Identifying the effective combination of acupuncture and traditional Chinese medicinal herbs for postmenopausal osteoporosis therapy through studies of their molecular regulation of bone homeostasis.

Worldwide, as the population age, osteoporosis is becoming increasingly common, and osteoporotic fractures have a significant economic burden. Postmenopausal women are the most susceptible to developing osteoporosis and the most critical time to prevent it is during the perimenopausal and early menopausal years. In this regard, we hypothesize rational combination of acupuncture and Traditional Chinese Medicine (TCM) in the form of herbal extract could prevent osteoporosis in women. Estrogen deficiency during menopause causes low-level inflammation that stimulates the formation of osteoclasts, the bone-resorbing cells, and simultaneously inhibits the viability and function of osteoblasts, the bone-forming cells. The most potent inflammatory cytokine in skeletal homeostasis is the receptor activator of nuclear factor kappa B ligand (RANKL) that stimulates osteoclast function. Conversely, the canonical Wnt pathway is essential for osteoblastogenesis and bone formation, and estrogen deficiency leads to diminished functioning of this pathway. TCM and acupuncture could target the RANKL and the Wnt pathway in favorable ways to prevent the accelerated bone loss experienced during the early menopausal stage and promote the gain in bone mass in postmenopausal women. In this review, we propose a rational combination of specific TCM and acupuncture targeting those signaling molecules/pathways by the drugs that are in clinical use for the treatment of postmenopausal osteoporosis. Our rational approach revealed that Danshen (Radix Salviae Miltiorrhizae) could exert a synergistic effect with acupuncture. We then propose a translational path for developing the putative combination in women with postmenopausal osteoporosis to curtail the risk of osteoporotic fractures.

Village doctors: a national telephone survey of Bangladesh's lay medical practitioners.

BACKGROUND: Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained 'village doctors' able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal 'clinics'. METHODS: The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. PRIMARY AND SECONDARY OUTCOME MEASURES: In addition to demographics, village doctors were asked about the characteristics of their 'clinics' including their equipment, their training, income and referral practices. RESULTS: Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor 'clinics' are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. CONCLUSIONS: Bangladesh's village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation's established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.

Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome: a network Meta-analysis.

OBJECTIVE: To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegm-stasis coronary heart disease by a network Meta-analysis. METHODS: Randomized controlled trials (RCTs) on clinical efficacy of CHD angina pectoris with interaction of phlegm and blood stasis were searched in PubMed, Springer, the Cochrane Library and Chinese-language databases China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Data from their inception to December 2021. Literature was screened and literature bias risk was assessed by RevMan5.4 software. The overall response rate, the duration of angina attack, the levels of serum lipids such as total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C), and expression of hypersensitive C-reactive protein (hs-CRP) were selected as outcome indicators for network Meta-analysis and mapped using Stata15.1 software. RESULTS: Totally, 26 RCTs were included, involving 2098 participants. There were 6 TCM formulas with the effects of dispelling phlegm and removing blood stasis. Taking conventional Western Medicine as the common intervention measures, the results showed that the overall response improvement rate from high to low was displayed as modified Xiaoxianxiong decoction (, MXD), Danlou tablet (, DT), modified Gualou Xiebai Banxia decoction (, MGXBD), modified Wendan decoction (, MWD), modified Zhishi Xiebai Guizhi decoction (, MZXGD), and modified Erchen decoction (, MED). The sequence of angina attack duration improvement from high to low was MZXGD, MGXBD, DT, MWD, MXD. The sequence of TC improvement from high to low was MZXGD, MED, DT, and MGXBD. Sequence of improving TG from high to low was MED, MZXGD, MGXBD, and DT. For LDL-C improvement, the effect from good to poor was MZXGD, MGXBD, DT, and MED. With regard to HDL-C improvement, the effect was ranked as MED, MZXGD, MGXBD, and DT from good to poor. hs-CRP expression from high to low was MZXGD, MXD, MED, MWD, and MGXBD. CONCLUSION: TCM formula with the effects of dispelling phlegm and removing blood stasis combined with conventional Western Medicine has obvious advantages in treating CHD angina pectoris with interaction of phlegm and blood stasis. MZXGD has great potential in increasing the overall response rate, reducing Duration of angina attack improving blood lipids, and reducing inflammatory factors. However, due to the limitations of extant studies, the conclusions of this study need to be confirmed by numerous reasonably-designed RCTs.

El valor de la acupuntura en la práctica de la medicina tradicional complementaria en el sector salud de México / The value of acupuncture in the practice of complementary traditional medicine in Mexico's health sector

Introduction: Complementary traditional medicine acquires an essential value from the diversity and pluralism of care and therapy. In this logic, it is up to people to search for alternatives when it comes to caring for and improving their own health. Specifically, acupuncture has had rapid growth, largely due to processes derived from globalization, migration and cultural exchange, which in some way force countries to modify their health system towards one that takes into account the transculturality of its population and treatment preferences. Development: With the establishment of a comprehensive health model, physicians can assess the person as a homeodynamic process (information exchange process between environment and man, to keep an internal and external homeostasis to the individual) and pandimensional (spiritual and energetic care) that allows to identify the health problem's origin and thus determine an intervention more in line with the person's needs during the health-disease, life-death processes, with the corresponding conventional or non-conventional therapy. Conclusions: The value and interest of acupuncture in the population derives from the degree of development of a country, its origin and the incorporation of the West as part of the diagnostic and therapeutic arsenal, in order to respond to the population needs by incorporating low-cost complementary treatments with proven effectiveness, without ceasing to consider its unquestionable cultural heritage.

Introducción: la medicina tradicional complementaria adquiere un valor imprescindible desde la diversidad y el pluralismo de la asistencia y la terapéutica. En esa lógica, corresponde a las personas la búsqueda social de alternativas cuando se trata de atender y mejorar la propia salud. En específico la acupuntura ha tenido un rápido crecimiento, en gran parte debido a la globalización, la migración y el intercambio cultural, que de alguna forma obligan a los países a modificar su sistema de salud hacia uno que tome en cuenta la transculturalidad de su población y las preferencias de tratamiento. Desarrollo: con el establecimiento de un modelo de salud integral, los médicos pueden valorar a la persona como un proceso homeodinámico (intercambio de información entre el ambiente y el hombre para mantener una homeostasis interna y externa del individuo) y pandimensional (cuidado espiritual y energético) que permita identificar el origen real del problema de salud y determinar una intervención más acorde a las necesidades de la persona durante los procesos de salud-enfermedad, de vida-muerte, con la terapia convencional o no convencional que corresponda. Conclusiones: el valor e interés de la acupuntura en la población se deriva del grado de desarrollo de un país, de su origen y de la incorporación de occidente como parte del arsenal diagnóstico y terapéutico, para responder a las necesidades de la población al incorporar tratamientos complementarios de bajo costo y con efectividad demostrada, y sin dejar de considerar su herencia cultural incuestionable.

Cuidados populares de las enfermedades crónicas entre indígenas Pijao durante la pandemia por Covid-19 / Folk care of chronic diseases among Pijao indigenous people during the Covid-19 pandemic

Justificación: la pandemia por Covid-19 ocasionó interrupción de los servicios dirigidos a atender las enfermedades crónicas provocando reajustes en el cuidado de los pacientes. Objetivo: Describir los cuidados populares empleados por los indígenas Pijao para el tratamiento y control de enfermedades crónicas, en contexto de pandemia, en Bogotá (Colombia). Metodología: Estudio cualitativo de tipo micro-etnográfico. Participaron 16 indígenas Pijao. Los datos, recolectados por medio de entrevistas y observación, fueron analizados temáticamente. Resultados: emergieron tres categorías, (1) del territorio de origen a la ciudad: cuidados populares para el tratamiento de las de enfermedades, (2) viviendo con la enfermedad: signos y síntomas de las de enfermedades, y (3) procura de otros recursos para el cuidado: autoatención y apoyo familiar. Conclusión: la trayectoria de cuidado de los Pijao con enfermedades crónicas fue permeada por la pandemia, convirtiendo los cuidados populares, caracterizados por un sincretismo de saberes, en parte fundamental de su rutina de cuidados. (AU)

Justification: The Covid-19 pandemic caused an interruption in the services aimed at attending to chronic diseases, resulting in readjustments in the care of patients. Objective: To describe the popular care used by the Pijao indigenous people for treating and controlling chronic diseases in the context of the pandemic in Bogotá (Colombia). Methodology: Qualitative micro-ethnographic study. Sixteen Pijao indigenous people participated. The data collected through interviews and observation were analyzed thematically. Results, three categories emerged: (1) from the territory of origin to the city: popular care for the treatment of illnesses, (2) living with the illness: signs and symptoms of illnesses, and (3) seeking other resources for care: self-attention and family support. Conclusion: the care trajectory of the Pijao with chronic diseases was permeated by the pandemic, turning popular care, characterized by a syncretism of knowledge, into a fundamental part of their care routine. (AU)

Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial.

Background: Burn wounds rank among the most serious healthcare issues. Many studies reported the effectiveness of natural products in the wound-healing process. The present study compared the effects of a standardized herbal formulation derived from Boswellia carteri (B. carteri) and silver sulfadiazine (SSD) cream 1% on the healing of burn wounds. Methods: This randomized double-blind clinical trial was conducted at Shiraz Burn Hospital (Shiraz, Iran) between July 2012 to August 2013. A sterilized formulation comprising B. carteri 40% was prepared. 54 second-degree burn patients of both sexes with age ranges of 20 to 60 were invited to participate in this double-blind, randomized clinical trial. They were randomly divided into two groups and given either the Boswellia formulation or SSD cream. The healing index was determined based on the wound area assessment using the planimetry technique. The Kaplan-Meier survival analysis was used to assess the primary outcome, which was the amount of time until complete healing. Results: The trial was completed by 17 patients from the SSD group and 15 patients from the Boswellia group. During the study period, both groups showed a progressive healing trend. The mean (95% CI) healing time in the SSD group was 10.94 (9.03-12.85) days and 10.73 (9.23-12.23) days in the Boswellia group (P=0.71), indicating no significant difference. On the 17th day, the healing index of all patients in the Boswellia group reached 1. Conclusion: Boswellia topical formulation had a burn wound healing effect comparable to that of the standard SSD 1% treatment. Based on the findings of this study, the likelihood of contact dermatitis with Boswellia should be taken into consideration.

Rabies research in Ethiopia: A systematic review.

Rabies is an important zoonosis in Ethiopia, where lack of research is cited as a constraint to implementation of the national rabies control strategy. We conducted a systematic review of publications and theses on rabies in Ethiopia, to document research gaps and areas of knowledge saturation in relation to geographic and species focus, methods and findings. We also examined funding sources and extent of local researcher participation. After screening titles and abstracts, the full text of 119 publications was included in data extraction. More than 40% of publications involved data collection in one region (Oromia); no publications reported findings from Benishangul-Gumuz, Dire Dawa or Gambella. Dogs and wildlife (especially Canis simensis) were the focus of research in 45% and 24% publications, respectively. Descriptive epidemiology (N = 39 publications), ethno-medicine/-pharmacology (N = 17) and knowledge, attitude, and practice surveys (KAP, N = 15) were amongst the most common study designs, while studies involving economic methods (N = 3) and experimental epidemiology to test interventions (N = 3) were under-represented. Incidence surveys (N = 9) commonly used post-exposure prophylaxis administration in humans as a proxy for exposure without laboratory confirmation of the rabies status of the animal. KAP surveys tended to highlight reasonable levels of knowledge of rabies and poor practices, including overreliance on medicinal plants. International researchers were the first or last (senior) author on 42% and 58% of publications, respectively, most of which were funded by international organizations (45/72 publications reporting funding source). Based on this systematic review, we suggest more applied research is needed to address gaps in laboratory surveillance (including in humans, domestic and wild animals); identify effective ways to overcome socio-cultural and other barriers to accessing effective rabies treatments; inform best approaches to incentivizing mass dog vaccination programs; and generate local estimates of the cost-benefit and cost-effectiveness of different control strategies to improve financing and political buy-in for rabies control in Ethiopia.

Development of precocious puberty in children: Surmised medicinal plant treatment.

Precocious puberty in children is one of the common endocrine diseases in paediatrics. Epidemiological surveys have shown that the number of children with precocious puberty has significantly increased globally. Precocious puberty negatively affects the physical and mental health of children and may increase the risk of hypertension, diabetes, obesity and infertility in adulthood. Therefore, the initiating factors of adolescence have become core issues in the study of sexual development in children. Owing to developments in molecular genetics, many studies have been able to show that precocious puberty is mostly resulted in autosomal inheritance. For instance, makorin ring finger protein 3 gene (MKRN3) may be implicated in familial CPP. Gonadotropin-releasing hormone agonist (GnRHa) is the gold standard for treatment, but its safety still requires long-term evaluation and management. Traditional medicinal plants have been used in clinical treatments and in exploring novel treatment methods. From the collected datas, in Asia, traditional Chinese medicine treatment is based on the principles of nourishing Yin, lowering fire and draining fire from the liver to help precocious children and alleviate or delay the onset of precocious puberty by medicinal plants such as Anemarrhena asphodeloides Bge., Phellodendron amurense Rupr., Rehmannia glutinosa and Poria cocos Wolf. They play an important role in exploring the pharmacological mechanisms of precocious puberty treatment effects and drug development. Therefore, by elucidating the occurrence and development of precocious puberty, this review provides novel and valuable insights of paediatric endocrine therapy accessing the published researches on the effectiveness of traditional herbal medicine in the treatment of precocious puberty and its therapeutic mechanisms.

Toxic medicine used in Traditional Chinese Medicine for cancer treatment: are ion channels involved?

Cancer has been one of the most serious public health issues in the world. Traditional medicines are widely used in adjunctive therapies in clinical cancer treatment in many countries. One of the unique traditional medicine usages in tumor treatment is the high-dose application of traditional toxin medicine, including venom or body from toxin animals. Evidence has shown that they are very likely to have direct effects on cancer cells. One of the potential pharmacological effects of traditional toxin medicines is their regulation of ion channels in cancers. Many ion channels are found critical in cancers. This study suggested that ion channels were involved in the effect of traditional toxin medicine on cancers. However, so far, the study of the effect of traditional toxin medicine on ion channels in cancers is relatively lacking. This perspective article urged the study in this field because, given the fact that these traditional toxin traditional medicines have been widely used in cancer treatment, the identification of the effective components and pharmacological targets can improve their clinical application.

The meaning attributed to the health-disease process by the elderly of the Makuxi ethnicity, Roraima, Brazil / O significado atribuído ao processo saúde-doença por idosos da etnia Makuxi, Roraima, Brasil

The objective of this study was to describe the meanings, representations of health and illness and therapeutic practices in the sociocultural context of the Makuxi indigenous elderly, from acertain community, in the Raposa/Serra do Sol Indigenous Land. This is a qualitative and exploratory study, based on ethnographic assumptions, carried out with 20 indigenous people. Data were collected in January 2020, through a semi-structured questionnaire, and submitted to Bardin's content analysis, and textual analysis using the Iramuteq software. The understanding of health and illness for the Makuxi elderly makes up questions of their daily life such as: the importance of working in the countryside, the consumption of typical foods of the culture and aspects of the elderly. The illness process, in his view, is strongly linked to the spell, and the search for traditional treatment is common in these cases, but the therapeutic itinerary occurs between traditional and biomedical systems. It is concluded that the knowledge of the health-disease process of the indigenous elderly has a strong cultural content associated with the Makuxi cosmovision, but which has already undergone transformations due to contact with non-indigenous people.

O objetivo deste estudo foi descrever os significados, representações de saúde e doença e as práticas terapêuticas no contexto sociocultural dos idosos indígenas Makuxi, de uma determinada comunidade, na Terra Indígena Raposa/Serra do Sol. Trata-se de um estudo qualitativo e exploratório, fundamentado pelos pressupostos etnográficos, realizado com 20 indígenas. Os dados foram coletados no mês de janeiro de 2020, por intermédio de um questionário semiestruturado, e submetidos a análise de conteúdo de Bardin, e análise textual por meio do software Iramuteq. O entendimento de saúde e doença para os idosos Makuxi compõe questões de sua vida cotidiana como: a importância do trabalho na roça, o consumo de alimentos típicos da cultura e aspectos da terceira idade. O processo de adoecimento, em sua visão, está fortemente ligado ao feitiço, e a busca pelo tratamento tradicional é comum nestes casos, mas o itinerário terapêutico ocorre entre os sistemas tradicionais e biomédico. Conclui-se que o conhecimento do processo saúde doença dos idosos indígenas possui um forte teor cultural associado à cosmovisão Makuxi, mas que já sofreu transformações devido ao contato com não indígenas.

Producción científica en Scopus sobre el uso de ayahuasca en la salud humana: Estudio Bibliométrico

Introducción: La ayahuasca (también llamada huasca, oasca, caapi o yagé) es un brebaje de uso tradicional, con efectos psicoactivos de interés en la salud humana. Esta situación crea la necesidad de generar conocimiento científico para identificar vacíos en el conocimiento y prioridades en investigación. Objetivo: Describir la producción científica sobre el uso de ayahuasca en seres humanos publicada en revistas indizadas en Scopus hasta octubre del 2021. Métodos: Estudio bibliométrico de bases de datos secundarias. Se realizó una búsqueda sistemática de información en Scopus de publicaciones científicas sobre el uso de Ayahuasca en problemas de salud. Se recolectó información sobre el año de publicación, idioma de publicación, áreas de conocimiento estudiadas, diseños de investigación involucrados, revista de publicación, proporciones de colaboración internacional, redes de colaboración interinstitucional, redes de coautoría, citas por documento y se describieron a los autores más productivos. Resultados: La tendencia de publicaciones fue creciente desde el 2012. El 36,8% de investigaciones se basaron en diseños observacionales. El promedio de citas por artículo fue 6,1 y el promedio de citas por año fue 3,9. Todas las publicaciones de Suiza, China, Nueva Zelanda y Perú tuvieron colaboración internacional; con cuatro conglomerados de cooperación. Conclusión: La producción científica sobre el uso de ayahuasca en la salud tiene una tendencia creciente, con preferencia en diseños observacionales, con una alta presencia de colaboración internacional y redes de colaboración institucional y de autores.

Introduction: Ayahuasca (also called huasca, oasca, caapi or yagé) is a concoction of traditional use, with psychoactive effects of interest in human health. This situation creates the need to generate scientific knowledge to identify gaps in knowledge and research priorities. Objective: To describe the impact of scientific production on the use of Ayahuasca in human health published in journals indexed in Scopus until October 2021. Methods: Bibliometric study of secondary databases. A systematic search of information was carried out in Scopus, in order to identify original articles that investigated the use of Ayahuasca in health problems. Information was collected on the year of publication, language of publication, areas of knowledge studied, research designs involved, journal of publication, proportions of international collaboration, inter-institutional collaboration networks, co-authorship networks, citations per document and the authors were described. more productive. Results: The trend of publications has been increasing since 2012. 36.8% of investigations were based on observational designs; with an average number of citations per article of 6.1 and an average number of citations per year of 3.9. All publications from Switzerland, China, New Zealand and Peru had international collaboration; with four cooperation conglomerates. Conclusion: The scientific production on the use of Ayahuasca in health has a growing trend, preferably in observational designs, with high international collaboration and institutional collaboration networks and authors.

Trends in traditional and complementary medicine practices in Turkey: Results of two consecutive surveys 2012-2018.

OBJECTIVE: To determine the knowledge, opinions, experiences and trends regarding herbal treatment, traditional medicine and other complementary and alternative medicine. METHODS: Two cross-sectional studies were conducted at Meram Faculty of Medicine Hospital, Konya, Turkey, in 2012 and 2018, comprising subjects of either gender aged >18 years. Data was collected using a survey form prepared in the light of relevant literature. Data was summarised and compared between the two studies. RESULTS: Of the 810 subjects in the two studies, there were 405(50%) in 2012 with a mean age of 32.5±14.0 years, while the remaining 405(50%) were part of the 2018 study with a mean age of 34.4±13.8. There were significant differences between the two group of subjects about the use and indications of traditional and complementary medicine as those who believed traditional and complementary medicine was proper to use increased and those who believed it should not be used decreased significantly (p<0.001). There was a twofold increase in the use of social media as the source of relevant information (p<0.001). CONCLUSIONS: Significant changes in trends related to the use of traditional and complementary medicine between 2012 and 2018 were observed.

Biosynthesis of titanium dioxide nanoparticles using Hypericum perforatum and Origanum vulgare extracts and their main components, hypericin and carvacrol as promising antibacterial agents.

OBJECTIVE: To evaluate the anti-bacterial activities of titanium dioxide (TiO) nanoparticles of Origanum (O.) vulgare and Hypericum (H.) perforatum extracts, carvacrol and hypericin against Staphylococcus (S.) aureus. METHODS: In this study, TiOnanoparticles of O. vulgare and H. perforatum extracts, carvacrol and hypericin, were prepared and their antibacterial effects were evaluated against Staphylococcus (S.) aureus. In this study, scanning electron microscope, fourier transform infrared spectrometer, atomic force microscopy, dynamic light scattering and zeta potential were used to investigate the structure of synthesized drugs. RESULTS: Anti-bacterial activity of synthesized NPs was tested by minimum inhibitory concentration (MIC), minimum bactericidal concentration and disc diffusion method. MICs of TiO-NPs synthesized using O. vulgare, H. perforatum, carvacrol and hypericin and TiO were obtained 250, 62.5, 250, and 250, and 500 µg/mL, respectively. The MBCs for all of these were obtained 1000 µg/mL. CONCLUSION: Green-synthesized of TiO nanoparticles provides a promising approach to the use of O. vulgare and H. perforatum, carvacrol and hypericin as novel agents and safer antibacterial compounds, especially anti-S. aureus compounds.

Current status of herbal medicine research for respiratory diseases induced by particulate matter: a protocol for a scoping review.

BACKGROUND: Particulate matter (PM) is an important environmental risk factor for the initiation and exacerbation of respiratory disease. Various herbal medicines have exhibited a reduction in symptoms of respiratory diseases induced by PM in animal models. However, the types and characteristics of studies on herbal medicine for respiratory diseases by PM have not been reviewed. This scoping review will focus on the currents status and research gap of herbal medicines for respiratory diseases caused by PM. METHODS: We will follow the scoping review framework developed by Arksey and O'Malley. MEDLINE (via PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials will be searched for relevant English-language publications, and only peer-reviewed, controlled comparative in vivo/in-vitro/human studies examining the effects of herbs on respiratory disease induced by PM will be included. The basic characteristics, research methods, detailed regimens, possible mechanisms, outcomes, and results will be extracted using a predefined standardized data extraction form. Outcomes will be presented in the following categories: pulmonary function, inflammatory markers, reactive oxygen species, histology and mechanisms, and adverse events. Two researchers will independently perform the study selection, data extraction, and quality assessment. We will also present the research map and implications for further study. ETHICS AND DISSEMINATION: Ethical approval is not required because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations. SYSTEMATIC REVIEW REGISTRATION: This review protocol has been registered with the Open Science Framework on February 12, 2021 ( https://osf.io/s7uvk/ ).

PEST analysis and countermeasure research on the development of Traditional Chinese Medicine in Lancang Mekong area / 国际中医中药杂志

This paper uses PEST analysis method to analyze the macro environment of the development of Traditional Chinese Medicine (TCM) in the Lancang-Mekong area. China has stable political relations with the other five countries in the Lancang-Mekong area, and governments attach great importance to TCM. TCM can reduce the economic burden of patients in the Mekong countries, and the five countries have extensive market. The Mekong countries recognize traditional medicine, and their local cultures and customs are similar to China. The medical level and pharmaceutical technology of TCM have advantages in the Mekong countries, and the registration standards of TCM and TCM practitioners are friendly. However, TCM also faces problems such as limited scale, insufficient service capacity, lack of policy guarantee and insufficient talents in the Mekong countries.Therefore, it is suggested to rely on intergovernmental cooperation to further tap the development potential of TCM in the Mekong countries; take advantage of overseas Chinese groups to promote the development of TCM; encourage enterprises to enter and expand the market of TCM; and actively cultivate international TCM talents.

Blessing as a health resource: cross-sectional study with elderly residents of rural areas / Benzeção como recurso em saúde: estudo transversal com idosos moradores de área rural

ABSTRACT OBJECTIVE To estimate the prevalence and factors associated with the search for folk healers for the treatment of health problems among elderly living in the rural area of the city of Rio Grande-RS. METHODS Cross-sectional, p opulation-based study with random sampling, carried out in 2017. The outcome was analyzed in three categories (never used/used in the last 12 months/used for more than 12 months). Multinomial logistic regression was used to analyze theassociated factors. RESULTS A total of 1,030 elderly individuals were interviewed. The prevalence of demand for folk healers in the last 12 months and for more than 12 months was 9.5% and 15.8%, respectively. In the adjusted analysis, the characteristics associated with the use of a folk healer for more than 12 months were: being in the age group of 80 years or more and having back problems and arthrosis. Following the evangelical religion was identified as a protective factor for using this resource. On the other hand, the demand for blessing in the last year was related to the age group of 70-79 years, following spiritual religions, presence of disease in the last 12 months, back problems and arthrosis, and preference for the use of urgency and emergency services. Being female was associated only with the use for more than 12 months. CONCLUSION This study brings an original contribution to a topic poorly evaluated in epidemiological studies, because the knowledge of the frequency and determinants of the search for this type of popular therapy can be used to improve the quality and access to health services offered to the elderly population in rural areas.

RESUMO OBJETIVO Estimar a prevalência e os fatores associados à procura de benzedeiras para tratamento de problemas de saúde entre idosos residentes na área rural do município do Rio Grande-RS. MÉTODOS Estudo transversal, de base populacional com amostragem aleatória, realizado no ano de 2017. O desfecho foi analisado em três categorias (nunca usou/usou nos últimos 12 meses/usou há mais de 12 meses). Para análise dos fatores associados foi utilizada regressão logística multinomial. RESULTADOS Foram entrevistados 1.030 idosos. As prevalências da procura por benzedeira nos últimos 12 meses e há mais de 12 meses foram de 9,5% e 15,8%, respectivamente. Na análise ajustada, as características associadas à utilização de benzedeira há mais de 12 meses foram: estar na faixa etária de 80 anos ou mais e ter problemas de coluna e artrose. Seguir a religião evangélica foi identificado como fator de proteção para a utilização desse recurso. Já a procura por benzedeira no último ano esteve relacionada com a faixa etária dos 70-79 anos, seguir religiões espiritualistas, presença de doença nos últimos 12 meses, problemas na coluna e artrose e preferência por utilização de serviços de urgência e emergência. Sexo feminino permaneceu associado apenas à utilização há mais de 12 meses. CONCLUSÃO Este estudo traz uma contribuição original a um tema pouco avaliado em estudos epidemiológicos, pois o conhecimento da frequência e dos determinantes da busca por esse tipo de terapia popular, pode ser utilizado para melhorar a qualidade e o acesso aos serviços de saúde oferecidos à população idosa de áreas rurais.

Racionalidades Médicas: avaliação de componente optativo na formação médica / Medical rationalities: evaluation of optional component in medical training

Resumo: Introdução: A superação da crise mundial do paradigma biomédico tem promovido a inserção de medicinas tradicionais nos sistemas públicos de saúde de muitos países. O Brasil é vanguarda desse movimento e, a partir do lançamento da Política Nacional de Práticas Integrativas e Complementares em 2006, insere oficialmente práticas na atenção à saúde ofertada pelo SUS. Entretanto, a baixa qualificação nessa área dos profissionais que atendem ao SUS tem dificultado a resolubilidade dos serviços. Um dos grandes desafios é a formação de profissionais sensíveis a práticas de saúde provenientes de outras culturas e com paradigma vitalista. A hipótese do estudo é que a inserção de conteúdo sócio-histórico-epistemológico de Racionalidades Médicas no período formativo pode introduzir uma efetiva articulação entre diferentes medicinas, saberes e práticas, promovendo integração do saber convencional com outras culturas em saúde. Objetivo: Este estudo teve como objetivo avaliar o interesse dos acadêmicos pelo tema, pouco reconhecido nos cursos de Medicina do Brasil, mas crescentemente valorizado e incorporado na educação médica de muitos países. Método: Trata-se de um estudo de abordagem mista. A análise qualitativa de delineamento exploratório-descritivo foi organizada mediante exploração dos dados coletados com perguntas abertas aplicadas aos acadêmicos no primeiro dia de aula e ao final do curso, com respostas manuscritas. A análise quantitativa de delineamento transversal foi feita por meio de informações coletadas em questionário fechado, aplicado no último dia de aula. Resultado: Considerando as questões apresentadas aos estudantes no início e ao final da oferta do componente, as expectativas foram superadas, sendo muito bem avaliado ao término. Os participantes do estudo demonstraram interesse em novos conhecimentos no período formativo. As análises permitem afirmar que inserir esse tema aguça a reflexão crítica sobre os paradigmas, mesmo sendo apresentado de forma vertical, pontual e de caráter informativo no contexto do curso estudado. Ficou demonstrado que, na percepção dos estudantes, há grande interesse na inclusão de disciplinas que abordem esse campo científico. Conclusão: Este estudo demonstra que, na realidade do curso pesquisado, há boas perspectivas de integração e complementaridade de novos saberes e práticas de saúde na formação médica.

Abstract: Introduction: Overcoming the global crisis of the biomedical paradigm has promoted the insertion of Traditional Medicine in public health systems in many countries. Brazil is at the forefront of this movement, and since the launch of the National Policy on Integrative and Complementary Practices in 2006, it has officially included practices in the health care offered by the SUS. However, low qualification in this area of the professionals who work for the SUS, has hindered the levels of resolution in these services. One of the major challenges is training professionals who would be sensitive to health practices from other cultures and follow a vitalist paradigm. The study hypothesis is that the inclusion of socio-historical-epistemological content of Medical Rationalities during professional training can introduce an effective articulation between different medicines, promoting integrated knowledge. Objective: To assess the interest of academics in the topic, which carries little recognition in medical courses in Brazil but has been increasingly valued and incorporated into medical education in many countries. Method: This is a mixed-approach study. The qualitative analysis was organized by exploring the data collected with open-ended questions applied to students on the first day of classes and at the end of the course. The cross-sectional analysis was performed using information collected in a closed questionnaire applied to students. Result: Considering the questions presented to students at the beginning and the end of the component, expectations were exceeded, with very high assessment levels achieved at the end. The study participants showed interest in new knowledge in the training period. The analyses allow us to assert that including this theme sharpens critical reflection on the paradigms, even though it is presented vertically, punctually, and with an informative character, in the context of the course. There was great interest from participants in disciplines that addressed this scientific field. Conclusion: There are good prospects for the integration and complementarity of new knowledge and health practices in medical education in the reality of the studied course.

[The perception of illness in people with chronic complications caused by diabetes mellitus]. / La percepción del padecer en personas con complicaciones crónicas por diabetes mellitus.

BACKGROUND: The representations and practices of people who suffer chronic complications of type 2 diabetes mellitus were described and analyzed. The information was analyzed with the constructivist grounded theory, the theories of social representations and experience of the disease, explanatory models of illness, and medical pluralism. The hypothesis of this research was to highlight the presence of diverse representations and practices in people with diabetes mellitus that help to signify the experience of the disease according to their sociocultural context. OBJECTIVE: To study the experience shared by people suffering from diabetes mellitus and its chronic complications. MATERIAL AND METHODS: An observational, retrospective, synchronous and qualitative study was carried out with a sample of five patients. The selection criteria were: having chronic complications of type 2 diabetes mellitus and living in the town of Coatetelco. Likewise, six physicians were included under the following selection criteria: attending to patients at Coatetelco. Eleven interviews were conducted. RESULTS: The interviews demonstrated that the explanatory models of the disease include biomedical, traditional medicine and self-care elements, and are built from collective experience. Culture adopts and resignifies knowledge from different forms of health care. Narratives are a useful tool for the analysis of the perspective and meaning of subjectivities. CONCLUSIONS: The knowledge of individuals affected with chronic complications from diabetes is made up of elements resignified from biomedical care, traditional medicine and self-care.

INTRODUCCIÓN: se describieron y analizaron las representaciones y prácticas de las personas con complicaciones crónicas de la diabetes para determinar sus saberes. Se retomaron la teoría fundamentada constructivista, las teorías de representaciones sociales, los modelos explicativos de la enfermedad y el pluralismo médico para el análisis sociocultural. La hipótesis de esta investigación fue destacar la presencia de diversas representaciones y prácticas en personas con diabetes mellitus que significan la experiencia de la enfermedad de acuerdo con su contexto sociocultural. OBJETIVO: estudiar la experiencia compartida por personas que padecen diabetes mellitus y sus complicaciones crónicas. MATERIAL Y MÉTODOS: se realizó un estudio observacional, retrospectivo, sincrónico y cualitativo con cinco padecientes, los criterios de selección fueron: tener complicaciones crónicas de diabetes mellitus tipo 2 y vivir en la localidad de Coatetelco; asimismo, se incluyeron seis médicos bajo el criterio de selección de atender a padecientes en Coatetelco. Se realizaron once entrevistas. RESULTADOS: las entrevistas demostraron que los modelos explicativos de la enfermedad incluyen elementos biomédicos, de medicina tradicional y de autoatención, y son construidos a partir de la experiencia colectiva. La cultura adopta y resignifica saberes desde las diferentes formas de atención a la salud. Las narrativas son una herramienta útil para el análisis de la perspectiva y el significado de las subjetividades. CONCLUSIONES: los saberes de los individuos con complicaciones crónicas por diabetes se componen de elementos resignificados desde la atención biomédica, la medicina tradicional y la autoatención.

Equity, intercultural approaches, and access to information on traditional, complementary, and integrative medicines in the Americas.

Access to information and intercultural approaches in the field of health are essential for the elimination of inequities in health access and care. Intercultural models such as traditional, complementary, and integrative medicine (TCIM) are an important part of health care in most countries and often contribute to expanding access to primary health care. Despite legal recognition and policies to integrate TCIM into health systems, their contribution to health, well-being, and people-centered care to achieve universal health is still underestimated. This article presents the progress (2017-2020) achieved by the Virtual Health Library specialized in the TCIM (VHL TCIM Americas), an initiative created as a tool to reduce the gaps in the production and access to validated information on TCIM. Through collaborative network work, VHL TCIM Americas contributes to the democratization of health, access to verified scientific data, visibility of non-conventional knowledge, strengthening of research capacities, and exchange of experiences for informed decision-making.

El acceso a la información y los abordajes interculturales en el ámbito de la salud son esenciales para la eliminación de inequidades en el acceso a los servicios de salud y la atención sanitaria. Los modelos interculturales, como las medicinas tradicionales, complementarias e integrativas (MTCI) son una parte importante del cuidado de la salud en la mayoría de los países y frecuentemente contribuyen a ampliar el acceso a la atención primaria de salud. A pesar del reconocimiento legal y de la existencia de políticas para la integración de las MTCI en los sistemas de salud, aún se subestima su contribución a la salud, el bienestar y la atención de la salud centrada en las personas para alcanzar la salud universal. En este artículo se presentan los avances (2017-2020) alcanzados por la Biblioteca Virtual en Salud especializada en las MTCI (BVS MTCI Américas), iniciativa creada como herramienta para disminuir las brechas en la producción y el acceso a la información validada sobre las MTCI. Mediante el trabajo colaborativo en red, la BVS MTCI Américas contribuye a la democratización de la salud, el acceso a datos científicos verificados disponibles, la visibilización de conocimientos no convencionales, el fortalecimiento de capacidades de investigación y el intercambio de experiencias para la toma informada de decisiones.

O acesso à informação e as abordagens interculturais no setor da saúde são essenciais para eliminar as desigualdades no acesso aos serviços de saúde. Os modelos interculturais, como as medicinas tradicionais, complementares e integrativas (MTCI), são uma parte importante da atenção à saúde na maioria dos países e frequentemente contribuem para ampliar o acesso à atenção primária. Apesar do reconhecimento legal e da existência de políticas para a integração das MTCI nos sistemas de saúde, a sua contribuição para a saúde, o bem-estar e a atenção centrada nas pessoas para alcançar a saúde universal ainda é subestimada. Este artigo apresenta o progresso (de 2017 a 2020) alcançado pela Biblioteca Virtual em Saúde especializada em MTCI (BVS MTCI Américas), uma iniciativa criada como ferramenta para reduzir as disparidades na produção e no acesso a informações validadas sobre as MTCI. Realizando um trabalho colaborativo em rede, a BVS MTCI Américas contribui para a democratização da saúde, o acesso a dados científicos verificados, a visibilidade dos conhecimentos não convencionais, o fortalecimento das capacidades de pesquisa e a troca de experiências para a tomada de decisões bem informada.