Association between time of residence and self-perception of distress, interpersonal relationships, and social role in Venezuelan immigrants in Lima, Peru 2018–19: mixed-methods study

Background: Immigrants arriving in a new country face changes that affect their social, employment, and migratory status. We carried out a mixed-methods study in the rapidly growing Venezuelan immigrant population in Lima, Peru. The objective was to determine whether there was an association between time in Peru and self-perception of symptom distress (SD), interpersonal relationships (IR), and social role (SR). Methods: The quantitative central component consisted of a cross-sectional study, surveying 152 participants using the Outcome Questionnaire 45.2 (OQ-45.2). The qualitative component, based on phenomenology, explored experiences and challenges during the migration process. Semi-structured in-depth interviews were conducted in 16 informants. Results: An association that was observed was the increase in the risk of clinically significant SR score with additional years of age. All informants mentioned having witnessed or experienced xenophobia in Peru. Every informant stated that significant labor differences existed between the countries. The most reported somatic symptoms were symptoms of anxiety and alterations of sleep. Additionally, no informant expressed a desire to remain in Peru long term. Conclusions: A minority of participants registered a clinically significant total score and in each of the three domains of SD, IR, and SR. No association between months in Lima and the self-perception of distress was found. However, this could be due to the short amount of time spent in Peru and any change in self-perception might only be perceived after years or decades spent in Peru. This study is one of the first to use mixed-methods to explore the mental health of the immigrant Venezuelan population.Revisión por pare

Linfoma hepático primario no Hodgkin de células T y B asociado a VEB: un reporte de caso

El linfoma hepático primario (LHP) es una forma rara de linfoma no Hodgkin que suele manifestarse clínicamente con dolor abdominal, pérdida de peso, hepatomegalia e ictericia, sin presencia de adenomegalias o invasión extrahepática. De todos lo linfomas este presenta una prevalencia 0.016%. La etiología no se encuentra bien definida, sin embargo, el LHP se ha reportado estar asociado al virus Epstein-Barr (VEB), el cual posee la capacidad promover el crecimiento de los linfocitos, mediante los mecanismos de expresión del antígeno nuclear de Epstein-Barr 1 (EBNA1), la proteína de membrana latente 1 (LMP1) y LMP2 que producen la proliferación de células B. Mientras que, la activación de citocinas proinflamatorias y expresión de genes latentes, conducen a la proliferación de células T. Presentamos el caso de una paciente de 68 años que acude por presentar pérdida de peso de 10 kg en un periodo de 3 meses, malestar general, dolor abdominal tipo cólico localizado en epigastrio y sensación de llenura precoz asociado a fiebre no cuantificada, episodios de náuseas, diarrea en múltiples ocasiones e ictericia en escleras en los últimos 5 días. Mediante biopsia, se identifica Linfoma no Hodgkin inmunofenotipo T y B.Primary liver lymphoma (LHP) is a rare form of non-Hodgkin lymphoma that usually manifests clinically with abdominal pain, weight loss, hepatomegaly and jaundice, without the presence of adenomegalies or extrahepatic invasion. Of all lymphomas, this has a prevalence of 0.016%. The etiology is not well defined, however LHP has been reported to be associated with the Epstein-Barr virus (EBV), which has the ability to promote lymphocyte growth, by means of the Epstein-Barr nuclear antigen expression mechanisms. 1 (EBNA1), the latent membrane protein 1 (LMP1) and LMP2 that produce B-cell proliferation. While, the activation of proinflammatory cytokines and latent gene expression, lead to the proliferation of T-cells. We present the case of a 68-year-old patient who presented with a 10 kg weight loss over a period of 3 months, malaise, abdominal cramps in the epigastrium and a feeling of early fullness associated with unquantified fever, nausea episodes, multiple diarrhea occasions and jaundice in scleras in the last 5 days. By biopsy, non-Hodgkin lymphoma immunophenotype T and B is identified

Climatic Changes, Water Systems, and Adaptation Challenges in Shawi Communities in the Peruvian Amazon

Climate change impacts on water systems have consequences for Indigenous communities. We documented climatic changes on water systems observed by Indigenous Shawi and resultant impacts on health and livelihoods, and explored adaptation options and challenges in partnership with two Indigenous Shawi communities in the Peruvian Amazon. Qualitative data were collected via PhotoVoice, interviews, focus group discussions, and transect walks, and analyzed using a constant comparative method and thematic analysis. Quantitative data were collected via a household survey and analyzed descriptively. Households observed seasonal weather changes over time (n = 50; 78%), which had already impacted their family and community (n = 43; 86%), such as more intense rainfall resulting in flooding (n = 29; 58%). Interviewees also described deforestation impacts on the nearby river, which were exacerbated by climate-related changes, including increased water temperatures (warmer weather, exacerbated by fewer trees for shading) and increased erosion and turbidity (increased rainfall, exacerbated by riverbank instability due to deforestation). No households reported community-level response plans for extreme weather events, and most did not expect government assistance when such events occurred. This study documents how Indigenous peoples are experiencing climatic impacts on water systems, and highlights how non-climatic drivers, such as deforestation, exacerbate climate change impacts on water systems and community livelihoods in the Peruvian Amazon

Achieving the Sustainable Development Goals: A Mixed Methods Study of Health-Related Water, Sanitation, and Hygiene (WASH) for Indigenous Shawi in the Peruvian Amazon

Sustainable Development Goal 6 (SDG-6) addresses poor water quality, inadequate sanitation, and improper hygiene, all of which negatively impact health and disproportionately impact Indigenous Peoples’ health. Understanding and responding to local contexts is critical to effectively improve water, sanitation, and hygiene (WASH); however, in-depth understanding of local knowledge, practices, and perceptions are often overlooked. As such, this study described the knowledge, practices, and perceptions of WASH held by residents of two Indigenous Shawi communities in the Peruvian Amazon. Quantitative data were collected via a cross-sectional survey and analyzed using descriptive statistics. Qualitative data were collected via interviews, PhotoVoice, focus group discussions, and participatory transect walks, and analyzed using a constant comparative approach to thematic analysis. Emergent themes included characterizing water sources, collection methods, and consumption patterns; knowledge, perceptions, and practices related to WASH; and knowledge and perceptions of health issues related to WASH. This study provides insight into the ongoing challenges related to WASH in Indigenous communities in the Peruvian Amazon and highlights the need to prioritize interventions that will advance WASH-related SDGs

Structural Determinants of Indigenous Health: A Photovoice Study in the Peruvian Amazon

Indigenous populations in the Americas carry a disproportionate burden of disease. Common to populations affected by health inequities is the exposure to structural factors—social, political, environmental and economic—that shape the risks for disease. We conducted a photovoice study in three Shipibo-Konibo indigenous villages in the Peruvian Amazon. Twenty-four indigenous participants consented to take part. The study found that Shipibo-Konibo villagers are exposed to a series of structural factors such as malfunctioning latrines, lack of garbage disposal systems, lack of health services, migration, and mixing with outsiders which they see as important determinants of their health. While primary health care is urgently needed among indigenous communities in this region, any public health intervention must take into account the structural forces that affect indigenous people\u27s health

Transformative learning for a sustainable and healthy future through ecosystem approaches to health: insights from 15 years of co-designed ecohealth teaching and learning experiences

This paper presents insights from the work of the Canadian Community of Practice in Ecosystem Approaches to Health (CoPEH-Canada) and 15 years (2008–2022) of land-based, transdisciplinary, learner-centred, transformative learning and training. We have oriented our learning approaches to Head, Hands, and Heart, which symbolise cognitive, psychomotor, and affective learning, respectively. Psychomotor and affective learning are necessary to grapple with and enact far-reaching structural changes (eg, decolonisation) needed to rekindle healthier, reciprocal relationships with nature and each other. We acknowledge that these approaches have been long understood by Indigenous colleagues and communities. We have developed a suite of teaching techniques and resources through an iterative and evolving pedagogy based on participatory approaches and operating reciprocal, research-pedagogical cycles; integrated different approaches and ways of knowing into our pedagogy; and built a networked Community of Practice for continued learning. Planetary health has become a dominant framing for health-ecosystem interactions. This Viewpoint underscores the depth of existing scholarship, collaboration, and pedagogical expertise in ecohealth teaching and learning that can inform planetary health education approaches.University of Northern British ColumbiaRevisión por pare