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1.
Scand J Occup Ther ; 30(8): 1441-1450, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37256557

RESUMEN

BACKGROUND: A growing body of literature points to the potential of mindfulness to support therapeutic relationships, and the importance of the therapeutic relationship when working with children and youth, yet little attention has been paid to this topic in occupational therapy. AIMS/OBJECTIVES: The aim of this study was to inquire into occupational therapists' experiences of mindfulness in the therapeutic relationship with children and youth. MATERIALS AND METHODS: Hermeneutic phenomenology was the methodological approach, with Heidegger's concepts of being-with and care as theoretical underpinnings of the study. Eight North American occupational therapists participated in semi-structured interviews that elicited first-hand accounts of mindfulness in the therapeutic relationship with children and youth. Interviews were transcribed verbatim and analysed using a phenomenological approach. RESULTS: Four key themes were identified: fostering a safe space, enhancing presence, being authentic, and cultivating acceptance. CONCLUSIONS AND SIGNIFICANCE: The findings offer insights regarding the potential affordances of mindfulness to support clinicians in the development of therapeutic relationships with children and youth. Further, this study highlights research priorities for future inquiry.


Asunto(s)
Atención Plena , Terapia Ocupacional , Adolescente , Humanos , Niño , Terapeutas Ocupacionales , Actitud del Personal de Salud , Investigación Cualitativa
2.
Disabil Rehabil ; : 1-9, 2023 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-37218111

RESUMEN

PURPOSE: While research into mindfulness practices is on the rise across populations, there is evidence to suggest that clinical practice has outpaced the literature with regard to mindfulness in pediatric rehabilitation. The aim of this study was to explore the perceptions of occupational therapists who opt to incorporate mindfulness into their clinical practices with children and youth. METHODS: Hermeneutic phenomenology was the methodology of the study. The theoretical framework employed a Heideggerian-informed phenomenology of practice. Eight occupational therapists practicing in Canada and the United States participated in 90-120 min semi-structured interviews that elicited first-hand accounts of mindfulness in pediatric occupational therapy practice. Interviews were transcribed verbatim and analyzed using Finlay's four-step approach. RESULTS: Six salient themes were identified in the data: drawing from personal practice, enhancing participation, fostering healthy habits, adapting for children, keeping it playful, and doing with. CONCLUSION: The findings of this study offer insights for therapists who are considering incorporating mindfulness into their practices with children and youth. Further, this research highlights a number of research priorities that require further inquiry.IMPLICATIONS FOR REHABILITATIONMindfulness is growing in popularity and may support occupational engagement in children and youth receiving rehabilitation services.Mindfulness practices may support rehabilitation providers in approaching their work with children and youth from a critical perspective.Further development of the child- and youth-centred mindfulness approaches may be warranted to enhance engagement and appropriateness for a range of ages and conditions.

3.
ACS Chem Neurosci ; 14(2): 195-197, 2023 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-36594896

RESUMEN

Alkaloids from the botanical Mitragyna speciosa (commonly referred to as "kratom") interact with opioid, adrenergic, serotonergic, and other receptors to provide myriad reported effects, including analgesia, energy, improved mood, and relaxation, among others. These alkaloids are complex and unique and may serve as a blueprint for the development of novel molecules to treat various substance use disorders.


Asunto(s)
Mitragyna , Alcaloides de Triptamina Secologanina , Trastornos Relacionados con Sustancias , Humanos , Extractos Vegetales , Alcaloides de Triptamina Secologanina/farmacología , Analgésicos Opioides
4.
Am J Drug Alcohol Abuse ; 49(1): 85-96, 2023 01 02.
Artículo en Inglés | MEDLINE | ID: mdl-36410029

RESUMEN

Background: Piper methysticum, commonly called kava, has long been consumed in beverage form in the Pacific Islands. Kava use in the US has slowly increased since the 1990s, but is not assessed in major epidemiological surveys.Objectives: To analyze social-media posts about kava from current, past, and prospective users, for motivations, patterns of co-use, and effects.Methods: Text from Reddit posts, and accompanying metadata, were collected and thematically coded by two independent raters.Results: 423 posts were collected, spanning January 2006 through December 2021. Of the 1,211 thematic codes applied, 1,098 (90. 7%) were concordant. Motivations for use bifurcated into self-treatment (for psychiatric or physical health conditions) and recreation; these were not mutually exclusive. Kava was rarely considered strongly euphoriant, but was valued as an anxiolytic. Kava was frequently used with other substances, most commonly kratom. Kava was used at lower doses for self-treatment than for other purposes (pseudo-R2 = 0.11). Undesirable effects (gastrointestinal upset, fatigue) were mentioned, though less often than benefits. Hepatotoxicity, reported elsewhere as a rare, non-dose-related risk, was disputed on the basis of its not having been experienced by those posting.Conclusion: Kava appears to be conceptualized among Reddit posters as an anxiolytic with few risks or adverse effects. As it grows in popularity, especially among people who use other drugs that are more liable to misuse or addiction, it should be assessed in probability samples (i.e. in the major national drug surveys) and clinical practice for its risks, potential benefits, and possible drug-drug interactions.


Asunto(s)
Ansiolíticos , Kava , Humanos , Estados Unidos , Extractos Vegetales , Ansiolíticos/uso terapéutico , Kava/efectos adversos , Estudios Prospectivos , Interacciones Farmacológicas
5.
J Addict Med ; 16(2): 223-228, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34001777

RESUMEN

OBJECTIVES: Kratom (Mitragyna speciosa Korth.), an indigenous medicinal plant, has been widely used as a traditional remedy in Southeast Asia. However, its combined consumption with other substances has received scarce attention. This study investigates the use of kratom among adults with a history of using heroin and methamphetamine in Malaysia. METHODS: A total of 332 patients who were mandated to undergo drug rehabilitation participated in this cross-sectional study. The study data were collected through face-to-face interviews using a semi-structured questionnaire. RESULTS: The majority were males (95%, n = 314/332) and Malays (98%, n = 325/332) with a mean age of 32.3 years (SD = 9.16). Over two thirds of the respondents used kratom to alleviate heroin withdrawal symptoms and to reduce methamphetamine intake; 59% used it as a substitute for heroin and methamphetamine. A similar proportion used kratom to reduce heroin intake (58%), while only 15% used it for its euphoric effects. Multivariate analysis showed that previous attendees of government rehabilitation programs had lower odds of using kratom as a heroin substitute. CONCLUSIONS: The potential of kratom to alleviate heroin withdrawal symptoms, and to reduce methamphetamine and heroin intake, among people who co-use heroin and methamphetamine warrants further research.


Asunto(s)
Metanfetamina , Mitragyna , Adulto , Estudios Transversales , Heroína , Humanos , Malasia , Masculino , Metanfetamina/efectos adversos , Extractos Vegetales
6.
Drug Alcohol Depend ; 208: 107849, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-32029298

RESUMEN

BACKGROUND: Kratom, a Southeast Asian plant with opioid-receptor mediated effects, has emerged as a potential substance of abuse, with limited data on its use and effects. This study characterized kratom user demographics, use patterns, and perceived drug effects. METHODS: A cross-sectional, anonymous online survey was conducted between January and December 2017. RESULTS: 2,798 kratom users - mean age 40 (SD = 12); predominantly White (90 %), female (61 %), and located in the US (97 %) - completed the survey. Kratom was primarily taken orally in doses of 1-3 g (49 %), with daily use (59 %) being most common. Kratom was used for pain (91 %), anxiety (67 %), and depression (65 %), with high ratings of effectiveness. 1,144 (41 %) used kratom to stop or reduce prescription or illicit opioid use, citing decreased opioid withdrawal and craving related to kratom use, with 411 reporting >1-year continuous abstinence from opioids attributed to kratom use. Roughly one-third of respondents reported adverse effects of kratom, largely rated as mild in severity and lasting ≤24 h. Seventeen participants (0.6 %) sought treatment for adverse effects. Fifty-six individuals (2 %) met DSM-5 criteria for a past-year moderate or severe kratom-related substance use disorder (SUD). When asked how troubled they felt regarding their kratom use, the mean (SD) rating was 3.2 (9.8) on a scale from 0 to 100. CONCLUSION: Kratom is used among White, middle-aged Americans for symptoms of pain, anxiety, depression, and opioid withdrawal. Although regular use was typical, kratom-related SUD and serious adverse effects were uncommon. Additional research on kratom epidemiology and pharmacology is imperative in light of the present opioid epidemic.


Asunto(s)
Analgésicos no Narcóticos/uso terapéutico , Mitragyna , Epidemia de Opioides/prevención & control , Trastornos Relacionados con Opioides/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Encuestas y Cuestionarios , Adulto , Analgésicos no Narcóticos/aislamiento & purificación , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/uso terapéutico , Ansiedad/tratamiento farmacológico , Ansiedad/epidemiología , Ansiedad/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/psicología , Dolor/tratamiento farmacológico , Dolor/epidemiología , Dolor/psicología , Extractos Vegetales/aislamiento & purificación , Adulto Joven
7.
Disabil Rehabil ; 42(2): 283-295, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-30517835

RESUMEN

Background: Investigations into the use of mindfulness with allied health and social care students, many of whom ultimately work in rehabilitation settings, is in the nascent stages and no systematic mapping of the literature has occurred. The purpose of this scoping review was to identify, summarise, and describe the current state of knowledge on mindfulness in allied health and social care professional education.Methods: Arksey and O'Malley's scoping review methodology was adopted. Five data bases were searched; inclusion and exclusion criteria were applied; and 50 papers were identified for inclusion in the study.Results: Quantitative studies depicted mindfulness interventions as contributing to: improved capacities for mindfulness; decreases in stress, anxiety, and depression; improvements in academic skills, quality of life and well-being, and empathy; improved physiological measures and emotional regulation; and mixed effects on burn-out. Qualitative studies highlighted: 1) mindfulness and self-care, 2) mindfulness within professional practice placements, 3) mindfulness in the classroom, and 4) the cultivation of mindful qualities.Conclusions: The study has important implications for the education of future rehabilitation professions and suggests that learning about mindfulness may be useful in assisting students to: manage academic stress, anxiety, and depression; cultivate a physical and mental state of calm; be more present and empathetic with clients; and be more focused and attentive in professional practice settings.Implications for rehabilitationFurther exploration of mindfulness as a promising educational intervention for the professional preparation of future rehabilitation practitioners in allied health and social care fields is recommended.Education and research about mindfulness and its potential opportunities for students in terms of the mediation of stress, anxiety, depression, and the cultivation of empathy, academic skills, quality of life, and resilience are recommended.Education and research about mindfulness and its potential for the cultivation of beneficial qualities of mind such as attention, self-awareness, compassion, non-judgment, and acceptance are recommended.Education and research about mindfulness as a potential means to develop capacities related to self-care, professional practice placements, and classroom performance in students is recommended.


Asunto(s)
Técnicos Medios en Salud , Educación Profesional , Atención Plena , Trabajadores Sociales , Ansiedad/prevención & control , Depresión/prevención & control , Empatía , Humanos , Calidad de Vida , Apoyo Social , Estrés Psicológico/prevención & control
8.
Med J Aust ; 207(10): S5-S18, 2017 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-29129182

RESUMEN

Although mental health problems represent the largest burden of disease in young people, access to mental health care has been poor for this group. Integrated youth health care services have been proposed as an innovative solution. Integrated care joins up physical health, mental health and social care services, ideally in one location, so that a young person receives holistic care in a coordinated way. It can be implemented in a range of ways. A review of the available literature identified a range of studies reporting the results of evaluation research into integrated care services. The best available data indicate that many young people who may not otherwise have sought help are accessing these mental health services, and there are promising outcomes for most in terms of symptomatic and functional recovery. Where evaluated, young people report having benefited from and being highly satisfied with these services. Some young people, such as those with more severe presenting symptoms and those who received fewer treatment sessions, have failed to benefit, indicating a need for further integration with more specialist care. Efforts are underway to articulate the standards and core features to which integrated care services should adhere, as well as to further evaluate outcomes. This will guide the ongoing development of best practice models of service delivery.


Asunto(s)
Atención a la Salud/organización & administración , Servicios de Salud , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Atención Primaria de Salud/organización & administración , Adolescente , Australia , Medicina Basada en la Evidencia , Humanos , Adulto Joven
9.
J Med Chem ; 59(11): 5356-67, 2016 06 09.
Artículo en Inglés | MEDLINE | ID: mdl-27167608

RESUMEN

Elevated levels of human lipoprotein-associated phospholipase A2 (Lp-PLA2) are associated with cardiovascular disease and dementia. A fragment screen was conducted against Lp-PLA2 in order to identify novel inhibitors. Multiple fragment hits were observed in different regions of the active site, including some hits that bound in a pocket created by movement of a protein side chain (approximately 13 Å from the catalytic residue Ser273). Using structure guided design, we optimized a fragment that bound in this pocket to generate a novel low nanomolar chemotype, which did not interact with the catalytic residues.


Asunto(s)
1-Alquil-2-acetilglicerofosfocolina Esterasa/antagonistas & inhibidores , Descubrimiento de Drogas , Inhibidores Enzimáticos/farmacología , Pirazoles/farmacología , Tiazoles/farmacología , 1-Alquil-2-acetilglicerofosfocolina Esterasa/metabolismo , Sitios de Unión/efectos de los fármacos , Cristalografía por Rayos X , Relación Dosis-Respuesta a Droga , Evaluación Preclínica de Medicamentos , Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/química , Humanos , Modelos Moleculares , Estructura Molecular , Pirazoles/síntesis química , Pirazoles/química , Relación Estructura-Actividad , Tiazoles/síntesis química , Tiazoles/química
10.
Neurobiol Learn Mem ; 119: 69-76, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25636201

RESUMEN

A neurobiological dual representation model of PTSD proposes that reduced hippocampus-dependent contextual processing contributes to intrusive imagery due to a loss of control over hippocampus-independent sensory and affective representations. We investigated whether PTSD sufferers show impaired allocentric spatial processing indicative of reduced hippocampal functioning. Trauma-exposed individuals with (N=29) and without (N=30) a diagnosis of PTSD completed two tests of spatial processing: a topographical recognition task comprising perceptual and memory components, and a test of memory for objects' locations within a virtual environment in which the test is from either the same viewpoint as presentation (solvable with egocentric memory) or a different viewpoint (requiring allocentric memory). Participants in the PTSD group performed significantly worse on allocentric spatial processing than trauma-exposed controls. Groups performed comparably on egocentric memory and non-spatial memory for lists of objects. Exposure to repeated incident trauma was also associated with significantly worse spatial processing in the PTSD group. Results show a selective impairment in allocentric spatial processing, implicating weak hippocampal functioning, as predicted by a neurobiological dual representation model of PTSD. These findings have important clinical implications for cognitive therapy.


Asunto(s)
Percepción Espacial , Memoria Espacial , Trastornos por Estrés Postraumático/psicología , Adolescente , Adulto , Anciano , Femenino , Hipocampo/fisiología , Humanos , Masculino , Persona de Mediana Edad , Reconocimiento en Psicología , Adulto Joven
11.
Bioorg Med Chem ; 16(14): 7039-45, 2008 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-18550377

RESUMEN

Eleven new tetraoxanes possessing cholic acid-derived carrier and isopropylidene moiety were synthesized and were tested in vitro and in vivo. In vitro screening revealed that nine of them were more potent against CQ-resistant W2 than CQ-susceptible D6 strain and that two of them were equally or more potent than artemisinin and mefloquine against multi-drug resistant TM91C235 strain. Amine 8 cured all mice at the dose of 160mg/kg/day, while the anilide 9 exhibited MCD

Asunto(s)
Antimaláricos/síntesis química , Tetraoxanos/síntesis química , Tetraoxanos/farmacología , Acetona , Animales , Artemisininas , Evaluación Preclínica de Medicamentos , Resistencia a Múltiples Medicamentos , Mefloquina , Ratones , Plasmodium falciparum/efectos de los fármacos
12.
Antimicrob Agents Chemother ; 50(5): 1649-55, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16641431

RESUMEN

Tetra-acetamide pyrroloquinazolinediamine (PQD-A4) and bis-ethylcarbamyl pyrroloquinazolinediamine (PQD-BE) are new derivatives of pyrroloquinazolinediamine (PQD) and are being investigated as potential chemotherapeutic agents for the treatment of malaria. Comparative studies to assess the therapeutic indices of PQD-A4, PQD-BE, and PQD were conducted in Plasmodium berghei-infected rats following daily intragastric dosing for three consecutive days. Artesunate (AS), a standard drug for treatment of severe malaria, was used as a comparator. The minimum doses required to clear malaria parasitemia were 156 micromol/kg of body weight for AS and 2.4 micromol/kg for PQD, PQD-4A, and PQD-BE. The maximum tolerated dose (MTD) of AS was 625 micromol/kg, and its therapeutic index was calculated to be 4. The MTDs of PQD-A4, PQD-BE, and PQD were found to be 190, 77, and 24 micromol/kg, respectively, yielding therapeutic indices of 80, 32, and 10, respectively. Although PQD-A4 and PQD-BE are only half as potent as PQD based on their curative effects, the two new derivatives, PQD-4A and PQD-BE, are 8.0-fold and 3.2-fold safer, respectively, than their parent compound when they are dosed for three consecutive days. Oral PQD-A4 and PQD-BE are 44 to 70 times more potent on an mg basis than intravenous AS. As assessed from the therapeutic index over 3 days, PQD-A4, PQD-BE, and PQD administered orally are 20.0, 8.0, and 2.5 times safer than AS given intravenously. The results indicate that PQD-4A is a promising candidate for antimalarial treatment.


Asunto(s)
Antimaláricos/farmacología , Profármacos , Pirroles/síntesis química , Pirroles/farmacología , Quinazolinas/síntesis química , Quinazolinas/farmacología , Animales , Antimaláricos/administración & dosificación , Artemisininas/farmacología , Artesunato , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Evaluación Preclínica de Medicamentos , Malaria/tratamiento farmacológico , Dosis Máxima Tolerada , Parasitemia/tratamiento farmacológico , Plasmodium berghei/efectos de los fármacos , Profármacos/administración & dosificación , Pirroles/química , Pirroles/farmacocinética , Pirroles/uso terapéutico , Quinazolinas/química , Quinazolinas/farmacocinética , Quinazolinas/uso terapéutico , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Sesquiterpenos/farmacología , Equivalencia Terapéutica
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