con hombres (HSH) experimentan una serie de disparidades de salud, incluyendo altas tasas de infección por VIH, que se relacionan a actividades sexuales riesgosas y múltiples parejas, y a comportamientos sexuales riesgosos. Sin embargo, se conoce muy poco acerca de las relaciones entre HSH hispanos y de los factores que contribuyen al riesgo dentro de estas relaciones. Objetivos: El propósito de este estudio es explorar mediante el uso de métodos cualitativos, los factores responsables del comportamiento sexual de alto riesgo dentro de las relaciones primarias entre HSH hispanos, Métodos: Se reclutaron veinte HSH hispanos de comunidades del sur de Florida, para participar en grupos focales grabados en audio. La información obtenida fue transcrita y analizada utilizando análisis de contenido. Se recolectó información hasta obtener un nivel de saturación. Resultados: Los participantes identificaron temas que contribuyen al riesgo: drogas/alcohol, sexo fuera de la relación, encubrimiento de infección por VIH, violencia, violencia sexual consensual y no consensual y ausencia de apoyo familiar. También describieron la relación entre riesgo sexual, uso de sustancias y violencia. Conclusiones: Los resultados de este estudio proporcionaron importantes implicaciones clínicas a los profesionales de salud que brindan cuidados a HSH hispanos.

Men who have sex with men (MSM) experience a number of health disparities including high rates of HIV, which are related to high risk sexual behaviors and multiple sexual partners, and also to high risk sexual behaviors. However, relatively little is known about relationships among Hispanic MSM, and about the factors that contribute to risk within these primary relationships. Aims: The purpose of this study is to use qualitative methods to explore the factors responsible for high risk sexual behavior within primary relationships among Hispanic MSM. Methods: Twenty Hispanic MSM were recruited from community sites in South Florida to participate in auditotaped focus groups. Data from the focus groups were transcribed and analyzed using content analysis. Data were collected until saturation was achieved. Results: Participants identified topics that contribute to risk: drugs/alcohol, outside sex, concealment of HIV infection, violence, consensual and non-consensual sexual violence, and absent family support. They also described the relationship of sexual risk, substance abuse, and violence. Conclusions: The results of the study provided some important clinical implications for clinicians providing care to Hispanic MSM. From the results of this study, directions for future research focused on the relationships of Hispanic MSM are evident.

Violencia de pareja en mujeres hispanas: implicancias para la investigación y la práctica / Intimate partner violence among Hispanic women: implications for research and practice

Las investigaciones sobre la violencia entre parejas sugieren que las mujeres hispanas están siendo afectadas desproporcionadamente por la ocurrencia y consecuencias de este problema de salud pública. El objetivo del presente artículo es dar a conocer el estado del arte en relación a la epidemiología, consecuencias y factores de riesgo para violencia de pareja (VP) entre mujeres hispanas, discutiendo las implicancias para la investigación y la práctica. Las investigaciones han demostrado una fuerte asociación del estatus socioeconómico, abuso de las drogas y el alcohol, la salud mental, aculturación, inmigración, comportamientos sexuales riesgosos e historia de abuso con la violencia entre parejas. Sin embargo, más estudios se deben llevar a cabo para identifi car otros factores de riesgos y de protección a poblaciones hispanas no clínicas. Mientras que el conocimiento sobre la etiología de la VP entre mujeres hispanas se expanda, enfermeras y otros profesionales de la salud deben desarrollar, implementar y evaluar estrategias culturalmente adecuadas para la prevención primaria y secundaria de la violencia entre pareja.

Research on intimate partner violence indicates that Hispanic women are disproportionately affected by the occurrence and consequences of this public health problem. The objective of this article is to review the state of the art regarding the epidemiology, consequences and risk factors for Partner violence IPV among Hispanic women, as well as discuss the implications these have for research and practice. Research has demonstrated a strong association between socioeconomic factors, drug and alcohol abuse, mental health, acculturation, immigration, risky sexual behaviors, history of abuse and IPV among community samples of Hispanics. As research elucidates the etiology of IPV among Hispanic women, Nurses and other health professionals should develop, implement and evaluate culturally appropriate strategies for the primary and secondary prevention of IPV.

Health domains and race in generic preference-based health-related quality of life instruments in the United States literature / Domínios de saúde e raça nas medidas genéricas de qualidade de vida associada à saúde na literatura dos Estados Unidos / Dominios de salud y raza en las medidas genéricas de calidad de vida, asociada a la salud, en la literatura de los Estados Unidos

Race differences in health have been extensively analyzed and documented in the literature, especially between African Americans or blacks and whites in the United States. Despite the vast literature in the area, the majority of studies that explore the relationship between race and health use outcomes such as self-rated health, mortality or morbidity, and disability, but very few use Health-Related Quality of Life (HRQoL) measures and their domains or dimensions. This narrative review aims to provide a better understanding of the relationship between race and health domains that are commonly used in preference-based HRQoL measures. We investigated the literature on race, physical health, mental health, pain and discomfort, cognition, neurologic spectrum domains, dexterity, ambulation, vitality and social functioning domains. We conducted a literature search and review using the key words race and the health domain of interest, using medical and social sciences databases, such as MEDLINE/Pubmed, Web of Science, and the Google Scholar portal.The majority of the studies identified in the literature show that African Americans or blacks in the United States tend to have lower scores than whites throughout a variety of health domains found in preference-based HRQoL measures. This review also emphasizes the scarcity of studies that investigate some health domains, such as social functioning, dexterity, vitality and neurologic spectrum domains, and therefore we identify the need for more studies focusing on race and measures that address such domains.

A literatura sobre raça nos Estados Unidos está repleta de estudos que documentam diferenças na saúde entre negros e brancos. Entretanto, a maioria dos trabalhos que exploram a relação entre raça e saúde utiliza medidas com saúde autorrelatada, mortalidade e morbidade, mas poucos empregam medidas de qualidade de vida relacionada à saúde e seus domínios específicos. Este artigo revisa a literatura sobre raça e qualidade de vida relacionada à saúde, especificamente examinando os domínios que constituem as principais medidas baseadas na teoria da utilidade: saúde física; saúde mental; dor e desconforto; cognição; domínios neurológicos; destreza; locomoção; vitalidade; e funcionamento social. Conduziu-se uma revisão da literatura usando as palavras-chave raça e o domínio da qualidade de vida de interesse nos Estados Unidos. Foram consultadas as bases de dados Medline/Pubmed, Web of Science e o portal Google Scholar. A maioria dos estudos sobre diversos domínios das medidas de qualidade de vida investigados sugere que negros têm pior qualidade de vida do que brancos nos Estados Unidos. A revisão salienta a escassez de estudos que exploram a relação entre raça e alguns domínios, como, por exemplo, funcionamento social, destreza, vitalidade e domínios de escopo neurológico, e, portanto, mostra a necessidade de que futuros estudos examinem a relação entre raça e estes domínios.

La literatura sobre raza en los Estados Unidos está repleta de estudios que documentan diferencias en la salud entre negros y blancos. No obstante, la mayoría de los trabajos que explotan la relación entre raza y salud utiliza medidas con salud autorrelatada, mortalidad y morbilidad, pero pocos emplean medidas de calidad de vida relacionada con la salud y sus dominios específicos. Este artículo revisa la literatura sobre raza y calidad de vida relacionada con la salud, específicamente, examinando los dominios que constituyen las principales medidas basadas en la teoría de la utilidad: salud física; salud mental; dolor y molestias; cognición; dominios neurológicos; agilidad; locomoción; vitalidad; y funcionamiento social. Se realizó una revisión de la literatura usando las palabras-clave raza y el dominio de la calidad de vida de interés en los Estados Unidos. Se consultaron las bases de datos Medline/Pubmed, Web of Science y el portal Google Scholar. La mayoría de los estudios sobre diversos dominios de las medidas de calidad de vida investigados sugiere que los negros tienen peor calidad de vida que los blancos en los Estados Unidos. La revisión resalta la escasez de estudios que explotan la relación entre raza y algunos dominios, como, por ejemplo, funcionamiento social, agilidad, vitalidad y dominios de objetivo neurológico, y, por tanto, muestra la necesidad de que futuros estudios examinen la relación entre raza y estos dominios.

The Relationship between the Optimistic Bias about Cancer and Cancer Preventive Behavior of the Korean, Chinese, American, and Japanese Adult Residing in Korea

PURPOSE: This study was conducted to provide basic data for developing education and health promotion programs for the prevention of cancer by identifying the relation between optimistic bias about cancer and cancer preventive behavior in Korean, Chinese, American, and Japanese residents in Korea. METHODS: Using a questionnaire administered by the researcher, data were collected from a convenience sample of 600, 19 to 64-yr-old male and female Korean, Chinese, American, and Japanese residents in Korea. Data was collected between February 6 and 28, 2009. RESULTS: Scores for optimistic bias about cancer by nationality were: Koreans, -1.03; Chinese, -0.43; Americans, -0.23; and Japanese, 0.05. The cancer preventive behavior scores were: Koreans, 43.17; Chinese, 71.84; Americans, 71.71; and Japanese, 73.97. Optimistic bias about cancer and cancer preventive behavior showed a significantly positive correlation in all participants: Koreans (r=.223, p=.006); Chinese (r=.178, p=.029); Americans (r=.225, p=.006); and Japanese (r=.402, p<.001). CONCLUSION: The greater the optimistic bias about cancer is, the lower the cancer preventive behavior. The findings suggest that nursing interventions are needed to reduce optimistic bias about cancer and to form a positive attitude towards cancer prevention because an optimistic bias about cancer adversely affects cancer preventive behavior.

Casos dos mestres traduzidos e comentados / Cases of teachers translated and commented

O presente artigo apresenta uma tradução, com comentários, de relatos de casos publicados pelos mestres homeopatas do passado. Neste caso trata-se de dois casos publicados na época de ouro da homeopatia norte-americana em The Medical Advance, em 1891. Trata-se de resgatar o saber de uma época quando se praticava uma homeopatia que lançou as bases da utilizada hoje e, ao mesmo tempo, ainda com fortes vínculos com o que se pode chamar, com alguma dose de certeza, de uma prática hahnemanniana clássica.

This article presents a commented translation of case reports published by homeopathic masters of the past. In this instance, the subject is two case reports published in the golden era of American homeopathy by The Medical Advance in 1891. The intention is to preserve the knowledge of a time when it was practiced the form of homeopathy that grounded the one practiced in our days and that, on the other hand, still had strong links to what may be rated as a classic Hahnemannian practice.

Secondhand smoke in the home and Pap testing among Vietnamese American women.

The purpose of this study was to report the prevalence of Vietnamese households with smokers and examine Papanicolau (Pap) testing among Vietnamese American women living in households with and without smokers. In 2002, we surveyed Vietnamese between 18 and 64 years of age from a population-based sample of randomly selected households in Seattle, Washington zip codes known to have a high density of Vietnamese residents. The response rate among eligible households was 82%, and our sample included 418 households. We used two measures of Pap testing: ever had a Pap test and had one in the last two years. Household smoking status was categorized as current smoker in the house vs. no current smoker in the house. Overall, 47% of Vietnamese American women lived with a current smoker in the household, 73% had ever received a Pap test, and 63% received one in the last two years. Pap testing behavior varied only slightly by household smoking status, and the findings were not statistically significant. With nearly half of Vietnamese women in our study currently living with smokers, future studies should examine the relationship between secondhand smoke at home and other health behaviors in Vietnamese American households.

Three Japanese encephalitis cases in Okinawa, Japan, 1991.

Since 1974, no Japanese encephalitis (JE) case had been reported on Okinawa island in either Okinawan people or US servicemen. In 1991, three US marines stationed on Okinawa island developed encephalitis symptoms. Neutralization (N) test and IgM-capture ELISA were carried out on the serial samples of serum and cerebrospinal fluid (CSF) taken from the patients. In each patient N test on both serum and CSF samples gave a significant rise in JE antibody titer in the comparison between the acute and convalescent phases, indicating that all the cases were infected with JE virus. The IgM-capture ELISA also showed a significant rise of antibody titer of the serum and CSF samples in the convalescent phase in patients 2 and 3, while in patient 1 a significant rise in IgM antibody was observed in the serum sample, but not in the CSF sample. None of the patients had been administered JE vaccine. This report underscores the importance of JE vaccination.

Adjustment of Korean-American physicians in Korea: aspect of personal satisfaction

This study was conducted to assess the psychosocial adjustment of Korean-American physicians in the aspect of personal satisfaction after returning to Korea. A questionnaire was mailed to 72 Korean-American physicians who were practicing medicine in Korea and forty physicians responded. These physicians, typically in their 50s, lived in America for 21-30 years before coming back to Korea. The most frequent motives for them to come back to Korea were giving back to their native country, longing for their native country, filial duty, and suggestions from their colleagues or professors to move back. Eighty percent of them were extremely satisfied or slightly satisfied with their work in Korea, and only 10% are extremely or slightly dissatisfied with their decision to return. Although most of them are content for the time being in Korea, only 12.5% have definite plans to stay in Korea after retirement. The variables that were most significantly related to personal satisfaction of returning to Korea were how well treated at work and how much satisfied with job rather than other factors such as motives for returning, duration of staying in America and in Korea, and family situation.

Al extremo norte del puente aéreo: las puertorriqueñas en los Estados Unidos / To the northernmost part of the airlift bridge: the Puerto Ricans in the United States

This article examines the available data on the health status of Puerto Rican women in the United States. Statistics on reproductive health, cancer and AIDS indicate that the health status of these women is lower than that of both their U.S. and island counterparts. Usually, the health of immigrants lies somewhere between that of the population of the country of origin, and that of the 'host' country. Puerto Rican women, however, deviate from this pattern. The health lag which U.S. Puerto Rican women are experiencing suggests that the social dislocation which accompanies migration has not diminished over time. Puerto Rican women in the U.S., on the contrary, seem to have lost protective factors that shielded them from certain risks without acquiring the monetary, psycological, and information resources which would allow them to adopt preventive measures and make a more effective use of the existing health services

Helicobacter Pylori y patología gastroduodenal en la República de Panamá / Helicobacter Pylori and gastroduodenal pathology in the República de Panamá

Se estudió prospectivamente la infección por Helicobacter pylori en 129 panameños y norteamericanos que tenían dispepsia crónica. Se correlacionó con la patología gastroduodenal diagnosticada por endoscopía e histología. Se comparó la utilidad de la prueba rápida de la urea con el método de cultivo. La infección por H. pylori aumentó con la edad. En menores de 30 años : 37 (por ciento); de 31 a 40 años : 61 (por ciento); de 41 a 70 : 75 (por ciento). Fué más común en los panameños (70 por ciento) que en los norteamericanos (54 por ciento). Se encontró en 81 (por ciento), 75 (por ciento), 54 (por ciento) y 29 (por ciento) de pacientes con ulcera duodenal, gastritis crónica, duodenitis y en pacientes con endoscopía e histología normales, respectivamente. La prueba rápida de la urea sirvió para producir la positividad de la enfermedad en 98 (por ciento). Se discuten los resultados y se revisa la literatura