Aristolochic Acid Exposure via Dermal Contact or Inhalation of Herbal Powders: Evidence of Occupational Exposure in Herbalists with Urothelial Cancer.

Emerging evidence showing urothelial cancer in herbalists is linked to aristolochic acid (AA) exposure; however, the exposure pathway remains unclear. Here, we show that dermal contact and inhalation of fine powders of AA-containing herbs are significant occupational AA exposure pathways for herbalists. We initiated the study by quantifying the amount of AA in the AA-containing powder deposited on gloves and face masks worn by the operators of an AA-containing herb grinding machine. Then, we measured the kinetics of dermal absorption and dissolution of AA from fine powders of AA-containing herbs into artificial sweat and surrogate lung fluid. Lastly, we quantified the mutagenic AA-DNA adduct levels formed in the kidneys of mice exposed to AA-containing fine powders through dermal contact. Our findings highlight an urgent occupational risk that should demand implementation of safety standards for herbalists exposed to AA-containing fine powders.

Traditional healers' perception on scabies causation and management in Ghana.

INTRODUCTION: Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. METHODS: A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. RESULTS: Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. CONCLUSION: The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.

Traditional healers' knowledge and infection control practices related to HIV in Bukavu City, Democratic Republic of the Congo.

BACKGROUND: Patients with HIV consult traditional healers (THs). These THs can both delay care for people living with HIV (PLHIV) and transmit HIV through poor infection control practices. The main objective of this study was to evaluate knowledge and practices of THs regarding HIV in Bukavu. METHODS: A cross-sectional study using quantitative approach was carried out among 71 THs in Bukavu City. The collected data included the following topics: personal and socio-demographic characteristics, HIV knowledge, and infection control practices. Descriptive statistics, independent-samples T-test or F-test, and multiple linear regression were used to analyze the data with a p-value < 0.05. RESULTS: The THs' mean age was 49.2 ± 11.2 years, and the majority were aged 40 to < 60 years. Males constituted 88.7% of THs with a male-to-female ratio of 7.9. In general, 47.9% of study participants had poor knowledge about HIV/AIDS infection, 45.1% of them had fair knowledge, and only 7.0% had good knowledge. Overall, 43.7% of THs had poor infection control practices, 52.1% of THs had fair practices, and only 4.2% of participants had good practices. Results of multiple linear regression analysis revealed that none of the personal and demographic variables studied were significant predictors of their knowledge about HIV/AIDS (p > 0.05). In terms of practices, two variables were significant predictors of infection control practices: living in Ibanda and receiving training in taking care of HIV/AIDS. CONCLUSION AND RECOMMENDATIONS: The study revealed that THs' knowledge about HIV infection was insufficient and that they had poor infection control practices. Formal standardized training on HIV infection should be organized for all THs so that they can always refer their patients to modern, reliable antiretroviral therapy (ART) clinics and reduce the risk of occupational exposure in their practices. Although PPE's assistance for THs is required in terms of protective measures, the province health authority must also oversee infection control procedures at THs' offices.

Practices and attitudes of herbalists regarding informed consent in Uganda: a qualitative study.

BACKGROUND: Informed consent (IC) is a fundamental principle in medical ethics that upholds respect for patient autonomy. Although widely applied in healthcare, its feasibility and implementation in herbal medicine have been underexplored. This study therefore aimed to explore the practices and attitudes of herbalists regarding informed consent. METHODS: To achieve these objectives, a qualitative cross-sectional study was conducted from June to December 2020. Twenty-one in-depth interviews with herbalists and four key informant interviews with leaders of the different traditional medicine organizations were conducted. The data were analyzed thematically using NVivo version 12 software. RESULTS: Sixteen of the twenty-one participants acquired oral herbal medicine knowledge from their relatives. Although a positive inclination toward obtaining IC was evident, the focus was on disclosing basic information. Discussions of alternative treatments and herbal specifics were less frequent. Disease management decisions often involve shared responsibility within families or societies. Documented IC procedures are rare among herbalists, who deem consent forms unnecessary, although they recognize the potential benefits of IC in fostering trust and professionalism. Challenges hindering IC implementation included regulatory gaps, inadequate skills, and the absence of mechanisms to protect the intellectual property rights of herbal medicine. CONCLUSION: This study illuminates how educational, cultural, familial, and regulatory factors influence herbalists' practices and attitudes toward informed consent.

The Influence of Culture on the Cause, Diagnosis and Treatment of Serious Mental Illness (Ufufunyana): Perspectives of Traditional Health Practitioners in the Harry Gwala District, KwaZulu-Natal.

Cultural beliefs influence the perceived cause, methods of diagnosis and treatment of mental illnesses. A qualitative study was conducted among traditional health practitioners (THPs) in the Harry Gwala District Municipality to further explore this influence. Purposive sampling assisted in the recruitment of 31 participants (9 males and 22 females). The four key themes this study investigated in relation to mental illness included its causes, methods of diagnosis, common symptoms observed and treatment approaches used by THPs, and the system of patient management. Culturally, mental illness was reported to be caused by witchcraft and an ancestral calling in this study. Mental illness was predominantly diagnosed by spiritual intervention which included divination through consultation with the ancestors, familial background, burning of incense which can also be part of communicating with the ancestors and through examining the patient. The common symptoms included aggression, hallucination and unresponsiveness. Prevalent modes of treatment included the use of a medicinal concoction and performing cultural rituals where ancestors and other spirits were assumed influential. The duration of the treatment process was dependent on guidance from the ancestors. Most causal aspects of mental illness from diagnosis to treatment seemed to be influenced by cultural beliefs and ancestors.

Experiences of traditional health practitioners in the management of female infertility in Harare urban areas: A qualitative study.

Female infertility is a health and social problem that traditional health practitioners (THPs) have been managing in African communities. This study explored the experiences of THPs in the management of female infertility, specifically focusing on their understanding, diagnosis, and treatment methods for female infertility. This was a qualitative study targeting six THPs in Harare urban areas registered with the Traditional Medical Practitioners Council (TMPC) in Zimbabwe. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed in the description of the study design, analysis and presentation of findings. The findings revealed that the etiology of female infertility was attributed to biomedical, lifestyle, spiritual, and male factors. Management of infertility depended on the type of THP. Spirit mediums relied on divination and dreams to diagnose and treat female infertility. Herbalists focused on the physical evidence provided by the client through history taking. THPs had a client referral system within their TMPC network. All THPs ultimately used medicinal plants for treating female infertility. THPs play an important role in the management of female infertility. Understanding their contributions to the management of female infertility provides an opportunity to obtain insight into their practices, thus identifying areas that responsible Ministries can use to strengthen traditional health care systems and ultimately improve reproductive health care for women in African communities.

L'infertilité féminine est un problème sanitaire et social que les tradipraticiens (PTS) gèrent dans les communautés africaines. Cette étude a exploré les expériences des THP dans la gestion de l'infertilité féminine, en se concentrant spécifiquement sur leur compréhension, leur diagnostic et leurs méthodes de traitement de l'infertilité féminine. Il s'agissait d'une étude qualitative ciblant six PTH des zones urbaines de Harare enregistrés auprès du Conseil des médecins traditionnels (TMPC) au Zimbabwe. Les lignes directrices COREQ (Consolidated Criteria for Reporting Qualitative Research) ont été suivies dans la description de la conception de l'étude, de l'analyse et de la présentation des résultats. Les résultats ont révélé que l'étiologie de l'infertilité féminine était attribuée à des facteurs biomédicaux, liés au mode de vie, spirituels et masculins. La prise en charge de l'infertilité dépendait du type de THP. Les médiums spirituels s'appuyaient sur la divination et les rêves pour diagnostiquer et traiter l'infertilité féminine. Les herboristes se sont concentrés sur les preuves matérielles fournies par le client grâce à l'anamnèse. Les THP disposaient d'un système de référencement des clients au sein de leur réseau TMPC. Tous les THP utilisaient finalement des plantes médicinales pour traiter l'infertilité féminine. Les THP jouent un rôle important dans la gestion de l'infertilité féminine. Comprendre leurs contributions à la gestion de l'infertilité féminine offre l'opportunité d'avoir un aperçu de leurs pratiques, identifiant ainsi les domaines que les ministères responsables peuvent utiliser pour renforcer les systèmes de santé traditionnels et, à terme, améliorer les soins de santé reproductive pour les femmes des communautés africaines.

Mental Health Literacy and Education of Complementary Medicine Practitioners: A Cross-Sectional Study.

An estimated 42% of Australians who consult complementary medicine (CM) practitioners have a mental health diagnosis. Preparedness of CM practitioners in managing such diagnoses is currently unknown. A cross-sectional survey of 257 CM practitioners who reported caring for people with a mental health diagnosis. Practitioners' mental health literacy, educational needs, and confidence in the assessment, management, and treatment of mental health-including suicide risk-were analysed. Most (59.1%) participants had no formal qualifications in mental health and 44.3% indicated they had not completed any training in psychological therapies. Only 20% were trained in mindfulness-based techniques or goal setting. Over 50% reported their undergraduate qualification contained insufficient mental health content to prepare them for clinical practice. Over one-half had attended continuing professional education on mental health. Practitioners reported greater confidence in assessing, managing, and treating mental wellbeing over complex mental health disorders and suicide risk. These findings uncovered a deficit in the CM practitioner's surveyed mental health education. As these CM practitioners are a primary point of contact for patients with mental health diagnoses, there is a critical need to expedite skills development in this workforce to support the delivery of safe and effective primary mental health care.

Assessment of traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia.

CONTEXT: Although pharmaceutical equipment and medical supplies play a vital role in the quality of traditional medicines, they have not received much attention from stakeholders and researchers nationally and internationally. OBJECTIVE: This study assesses traditional healers' knowledge and utilization of pharmaceutical equipment and medical supplies in the Amhara region, North West Ethiopia. MATERIALS AND METHODS: A quantitative cross-sectional study was conducted on 70 traditional healers. The data were collected using an interview-based questionnaire. The collected data were checked and entered into Statistical Package for Social Sciences version 25.0 for analysis. The results were presented as percentages. The association between socio-demographic characteristics and traditional healers' knowledge of pharmaceutical equipment and medical supplies was examined using Pearson's Chi-squares test. RESULTS: About 90% of traditional healers had information about pharmaceutical equipment and medical supplies, and currently 80% of them used different pharmaceutical equipment and medical supplies individually and in combination with traditional equipment. Although most traditional healers used different pharmaceutical equipment and medical supplies, only 13.3% of them used equipment and supplies a day. Only 15% of traditional healers continuously cleaned their equipment. None of the socio-demographic variables were significantly associated to the knowledge of pharmaceutical equipment and medical supplies. DISCUSSION AND CONCLUSIONS: Pharmaceutical equipment and medical supplies used by traditional healers was inconsistent, mainly associated with their habit of using self-prepared and home-available equipment. Moreover, the checkup status of compounding equipment was poor. As Traditional healers provide high-patient care services, emphasis should be given to improving their preparation and treatment strategies.

Religious and Medical Pluralism Among Traditional Healers in Johannesburg, South Africa.

Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted with 18 THPs in Johannesburg, South Africa between January and May, 2022. Interviews were transcribed and translated into English. Data were managed using NVivo 12 software and thematically analyzed. The majority of THPs interviewed indicated that initiation as a THP was almost always preceded by a sickness accompanied by dreams/visions that represented an "ancestral calling" to become a healer. Most THPs also trained as both sangomas-who healed according to traditional beliefs-and prophets-who healed according to Christian beliefs. This reflects a syncretic relationship between traditional African beliefs and Christianity. However, not all churches are accepting of traditional beliefs and subsequently these THPs are members only at non-Pentecostal AIC churches who blend both African and Christian practices. Similar to these forms of religious pluralism melding Christianity and traditional beliefs, many THPs also often practice medical pluralism, mixing Western treatments with traditional practices/medicines. THPs are able to adapt elements of Western and African beliefs into healing practices that span multiple religious and medical fields. Thus, collaborative and decentralized healthcare services may be highly acceptable among such a pluralistic community.

Beliefs and attitudes of traditional healers regarding epilepsy in Cameroon.

INTRODUCTION: People living with epilepsy suffer from stigmatization, overprotection, or exclusion, thus, part of these population in developing countries uses traditional medicine as a first resort. METHODS: We prospectively conducted a study to determine the knowledge, attitudes, and practices (KAP) of traditional healers (THs) concerning epilepsy. Over a 9-month period, we included 208 THs practicing in the Littoral, Center and West regions of Cameroon who agreed to participate in the study. The THs were interviewed using a standardized questionnaire. Data were analyzed using Epi Info version 7.2 software. RESULTS: Two-hundred and eight THs were recruited, with a mean age ± standard deviation (SD) of 49.9 ± 11.4 years, and 169 (81.2%) were male. Primary 77(37.0%) and secondary 67(32.2%) levels of education were the most represented, and most of the THs had more than 10 years of professional experience. One hundred and forty-one TH (68,7%) had poor knowledge about epilepsy. The independent factors associated with poor knowledge were female sex, Muslim religion, and marital status of cohabitation. One hundred and eighty-four THs (88.4%) had a good attitude and practices toward people with seizures. Factors independently associated with poor practices and attitude were rural residence, Muslim religion, and education level. CONCLUSION: Our result confirmed that THs had poor knowledge about epilepsy but good attitudes and practices about epilepsy. THs were in favor of future collaboration with modern medicine in the care of people living with epilepsy.

Utilisation of traditional healers among older people living with HIV in South Africa: a WHO SAGE well-being of older people study.

BACKGROUND: Within the African region, there are an estimated 8 million people living with HIV (PLHIV) in South Africa. Seeking healthcare services from traditional healers (TH) is one of the alternative and complementary approaches to HIV/AIDS treatment. Identifying the associated factors of TH utilisation among older PLHIV is crucial in developing healthcare interventions that cater to the unique needs of this vulnerable group. This study investigated the factors associated with TH utilisation among older PLHIV. METHODS: We studied 516 older PLHIV using data from the WHO SAGE Well-Being of Older People Study (2011-2013). Chi-square, bivariate and multivariate logistic regression were computed in STATA Version 14. The results were presented with both crude and adjusted odds ratio (AOR) and at 95% confidence interval (CI). RESULTS: Of the 516 participants, 15.89% utilised TH. The major reason for TH utilisation among older PLHIV was the perception of receiving better healthcare services from TH (51.2%) and the flexibility to pay with goods instead of money (14.6%). The factors associated with TH utilisation were age [AOR = 0.05; CI 0.01, 0.37], being hypertensive [AOR = 2.07; CI 1.04, 4.11], and having more than four servings of fruits [AOR = 10.64; CI 2.95, 38.34]. TH utilisation was significantly lower among those who visited the clinic once or twice [AOR = 0.17; CI 0.05, 0.63], three to six times [AOR = 0.16; CI 0.05, 0.56], and more than 6 times [AOR = 0.09; CI 0.03, 0.34] compared to those who had no clinic visits. CONCLUSION: In conclusion, a low proportion of TH utilisation was reported among older PLHIV in South Africa. TH utilisation is associated with age, hypertension status, frequency of clinic visits and fruit servings consumed. Our study suggests that being hypertensive was a motivating factor for older PLHIV to utilise TH. Therefore, it is imperative for the South African health department to integrate the services of TH into the mainstream health system to manage non-communicable diseases, particularly hypertension, among older PLHIV.

Traditional healers or bonesetters ("rebouteux") in France: A survey of their practice, profile, and customers.

BACKGROUND: In France, many people consult "bonesetters" for several medical reasons. Little is known about them. We aimed to investigate the practices of traditional healers in France as well as their profile and that of their customers. METHODS: This was a survey carried out in Metropolitan France. A 33-item questionnaire developed by a multidisciplinary group was sent to a sample of 148 traditional healers found on the Internet and by word of mouth. RESULTS: Of the 148 questionnaires sent, 89 (60.1 %) were returned and 67 (45.3 %) were analyzed: 51.5 % (n = 34) of respondents were men, and the mean (±standard deviation) age was 51.6 ±â€¯11.6 years. The respondents considered that they had received a gift of healing and were mainly magnetic healers (68.2 %). They became aware of this gift at a mean age of 19.9 ±â€¯14.1 years. The traditional healers practiced mainly in rural areas (54.5 %), at home (59.1 %), and used their hands to transmit energy (95.5 %). They advertised their practice mainly by word of mouth (89.4 %) and had a predominantly female clientele (78.1 %). Various diseases were treated, with the most frequent being subjective complaints (pain, stress, fatigue, insomnia) and dermatological complaints (eczema, accidental and post-herpes-zoster burns, psoriasis, and warts). Most respondents considered their activities to be complementary to conventional medicine, and 10.9 % considered them more effective. Some indicated that they did not consider themselves "healers" but rather "providers of relief". DISCUSSION: The results of this survey provide a better understanding of this network of local care that revolves around medicine.

Herbalists' explanations of infertility: The case of Northern and Southern Ghana.

In sub-Saharan Africa, traditional medical practitioners also referred to as herbalists, offer diagnostics and therapeutics for diverse medical conditions irrespective of the cause. Given their traditional role as healers and repository of knowledge about medicinal plants, spirituality, customs and religion, people use their services regardless of their location, education, or socio-economic backgrounds. The aim of the study is to explore herbalists´ views and explanations on infertility and women with infertility. Using an exploratory qualitative design, semi-structured interviews were conducted with 10 herbalists, 5 from the North-East region, 2 from Ashanti region and 3 from the Greater Accra region. Following thematic analysis, findings show that infertility has multiple causes - medical, natural, spiritual and lifestyle. Some herbalists stated that everyone was created to bear children while others refuted this notion. They shared the common consensus that not everyone can have children even though they may be medically and spiritually fit. The public should be advised on the need for periodic reproductive health checks. Also, there should be a conscious, concerted efforts to gradually dissociate unhealthy explanations of infertility from the actual empirically proven realities. This would empower society to rise above those entrenched beliefs, thereby reducing the stigma associated with infertility and women with infertility.

[Geographical views in traditional Chinese medicine].

Interdisciplinary integration is a major feature of current scientific and technological development and also an inherent demand of economic and social development. The classic works in traditional Chinese medicine(TCM), such as Huangdi's Internal Classic(Huang Di Nei Jing) and Shennong's Classic of Materia Medica(Shen Nong Ben Cao Jing), contain rich and distinctive geographic ideas about the origin of Chinese medicine and prescriptions. There are many TCM schools and the distribution of each school has obvious geographical characteristics. The difference in geographical space is a major factor causing the difference in schools. There have been records of drugs and places of origin in previous documents of the Han Dynasty. Many drug names in Shennong's Classic of Materia Medica begin with ancient country names or ancient place names, indicating that the compilers attached great importance to the relationship between drugs and places of origin. Doctors in the Tang Dynasty have realized that the quality of medicinal materials was closely related to the place of origin, and each place of origin had herbalists to support the harvesting. The national yearly harvested drugs were all distributed with the places of origin. In the Song Dynasty, there were more records about the origin of drugs than in the Tang Dynasty, and the drawings attached to the Materia Medica Arranged According to Pattern(Zheng Lei Ben Cao) were titled with the names of the origins. In the Jin and Yuan dynasties, the literature on Chinese materia medica inherited the relationship between the origin and quality of drugs and contained rich geographical views in the "medication method". In the Ming Dynasty, the literature on Chinese materia medica was the first to clearly label the Daodi origin, and recognized the differences in quality and application of drugs between different origins. In the Qing Dynasty, doctors realized that there were variations and differences in the origins of drugs used by doctors in different periods, and the problem of origin was one of the reasons for the ineffectiveness of drugs. During the period of the Republic of China, doctors also paid great attention to the relationship between the origin of drugs and the quality of drugs, and the changes in the origin of drugs. TCM and geography share a common philosophical foundation. To inherit and develop the experience of doctors in the past dynasties on the relationship between drugs and origins, it is necessary to combine "Chinese materia medica" with "geography" to carry out the research on the geography of Chinese medicine, conduct multidisciplinary integration, build a new way to inherit and innovate the essence of TCM, promote the connection between philosophy of Yi, medical science, pharmacology, and geography, better serve the production practice of TCM, and promote the solution of problems related to the development of the Chinese medicine industry.

Evidence-Based Comparison of Physical Therapists and Traditional Healers: Distinguishing Science from Quackery.

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Mental health literacy and its associated factors among traditional healers toward mental illness in Northeast, Ethiopia: A mixed approach study.

BACKGROUND: Currently, the biggest issue facing the entire world is mental health. According to the Ethiopian Ministry of Health, nearly one-fourth of the community is experiencing any of the mental illness categories. Most of the cases were treated in religious and traditional institutions, which the community most liked to be treated. However, there were very limited studies conducted to show the level of mental health literacy among traditional healers. AIMS: The study aimed to assess the level of mental health literacy and its associated factors among traditional healers toward mental illness found in Northeast, Ethiopia from September 1-30/2022. METHOD: A mixed approach cross-sectional study design was carried out on September 130, 2022, using simple random sampling with a total sample of 343. Pretested, structured questionnaires and face-to-face interviews were utilized for data collection. The level of Mental Health Literacy (MHL) was assessed using the 35 mental health literacy (35-MHLQ) scale. The semi-structured checklist was used for the in-depth interview and the FGD for the qualitative part. Data was entered using Epi-data version 4.6 and, then exported to SPSS version 26 for analysis. The association between outcome and independent variables was analyzed with bivariate and multivariable linear regression. P-values < 0.05 were considered statistically significant. Thematic analysis was used to analyze the qualitative data, and the findings were then referenced with the findings of the quantitative data. RESULTS: The findings of this study showed that the sample of traditional healers found in Dessie City scored a total mean of mental health literacy of 91.81 ± 10:53. Age (ß = -0.215, 95% CI (-0.233, -0.05), p = 0.003, informal educational status (ß = -5.378, 95% CI (-6.505, -0.350), p = 0.029, presence of relative with a mental disorder (ß = 6.030, 95% CI (0.073, 7.428),p = 0.046, getting information on mental illness (ß = 6.565, 95% CI (3.432, 8.680), p = <0.001, and mental health training (ß = 4.889, 95% CI (0.379, 6.455), p = 0.028 were variables significantly associated with mental health literacy. Traditional healers provide a variety of explanations for the causes of mental illness, including biological, psychological, and supernatural ones. CONCLUSION: The mean score of the Mental Health Literacy Scale (MHLS) is lower among traditional healers compared with other studies. Age, informal educational status, family history of mental illness, getting information on mental illness, and mental health training were significantly associated with mental health literacy. Therefore, different works to improve the levels of mental health literacy among traditional healers are essential.

Identifying small-molecules binding sites in RNA conformational ensembles with SHAMAN.

The rational targeting of RNA with small molecules is hampered by our still limited understanding of RNA structural and dynamic properties. Most in silico tools for binding site identification rely on static structures and therefore cannot face the challenges posed by the dynamic nature of RNA molecules. Here, we present SHAMAN, a computational technique to identify potential small-molecule binding sites in RNA structural ensembles. SHAMAN enables exploring the conformational landscape of RNA with atomistic molecular dynamics simulations and at the same time identifying RNA pockets in an efficient way with the aid of probes and enhanced-sampling techniques. In our benchmark composed of large, structured riboswitches as well as small, flexible viral RNAs, SHAMAN successfully identifies all the experimentally resolved pockets and ranks them among the most favorite probe hotspots. Overall, SHAMAN sets a solid foundation for future drug design efforts targeting RNA with small molecules, effectively addressing the long-standing challenges in the field.

Implementation and Evaluation of a Training Program for Traditional Healers to Improve Knowledge of Noma (Cancrum Oris) in Burkina Faso.

Noma (cancrum oris) is an orofacial gangrene affecting young children living in extreme poverty. The acute morbidity is high, and survivors suffer from physical and social sequelae. When diagnosed early, noma can be cured. Noma is especially prevalent in sub-Saharan Africa, where traditional medicine is the norm. The aim of this work was to provide 1-day training to traditional healers in Burkina Faso and to evaluate change in knowledge of noma across time. A sample of 78 healers who attended the training were asked to complete the same questionnaire before, immediately after, and 8 months after the training. A total of 66 healers completed the entire study. Before training, more than 40% of the participants did not know any of its key messages. Most of the key messages were acquired and still present after 8 months by a large proportion of the participants. Systematic intraoral examination was practiced by 7 (9.0%) of the traditional healers before training, and 43 (65.2%) reported doing so 8 months after training. The key messages aiming to improve early diagnosis as well as rapid and adequate treatment (the recognition of facilitating factors and the need to perform a systematic oral examination and to advise hospital transfer) have been well integrated. The study suggests that organizing a self-managed training program is feasible when done within an association, as was the case here, and owing to the willingness to collaborate shown by the traditional healers who participated in our study.

Collaboration between traditional health practitioners and biomedical health practitioners: Scoping review.

BACKGROUND:  Collaboration between traditional health practitioners (THPs) and biomedical health practitioners (BHPs) is highly recommended in catering for pluralistic healthcare users. Little is known about bidirectional collaborations at healthcare service provision level. AIM:  To map global evidence on collaboration attempts between THPs and BHPs between January 1978 and August 2023. METHOD:  We followed the Arksey and O'Malley framework in conducting this scoping review. Two reviewers independently screened articles for eligibility. A descriptive numerical and content analysis was performed on ATLAS.ti 22. A narrative summary of the findings was reported using the PRISMAScR guideline. RESULTS:  Of the 8404 screened studies, 10 studies from 12 articles were included in the final review. Studies came from America (n = 5), Africa (n = 2), China (n = 2) and New Zealand (n = 1). Eight studies reported case studies of bidirectional collaboration programmes, while two studies reported on experimental research. All collaborations occurred within biomedical healthcare facilities. Collaboration often entailed activities such as relationship building, training of all practitioners, coordinated meetings, cross-referrals, treatment plan discussions and joint health promotion activities. CONCLUSION:  This study confirmed that practitioner-level collaborations within healthcare are few and sparse. More work is needed to move policy on integration of the two systems into implementation. There is a need to conduct more research and document emerging collaborations.Contribution: This research illuminates the contextual challenges associated with sustaining collaborations. The data would be important in informing areas that need strengthening in the work towards integration of THPs and BHPs.