Past experiences enhance the future. Health care providers gaining expertise in creative thinking, traditional medicine, spirituality, and cultural sensitivity is an essential requirement for 21st century health care. We must stay mindful that poverty, isolation, and rural living may create new forms of social exclusion because of lack of communication and rapidly changing technology. Conversely, sensory overload resulting from a faster paced lifestyle and rapid enhancements in technology may cause increased tension and stress. This article reviews successes that may offer the reader ideas on coping with the provision of health care services in such a volatile changing environment, while honoring tradition and cultural competency.
The pine-dominated forests of west-central Mexico are internationally recognized for their high biodiversity, and some areas are protected through various conservation measures including prohibition of human activity. In this region, however, there is evidence for human settlement dating back to ca. AD 1200. It is therefore unclear whether the present forest composition and structure are part of a successional stage following use by indigenous human populations during the past, or due to natural processes, such as climate. We present a study reconstructing the vegetation dynamics of pine-dominated forest over the past 4200 years using paleoecological techniques. Results from fossil pollen and charcoal indicate that, in this region, pine-dominated forests are the native vegetation type and not anthropogenically derived secondary succession. The predominant driving mechanism for the expansion of pine-dominated forest appears to be intervals of aridity and naturally induced burning. A close association is noted between pine abundance and longer-term climatic trends, including intervals of aridity between ca. 4200 and 2500, 1200 and 850, and 500 and 200 cal yr BP and shorter-term trends. Evident periodicity occurs in pine and Poaceae abundance every 80 years. These short-term quasi-periodic oscillations have been recorded in a number of lake and ocean sediments in Mexico and are thought to be linked to solar forcing resulting in drought cycles that occur at approximately the same time intervals.
Outbreaks of food-borne listeriosis have often involved strains of serotype 4b. Examination of multiple isolates from three different outbreaks revealed that ca. 11 to 29% of each epidemic population consisted of strains which were negative with the serotype-specific monoclonal antibody c74.22, lacked galactose from the teichoic acid of the cell wall, and were resistant to the serotype 4b-specific phage 2671.
Cites: Appl Environ Microbiol. 1999 Nov;65(11):4793-810543788
Cites: MMWR Morb Mortal Wkly Rep. 1999 Jan 8;47(51-52):1117-89921730
Cites: N Engl J Med. 1983 Jan 27;308(4):203-66401354
Cites: J Biochem. 1983 May;93(5):1401-96411698
Cites: N Engl J Med. 1985 Feb 14;312(7):404-73918263
Cites: J Biochem. 1986 Feb;99(2):315-273084460
Cites: N Engl J Med. 1988 Sep 29;319(13):823-83137471
Cites: JAMA. 1989 Mar 3;261(9):1313-202492614
Cites: Appl Environ Microbiol. 1991 Apr;57(4):969-751905523
An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house.
This study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program's target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded.
Findings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.
Cites: J Sex Res. 2002 Feb;39(1):58-6212476258
Cites: Midwifery. 2004 Sep;20(3):217-2515337277
Cites: Salud Publica Mex. 2004 Sep-Oct;46(5):388-9815521523
Cites: Soc Sci Med. 2005 Aug;61(4):785-9515950091
Cites: Lancet. 2006 Jun 3;367(9525):1859-6916753489
Abstract: As health care disparities become more evident in our multicultural nation, culture sensitive health research needs to be a priority in order for good health care to take place. This article will explore the literature related to acculturation stress and mental health disparities among the Mayan population. Literatures of similar but distinct groups are included due to the limited amount of research of the Mayan population. Using Leiniger's Transcultural nursing theory, these findings suggest that nurses have a large gap to fill to address the mental health disparities of specific cultural groups like the indigenous Maya, thereby satisfying their nursing obligations.
A common cause of hereditary thrombophilia is activated protein C resistance (APCR), and most cases result from factor V Leiden mutation. An APCR phenotype without association with factor V Leiden has been described. This transversal, observational, nonrandomized study evaluated these 2 phenomena in healthy indigenous and mestizo Mexican subjects (n = 4345), including 600 Mexican natives. No indigenous subjects had APCR, but 82 mestizo subjects did. After retesting, 50 subjects had a negative test. The remaining 32 subjects had factor V Leiden, giving a 0.85% prevalence of factor V Leiden in the mestizo Mexican population. Only 31% of APCR carriers had factor V Leiden. These results show a very low prevalence of APCR and factor V Leiden in Mexico. Except for factor V Leiden, there are no other mutations in the factor V gene responsible for the APCR phenotype. Acquired APCR is nearly twice as prevalent as the inherited variant.
The proportion of identifiable causes of familial thrombophilia has increased from 5-10% to 60-70% since the identification of activated protein C resistance (aPCR) in February 1993 by DahlbÃ¤ck et al. A mutation in the factor V gene (G-->A, 1691) leads to the so called Leiden mutation (R 506 Q) that produces a mutated factor V resistant to the catalytic action of activated protein C (aPC), yet normal in its procoagulant properties. This recently identified aPCR is in Nordic populations the most prevalent and well defined genetic defect associated with disease so far described. Its prevalence in the general population ranges from 0% to up to 15% and suggests that a positive genetic selection pressure has been involved. The aPCR phenotype can be assessed in vitro by measurement of the prolongation of the activated partial thromboplastin time in the presence of aPC, whereas the aPCR genotype is studied using polymerase chain reaction searching for the Arg to Gln mutation in the coagulation factor V gene. Some acquired conditions such as the presence of lupus anticoagulants, antiphospholipid antibodies, pregnancy, liver disease and contraceptives may lead into the aPCR phenotype. The aPCR search must be the initial step in the study of a patient with thrombophilia, either inherited or acquired aPCR together with protein C, protein S and antithrombin III explain 60 to 70% of cases of familial thrombophilia.
Given the high rates for substance use among women and men of childbearing age, perinatal and early childhood home-visiting programs serving tribal communities must consider how they will address substance-use problems among the families they support. In this study, we explored the approaches to identifying and addressing family-based substance-use problems that were implemented by nine home-visiting programs serving American Indian/Alaska Native (AI/AN) communities that are funded through the federal Tribal Maternal, Infant, and Early Childhood Home Visiting Program (Tribal MIECHV). These programs demonstrated a high awareness of substance-use problems and took concrete action to address them above and beyond that included in the home-visiting model they used. All nine programs reported that they provided substance-use preventive services and screened for substance-use problems. While all programs referred to substance-use treatment programs when needed, in six programs the home visitor provided substance-use services. Through Tribal MIECHV, the intense need for substance-use education, assessment, service delivery, and referral in many AI/AN communities is pushing the home-visiting field forward to address this increasingly critical issue for low-income families across the United States and the world.
To assess the adequacy and variability of the diet served to Tarahumara children in indigenous boarding schools.
Records of food and drinks served for meals, weighed daily, were obtained from Monday through Friday for 10 consecutive weeks in two selected boarding schools. Nutrient intake for Tuesdays, Wednesdays and Thursdays was calculated and analyzed for weeks 3, 5 and 7.
The number of food items used per week ranged from 33 to 46. The most frequently utilized items were cooking oil, fortified corn tortilla, milk, onion, sugar and beans. Total energy served per day fluctuated between 1309 and 2919 Kcal; proteins comprised 10.5 to 21.2% (45 to 127 g/day), carbohydrates 40.7 to 61.9% (145 to 433 g/day), and lipids 22.5 to 48.1% (45 to 125 g/day) of the total. Daily micronutrient content ranges were: iron 15-33 mg, calcium 686-1795 mg, zinc 8-19 mg, vitamin A 118-756 mcg, vitamin B(9) 42-212 mcg, and vitamin B(12) 0.8-5 mcg.
There was significant daily variability in the diet, which was hypercaloric due to the high lipid content, and yet insufficient in vitamins B(9), B(12) and A.