Communalistic use of psychoactive plants as a bridge between traditional healing practices and Western medicine: A new path for the Global Mental Health movement.

The Global Mental Health (GMH) movement aims to provide urgently needed treatment to those with mental illness, especially in low- and middle-income countries. Due to the complexity of providing mental health services to people from various cultures, there is much debate among GMH advocates regarding the best way to proceed. While biomedical interventions offer some degree of help, complementary approaches should focus on the social/community aspects. Many cultures conduct traditional rituals involving the communal use of psychoactive plants. We propose that these practices should be respected, protected, and promoted as valuable tools with regard to mental health care at the community level. The traditional use of psychoactive plants promotes community engagement and participation, and they are relatively affordable. Furthermore, the worldviews and meaning-making systems of local population are respected. The medical systems surrounding the use of psychoactive plants can be explained in biomedical terms, and many recently published clinical trials have demonstrated their therapeutic potential. Psychoactive plants and associated rituals offer potential benefits as complementary aspects of mental health services. They should be considered as such by international practitioners and advocates of the GMH movement.

Correlación entre el cociente proteína/creatinina en orina esporádica y las proteínas en orina de 24 horas / Correlation between the protein/creatinine ratio in spot urine and 24-hour urine protein

Introducción: Las proteínas presentan una eliminación variable a lo largo del día; por ello clásicamente se ha considerado la proteinuria de 24 horas como el método de referencia para su cuantificación. Dada la dificultad de la recogida de la muestra, aparece el cociente proteína/creatinina (P/C) en orina esporádica como herramienta diagnóstica. Objetivo: El objetivo de este estudio es evaluar la correlación entre la medida de proteinuria de 24 horas y el P/C, comparando muestras recogidas de forma consecutiva en pacientes del Hospital del Mar durante el último año. Métodos: Estudio observacional transversal en una muestra de 159 determinaciones analíticas del Servicio de Nefrología. Valoración de la correlación entre proteinuria de 24 horas y P/C según diferentes grados de proteinuria mediante el coeficiente de correlación intraclases (CCI) y el coeficiente de correlación de Spearman (CCS). Resultados: Se observó una correlación directa y estadísticamente significativa entre proteinuria/24 horas y P/C en todo el grupo estudiado (CCS: r = 0,91, p < 0,001). Las correlaciones según diferentes grados de proteinuria/24 horas fueron: < 300 mg (CCS: r = 0,498, p < 0,001; CCI: 0,46), 300-3499 mg (CCS: r = 0,828, p < 0,001; CCI: 0,66) y ≥ 3500 mg (CCS: r = 0,181, p = NS; CCI: 0,18). Conclusión: El cociente P/C presenta una buena correlación con valores de proteinuria/24 horas entre 300-3499 mg. Dicha correlación se mantiene, pero con menor intensidad, en < 300 mg. En el grupo estudiado, el cociente P/C en orina esporádica no se correlaciona con la proteinuria/24 horas en rango nefrótico (AU)

Introduction: Measurement of the protein content in a 24-hour urine sample is the definitive method of establishing the presence of abnormal proteinuria. However, the urine collection is cumbersome. The spot urine protein to creatinine ratio seems to be a reliable diagnostic tool for urine protein measurement. Objective: Our aim was to evaluate the spot urine protein/creatinine ratio against 24-h urine total protein excretion in different proteinuria ranges by comparing samples collected simultaneously in patients of Hospital del Mar during the last year. Material and method: Observational, cross-sectional study of 159 consecutive paired determinations of 24-h urine total protein excretion and the spot urine protein/creatinine ratio (P/C) in renal patients. The strength of the correlation was determined by calculating the intraclass correlation coefficient (ICC) and the Spearman correlation coefficient (SCC). Results: Among all groups, there was a significant correlation between 24-hour proteinuria and the P/C ratio (SCC: r=0.91, P<0.001). The correlation in different levels of proteinuria were: <300mg (SCC: r=0.498, P<0.001; ICC: 0.46), 300-3499mg (SCC: r=0.828, P<0.001; ICC: 0.66) and ≥3500mg (SCC: r=0.181, P=NS; ICC: 0.18). Conclusions: In summary, a strong correlation was observed between spot urine protein/creatinine ratio and 24-h urine total protein excretion in proteinuria levels from 300mg/day to 3499mg/day. A lower correlation was also maintained in 24-h urine total protein <300mg. In our experience, there is no relevant correlation between spot urine protein/creatinine ratio and 24-h urine total protein excretion in nephrotic-range proteinuria (AU)

Correlation between the protein/creatinine ratio in spot urine and 24-hour urine protein.

INTRODUCTION: Measurement of the protein content in a 24-hour urine sample is the definitive method of establishing the presence of abnormal proteinuria. However, the urine collection is cumbersome. The spot urine protein to creatinine ratio seems to be a reliable diagnostic tool for urine protein measurement. OBJECTIVE: Our aim was to evaluate the spot urine protein/creatinine ratio against 24-h urine total protein excretion in different proteinuria ranges by comparing samples collected simultaneously in patients of Hospital del Mar during the last year. MATERIAL AND METHOD: Observational, cross-sectional study of 159 consecutive paired determinations of 24-h urine total protein excretion and the spot urine protein/creatinine ratio (P/C) in renal patients. The strength of the correlation was determined by calculating the intraclass correlation coefficient (ICC) and the Spearman correlation coefficient (SCC). RESULTS: Among all groups, there was a significant correlation between 24-hour proteinuria and the P/C ratio (SCC: r=0.91, P<0.001). The correlation in different levels of proteinuria were: <300 mg (SCC: r=0.498, P<0.001; ICC: 0.46), 300-3,499 mg (SCC: r=0.828, P<0.001; ICC: 0.66) and ≥3,500 mg (SCC: r=0.181, P=NS; ICC: 0.18). CONCLUSIONS: In summary, a strong correlation was observed between spot urine protein/creatinine ratio and 24-h urine total protein excretion in proteinuria levels from 300 mg/day to 3,499 mg/day. A lower correlation was also maintained in 24-h urine total protein <300 mg. In our experience, there is no relevant correlation between spot urine protein/creatinine ratio and 24-h urine total protein excretion in nephrotic-range proteinuria.