From colonial America to bicentennial America: two centuries of vicissitudes in the institutional care of mental patients.
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Archaeological and palaeogenomic data show that dogs were the only domestic animals introduced during the early peopling of the Americas. Hunter-gatherer groups spread quickly towards the south of the continent, but it is unclear when dogs reached Central and South America. To address this issue, we generated and analysed 70 complete mitochondrial genomes from archaeological and modern dogs ranging from Central Mexico to Central Chile and Argentina, revealing the dynamics of dog populations. Our results demonstrate that pre-contact Central and South American dogs are all assigned to a specific clade that diverged after dogs entered North America. Specifically, the divergence time between North, Central and South American dog clades is consistent with the spread of agriculture and the adoption of maize in South America between 7000 and 5000 years ago. An isolation-by-distance best characterizes how dogs expanded into South America. We identify the arrival of new lineages of dogs in post-contact South America, likely of European origin, and their legacy in modern village dogs. Interestingly, the pre-contact Mesoamerican maternal origin of the Chihuahua has persisted in some modern individuals.
OBJECTIVES: From the perspective of uniparental markers, the view of the human prehistoric settlement of America is that it resulted from a single main migration after the Last Glacial Maximum, following a long or short period of genetic isolation in Beringia. Ancient DNA and whole genome analyses have confirmed this view. My objective here is to demonstrate that humans entered America before the LGM and that the documented post-LGM expansions began in South instead of North America. METHODS: In this work, I have reanalyzed all publicly available mitochondrial DNA and Y-chromosome haplogroups in the American population using simple phylogenetic and phylogeographic methodologies. RESULTS: The arrival of the American settlers occurred more than 30,000 years ago, preceding the LGM. As genomic studies have uncovered, at least two Asian populations contributed to the ancestry of the immigrant population. Low population density and climatic deterioration led to a long period of demographic eclipse, during which small bands of hunter-gatherers made long journeys in search of favorable niches. After the LGM, the climate improved, and demographic expansions occurred in multiple independent centers. The founding and expansion ages of the uniparental haplogroups indicate that these centers were in South America, particularly the Colombian isthmus, the Andean region, the Southern Cone, and the Amazon. Subsequent dispersals occurred in North America, one involving mitochondrial haplogroups A2, C1, and D1, but not B2, and another, of lesser magnitude, represented by the expansion of haplogroups C4c and X2a. CONCLUSION: This work offers a previously unexplored model for the colonization of the Americas.
Suicide is a leading cause of death globally, with over 75 % of cases occurring in low- and middle-income countries (LMICs). Latin America, a severely underrepresented region in suicide research, has experienced a 6 % increase in its suicide rate from 2010 to 2016, contrasting with a global decline. In this commentary, we provide an overview of the epidemiological, social, and clinical factors influencing suicide in Latin America. We highlight the distinct trends in Latin America compared to other world regions, including the significant disparities in mental health care accessibility. Our review also considers the role of sociocultural factors such as strong family ties, traditional gender norms, and the impact of religiosity on stigma and care-seeking behaviors. Additionally, we address the lack of representation of Latin American populations in genetic studies on suicide, which hinders the identification of relevant biological markers and the development of tailored interventions. We call for increased research on the clinical, genetic, and social determinants of suicide in this region to better understand risk factors and ultimately inform suicide prevention strategies. Addressing this gap is critical for reducing suicide rates in Latin America.
Plasmodium vivax is the predominant malaria parasite in Latin America. Its colonization history in the region is rich and complex, and is still highly debated, especially about its origin(s). Our study employed cutting-edge population genomic techniques to analyze whole genome variation from 620 P. vivax isolates, including 107 newly sequenced samples from West Africa, Middle East, and Latin America. This sampling represents nearly all potential source populations worldwide currently available. Analyses of the genetic structure, diversity, ancestry, coalescent-based inferences, including demographic scenario testing using Approximate Bayesian Computation, have revealed a more complex evolutionary history than previously envisioned. Indeed, our analyses suggest that the current American P. vivax populations predominantly stemmed from a now-extinct European lineage, with the potential contribution also from unsampled populations, most likely of West African origin. We also found evidence that P. vivax arrived in Latin America in multiple waves, initially during early European contact and later through post-colonial human migration waves in the late 19th-century. This study provides a fresh perspective on P. vivax's intricate evolutionary journey and brings insights into the possible contribution of West African P. vivax populations to the colonization history of Latin America.
Rather than providing a comprehensive overview of the sexually transmitted disease (STD) picture in the Americas, this presentation contrasts the STD problem in Latin America and the Caribbean with the situation in both less developed and more developed regions of the world. It also points out three areas of opportunity for improving preventive and curative STD services, specifically: (1) more effective utilization of social security institutions in Latin America, (2) incorporation of STD services into primary health care programs, and (3) development of pilot projects in the smaller Caribbean territories. It is noted, in addition, that the more developed countries of the region are showing increased interest in sexually transmitted diseases. Among other things, the recruitment of a PAHO epidemiologist in venereal diseases on Jamaica--to assist in the development of a national STD program--opens up a new area for PAHO technical assistance which, if successful, may be extended elsewhere.
The production and control of biologicals sufficient to meet the needs of the countries in the Americas has been of basic concern to the Pan American Health Organization for many years. This is evidenced by the Ten-Year Health Plan for the Americas, drawn up in Santiago, Chile in 1972 by the Health Ministers of the Americas, in which the goal of making the Region self-sufficient in all of the essential immunizing agents within a ten-year period, was established. At present only Canada and the United States are more or less self-sufficient in this regard. All of the others are, to a greater or lesser degree, dependent on imports. In PAHO's present program the greatest emphasis is being placed on the development of effective control systems, particularly at the national level. The steps taken to achieve this goal and the progress to date are outlined.
BACKGROUND: Substance use and co-occurring mental health conditions are common among adolescents and young adults and represent an important clinical and public health concern in North America. Trauma exposure, psychiatric symptoms, and social adversity frequently co-occur with substance-related problems in this population. This systematic review aimed to synthesize evidence on prevalence patterns, associated clinical and psychosocial factors, and care-related implications described in the literature on adolescents and young adults with substance use and co-occurring mental health conditions. METHODS: This systematic review followed PRISMA guidelines and was preregistered in PROSPERO (CRD42024581685). A systematic search was conducted in MEDLINE (Ovid), Embase, PsycINFO, and Google Scholar. Eligible studies examined adolescents and young adults (≤ 25 years) in North America. A combination of subject headings, keywords, and synonyms for the concepts "adolescents," "young adults," "substance use disorders," and "co-occurring mental health conditions" was used. Of 1,882 records identified, 29 studies met the inclusion criteria. Given the heterogeneity of the literature, findings were synthesized narratively. RESULTS: The included studies showed heterogeneity in population, setting, denominator, and ascertainment method. Across the literature, depressive, anxiety-related, trauma-related, and externalizing mental health presentations were frequently reported alongside substance-related problems in adolescents and young adults. Trauma exposure, adverse childhood experiences, and broader social adversity were also commonly reported in association with substance-related problems across studies. Care-related implications were more limited and were largely derived as future directions mentioned across studies rather than direct evaluations of youth-specific service models. CONCLUSION: Co-occurring mental health and substance-related problems were frequently reported among adolescents and young adults in high-risk and service-engaged populations in North America. Trauma and social adversity were prominent across the reviewed literature, while direct evidence for evaluated, integrated, youth-specific care models remains limited. These findings support the relevance of developmentally appropriate, integrated, and trauma-informed approaches to care and highlight the need for further research directly evaluating improved service delivery models for this population. CLINICAL TRIAL NUMBER: Not applicable.
Malnutrition, an illness which can easily be prevented and cured with existing resources and technology, is perhaps the most widespread disease in Latin America. However, it is unrecognized as such, and those population groups that suffer most from it are most prone to have their sufferings unrecorded. Two factors contribute to this: (a) the inaccuracy and incomplete coverage of vital statistics, as reflected by underregistration of deaths, insufficient medical certification of registered deaths, and biases both among certifying physicians and in the International Classification of Diseases; and (b) low population coverage by the health care systems and thus by the statistics which they generate. These factors are related to the ideological bias of those statistical systems and to the concepts of causality which they use. Through a review and analysis of "ad hoc" studies on the frequency of malnutrition in Latin America and its incidence in relation to morbidity and mortality, an estimation is made of malnutrition-caused deaths, which would amount to almost one-fifth of deaths from all causes. As overall availability of food in Latin America is adequate, it is held that this continent ultimately has the level of malnutrition that it wishes to have.
The arthropod-borne encephalitides are an important cause of equine and human morbidity in the Americas. Between 1975 and 1978, 6970 human cases of arboviral encephalitis were reported in the United States of America; however, this represents only a fraction of the true incidence. St Louis encephalitis (4824 cases), California encephalitis (1035 cases), and western equine encephalitis (WEE, 947 cases) accounted for 98.5% of all reported infections. Approximately 1000-4000 cases of equine encephalitis occur annually in the United States, the majority due to WEE. In tropical America, important outbreaks of Venezuelan, eastern, and western equine encephalitis, and of Rocio encephalitis have occurred.In this article, epidemiological aspects of arboviral encephalitis outbreaks occurring within the past 5 years are reviewed. In addition, summaries of current research activities on the ecology and epidemiology of St Louis, western equine, Venezuelan equine, Rocio, and California encephalitis viruses are presented, and the problem of control of these infections is discussed.
The principal objective of this study was to determine ecological associations of vesicular stomatitis virus (VSV)- New Jersey and VSV-Indiana in rural Central America and Panama. Two types of information were linked: the results of neutralizing antibody tests performed on sera from 3,232 lifetime residents of 189 rural study communitities of Central America and Panama, and ecological characteristics of the study communities as determined from natural resource atlases. The major finding was that neutralizing antibody acquistion to VSV-New Jersey was greatest for persons living at elevations between 350 and 649 meters, with relatively open, dry vegetation and distinct seasonal alternation of dry and moist (not wet) ground conditions. Similar ecological associations were found for VSV-Indiana, except that the risk of infection was also high in moist environments with dense tree cover. The results suggest that VSV-New Jersey and VSV-Indiana have similar but not identical maintenance and transmission cycles and that basic maintenance cycles for both viruses may exist in dry, open habitats rather than in tropicla rain forest habitats as was previously assumed for VSV-Indiana.
Six cases of cutaneous myiasis occurred in three groups of visitors to Guatemala between February and May 1978. Attack rates ranged from 12% to 50%. Furuncular lesions were generally multiple and involved both exposed and usually unexposed areas of the body. Parasitic fly larvae recovered from two patients were identified as the botfly, Dermatobia hominis. Botfly infestation is endemic in areas of Central and South America and is acquired indirectly through the bite of carrier arthropods, including mosquitoes. Although reports of cases in North Americans visting endemic areas are rare, the condition is probably much more common in such persons than it is currently believed to be. A history of travel to Central or South America should suggest the diagnosis.
The microscopic nematode Caenorhabditis elegans stands unrivaled as a model for developmental biology, neurobiology, and genetics, but fundamental aspects of its ecology, biogeography, and natural history remain unknown. Leveraging recent findings that place its center of diversity in the cool, high-elevation forests of Hawaii, we performed an intensive survey of the Caenorhabditis fauna of Pohnpei, a high island in Micronesia that is home to the largest patch of high-elevation forest between Hawaii and East Asia. We found nine species of Caenorhabditis, five of them new, but not C. elegans. Most species were limited to the hot lowlands but three spanned the elevational range and one was found only in the cloudforest. Using the distribution of Caenorhabditis nematodes among habitat patches - individual rotting fruits or flowers - we parameterized simple models that capture key aspects of the population biology of these animals. We generated transcriptomes for the new species and inferred a phylogeny for 70 species of Caenorhabditis, based on 2955 genes. This phylogeny allowed us to perform the first quantitative biogeographic analysis for the group. Our analysis suggests that the deep ancestors of the Elegans Supergroup of species lived in the Americas, and that the Supergroup's subsequent diversification occurred in Remote Oceania. The ancestors of the Supergroup gave rise to a diverse Oceanian fauna and ultimately to multiple lineages that moved into Asia, Africa, Australasia, and back into the Americas. Though biogeographic inferences are limited by the lack of information from key regions of the southwest Pacific, the data are consistent with a model of trans-Pacific migration, with the islands of Oceania serving as sources rather than sinks for biodiversity.
Telenomus alsophilae, a parasite of the eggs of the geometrid Alsophila pometaria in North America, was introduced into Columbia, South America, for the biological control of a pest host in another genus, Oxydia trychiata. Successful results were obtained with this unorthodox procedure to control a forest insect.
In the Western Hemisphere, prior to 1950, there were few reliable data on the incidence, geographic distribution or population patterns of diseases of the nervous system. Impressions of prevalence were generally derived from the European literature and from a variety of case reports and relative frequencies based on clinic or hospital admissions or selected autopsy series. Since such data from different sources generally defy comparison, it has been necessary to develop data sources for defined populations to provide incidence and prevalence rates. Such an effort, initially concerned with multiple sclerosis, was launched in 1950 by NIH. International mortality statistics were also collected and analyzed and intensive population surveys in the United States and Canada were planned and carried out. In time, such efforts were extended to cover a wide variety of other chronic and subacute diseases of the nervous system, and support was provided by NIH and voluntary agencies for studies in many other countries. Independently, population studies were developed at various Universities and health care facilities in Latin America. ISSSTE in Mexico City provided a broad experience on multiple sclerosis, ALS, epilepsy, stroke and brain tumor; studies developed in the West Indies on Jamaican Neuropathy; and there were studies in several countries on cysticercosis, Chagas' disease and epilepsy. Also notable are recent studies in Guatemala and plans for geographic comparisons over the broad range of latitude in Chile. The advantages and limitations of mortality statistics will be discussed. The priorities in the selection of the disorders which were to be studied, the procedures which were developed, and the highlights of the results of such investigations will be presented. In addition to descriptive population surveys, case control comparisons and prospective studies are also being developed which seek to identify the risk factors or etiologic determinants that may account for the population pattern which have been observed.
A multivalent coral snake antivenin was prepared in horses immunized with a mixture of venoms from the species Micrurus nigrocinctus, M. mipartitus, and M. frontalis, following immunization procedures previously reported (2). Plasma from the horses was fractionated with ammonium sulfate. The antivenin produced was then tested against venoms from ten species. The neutralization titers obtained indicate it would be useful in treating bites received from most of the important coral snake species in North and South America, namely: M. fulvius, M. alleni, M. carinicaudus dumerilii, M. corallinus, M. frontalis, M. lemniscatus, M. mipartitus, M. nigrocinctus, and M. spixii. The authors note that appropriate cooperation by scientists in various countries would make production of this antivenin an easy matter, and that the product could conveniently be distributed via PAHO or other international agencies. They also note that the antivenin showed no significant neutralizing effect against M. surinamensis venom. This situation would appear to justify preparing a monovalent antivenin against M. surinamensis, or else including M. surinamensis venom in an immunization formula for a multivalent antidote.
A survey on rate of illness among 10 500 tourists returning from the tropics and a control group of 1300 from the United States and Canada was performed by a questionnaire completed during the flight back to Switzerland. Only 25% from southern destinations, but 53% from North America, were never incapacitated during their travels. The vast majority of the illnesses were of no consequence, as was reflected by a low rate for bed confinement of 4% and 1% respectively. The most frequent symptoms in the tropics were diarrhea in 34% (mostly of short duration and mild degree), constipation in 14%, upper respiratory illness in 12% and insomnia in 11%. There were significant differences according to sex, age and tropical experience. The influence on pre-existing diseases was assessed. 7% of the tourists returning from the tropics were sick in the course of the year following the journey.
Ease of performance, safety and effectiveness of laparoscopic sterilization techniques are evaluated for 8186 procedures (6995 interval, 680 postabortion and 511 postpartum) performed in Latin America from June 1972 through February 1978. The tubes were occluded via electrocoagulation or application of the spring-loaded clip or the tubal ring. Less than 1% of the procedures were declared technical failures (ie, those which were not completed as planned). For all the tubal occlusion techniques, interval patients had the lowest rate of surgical complications. Pregnancy rates were low for the electrocoagulation and for the tubal ring techniques; patients sterilized by the spring-loaded clip, however, had a significantly higher pregnancy rate.