Latin Research Articles

Communicating educational innovation projects in Latin America mediated by the scaling of complex thinking: Contribution of the UNESCO-ICDE Chair in Mexico

The United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair in the open educational movement for Latin America aims to promote scientific, technological, entrepreneurial, and innovative development. In Mexico, face-to-face bootcamps occur every two years, where prototypes of high-value solutions for education are developed using design and active learning methodologies, with the aim of scaling complex thinking and sustainable development. In the 2023 edition, 94 academicians from 12 countries participated (Argentina, Bolivia, Chile, Colombia, Ecuador, Germany, Guatemala, Mexico, Peru, Spain, the Dominican Republic, and the United Kingdom). Experts from Tecnológico de Monterrey, the Open University, the University of Leeds, and Siemens Stiftung supervised the process. This article presents the prototyped proposals and the results of applying the Play2Train4C methodology, enabling participants to develop educational innovation projects under the paradigm of complex thinking. The results indicate that (1) the participants managed to prototype ten proposals validated by experts and (2) their perceptions of their systemic, critical, scientific, and innovative thinking (sub-competencies of complex thinking) improved by the end of the bootcamp. The conclusion was that the UNESCO Chair boosted solution-building skills for the complex problems arising in Latin America and enabled key agents in education to improve their complex thinking skills for quality education, as promulgated by sustainable development goal 4.

Is It Possible to Decolonize the Field of Physical Activity and Health?

Is it possible to decolonize the field of physical activity and health? Decoloniality presupposes a body-geopolitical location, such as in the Brazilian and Latin American context, where it is crucial to use social identity lenses related to race, gender, sexuality, and other social markers that affect the body. Understanding health and physical activity from a decolonial perspective would bring the oppressions that connect capitalism, patriarchy, and racism to the center of the discussion. For a "physical activity other," we challenged the general recommendation of physical activity in the 4 domains. Physical activity should be understood as an end in itself, as a right, and as human development. Approaches that advocate physical activity at work, at home, and while commuting use other human activities to relate these domains to health without considering the inequalities and oppressions that constitute them in most parts of the world. Is it fair to apply "global recommendations" for physical activity to scenarios such as Brazil and Latin America, using models that are inappropriate to the context and history of these places, people, and cultures? Perhaps it is time to socially reorient and reposition physical activity from a decolonial perspective. We need Black, Indigenous, Latino, African, and other people from the Global South to move the research agenda, recommendations, and policies on physical activity from "any" health to a fair health.

Factor structure of the Impact of Events Scale-Revised in Latin American young adults.

More than 550 million people speak Spanish and, yet, psychometric data on psychological instruments in Spanish lags. Given evidence of significant traumatic exposure and distress among Spanish speakers, the aim of the current study was to examine the factor structure of the Impact of Events Scale-Revised (IES-R), in a large sample of Spanish-speaking adults. Participants (n = 725) were university students living in Latin America (M = 21.02; SD = 3.12). Most were born in Mexico (77.6%) and the next largest subgroup was from Ecuador (18.9%). Respondents completed the 22-item IES-R. The IES-R mean score was 20.08 (SD = 21.34) and 26.6% of the sample met the cutoff score for clinically significant symptoms. Regarding factor structure, eight different factor structures that have demonstrated a good fit in the extant literature were examined. The one-factor model demonstrated an acceptable fit, χ²(209) = 839.13, p < .0001; root-mean-square error (RMSEA) = 0.06, 95% confidence interval (CI) [0.06, 0.07]; comparative fit index (CFI) = 0.91, Tucker-Lewis index (TLI) = 0.90. The two-factor model demonstrated good fit, χ²(208) = 746.70, p < .0001; RMSEA = 0.06, 95% CI [0.05, 0.06]; CFI = 0.92, TLI = 0.91, and nested model comparisons of the two-factor and one-factor models using the chi-square difference test supported the two-factor model. The most parsimonious of the multifactor models, a two-factor model with Avoidance symptoms as one factor and Intrusions and Hyperarousal combined into a second may be of greatest use for this particular version of the IES-R. The current research demonstrates strong psychometric support for Intrusion/Hyperarousal and Avoidance subscales when measuring traumatic stress in Spanish speakers and underscores the need for culturally and contextually sensitive assessment in this population, in which posttraumatic stress is prevalent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decolonizing nursing knowledge: Challenging Eurocentrism centering Global South voices

BackgroundExploring decolonization in nursing knowledge, particularly through Latin American nursologists, is crucial. Initially focused on underrecognized thought schools in Latin America and the concept of “Cuidado” versus Eurocentric paradigms, this paper extends the discussion on decolonization as potentially colonizing. PurposeThis paper examines the decolonization discourse in nursing reinforcing colonization, arguing that the nursing metaparadigm remains Eurocentric, neglecting Global South contributions. MethodsThe article critically discusses emerging theoretical ideas and situational theories from Latin America relevant to decolonizing nursing knowledge, providing analysis and proposing decolonization paths in nursing. DiscussionThe paper calls for genuine decolonization, urging Global North scholars to engage with indigenous, marginalized, and non-Western perspectives. It stresses the importance of acknowledging historical injustices, fostering cultural sensitivity, and revising nursing curricula for inclusivity and equity. ConclusionUltimately, the paper advocates for a transformative approach to nursing knowledge that challenges colonial legacies, promoting a more inclusive and equitable field.

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Body Mapping: A Decolonial Method Towards Intergenerational Healing

In this paper, I examine the embodied transformative memory of GuateMaya feminist group, GuateMaya Mujeres en Resistencia-Los Angeles (GMR-LA). Through a decolonial feminist perspective and feminist ethnographic approach, I built intimate relationships with the grassroots group in Los Angeles. GMR-LA comprises Guatemala’s 36-year (1960-1996) war survivors and women in the diaspora who continue to amplify the cultural memory of the disappeared. The article will delve into the concept of healing cartographies and the ethnographic work I employed in Los Angeles from 2019 to 2023. A particular method I used was body mapping to examine the embodied transformative memory of the groups and women who seek justice. Body mapping has been used with HIV-positive patients and migrant children. Latin American feminist decolonial geographers (Cabnal 2010; Zaragocin 2020, GeoBrujas 2021) are using the method of body mapping as a decolonial, counter-cartographic perspective that highlights Indigenous peoples’ lived experiences. I use the method to explore the relationships between the body, memory, and healing from intergenerational trauma. Informed by decolonial feminists, I aim to center the oral and embodied testimonios of the GuateMaya feminist group and be guided by a body-mind-spirit perspective to amplify the concerns, visions, and futures of GuateMaya feminist groups across the hemisphere.

An Ecofeminist Contribution to the Debates on the Neoextractivist Development Model in Latin America

This article presents a materialist ecofeminist critique of neoextractivism by highlighting its historical origins and elaborating its economic policy implications in Latin America. Three questions addressed are as follows: 1) How can materialist ecofeminism contribute to understanding the current dynamics of capitalist development in the Global South, 2) why (neo)extractivism hits women hardest, and 3) to what extent and how ecofeminist movements can shape a post-extractivist transition to a just and sustainable future. The article’s main argument is that exploitation and oppression in Latin America can be understood in terms of gender, race, and class and, therefore, require an intersectional analysis framework. Within this framework, post-extractivist alternatives in this region must incorporate an ecofeminist analysis to understand better how social expression systems (including sexism, white supremacy, and ecological crises) intersect and reinforce each other. In this framework, this study is intended to contribute to the growing literature and debate on the development and resistance dynamics of neoextractivism in Latin America, where long-standing racial and gender inequalities intersect with class inequalities.

Deep brain stimulation for Parkinson's disease: experience, benefits and limitations in a center in Latin America

Parkinson's disease is poorly studied in Colombia. It is pharmacologically managed, but for refractory cases, surgery is a therapeutic option, positively impacting on quality of life. To determine the impact of deep brain stimulation as management in the control of progression in patients with Parkinson's disease attended our institution between the years 2014 to 2020. Descriptive retrospective study, with patients collected between 2014 and 2020 undergoing deep brain stimulation surgery. The MDS-UPDRS (Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale) was applied in the pre- and postoperative period, and the results were compared. 21 patients were included and the UPDRS was applied, finding a decrease in scores in the postoperative period. One patient had an operative site infection. There was an improvement in the MDS-UPDRS score, with a low rate of complications. The procedure time was prolonged from the preoperative evaluation. Deep brain stimulation is the management of choice for refractory Parkinson's disease. The patients in this series showed improvement in their symptoms. Unfortunately, there are limitations to perform this procedure in Colombia, such as the delay in the authorization of the procedure.

FAOSTAT Food Value Chain Domain implementation: Input Output modelling and analytical applications

The recent increasing attention to the economic and policy analysis of the food systems from international fora, public institutions and academia calls for the availability of information and data capable of informing about the interrelations across economic sectors and within value chains. The international policy agenda is pushing for a more effective application of measures at country and regional level in line with the recommendations of the 2030 Agenda and its Sustainable Development Goals, for which more systematic and integrated data about economic, social and environmental impacts of policies are requested. The Food Value Chain Domain recently published in FAOSTAT responds to this call. Its data and information shed light on the distribution of final domestic food expenditures across industries (Agriculture, Food Processing, Wholesale, Retail, Accommodations and Food Services) and primary factors (e.g.: Labour, Gross Operating Surplus) on the relative food value chain. The FAOSTAT Domain offers therefore robust and granular information on both the farm and the post-farm gate component of the Food Value Chain. The applied Global Food Dollar methodology, that FAO is contributing to upscale at global level, is based on Leontief decomposition approach on the Input-Output tables. Moreover, whenever the Input-Output table are not available, it is now possible to impute them from Supply-Use tables by applying a conversion methodology, developed by FAO in compliance with European (EUROSTAT), United Nations (UNSD) and international statistical standards as the System of National Accounts. This allows to extend the analysis to several African, Asian, and Latin American countries that produce on regular basis only Supply and Use Tables, and not Industry by industry Input Output Tables. The potential time and data coverage of the methodology is therefore significantly expanded. The aim of this paper is to describe the conceptual framework of the conversion methodology of Supply-Use Tables into Input-Output Tables of the Global Food Dollar methodology, and the potential implementation scope of these methodologies. Preliminary analytical findings of the applied methodologies are presented as well. The new methods and data presented in this paper, being based on data compliant with the International Statistical Standards, as the System of National Accounts, and therefore comparable across countries, associated to larger data availability, have the potential to effectively support food policies at international, regional and national level, as well as contribute to a decision making in line with the 2030 Agenda.

Pension Reform Policy in Latin America: A Fuzzy-Set Qualitative Comparative Analysis

Latin American countries have been at the forefront of pension privatization and since 2008 they have also pioneered reform reversals. Previous studies have focused on single cases or a small number of them, given that pension reform is a complex phenomenon arising from the combination of different causes. Using fuzzy-set Qualitative Comparative Analysis (fsQCA), the article analyzes a set of 32 pension reform cases in eight countries from the early 1990s until 2021. It finds four different pathways that combine institutional, structural and policy legacy conditions. It demonstrates that fsQCA is a useful tool for broader comparative policy work.

Patch Test Results with the Latin American Baseline Series in a Colombian Population. 2016-2021.

Background: Contact dermatitis (CD) is one of the most prevalent skin diseases. It is commonly divided into irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD). Patch testing is a procedure used to support the diagnosis of ACD. This test should be interpreted along with the clinical history and morphology of the skin lesions to determine clinical relevance. Objective: To describe the sensitization patterns of patients undergoing patch testing with the Latin American baseline series. Methods: A single-center retrospective study was performed. For the study, patients older than 18 years with a clinical diagnosis of contact dermatitis, who underwent patch testing using the Latin American baseline series were considered. These tests took place at the Alma Mater Hospital of Antioquia between January 1, 2016, and December 31, 2021. Results: A total of 648 patients were included. Patch tests were positive in 63% of cases, with a mean age of 51.5 years. Around 36.6% had atopy-related diseases. The main occupation was housework (30.7%). The hands were the most affected area in the body (31%). The main allergens were nickel sulfate (34%), sodium tetrachloropalladate (24.2%), and thimerosal (8.0%). Fifteen allergens had a percentage below 1%. Hydrocortisone and budesonide did not yield positive results. Conclusion: Nickel sulfate was the most frequent allergen, and women were the most affected. The information gathered could be useful for adjusting the allergens that should be included in the regional baseline series, taking into account the frequency found.

Social determinants of health but not global genetic ancestry predict dementia prevalence in Latin America.

Leveraging the nonmonolithic structure of Latin America, which represents a large variability in social determinants of health (SDoH) and high levels of genetic admixture, we aim to evaluate the relative contributions of SDoH and genetic ancestry in predicting dementia prevalence in Latin American populations. Community-dwelling participants aged 65 and older (N=3808) from Cuba, Dominican Republic, Mexico, and Peru completed the 10/66 protocol assessments. Dementia was diagnosed using the cross-culturally validated 10/66 algorithm. Multivariate linear regression models adjusted for SDoH were used in the main analysis. This study used cross-sectional data from the 1066 population-based study. Individuals with higher proportions of Native American (>70%) and African American (>70%) ancestry were more likely to exhibit factors contributing to worse SDoH, such as lower educational levels (p<0.001), lower socioeconomic status (p<0.001), and higher frequency of vascular risk factors (p<0.001). After adjusting for measures of SDoH, there was no association between ancestry proportion and dementia probability, and ancestry proportions no longer significantly accounted for the variance in cognitive performance (African predominant p=0.31 [-0.19, 0.59] and Native predominant p=0.74 [-0.24, 0.33]). The findings suggest that social and environmental factors play a more crucial role than genetic ancestry in predicting dementia prevalence in Latin American populations. This underscores the need for public health strategies and policies that address these social determinants to effectively reduce dementia risk in these communities. Countries in Latin America express a large variability in social determinants of health and levels of admixture. After adjustment for downstream societal factors linked to SDoH, genetic ancestry shows no link to dementia. Population ancestry profiles alone do not influence cognitive performance. SDoH are key drivers of racial disparities in dementia and cognitive performance.

Patient-reported outcomes and treatment adherence in type 2 diabetes using natural language processing: Wave 8 of the Observational International Diabetes Management Practices Study.

We analyzed patient-reported outcomes of people with type 2 diabetes to better understand perceptions and experiences contributing to treatment adherence. In the ongoing International Diabetes Management Practices Study, we collected patient-reported outcomes data from structured questionnaires (chronic treatment acceptance questionnaire and Diabetes Self-Management Questionnaire) and free-text answers to open-ended questions to assess perceptions of treatment value and side-effects, as well as barriers to, and enablers for, adherence and self-management. Free-text answers were analyzed by natural language processing. In 2018-2020, we recruited 2,475 patients with type 2 diabetes (43.3% insulin-treated, glycated hemoglobin (HbA1c) 8.0 ± 1.8%; 30.9% with HbA1c <7%) from 13 countries across Africa, the Middle East, Europe, Latin America and Asia. Mean ± standard deviation scores of chronic treatment acceptance questionnaire (acceptance of medication, rated out of 100) and Diabetes Self-Management Questionnaire (self-management, rated out of 10) were 87.8 ± 24.5 and 3.3 ± 0.9, respectively. Based on free-text analysis and coded responses, one in three patients reported treatment non-adherence. Overall, although most patients accepted treatment values and side-effects, self-management was suboptimal. Treatment duration, regimen complexity and disruption of daily routines were major barriers to adherence, whereas habit formation was a key enabler. Treatment-adherent patients were older (60 ± 11.6 vs 55 ± 11.7 years, P < 0.001), and more likely to have longer disease duration (12 ± 8.6 vs 10 ± 7.7 years, P < 0.001), exposure to diabetes education (73.1% vs 67.8%, P < 0.05), lower HbA1c (7.9 ± 1.8% vs 8.3 ± 1.9%, P < 0.001) and attainment of HbA1c <7% (29.7% vs 23.3%, P < 0.01). Patient perceptions/experiences influence treatment adherence and self-management. Patient-centered education and support programs that consider patient-reported outcomes aimed at promoting empowerment and developing new routines might improve glycemic control.

BIOMX-DB: A web application for the BIOFACQUIM natural product database.

Natural product databases are an integral part of chemoinformatics and computer-aided drug design. Despite their pivotal role, a distinct scarcity of projects in Latin America, particularly in Mexico, provides accessible tools of this nature. Herein, we introduce BIOMX-DB, an open and freely accessible web-based database designed to address this gap. BIOMX-DB enhances the features of the existing Mexican natural product database, BIOFACQUIM, by incorporating advanced search, filtering, and download capabilities. The user-friendly interface of BIOMX-DB aims to provide an intuitive experience for researchers. For seamless access, BIOMX-DB is freely available at www.biomx-db.com.

Perspective on Emerging Micronutrient Deficiencies in Latin America and the Caribbean.

The moral imperative of public health systems is to maximize the health and welfare of the population to the extent possible. Constraints often include a lack of resources, political will, popular acceptance, or an acceptable safety margin. Major agencies have established iron, iodine, and vitamin A as the principal elements for micronutrients, with folate and zinc on the second plane. As the armamentarium of interventions to favor micronutrient nutrition, for example, preventive health measures, dietary improvement, forms of fortification, and nutrient supplements, is offered in public health policy. The utility of their merger with other nutrients, emergent nutrients, has been considered. The Latin America and Caribbean Region has unique characteristics. The scientific and epidemiology considerations for action in the Region's health concern on 4 emergent nutrient deficiencies of public health-vitamins D and E, essential fatty acids, and choline-are reviewed.

Undergraduate dissertation problems: an aggregate cross-sectional analysis from five Latin American universities

ABSTRACT Latin America may have higher attrition rates than previously assumed. Many students in Latin America do not graduate on time because they cannot complete the traditional undergraduate dissertation. This paper examines the factors contributing to delayed graduation for a context-specific variable: dissertation problems. We designed a questionnaire survey based on multi-item scales and surveyed 480 university students from Argentina, Bolivia, Chile, Colombia, and Mexico. Aggregate-cross-sectional data and multilevel structural equation modeling show that institutional assistance and supervision quality [personal problems] reduce [increase] dissertation problems. These results may enable university authorities to identify undergraduate students with dissertation problems and thus improve their strategies for reducing attrition rates.

Ataxia-telangiectasia in Latin America: clinical features, immunodeficiency, and mortality in a multicenter study.

Ataxia-telangiectasia (AT) is a rare genetic disorder leading to neurological defects, telangiectasias, and immunodeficiency. We aimed to study the clinical and immunological features of Latin American patients with AT and analyze factors associated with mortality. Referral centers from 9 Latin American countries participated in this retrospective cohort study, and 218 patients were included. Median (IQR) ages at symptom onset and diagnosis were 1.0 (1.0-2.0) and5.0 (3.0-8.0)years, respectively. Most patients presented recurrent airway infections, which was significantly associated with IgA deficiency. IgA deficiency was observed in 60.8% of patients and IgG deficiency in 28.6%. T- and B-lymphopenias were also present in most cases. Mean survival was 24.2years, and Kaplan-Meier 20-year-survival rate was 52.6%, with higher mortality associated with female gender and low IgG levels. These findings suggest that immunologic status should be investigated in all patients with AT.

Association between intrinsic capacity and weak muscle strength in naval medical center older adults

Purpose The purpose of this study was to determine the association between intrinsic capacity (IC) and dynapenia in older adults in outpatient clinics at the Naval Medical Center. Design/methodology/approach The study design was observational, analytical and retrospective. The study from which the collected data came was an observational analytical cohort, whose main objective was to describe the factors associated with frailty in older adults. The population comes from the Peruvian Naval Medical Center. This was a retrospective, observational, analytical study of the factors associated with frailty in older adults from the Naval Medical Center of Peru. Findings Data from 1667 participants was analyzed, 682 of them were female (40.9%) and 985 were male (50.1%); regarding age, most participants had 71–80 years (n = 761, 45.6%). Prevalence of the dynapenia was 34.5% (n = 576), and 80.08% (n = 1335) had an altered IC. In an adjusted model using Poisson regression, a prevalence ratio of 2.76 (95%, CI 2.06–3.70) was found. In conclusion, there is an association between IC and dynapenia in older adults. Originality/value In Latin America and Peru, there is limited information regarding this topic and tools for the evaluation of IC.

The HyperPed-COVID international registry: Impact of age of onset, disease presentation and geographical distribution on the final outcome of MIS-C

ObjectivesThe aim of the study was to establish an international multicenter registry to collect data on patients with Multisystem Inflammatory Syndrome in Children (MIS-C), in order to highlight a relationship between clinical presentation, age of onset and geographical distribution on the clinical outcome. Study designMulticenter retrospective study involving different international societies for rare immunological disorders.1009 patients diagnosed with MIS-C between March and September 2022, from 48 centers and 22 countries were collected. Five age groups (<1, 1–4, 5–11, 12–16, >16 years) and four geographic macro-areas, Western Europe, Central-Eastern Europe, Latin America, Asian-African resource-limited countries (LRC), were identified. ResultsTime to referral was significantly higher in LRC. Intensive anti-inflammatory treatment, including biologics, respiratory support and mechanic ventilation were more frequently used in older children and in European countries. The mortality rate was higher in very young children (<1 year), in older patients (>16 years of age) and in LRC. Multivariate analysis identified the residence in LRC, presence of severe cardiac involvement, renal hypertension, lymphopenia and non-use of heparin prophylaxis, as the factors most strongly associated with unfavorable outcomes. ConclusionsThe stratification of patients by age and geographic macro-area provided insights into the clinical presentation, treatment and outcome of MIS-C. The mortality and sequelae rates exhibited a correlation with the age and geographical areas. Patients admitted and treated in LRC displayed more severe outcomes, possibly due to delays in hospital admission and limited access to biologic drugs and to intensive care facilities.

Topical Ophthalmic Anesthetics for CornealAbrasions: Findings from a Cochrane SystematicReview and Meta-Analysis.

Despite potential benefit, outpatient use of topical ophthalmic anesthetics can result in poor healing, infection, scar, and blindness. An unbiased analysis of randomized controlled trials (RCTs) is needed to examine their effectiveness and safety compared with placebo or other treatments for corneal abrasions. Cochrane Central Register of Controlled Trials, MEDLINE, Embase.com, Latin American and Caribbean Health Sciences, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched on February 10, 2023, without restriction on language or publication date. Systematic review and meta-analysis of nine RCTs describing 314 participants with post-traumatic abrasions and 242 participants with post-surgical abrasions, with a median study length of 7 days (interquartile range, 7-14), show no evidence of a difference in pain control between anesthetics and placebo at 24 hours in post-trauma cases. Self-reported pain at 24 hours is reduced with anesthetics plus topical nonsteroid anti-inflammatory drug in post-surgical participants (mean difference [MD], -5.72 on a 10-point scale; 95% CI, -7.35 to -4.09; 1 RCT; 30 participants) and at 48 hours with anesthetics alone in post-trauma participants (MD, -5.68; 95% CI, -6.38 to -4.98; 1 RCT; 111 participants). Anesthetics are associated with 37% increased risk of non-healing defects (risk ratio, 1.37; 95% CI, 0.78 to 2.42; 3 RCTs; 221 post-trauma participants). All evidence is of very low certainty. Over 50% of trials have an overall high risk of bias. Available evidence is insufficient to support outpatient use of topical anesthetics for corneal abrasions with respect to pain, re-epithelialization, and complication risk.