Indagações sobre experiência de quase morte, memória episódica e o psicóide na visão da psicología / Inquiries about near-death experiences, episodic memory and the psychoid from the view of analytical

Busca-se discutir a relação da Experiência de Quase Morte (EQM) a partir dos conceitos junguianos, particularmentea Individuação e a Espiritualidade. Pretende-se ainda, explorar possíveis relações entre a memória da EQM e Neuropsicologia, analisando o arquétipo psicóide e possíveis relações entre ele e a memória episódica, procurando-se possibilidades viáveis de pesquisas exploratórias que possam trazer maiores esclarecimentos na relação entre a experiência de quase morte, o conceito do psicóide da Psicologia analítica de C. G. Jung e a memória episódica tratada em neuropsicologia AU

We seek to discuss the relationship of the Near Death Experience (NDE) from the Jungian concepts, particularly Individuation and Spirituality. It is also intended to explore possible relationships between NDE memory and Neuropsychology, analyzing the psychoid archetype and possible relationships between it and episodic memory, looking for viable possibilities for exploratory research that can bring further clarification on the relationship between the experience of almost death, the psychoid concept from C. G. Jung's Analytical Psychology and the episodic memory treated in neuropsychology AU

Women's health access in the context of forced migration in portugal: vulnerabilities and adaptation / Acesso à saúde de mulheres em contexto de migração forçada em Portugal: vulnerabilidades e adaptação / Acceso a la salud de las mujeres en el contexto de la migración forzada en Portugal: vulnerabilidades y adaptación

This article presents, the vulnerabilities related with regarding access to health services facedby refugee women, of a research project conducted in Portugal between 2020 and 2022 as part of the Masters in Intercultural Relations program at Universidade Aberta. Objective: The overall goal was to gain a better understanding of the psychosocial reality of women who arrived in Portugal as a result of forced migration, focusing on the main difficulties of the migratory and adaptation journey -highlighting vulnerabilities related to health and access to health services at the present article -and the protective factors that facilitated their processes of resilience, adaptation, and social integration. Methodology:The meaningsof the protagonists' experiences were disclosed through nine semi-structured and in-depth interviews with a woman from Iraq, seven from Syria, and one from Libya, which were conducted separately, recorded and transcribed. Following the transcription and translation of the interviews, the content analysis began with the coding and categorization of the obtained data. Results:The investigationuncovered a number of vulnerabilities triggered by the migratory experience and gender belonging, such as prejudice, social isolation, and cultural shock (mostly linked to religion and clothing), which validated the intersectional analysis. The findings highlight a number of obstacles in the host nation, including access to health care, the quality of institutional interactions, and knowledge of the Portuguese language.Conclusions:The current investigation led to theconclusion that there are flawsin Portugal in terms of ensuring full access to health care for forced migrant women, highlighting as major obstacles: a lack of information in languagesother than Portuguese, a lack of offers tolearn and masterthe Portugueselanguage, a lack of knowledge about how health institutions work, and a lack of sensitivity and intercultural skills inhealthcareservices (AU).

Este artigo apresenta as vulnerabilidades relacionadas no acesso aos serviços de saúde sentidas por mulheres refugiadas, de um projeto de investigação realizado em Portugal entre 2020 e 2022 no âmbito do Mestrado em Relações Interculturais da Universidade Aberta. Objetivo:O objetivo geral foi conhecer melhor a realidade psicossocial das mulheres que chegaram a Portugal como resultado da migração forçada, focando as principais dificuldades do percurso migratório e de adaptação,destacando as vulnerabilidades relacionadas com a saúde e acesso aos serviços de saúde, além dos fatores de proteção que facilitaram seus processos de resiliência, adaptação e integração social. Metodologia:Os significados das vivências das protagonistasforam relevados por meio de nove entrevistas semiestruturadas e em profundidade, realizadas individualmente, gravadas e transcritas, com umamulher do Iraque, seteda Síria e umada Líbia. Após transcrição e tradução das entrevistas, a análise de conteúdopartiu da codificação e categorização da informação recolhida.Resultados:A investigação desvelou uma série de vulnerabilidadescausadas pela experiência migratória epertença de gênero,como a discriminação sentida sob a forma de preconceitos, o isolamento social e o choque cultural (sobretudo relacionado com a religião e o vestuário utilizado), o que justificou a análise intersecional. Os resultados revelam umconjuntode desafiosno país de acolhimento, como o acesso à saúde, a qualidade das relações institucionais e o domínio da língua portuguesa.Conclusões: A presente investigação permitiu concluir que existem algumas carências em Portugal no que diz respeito à garantia do pleno acesso aos cuidados de saúde sentidas pelasmulheres migrantes forçadas, destacando-se como principais obstáculos: a falta de informação numa língua que não o português, a falta de domínio da língua portuguesa, o desconhecimento sobre o funcionamento das instituições de saúde e falta de sensibilidade e de competências interculturais nos cuidados de saúde (AU).

Este artículo presenta, las vulnerabilidades relacionadasconen el acceso a los servicios de salud que sienten las mujeres refugiadas, de un proyectorealizado en Portugal entre 2020 y 2022 en el ámbito del Máster en Relaciones Interculturales de la Universidade Aberta.Objetivo: El objetivo fue comprender la realidad psicosocial de las mujeres que llegaron a Portugal como resultado de la migración forzada, centrándose en las principales dificultades del viaje de migración y adaptación, destacandovulnerabilidades relacionadas con la salud y el acceso a los servicios de salud, además de los factores de protección que facilitaron sus procesos de resiliencia, adaptación e integración social. Metodología: Los significados de las experiencias fueron revelados através de nueve entrevistas semiestructuradas y en profundidad, realizadas individualmente, grabadas y transcritas, con una mujer de Irak, siete de Siria y una de Libia. Luego de la transcripción y traducción, se inició el análisis de contenido con la codificación y categorización de la información.Resultados: La investigación reveló vulnerabilidades provocadas por la experiencia migratoria y la pertenencia de género,como la discriminación sentida en forma de prejuicio, el aislamiento social y el choque cultural (principalmente relacionado con la religión y la vestimenta), que justificaron el análisis interseccional.Los resultados revelan desafíos en Portugal,como el acceso a la salud, la calidad de las relaciones institucionales y el dominio de la lengua portuguesa.Conclusiones: La presente investigación llevó a la conclusión de que existen fallas en Portugal en cuanto a garantizar el pleno acceso a la atención de la salud de las refugiadas,destacándose: falta de información en un idioma diferenteal portugués, falta de dominio de la lengua portuguesa, falta de conocimiento sobre el funcionamiento de las instituciones de salud y falta de sensibilidad y habilidades interculturales en la atención de la salud (AU).

Síndrome autoimune induzida por adjuvantes (ASIA) sinais e sintomas experienciados por mulheres / Implementation of an intravenous therapy team based on convergent-assistance research / Síndrome autoinmune inducido por adyuvante (ASIA) signos y síntomas experimentados por mujeres

Objetivo: Identificar sinais e sintomas experienciados por mulheres com síndrome autoimune induzida por adjuvantes (ASIA) devido ao uso de prótese mamária e os tratamentos realizados. Método: Estudo de campo de abordagem qualitativa realizado por meio de entrevistas online utilizan-do-se a técnica bola de neve. Incluíram-se 13 participantes. Resultados: A partir da análise dos dados, foram elencadas quatro categorias: conhecimento acerca da síndrome; sinais e sintomas; tratamento; e cuidados e implicações de Enfermagem. Identificaram-se mais de 120 sinais e sintomas, e o explante foi mencionado como tratamento definitivo por todas as entrevistadas. Os sinais e sintomas apresentados pelas participantes vão ao encontro do que é descrito pela literatura. Conclusão: Antes da descoberta da doença, as participantes realizaram tratamento com foco no alívio dos sintomas. Após o diag-nóstico, todas as mulheres procederam com o explante

Objective: To identify signs and symptoms experienced by women with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to the use of breast implants and the treatments performed. Method: Field study with a qualitative approach carried out through online interviews using the snowball technique. 13 participants were included. Results: Based on data analysis, four categories were listed: knowledge about the syndrome; signs and symptoms; treatment; and nursing care and implications. Over 120 signs and symptoms were identified, and the explant was mentioned as a defi-nitive treatment by all interviewees. The signs and symptoms presented by the participants are in line with what is described in the literature. Conclusion:Before discovering the disease, the participants underwent treatment focused on symptom relief. After diagnosis, all women proceeded with the explant.Keywords: Autoimmune diseases. Prothesis implantation. Breast implantation. Silicones. Perioperative nursing

Objetivo: Identificar los signos y síntomas experimentados por mujeres con síndrome autoinmune inducido por adyuvantes (ASIA) debido al uso de implantes mamarios y los tratamientos realizados. Método: Estudio de campo con enfoque cualitativo realizado a través de entrevistas en línea utilizando la técnica de bola de nieve. Se incluyeron 13 participantes. Resultados: Con base en el análisis de los datos, se enumeraron cuatro categorías: conocimiento sobre el síndrome; signos y síntomas; tratamiento; y cuidados e implicaciones de enfermería. Se identificaron más de 120 signos y sínto-mas, y todos los entrevistados mencionaron el explante como tratamiento definitivo. Los signos y síntomas presentados por los participantes están en línea con lo descrito en la literatura. Conclusión: Antes de descubrir la enfermedad, los participantes realizaban un tratamiento enfocado en el alivio de los síntomas. Después del diagnóstico, todas las mujeres procedieron al explante

Qual família e qual comunidade? Reconfigurações da Medicina de Família e Comunidade na saúde suplementar / ¿Qué familia y qué comunidad? Reconfiguraciones de la Medicina Familiar y Comunitaria en salud complementaria / Which family and which community? Reconfigurations of Family and Community Medicine in supplementary health

RESUMO: Trata-se de um estudo cartográfico que buscou analisar a atuação de médicos(as) de família e comunidade na Atenção Primária da saúde suplementar, realizado por meio de diários e entrevistas cartográficas entre março de 2021 e janeiro de 2022, processados semanalmente em reuniões de pesquisa. Tal estudo se deu com base nos analisadores: 'território', 'família' e 'comunidade'. Notou-se que a territorialização e a abordagem familiar ganham outros contornos na Medicina de Família e Comunidade praticada na saúde suplementar. Além disso, verificou-se que algumas das ferramentas típicas da Atenção Básica - como visita domiciliar, educação em saúde, genograma, ecomapa e vigilância em saúde - não eram utilizadas na atenção suplementar ou tiveram outras aplicabilidades dissonantes do modelo preconizado. Concluiu-se que a Medicina de Família e Comunidade na saúde suplementar se aproxima de uma atuação mais clínica, com perda da potência das linhas de força que constituem tal especialidade, tendendo a uma medicina menos familiar e comunitária.

RESUMEN: Se trata de un estudio cartográfico que buscó analizar el desempeño de los médicos de familia y comunidad en atención primaria de salud complementaria, realizado a través de diarios y entrevistas cartográficas entre marzo de 2021 y enero de 2022, que fueron procesados semanalmente en reuniones de investigación. Este estudio se basó en los analizadores: 'territorio', 'familia' y 'comunidad'. Se observó que la territorialización y el enfoque familiar adquieren otros contornos en la Medicina Familiar y Comunitaria practicada en salud complementaria. Además, se encontró que algunas de las herramientas típicas de la atención básica, como las visitas domiciliarias, la educación sanitaria, el genograma, el ecomap y la vigilancia sanitaria, no se utilizaron en la atención complementaria o tenían otra aplicabilidad disonante del modelo recomendado. Se concluyó que la Medicina Familiar y Comunitaria en salud complementaria se aproxima a una práctica más clínica, con pérdida de potencia de las líneas eléctricas que constituyen dicha especialidad, tendiendo a una medicina menos familiar y comunitaria.

ABSTRACT: This is a cartographic study that sought to analyze the performance of family and community physicians in primary care of supplementary health, carried out through diaries and cartographic interviews between March 2021 and January 2022, which were weekly processed in research meetings. This study was based on the analyzers: 'territory', 'family' and 'community'. It was noticed that territorialization and family approach gain other contours in Family and Community Medicine practiced in supplementary health. In addition, it was found that some of the typical tools of basic care - such as home visits, health education, genogram, ecomap and health surveillance - were not used in supplementary care or had other dissonant applicabilities of the recommended model. It was concluded that Family and Community Medicine in supplementary health approaches a more clinical practice, with loss of power from the power lines that constitute such specialty, tending to a less familiar and community medicine.

Itinerário terapêutico de idosos vivendo com HIV/Aids: perspectivas da história oral / Therapeutic Itinerary of Elderly Living with HIV/Aids: Oral History Perspectives

Resumo Objetivo: Analisar o itinerário terapêutico de idosos vivendo com HIV em assistência num município do Oeste Catarinense. Metodologia: Estudo qualitativo com método história oral temática. A população foi composta por idosos que vivem há mais de cinco anos com HIV/Aids, assistidos em um Serviço de Atendimento Especializado. Foram realizados dois encontros para aproximação e três momentos de entrevistas em profundidade abordando questões relacionadas as trajetórias assistenciais dos sujeitos e sua relação com a doença. A análise de dados foi realizada por meio da análise temática de conteúdo. Resultados e Discussão: Os idosos tiveram seu diagnóstico em fase tardia o que mostra a dificuldade dos serviços de saúde em identificar precocemente o HIV na pessoa idosa. O tratamento foi centralizado na medicação com antirretrovirais, de maneira setorializada em serviço especializado e com equipe constituída por profissional médico, enfermeiro e farmacêutico. Também foi evidenciado baixo acesso a recursos não farmacológicos, como assistência psicoterapêutica. Considerações finais: A trajetória assistencial precisa ser qualificada na direção de garantir maior acesso as redes de saúde e as equipes interprofissionais para uma atenção à saúde integral que realize o diagnóstico precoce com vistas a reduzir os riscos de complicações e ofereça um cuidado integral e humanizado, que extrapole o uso de medicamentos.

Abstract Objective: To analyze the therapeutic itinerary of elderly people living with HIV assisted in a municipality in Western Santa Catarina. Methodology: Qualitative study with thematic oral history method. The population was consisted of elderly people who have been living with HIV/Aids for more than five years, assisted in a Specialized Care Service. Two meetings were held for approximation and three moments of in-depth interviews. Data analysis was performed through thematic content analysis. Results and Discussion: The elderly had their diagnosis at a late stage, use antiretrovirals in their therapeutic journey, they have the specialized service as the central treatment space and greater contact with the medical professional, nurse and pharmacist. Final considerations: The therapeutic itineraries were built in a way that diagnoses happen late, with treatment focused on medication, in a sectorized way and without a diverse interprofessional team.

Análise da abordagem familiar na perspectiva de implementação da prática no cenário da Residência de Medicina de Família e Comunidade do município de João Pessoa, PB / Analysis of the family approach through the implementation of this practice in the setting of the Family and Community Medicine Residency in the city of João Pessoa-PB

Objetivo: Analisar analisar de que modo a abordagem familiar está inserida no cenário da Residência de Medicina de Família e Comunidade do município de João Pessoa-, PB. Metodologia: Tratatrata-se de uma pesquisa do tipo exploratória qualitativa com uma amostra composta por residentes do segundo ano da especialização pertencentes a 4 quatro instituições de ensino do município. Os dados foram coletados por meio de roteiro de entrevista semiestruturada e analisados através da Técnica de Análise de Conteúdo. Resultados: Foram foram entrevistados 08 oito residentes com faixa etária entre 26 e 43 anos, formados entre os anos de 2012 e 2019. Observou-se que os residentes entendem a importância da abordagem familiar para uma assistência integral a à saúde dos usuários. Em sua totalidade concordam que é uma competência fundamental para a formação do médico de família, entretanto, 75% deles consideram seus conhecimentos e habilidades em abordar as famílias baixos ou medianos. Conclusão: A a análise das entrevistas evidenciou a baixa utilização da abordagem familiar nos processos de trabalho das equipes saúde da família. Na perspectiva de implementação da prática da abordagem familiar, foram sugeridas mudanças estratégicas tanto para atividades teóricas quanto para o campo da prática.

Objective: To analyze how the family approach operates within the setting of the Family and Community Medicine Residency in the city of João Pessoa-PB. Methodology: This is qualitative exploratory research with a sample composed of residents in their second year of specialization belonging to four educational institutions in the city. Data was collected through direct interviews with a semi-structured questionnaire and analyzed using the Content Analysis Technique. Results: Eight residents aged between 26 and 43 years old, who graduated between 2012 and 2019, were interviewed. It was observed that residents understand the importance of the family approach to comprehensive care for users' health. In their entirety, they agree that it is a fundamental competence for the formation of family doctors. However, 75% of them believe they have low or average knowledge and skills for approaching families. The analysis of the interviews showed low use of the family approach in the work processes of the family health teams. From the perspective of implementing the practice of the family approach, strategic changes were suggested both for theoretical activities and for the field of practice.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh.

BACKGROUND: While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. METHODS: A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. RESULTS: Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12-0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35-18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34-2.85). CONCLUSION: Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people's health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

Complementary and integrative medicine perspectives among veteran patients and VHA healthcare providers for the treatment of headache disorders: a qualitative study.

OBJECTIVE: To evaluate veteran patient and provider perceptions and preferences on complementary and integrative medicine (CIM) for headache management. BACKGROUND: The Veterans Health Administration (VHA) has spearheaded a Whole Health system of care focusing on CIM-based care for veteran patients. Less is known about patients' and providers' CIM perceptions and preferences for chronic headache management. METHODS: We conducted semi-structured interviews with 20 veteran patients diagnosed with headache and 43 clinical providers, across 12 VHA Headache Centers of Excellence (HCoE), from January 2019 to March 2020. We conducted thematic and case comparative analyses. RESULTS: Veteran patients and VHA clinical providers viewed CIM favorably for the treatment of chronic headache. Specific barriers to CIM approaches included: (1) A lack of personnel specialized in specific CIM approaches for timely access, and (2) variation in patient perceptions and responses to CIM treatment efficacy for headache management. CONCLUSION: Veteran patients and VHA clinical providers in this study viewed CIM favorably as a safe addition to mainstream headache treatments. Advantages to CIM include favorable adverse effect profiles and patient autonomy over the treatment. By adding more CIM providers and resources throughout the VHA, CIM modalities may be recommended more routinely in the management of veterans with headache.

Wading through Molasses: A qualitative examination of the experiences, perceptions, attitudes, and knowledge of Australian medical practitioners regarding medical billing.

BACKGROUND: Medical billing errors and fraud have been described as one of the last "great unreduced healthcare costs," with some commentators suggesting measurable average losses from this phenomenon are 7% of total health expenditure. In Australia, it has been estimated that leakage from Medicare caused by non-compliant medical billing may be 10-15% of the scheme's total cost. Despite a growing body of international research, mostly from the U.S, suggesting that rather than deliberately abusing the health financing systems they operate within, medical practitioners may be struggling to understand complex and highly interpretive medical billing rules, there is a lack of research in this area in Australia. The aim of this study was to address this research gap by examining the experiences of medical practitioners through the first qualitative study undertaken in Australia, which may have relevance in multiple jurisdictions. METHOD: This study interviewed 27 specialist and general medical practitioners who claim Medicare reimbursements in their daily practice. Interviews were recorded, transcribed, and analysed using thematic analysis. RESULTS: The qualitative data revealed five themes including inadequate induction, poor legal literacy, absence of reliable advice and support, fear and deference, and unmet opportunities for improvement. CONCLUSION: The qualitative data presented in this study suggest Australian medical practitioners are ill-equipped to manage their Medicare compliance obligations, have low levels of legal literacy and desire education, clarity and certainty around complex billing standards and rules. Non-compliant medical billing under Australia's Medicare scheme is a nuanced phenomenon that may be far more complex than previously thought and learnings from this study may offer important insights for other countries seeking solutions to the phenomenon of health system leakage. Strategies to address the barriers and deficiencies identified by participants in this study will require a multi-pronged approach. The data suggest that the current punitive system of ensuring compliance by Australian medical practitioners is not fit for purpose.

What can we learn from past and recent Bavarian knowledge for the future development of European veterinary herbal medicine? An ethnoveterinary study.

ETHNOPHARMACOLOGICAL RELEVANCE: While the interest in finding medical solutions for the worldwide antibiotics crisis is rising, the legal possibility of simplified authorization of herbal veterinary medicinal products is dwindling. An important basis for both the preservation and development of knowledge in veterinary herbal medicine are pharmacological and clinical studies on the performance of herbal remedies, based on historical written sources on the treatment of farm animals with medicinal plants, as well as current ethnoveterinary research. Nevertheless, there is only limited systematic ethnoveterinary research in Europe, with the exceptions of the Mediterranean region, Switzerland and Austria. We conducted a survey on the ethnoveterinary knowledge of farmers in Bavaria, and analyzed two regional historical textbooks. AIM OF THE STUDY: We documented the local veterinary knowledge about livestock in Bavaria based upon local historical textbooks and upon ethnoveterinary interviews to discover opportunities for the future development of European veterinary herbal medicine. MATERIAL AND METHODS: In 2018/2019 we conducted 77 semi-structured interviews with 101 farmers from different types of farms. Detailed information about homemade herbal remedies (plant species, plant part, manufacturing process, source of knowledge) and the corresponding use reports (target animal species, category of use, route of administration, dosage, source of knowledge, frequency of use, last time of use and farmers' satisfaction) were collected. To compare our data with the literature, the use reports of two local historical textbooks were analyzed and compared with the data from the interviews. RESULTS: 716 homemade remedy reports (HRs) for altogether 884 use reports (URs) were documented in this study. We picked the 363 HRs that consisted of a single plant species with or without other natural products (HSHRs) for a deeper analysis. These HSHRs were prepared from 108 plant species that belonged to 57 botanical families. The most URs were documented for the families of: Asteraceae, Linaceae and Urticaceae. Calendula officinalis L. (Asteraceae), Linum usitatissimum L. (Linaceae) and Urtica dioica L. (Urticaceae) were the most often documented single species. A total of 448 URs were gathered for the 363 HSHRs. The largest number of URs was for treatments of gastrointestinal disorders and metabolic dysfunctions, followed by skin alterations and sores. For nearly half of the URs the source of knowledge was family and friends. For 80 URs the source of knowledge was different from that of the corresponding HSHRs. For 68% of the URs farmers mentioned at least one use during the last 5 years. Half of the plant species that were mentioned in the historical literature were also mentioned in URs by the interviewees. CONCLUSION: In Bavaria, medicinal plants are actively used by farmers to treat their livestock with a high level of satisfaction. The knowledge is not passed on from generation to generation in a purely static way, but is dynamically developed by the users in almost one fifth of the URs. Ethnoveterinary research combined with data from regional historical textbooks may facilitate pharmacological and clinical studies in veterinary medicine, and the discussion about a simplified registration for traditional herbal veterinary medicinal products.

Spiritual care in critically ill patients during COVID-19 pandemic.

INTRODUCTION: Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. PURPOSE: The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. METHODS: A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. FINDINGS: During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. DISCUSSION: These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Dysphania schraderiana (Schult.) Mosyakin & Clemants - An overlooked medicinal and ritual plant used in Poland.

ETHNOPHARMACOLOGICAL RELEVANCE: The paper discusses the traditional ritual, medicinal and insect repellent use of Dysphania schraderiana in Poland, a plant with little ethnobotanical and phytochemical data. Our research suggests that its properties should be further studied comparing it with the related D. botrys and D. ambrosioides. AIM OF THE WORK: D. schraderiana is an aromatic and medicinal annual herb related to D. ambrosioides and D. botrys and practically absent from historical accounts of plant uses in Europe. The aim of this work is to characterise the current use of D. schraderiana in south east Poland on the background of historical Dysphania species use in Europe. MATERIALS AND METHODS: The data on D. schraderiana was collected in 2020, based on interviews with 42 people in rural areas of south-eastern Poland where the species is used today. A range of textual sources were searched including old medicinal herbals, pharmaceutical handbooks, ethnobotanical publications and culinary databases regarding all the uses of Dysphania species in Europe. RESULTS: In the study area D. schraderiana occurs in the whole spectrum of cultivation stages - from being intentionally cultivated to completely wild. The plant is used mainly as an apotropaic and insect repellent, blessed during Catholic church holidays (mainly Assumption Day), and sometimes used as incense in churches (and blessed on Epiphany Day). D. schraderiana rarely occurs in European historical sources, except sometimes classed as a false, inferior form of D. botrys, which has been known for centuries as a moth repellent and treatment for respiratory illness. We hypothesise that the plant was not easily distinguished from D. botrys and their uses strongly overlapped. For some unknown reason the use of D. botrys died out, whereas a relatively large semi-feral population of D. schraderiana exists in south-eastern Poland where it has remained a culturally important plant. CONCLUSIONS: D. schraderiana is a rare case of a non-native plant traditionally used within an area of Europe but previously nearly overlooked in European ethnobotanical literature. Historical uses of Dysphania spp. in other areas of Poland and former Poland (now western Ukraine) suggest that the genus was used more widely in regions beyond the one studied. However, a very compact distribution of use suggests that D. schraderiana may have been brought to SE Poland from a single source outside the study area. Its common name, and use as a holy incense plant, is associated it with the well-known biblical tree resin obtained from Commiphora myrrha (Nees) Engl.

Teacher plants - Indigenous Peruvian-Amazonian dietary practices as a method for using psychoactives.

ETHNOPHARMACOLOGICAL RELEVANCE: Indigenous groups of the Amazon have developed intricate methods for the application of psychoactives, among which particularly the dieta or diet method of Peruvian-Amazonian traditional medicine stands out. It is a retreat-like intervention involving lengthy periods of social, behavioural, and alimentary restrictions, while ingesting specially prepared plant substances. The interplay of the dietary conditions and plants ingested sensitizes the dieter to receive healing, strength, guidance, and knowledge. From a clinical scientific point of view, the method has remained largely underexplored, but seems more pertinent than ever given the increasing interest in Amazonian psychoactive preparations including ayahuasca (Banisteriopsis caapi) and the burgeoning field of psychedelic-assisted therapies in general. AIM OF THE STUDY: This study offers a descriptive account and emic interpretation of the Peruvian-Amazonian dieta. More specifically we document in detail the procedure, its context and purpose of application, effects, modes of action, adverse effects, and risks, from the perspectives of a sample of Peruvian traditional healers. The Peruvian-Amazonian dieta is a multi-purpose method for making use of medicinal plants, many of which (but not all), are psychoactive; the current work especially focuses on its therapeutic applications in conjunction with psychoactives. METHODS: We interviewed 16 healers working in the Ucayali, San Martín, and Loreto provinces of Peru using a semi-structured interview approach. Interviews were audio-recorded and transcribed verbatim. The extensive data derived from these interviews were analysed by means of computer-assisted manifest qualitative content analysis using a theory-advancing approach. Over 500 coded text segments were categorized, resulting in 7 main theme clusters and corresponding sub-themes. RESULTS: The interviewed healers described a complex intervention with multifaceted applications (treatment, prevention, training) and effects in various domains (body, mind, spirit, energy). The process was portrayed as transformative, with benefits attributed to the effects of the so-called teacher plants in conjunction with the diet's conditions, along with the skill of the healer guiding the intervention. Further, a detailed risk assessment revealed sophisticated safety measures and tools designed to address adverse responses. The importance of adequate training of the healer that administers the diet was particularly highlighted in this context. CONCLUSIONS: The dieta is a central therapeutic concept and tool in Peruvian-Amazonian traditional medicine and a unique method for using psychoactive plants. Multidisciplinary health research that includes traditional treatment methods from Indigenous cultures, Amazonian and other, should not be neglected in the current global interest in psychedelic therapies; such research may in the long-term contribute to a more inclusive psychedelic research paradigm as well as healthcare practice in countries where rich traditional healing systems exist, and perhaps beyond. It may also contribute to the recognition of the Indigenous healers as not only historical forerunners, but also current leading experts in psychedelic medicine.

Efetividade das essências florais no trabalho de parto e nascimento: avaliação dos parâmetros obstétricos e neuroendócrinos / Efectividad de las esencias florales en el trabajo de parto y nacimiento: evaluación de los parámetros obstétricos y neuroendócrinos / Effectiveness of flower essences in labor and birth: evaluation of obstetric and neuroendocrine parameters

Resumo Objetivo Avaliar a efetividade da terapia floral associados aos fatores que potencializam a dor e o estresse no processo de parturição por meio de parâmetros obstétricos e neuroendócrinos. Métodos Ensaio clínico randomizado, triplo cego, placebo controlado, realizado com 164 parturientes de risco obstétrico habitual, subdivididas entre dois grupos para as quais foram ministradas essência floral Five Flower e placebo, respectivamente. Avaliou-se aspectos obstétricos e neuroendócrinos por meio da análise bioquímica dos hormônios Beta-endorfina e Cortisol salivar antes e ao término da intervenção. Resultados A essência floral modulou os fatores que potencializam a dor no trabalho de parto, isto é, rotura das membranas amnióticas, fase ativa e indução do parto. Houve aumento dos níveis de Beta-endorfina juntamente com a diminuição de uma contração em mulheres com rotura das membranas ovulares e com indução. Em relação ao estresse, houve constância dos valores do Cortisol para o Grupo Experimental, não alterando seu valor na fase ativa, rotura das membranas ovulares ou indução. A Essência Five Flower mostrou-se eficaz na redução de uma hora e vinte e cinco minutos do tempo do trabalho de parto no Grupo Experimental. Conclusão A terapia floral realizada, mostrou-se eficaz no controle da dor e estresse durante o trabalho de parto, refletindo positivamente na sua brevidade e qualificando seu desfecho.

Resumen Objetivo Evaluar la efectividad de la terapia floral asociada a los factores que potencializan el dolor y el estrés en el proceso de parto por medio de parámetros obstétricos y neuroendócrinos. Métodos Ensayo clínico aleatorizado, triple ciego, placebo controlado, realizado con 164 parturientas de riesgo obstétrico normal, subdivididas en dos grupos en que se les administró esencia floral Five Flower y placebo. Se evaluaron aspectos obstétricos y neuroendócrinos por medio del análisis bioquímico de las hormonas betaendorfina y cortisol salival antes y al final de la intervención. Resultados La esencia floral reguló los factores que potencializan el dolor en el trabajo de parto, es decir, ruptura de las membranas amnióticas, fase activa e inducción del parto. Hubo aumento de los niveles de betaendorfina junto con la reducción de una contracción en mujeres con ruptura de las membranas ovulares y con inducción. Con relación al estrés, hubo constancia de los valores de cortisol en el grupo experimental, sin aumento de su valor en la fase activa, ruptura de las membranas ovulares o inducción. La esencia Five Flower demostró ser eficaz para la reducción de una hora y veinticinco minutos de tiempo de trabajo de parto en el grupo experimental. Conclusión La terapia floral realizada demostró ser eficaz en el control del dolor y del estrés durante el trabajo de parto, con un impacto positivo en su brevedad y en la cualificación de su desenlace.

Abstract Objective To evaluate the effectiveness of floral therapy associated with factors that strengthen pain and stress in the labor process through obstetric and neuroendocrine parameters. Methods Randomized, triple-blind, placebo-controlled clinical trial performed with 164 parturients at usual obstetric risk subdivided into two groups to which Five Flower floral essence and placebo were administered. Obstetric and neuroendocrine aspects were evaluated through biochemical analysis of the beta-endorphin and cortisol hormones through salivary samples before and after the intervention. Results The flower essence modulated the factors that strengthen pain in labor, that is, rupture of amniotic membranes, active phase and induction of labor. There was an increase in beta-endorphin levels along with one less contraction in women with ruptured ovular membranes and labor induction. Regarding stress, cortisol values were constant for the Experimental group, and did not change in the active phase, rupture of the ovular membranes or induction. The Five Flower essence proved to be effective in reducing labor time by 1 hour 25 minutes in the Experimental group. Conclusion The floral therapy used proved to be effective in controlling pain and stress during labor, and reflected positively on its agility and qualified its outcome.

"Eu me sentia um nada": história oral de mulheres em sofrimento psíquico na Atenção Básica sob uma perspectiva de gênero e a repercussão de práticas integrativas e complementares / Oral History of women in psychological distress in Primary Care from a gender perspective and the repercussion of Integrative and Complementary Practices

Resumo Articular gênero e saúde mental é um desafio urgente. Este artigo analisa relatos de mulheres em sofrimento psíquico na Atenção Básica sob uma perspectiva de gênero e as repercussões de práticas integrativas e complementares na percepção dessas mulheres. Para tanto, foram realizadas entrevistas com cinco usuárias de uma Unidade Básica de Saúde acompanhadas nas atividades de terapia de florais e grupo de mulheres. Para as entrevistas, utilizou-se a técnica da História Oral Temática entre novembro e dezembro de 2018. A análise dos dados foi feita nos termos da Análise de Conteúdo, resultando na síntese das seguintes categorias: 1) histórias de sofrimento das mulheres acolhidas na Atenção Básica, e 2) a produção de saúde mental a partir da terapia de florais e do grupo de mulheres. Ao lançar luz sobre as histórias por trás dos diagnósticos de transtornos mentais comuns, a compreensão de sofrimento psíquico das mulheres foi ressignificada, revelando sua dimensão ético-política. A terapia de florais e o grupo de mulheres apresentaram um potencial de produção de saúde mental e empoderamento, apontando um caminho para a desconstrução do caráter a-histórico do sofrimento psíquico e da medicalização de fenômenos sociais no âmbito da Atenção Básica.

Abstract Articulating gender and mental health is an urgent challenge. This article analyzes reports of women in psychic suffering in Primary Health Care from a gender perspective and the repercussions of Integrative and Complementary Practices in these women's perception. To this end, interviews were conducted with five users of a Basic Health Unit, accompanied by floral therapy activities and a group of women. For the interviews, the Thematic Oral History technique was used between November and December 2018. The data analysis was carried out in terms of Content Analysis, resulting in the synthesis of the following categories: 1) stories of suffering of the women welcomed in Primary Health Care, and 2) the production of mental health based on flower therapy and the women's group. By shedding light on the stories behind the diagnosis of Common Mental Disorders, women's understanding of psychic suffering has been reframed, revealing its ethical-political dimension. The flower therapy and the group of women present a potential for the production of mental health and empowerment, pointing a way to deconstruct the a-historical character of psychological suffering and the medicalization of social phenomena within the scope of Primary Care.

The impact of conducting preclinical systematic reviews on researchers and their research: A mixed method case study.

BACKGROUND: Systematic reviews (SRs) are cornerstones of evidence-based medicine and have contributed significantly to breakthroughs since the 1980's. However, preclinical SRs remain relatively rare despite their many advantages. Since 2011 the Dutch health funding organisation (ZonMw) has run a grant scheme dedicated to promoting the training, coaching and conduct of preclinical SRs. Our study focuses on this funding scheme to investigate the relevance, effects and benefits of conducting preclinical SRs on researchers and their research. METHODS: We recruited researchers who attended funded preclinical SR workshops and who conducted, are still conducting, or prematurely stopped a SR with funded coaching. We gathered data using online questionnaires followed by semi-structured interviews. Both aimed to explore the impact of conducting a SR on researchers' subsequent work, attitudes, and views about their research field. Data-analysis was performed using Excel and ATLAS.ti. RESULTS: Conducting preclinical SRs had two distinct types of impact. First, the researchers acquired new skills and insights, leading to a change in mindset regarding the quality of animal research. This was mainly seen in the way participants planned, conducted and reported their subsequent animal studies, which were more transparent and of a higher quality than their previous work. Second, participants were eager to share their newly acquired knowledge within their laboratories and to advocate for change within their research teams and fields of interest. In particular, they emphasised the need for preclinical SRs and improved experimental design within preclinical research, promoting these through education and published opinion papers. CONCLUSION: Being trained and coached in the conduct of preclinical SRs appears to be a contributing factor to many beneficial changes which will impact the quality of preclinical research in the long-term. Our findings suggest that this ZonMw funding scheme is helpful in improving the quality and transparency of preclinical research. Similar funding schemes should be encouraged, preferably by a broader group of funders or financers, in the future.

Multiple Mini Interviews as Part of Holistic Admissions Review for Nursing Schools.

Studies in the nursing admission process have demonstrated the benefits of holistic admissions review. Literature regarding the use of multiple mini-interviews (MMI's) as it relates to the holistic admissions process has been minimally addressed in nursing literature, although widely described in medical education journals. This article will describe the change in the interview process from unstructured group interviews to a structured MMI process for California Baptist University (CBU) College of Nursing, Riverside, CA, and how changes were beneficial for the institution's holistic admissions review process. Many activities were included in this holistic interview process to capture the unique attributes and strengths of each applicant. It was discovered that the change from the unstructured group interview process to the holistic MMI approach helped to identify strong candidates who align with the mission and values of California Baptist University College of Nursing.

Bioética do cuidado na clínica de ensino: aprendendo com pacientes / Bioethicsof the care in the teaching clinic: learning with patients

O estudo buscou compreender práticas de acolhimento de pacientes em uma clínica de ensino odontológico.Trata-se de um estudo de caso único e holístico, com abordagem qualitativa. Foram realizadas entrevistas abertas com 20 pacientes, guiadas por um roteiro com temas problematizadores que procuram ligar princípios bioéticos a dispositivos subjetivos do cuidado: conceito ampliado de saúde e doença, intersubjetividade, corresponsabilidade e qualidade de vida. As práticas discursivas analisadas mostraram que o vínculo entre estudantes e pacientes da clínica de ensino se estabelece em uma construção mediada pelo longo tempo da formação. A corresponsabilidade está relacionada às construções intersubjetivasnocuidado e tem como atores do processo osestudantes e os pacientes. Ao afirmarem sentirem-se livres para opinar sobre seus tratamento também expressam uma postura de reduzida autonomia, pois consideramque não sejanecessário fazê-lo. Como reflexo da fragmentação do cuidado nas clínicas de ensino, muitos silenciamentos emergem destas relações de poder e cuidado. Acredita-se que é clara a importância de práticas que se desvinculem de funções estritamente técnicas e invistam nos processos de fala e escuta, incansavelmente buscando empatia e vínculo como as tecnologias de saúde mais potentes para o tratamento, pois reafirmam a autonomia das pessoas na construção de seus itinerários de cuidado e a dignidade humana como valor central da prática de saúde (AU).

The study aimed to understand welcoming patients practices in a dentistry teaching clinic.It is a holistic single-case study with a qualitative approach.Twenty patients were interviewed following anopen-ended script containing problematizing topics trying to connect bioethical principles tosubjective devices of care: expandedconcept of health and illness, intersubjectivity, co-responsibility, and quality of life.The discursive practices analyzed showed that the bond between students and patients of the teaching clinic is established in a construction mediated by the long training time.Co-responsibility is related with the intersubjective constructions in the care, being the actors of the process both the students and the patients.When claiming to feelfree to give an opinion on their treatment, they also express a position of reduced autonomy, as they consider that it is not necessary to give it.As a reflection of the fragmentation of the care in the teaching clinics, much silencing emerges from these relations of power and care.It is believed that that the importance of practices that unlinkthemselvesfrom strictly technical functions and invest in the speaking and listening processes is clear. In an untiring search for empathy and bond as the mostpowerful health technologies for the treatment, they reaffirm the autonomy of the people in the construction of their itineraries of care and human dignity as a core value of the practice of health (AU).

Psychological ailments and their treatment protocols: a case study of Swati traditional healers in Mpumalanga Province, South Africa.

BACKGROUND: Evidence suggests that South African traditional healers (THs) treat various mental complaints. However, there is little literature on Swati THs' accounts on this subject. The current study therefore, sought to address this gap. METHODS: Data was gathered using qualitative research methods, namely semi-structured interviews with 10 purposely sampled Swati THs practicing in the Kanyamazane peri-urban township (Mpumalanga Province, South Africa). Data was thematically analysed. RESULTS: Results showed that THs treat seven psychological aliments, viz. adjustment disorders, depression, mental illness due to ancestral calling, mental illness due to bewitchment, mental illness due to breaking of taboos, psychotic disturbance and substance induced mental illness. Generally, an integrated treatment protocol was utilised by THs to treat and manage these disorders. Most of these procedures are acceptable from either folkloric or scientific viewpoint, and have demonstrated certain level of efficacy in treating mental illness. CONCLUSION: Taken together, the evidence presented indicates that Swati THs use different traditional methods to manage various mental complaints. In doing so, they carry a large share of the community caseload for mental health, whilst admitting patients in their homes for extended periods of time, and also referring some (patients) for additional care within the Western health sector.

Using self-determination theory to understand and improve recruitment for the Coaching for Healthy Ageing (CHAnGE) trial.

BACKGROUND: Intervention trials promoting physical activity among older people frequently report low and unrepresentative recruitment. Better understanding of reasons for participation can help improve recruitment. This study explored why participants enrolled in the Coaching for Healthy Ageing (CHAnGE) trial, including how their decision was influenced by recruitment strategies. CHAnGE was a cluster randomised controlled trial testing the effectiveness of a healthy ageing program targeting inactivity and falls. Seventy-two groups of people aged 60+ were recruited from community organisations via informal presentations by the health coaches. METHODS: We conducted a secondary thematic analysis of interview data from our wider qualitative evaluation in which 32 purposively sampled trial participants took part in semi-structured interviews about their experiences of CHAnGE. Data relating to recruitment and participation were analysed inductively to identify themes, then a coding framework comprising the core constructs from self-determination theory-autonomy, competence and relatedness-was used to explore if and how this theory fit with and helped to explain our data. RESULTS: Recruitment presentations promoted the CHAnGE intervention well in terms of addressing value expectations of structured support, different forms of accountability, credibility, achievability and, for some, a potential to enhance social relationships. Participation was motivated by the desire for improved health and decelerated ageing, altruism and curiosity. These factors related strongly to self-determination concepts of autonomy, competence and relatedness, but the intervention's demonstrated potential to support self-determination needs could be conveyed more effectively. CONCLUSIONS: Findings suggest that recruitment could have greater reach using: 1. Strengths-based messaging focusing on holistic gains, 2. Participant stories that highlight positive experiences, and 3. Peer support and information sharing to leverage altruism and curiosity. These theory-informed improvements will be used to increase participation in future trials, including people in hard-to-recruit groups. They may also inform other physical activity trials and community programs.