RESUMO
A sunken soft-spot or fontanel is a sign for dehydration in infants. Around the world, folk illnesses, such as caída de la mollera in some Latin American cultures, often incorporate this sign as a hallmark of illness, but may or may not incorporate re-hydration therapies in treatment strategies. This report describes a study of lay descriptions of causes, symptoms, and treatments for caída de la mollera in three diverse Latin American populations. A mixed-methods approach was used. Representative community-based samples were interviewed in rural Guatemala, Guadalajara, Mexico, and Edinburgh, Texas, with a 132 item questionnaire on the causes, susceptibility, symptoms, and therapies for caída de la mollera. Cultural consensus analysis was used to estimate community beliefs about caída. Interviews conducted in rural Guatemala (n = 60), urban Mexico (n = 62), and rural Texas on the Mexican border (n = 61) indicated consistency in thematic elements within and among these three diverse communities. The high degree of consistency in the illness explanatory models indicated shared beliefs about caída de la mollera in each of the communities and a core model shared across communities. However, an important aspect of the community beliefs was that rehydration therapies were not widely endorsed. The consistency in explanatory models in such diverse communities, as well as the high degree of recognition and experience with this illness, may facilitate communication between community members, and health care providers/public health intervention planners to increase use of rehydration therapies for caída de la mollera. Recommendations for culturally informed and respectful approaches to clinical communication are provided.
Assuntos
Desidratação/etnologia , Desidratação/terapia , Hidratação/métodos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispânico ou Latino/psicologia , Adulto , Desidratação/fisiopatologia , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Masculino , Medicina Tradicional , México/epidemiologia , População Rural , Texas/epidemiologia , População UrbanaRESUMO
PURPOSE: To describe the intake of water and all other fluids and to evaluate the proportion of adults exceeding the World Health Organisation (WHO) recommendations on energy intake from free sugar, solely from fluids. METHODS: A total of 16,276 adults (46 % men, mean age 39.8 years) were recruited in 13 countries from 3 continents. A 24-h fluid-specific record over 7 days was used for fluid assessment. RESULTS: In Spain, France, Turkey, Iran, Indonesia and China, fluid intake was characterised by a high contribution of water (47-78 %) to total fluid intake (TFI), with a mean water intake between 0.76 and 1.78 L/day, and a mean energy intake from fluids from 182 to 428 kcal/day. Between 11 and 49 % of adults exceeded the free sugar WHO recommendations, considering solely fluids. In Germany, UK, Poland and Japan, the largest contributors to TFI were hot beverages (28-50 %) and water (18-32 %). Mean energy intake from fluids ranged from 415 to 817 kcal/day, and 48-62 % of adults exceeded free sugar WHO recommendations. In Mexico, Brazil and Argentina, the contribution of juices and regular sugar beverages (28-41 %) was as important as the water contribution to TFI (17-39 %). Mean energy intake from fluids ranged 565-694 kcal/day, and 60-66 % of the adults exceeded the free sugar WHO recommendation. CONCLUSIONS: The highest volumes recorded in most of the countries were for water, mean energy intake from fluids was up to 694 kcal/day, and 66 % of adults exceeded the free sugar WHO recommendation solely by fluids. Actions to create an environment in favour of water consumption and reduce sugar intake from fluids therefore are warranted.
Assuntos
Bebidas , Dieta , Ingestão de Líquidos , Ingestão de Energia , Saúde Global , Política Nutricional , Cooperação do Paciente , Adulto , Ásia , Bebidas/análise , Estudos Transversais , Desidratação/etnologia , Desidratação/prevenção & controle , Dieta/efeitos adversos , Dieta/etnologia , Registros de Dieta , Sacarose Alimentar/administração & dosagem , Sacarose Alimentar/efeitos adversos , Ingestão de Líquidos/etnologia , Ingestão de Energia/etnologia , Europa (Continente) , Feminino , Saúde Global/etnologia , Humanos , Masculino , México , Avaliação Nutricional , Cooperação do Paciente/etnologia , Recomendações Nutricionais , América do Sul , Água/administração & dosagem , Água/análiseRESUMO
PURPOSE: To describe the intake of water and all other beverages in children and adolescents in 13 countries of three continents. METHODS: Data of 3611 children (4-9 years) and 8109 adolescents (10-17 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, stratified cluster sampling design was applied to randomly recruit schools classes. A quota method was applied in the other countries to randomly recruit participants. Details on the intake of all fluid types were obtained with a fluid-specific record over 7 consecutive days. RESULTS: In the total sample, the highest mean intakes were observed for water (738 ± 567 mL/day), followed by milk (212 ± 209 mL/day), regular soft beverages (RSB) (168 ± 290 mL/day) and juices (128 ± 228 mL/day). Patterns characterized by a high contribution of water, RSB or hot beverages to total fluid intake were identified among the countries with close geographical location. Adolescents had a significantly lower milk intake and higher intake of RSB and hot beverages than children in most countries. The most consistent gender difference observed was that in both age groups males reported a significantly higher RSB consumption than females. CONCLUSION: On average, water was the fluid consumed in the largest volume by children and adolescents, but the intake of the different fluid types varied substantially between countries. Since the RSB intake was as large, or even larger, than water intake in some countries, undertaking actions to improve fluid intake habits of children and adolescents are warranted.
Assuntos
Bebidas , Fenômenos Fisiológicos da Nutrição Infantil , Dieta , Ingestão de Líquidos , Saúde Global , Política Nutricional , Cooperação do Paciente , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente/etnologia , Ásia , Bebidas/análise , Criança , Fenômenos Fisiológicos da Nutrição Infantil/etnologia , Pré-Escolar , Estudos Transversais , Desidratação/etnologia , Desidratação/prevenção & controle , Dieta/efeitos adversos , Dieta/etnologia , Ingestão de Líquidos/etnologia , Europa (Continente) , Feminino , Saúde Global/etnologia , Humanos , Masculino , México , Avaliação Nutricional , Inquéritos Nutricionais , Cooperação do Paciente/etnologia , Recomendações Nutricionais , Caracteres Sexuais , América do SulRESUMO
Disciplines such as sociology and anthropology have showed that the experience of illness, is above all, a social product, that is, that social factors of different kinds play a central role in shaping individuals' subjectivity. This paper refers to the case of Ocuituco, a rural town of central Mexico. The article presents some of the results achieved through an interpretive sociological study of individuals' subjective experience of traditional illnesses such as susto, soul-loss, and fallen fontanelle. The aim is to analyze how Ocuituco's inhabitants attach meaning to, interpret, and experience these illnesses. The main point being made is that the subjective experience of traditional illnesses is shaped both by the cultural background of individuals, and by the sociological features of the setting where these individuals live. Data are interpreted in connection both to structural factors (poverty, medicalization, and patriarchy), and to the main traits that characterize individuals' view of their world: a sense of uncertainty, a sense of the unexpected as being normal, a sense of being oppressed, a familiarity with a patriarchal order. It is shown that both susto and fallen fontanelle are belief systems which allow individuals to interpret their circumstances and attach meaning to their problematic everyday life.