The state mindfulness scale for physical activity: further psychometrics properties / Escala de estado de mindfulness para atividade física: novas propriedades psicométricas / Escala de mindfulness en la actividad física: nuevas propiedades psicométricas

Mindfulness has been defined as attention and awareness to the present with an attitude of openness, non-judgment, and acceptance. It is suggested that mindfulness can positively influence experiences in sports and physical activity, increasing adherence to these activities. This study aimed to examine new psychometric properties of the State Mindfulness Scale for Physical Activity (SMS-PA) using classical and modern testing theories among Brazilian sport and exercise practitioners. Two studies were conducted. In the first, with 617 Brazilian sports practitioners, confirmatory factor analysis supported the bifactor structure of the SMS-PA composed of two specific (mental and body mindfulness) and one general factor (state mindfulness), which did not vary among genders. The Rasch Rating Scale Model (RSM) supported essential one-dimensionality indicated by the general factor with good item fit statistics (infit/outfit 0.62-1.27). The model presented a good level of Rasch reliability (0.85), and the items difficulty estimation provided an understanding of the continuum represented by their content. In the second study, with 249 Brazilian exercise practitioners, the structural equation modeling showed that Body Mindfulness was associated with positive outcomes (positive affect and satisfaction with practice). The mediation analysis showed that people with higher levels of Body mindfulness tend to experience greater levels of Positive Affect and, consequently, greater Satisfaction with exercises. The results suggest that the Brazilian version of the SMS-PA is an appropriate measure of the state of mindfulness.(AU)

Mindfulness pode ser definido como atenção e consciência no momento presente com uma atitude de abertura, não julgamento e aceitação. A literatura sugere que o mindfulness pode influenciar positivamente experiências no esporte e atividade física e pode exercer um papel na adesão a essas atividades. Este estudo teve como objetivo investigar novas propriedades psicométricas da State Mindulness Sacale for Physical Activity (SMS-PA) utilizando as teorias clássicas e modernas dos testes em praticantes de exercício físico e esporte brasileiros. Dois estudos foram conduzidos. No primeiro, com 617 brasileiros praticantes de esporte, a Análise Fatorial Confirmatória (AFC) demonstrou adequação à estrutura bifatorial da SMS-PA composta por dois fatores específicos (mindfulness mental e físico) e um fator geral (estado de mindfulness), que apresentou invariância entre sexos. A Rasch Rating Scale Model (RSM) corroborou a unidimensionalidade essencial indicada pelo fator geral com bons índices de ajustes (infit/outfit 0.62 -1.27). O modelo apresentou bom nível de precisão Rasch (.85), e a estimação de dificuldade dos itens possibilitou compreensão do continuum representado pelo conteúdo dos itens. No segundo estudo, com 249 brasileiros praticantes de esporte, a Modelagem de Equações Estruturais demonstrou que o mindfulness físico esteve associado a afetos positivos e satisfação com a prática. A análise de mediação mostrou que pessoas com níveis altos de mindfulness físico tendem a apresentar níveis mais elevados de afeto positivo e, consequentemente, níveis mais elevados de satisfação com a prática. Os resultados sugerem que a versão brasileira do SMS-PA é uma medida apropriada do estado de mindfulness para atividades físicas.(AU)

La atención plena puede definirse como la atención y la conciencia en el momento presente con una actitud de apertura, no juicio y aceptación. La literatura sugiere que el mindfulness puede influir positivamente en las experiencias en el deporte y en la actividad física, además de desempeñar un papel en la adherencia a estas actividades. Este estudio tuvo como objetivo investigar nuevas propiedades psicométricas de la State Mindfulness Scale for Physical Activity (SMS-PA) utilizando las teorías clásicas y modernas de las pruebas en practicantes de ejercicio físico y de deporte en Brasil. Para ello, se realizaron dos estudios. En el primer, participaron 617 practicantes de deporte brasileños, y el análisis factorial confirmatorio (AFC) demostró adecuación en la estructura bifactorial de la SMS-PA, compuesta por dos factores específicos (mindfulness mental y físico) y un factor general (estado de mindfulness), que mostró invarianza entre sexos. El Rasch Rating Scale Model (RSM) corroboró la unidimensionalidad esencial indicada por el factor general con buenos índices de ajuste (infit/outfit 0,62-1,27). El modelo mostró un buen nivel de precisión de Rasch (.85), y la estimación de la dificultad de los ítems permitió comprender el continuo representado por el contenido de estos. En el segundo estudio, con 249 practicantes de deporte, el modelo de ecuaciones estructurales mostró que el mindfulness físico estaba asociado a resultados positivos (afecto positivo y satisfacción con la práctica). El análisis de mediación reveló que las personas con altos niveles de mindfulness físico tendían a tener mayores niveles de afecto positivo y, en consecuencia, mayores niveles de satisfacción con la práctica. Los resultados sugieren que la versión brasileña de la SMS-PA es una medida adecuada de mindfulness.(AU)

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

Cultura científica, magnetismo y espiritismo durante fines del siglo XIX en Buenos Aires: un análisis desde Ovidio Rebaudi / Scientific culture, magnetism and spiritualism during the end of the 19th century in Buenos Aires: an analysis from Ovidio Rebaudi

El objetivo de este artículo es analizar a un personaje remarcable del escenario cultural y científico de Buenos Aires de fines de siglo, el director de la Revista Magnetológica: Ovidio Rebaudi (1860-1931), renombrado químico así como adherente al espiritismo y el magnetismo. La vida y obra del mismo, oriundo de Paraguay y radicado en Argentina, resulta de utilidad para comprender cómo actores de filiación científica practicaban y defendían, al mismo tiempo, la hipnosis y el magnetismo. De hecho, Rebaudi dedicó gran parte de su vida a estudiar y conceptualizar acerca de los fenómenos sobrenaturales, llevando a cabo también curaciones magnéticas y diversas experiencias espiritistas, siempre dotando sus prácticas de cientificidad. El presente artículo analiza a este personaje de fin de siglo que abogaba, al mismo tiempo, por las prácticas científicas y por el estudio de lo sobrenatural. Entendemos que dicho análisis servirá para iluminar las zonas de mixtura y entrelazamiento entre terrenos tan disímiles como el científico y el de las energías y fluidos magnéticos.

The aim of this paper is to analyze a remarkable character of Buenos Aires cultural and scientific scenario during the end of the century, the producer of the Revista Magnetológica (Magazine of magnetism) Ovidio Rebaudi (1860-1931), a well-known chemist and follower of magnetism and spiritualism. The life and work of this chemist, native of Paraguay and resident of Argentina, seem useful to understand how scientific actors held and protect hypnotic and magnetic practices. In fact, Rebaudi dedicated a great part of his life to the study and conceptualization of supernatural phenomena, performing magnetic healings and diverse spiritualist experiments, enduing their practices with scientific attributes. This paper intends to analyze this end-of-the-century character, who pleaded for scientific practices on the one hand, and for supernatural studies on the other. We understand that this analysis could enlighten some mixture zones and interweaved soils between the scientific and the magnetic grounds.

Concept Analysis of Healing: Focusing on Patient Health related Literatures

PURPOSE: The purpose of this study was to identify attributes of the concept of healing. METHODS: Using Walker & Avant's concept analysis framework, medical & nursing text books and, research articles about healing published between 2000 and 2014 were reviewed. RESULTS: There were four aspects of the concept of healing: natural process through spiritual and mental purification; resilience of emotions and feeling in human nature; holistic cure as well as physical and mental treatment of disease; and harmonious balance and overall well-being of mind and body. Antecedents of healing that helped to purify the mind were illness recovery and injury perception. Empirical referents of healing were purifying the mind, quality of life and health-related spirituality. The consequences of healing were effective on the physical, psychosocial, spiritual and overall well-being of the patients. CONCLUSION: This concept analysis of healing help us to understand more clearly overall health and the health of patients in the clinical field. The concept of healing could be useful to promote health and well-being.

Influencia mental a distancia sobre los organismos vivientes / Distant mental influence on living organisms

Este artículo revisa estudios relacionados con la influencia mental a distancia sobre los organismos vivientes, incluyendo las sugestiones mentales de sueño y despertar, la influencia mental a grandes distancias, las interacciones mentales con sistemas biológicos remotos, los efectos de la mente en la actividad fisiológica y el sentimiento de ser observado. Los efectos significativos de la influencia mental a distancia se han demostrado en varios ensayos bien controlados, doble-ciegos, realizados en el laboratorio, en humanos, animales, plantas y bacterias. Aunque la influencia mental a distancia parece contradecir nuestro sentido ordinario de la realidad y las leyes definidas por la ciencia convencional, se han propuesto varias hipótesis para explicar los efectos observados, entre las cuales se incluyen las hipótesis de los escépticos, la de la transferencia de señales, la de los campos, las multidimensionales de espacio-tiempo y las hipótesis de la mecánica cuántica. En conclusión, a medida que los progresos en la física continúen refinando nuestra comprensión de la realidad, surgirá una explicación racional para esta interacción mental a distancia y, como lo ha mostrado la historia frecuentemente, cada vez que las fronteras científicas se expanden, los eventos sobrenaturales se transforman en paranormales y luego en normales.

This article reviews studies of distant mental influence on living organisms, including mental suggestions of sleeping and awakening, mental influence at long distances, mental interactions with remote biological systems, mental effects on physiological activity and the sense of being stared at. Significant effects of distant mental influence have been shown in several randomized controlled trials in humans, animals, plants, bacteria and cells in the laboratory. Although distant mental influence on living organisms appears to contradict our ordinary sense of reality and the laws defined by conventional science, several hypotheses have been proposed to explain the observed effects; they include skeptical, signal transfer, field, multidimensional space/time and quantum mechanics hypotheses. In conclusion, as the progress of physics continues to expand our comprehension of reality, a rational explanation for distant mind-matter interaction will emerge and, as history has shown repeatedly, the supernatural events will evolve into paranormal and then, into normal ones, as the scientific frontiers expand.

A emergência da cura pela palavra na medicina mental do século XIX / The emergence of the talking cure in 19-century mental medicine / La naissance de la thérapie par la parole au 19e siècle / La emergencia de la terapia por la palabra en la medicina mental del siglo XIX

Este artigo analisa algumas das condições de possibilidade da emergência da terapia pela palavra no rol de terapêuticas médicas no fim do século XIX. A hipótese é de que o processo de construção do psiquismo, como objeto médico, está relacionado à emergência de categorias de doença referidas a sintomas sem explicação anatômica, como foi o caso da neurastenia, da histeria e da psicastenia, que contribuíram para tornar insuficiente a referência à organicidade como causa de doenças mentais e para a criação de um novo gênero de clínica centrado na fala.

This paper analyses the conditions present for the emergence of the talking cure as one among other medical therapies in the late 19th century. The hypothesis is that the construction of the psychism as a medical object is related to the emergence of medical categories for symptoms that seem to have no anatomical basis, such as neurasthenia, hysteria and psychosthenia. These categories helped show that purely organic explanations were insufficient to explain many symptoms. They therefore contributed to the establishment up a new style of clinical treatment based on speech.

Cet article analyse quelques conditions qui ont favorisées le surgissement de la thérapie par la parole parmi d'autres thérapeutiques médicales à la fin du XIX siècle. Notre hypothèse défend que le processus de construction du psychisme comme objet de la médicine va de pair avec le surgissement des catégories des maladies dont les symptômes n'ont pas de cause anatomique, comme la neurasthénie, l'hystérie et la psychasthénie. Celles-ci ont contribué à la conclusion que les explications organiques sont insuffisantes, ainsi qu'à la création d'un nouveau genre de clinique centrée sur la parole.

Este artículo presenta algunas condiciones que permiten tratar el psiquismo através del surgimiento de la terapia por la palabra en las terapéuticas medicas a finales del siglo XIX. La hipótesis que se defiende es la de que el proceso de construcción del psiquismo como objeto médico está relacionado con el surgimiento de categorías de enfermedades para síntomas sin explicación anatómica, como la neurastenia, la histeria y de la psicoastenia que contribuyeron para tornar insuficiente como causa la organicidad y para la creación de un nuevo genero de clínica centralizado en la palabra.

Efeito das terapias associadas de imagem motora e de movimento induzido por restrição na hemiparesia crônica: estudo de caso / Effects of associated therapies of motor imagery and constraint-induced movement in chronic hemiparesis: a case study

Este estudo analisa os efeitos da associação das terapias de imagem motora e de movimento induzido por restrição na reeducação funcional do membro superior (MS) de um paciente com deficit sensorial e motor determinado por acidente vascular encefálico (AVE). A terapia de imagem motora (IM) consistiu em: 1o, estimulo visual do espelho, em 3 sessões semanais de 30 a 60 minutos por 4 semanas; e 2o, IM com prática mental, em 3 sessões semanais de 15 minutos por 3 semanas. Por último foi aplicada a terapia de indução ao movimento por restrição do membro superior não-afetado por 14 dias, em 10 dos quais foi feita atividade funcional do membro parético por 6 horas diárias. Além da avaliação clinica da sensibilidade e medida da força de preensão palmar, antes do tratamento e após cada modalidade de terapia foi medida a amplitude de movimentos de ombro,cotovelo e punho e aplicada a escala de avaliação motora (EAM). Os escores dos quatro momentos da coleta foram comparados estatisticamente. Após o tratamento os resultados mostraram diferença significativa (p<0,05) com aumento da amplitude de movimentos em todas as articulações do MS e na força de preensão palmar; redução no tempo de execução de tarefas da função de braço e mão na EAM; e recuperação clinica da sensibilidade, especialmente tátil e sensação de pressão. No paciente estudado a associação da IM e da terapia de movimento induzido por restrição foi eficaz na recuperação funcional do membro superior parético pós-AVE.

This study assessed the efficacy of the association of motor imagery and constraint-induced movement therapies in functional rehabilitation of the upper limb in a patient with somatosensory and motor deficits following stroke. Motorimagery (MI) therapy, i.e., mental simulation of body image, consisted in: 1st, mirror visual stimulus, at three 30-60-minute weekly sessions for four weeks; and 2nd, MI with mental practice, at three 15-minute sessions per week for three weeks. Lastly, constraint-induced movement therapy was applied for 14 days, in 10 of which the patient underwent 6 hours daily of paretic limb functional training. The patient was assessed at baseline and at the end of each therapy modality as to clinical examination of sensation; hand grip strength; shoulder, elbow and wrist range of motion; and the motor assessment scale (MAS) was applied. Scores obtained at the four assessment moments were statistically compared. Results showed significant differences (p<0.05) after treatment: increased range of motion at all upper limb joints, increased hand grip strength, decrease in time of task performance at MAS, and recovery of clinical sensation, especially tactile detection and pressure sense. The association of IM and constraint-induced therapies thus proved effective infunctional rehabilitation of the upper limb of the poststroke patient with chronic hemiparesis.

Encontros para a construção coletiva de reflexões: uma possibilidade de lidar com o sofrimento mental para além da consulta / Meetings for the construction of collective reflections: a possibility of dealing with mental distress in addition to consultation / Reuniones para la construcción de la reflexión colectiva: la posibilidad de hacer frente a los transtornos mentales, además de la consulta

Este trabalho descreve uma maneira de ampliar as possibilidades de participação de pessoas com sofrimento mental no entendimento e consequente melhora de suas queixas. Percebeu-se durante os atendimentos em consultas psiquiátricas que, sob os sintomas de parte dos pacientes, ocultavam-se dificuldades existenciais humanas, como, por exemplo, intolerância aos períodos de tristeza que podem fazer parte da vida. Tais dificuldades permaneciam inconscientes, como se os sintomas fossem algo que surgisse do nada, causando passividade e exagerada expectativa no efeito exclusivo dos medicamentos. Criamos encontros abertos à população baseados nessas percepções, com a intenção de, por meio de temas e de formas de apresentação provocativas, convidar os participantes a uma reflexão ativa e conjunta. Tais encontros tiveram por objetivo favorecer o surgimento de novos olhares e atitudes frente aos sintomas, colocando o “doente/sofredor” no papel de cocriador de novas possibilidades frente ao sofrimento e à própria vida e, por fim, favorecendo a transformação dos sintomas em possibilidade de cura.

This study describes a way to expand the opportunities for people with mental distress to understand their complaints and, in consequence, to improve. It was noticed during the psychiatric consultations that behind the symptoms of the patients, human existential difficulties were hidden, such as intolerance to periods of sadness that can be part of life. Such difficulties remained unconscious, as if the symptoms were something that arose from nowhere, causing exaggerated expectations and passivity in the exclusive effect of drugs. We created meetings open to the population, with the intention to invite, through themes and provocative presentations, participants to join an active and conjoint reflection. These meetings were intended to encourage the emergence of new perspectives and attitudes towards symptoms, positioning the "patient / sufferer" in the role of co-creator of new possibilities in response to suffering and life itself, and finally, promoting the transformation of symptom into the possibility of cure.

Este estudio describe una forma de ampliar las oportunidades de participación de las personas con trastornos mentales en la comprensión y la consiguiente mejora de sus quejas. Se observó durante las visitas en las consultas psiquiátricas que, debajo de los síntomas de los pacientes, se ocultaron humanos dificultades existenciales, como la intolerancia a los períodos de tristeza que puede ser parte de la vida. Estas dificultades se mantuvieron inconscientes, como si los síntomas fueron algo que surgió de la nada, haciendo que las expectativas exageradas y la pasividad en el efecto único de los medicamentos. Sobre la base de estas percepciones se crearon las reuniones abiertas a la población, con la intención, a través de temas y presentaciones de provocación, de invitar a los participantes a una reflexión conjunta y activa. Estas reuniones tenían por objeto favorecer la emergencia de nuevas perspectivas y actitudes de los síntomas, haciendo que el "paciente / víctima" en el papel de co-creador de nuevas posibilidades en respuesta al sufrimiento y la vida misma, y, por último, promover la transformación de los síntomas en posibilidad de cura.

effect of the holy quran reading fistruction on stress reduction in the young and adolescents

Although stress will cause dynamic and stimulus in life, special amount of stress is beneficial for human being, but too much of it may case physical and psychological illness. Study the effect of Quran reading instruction on stress reduction in the form of comparison of experimental and control groups and determine the role of gender and group factors on global scores of stress. This study was quasi-experimental and after cluster sampling, 170 person of 16- 26 year old which consisted of 87 Quran instruction classes attendants and 83 of control group, were tested with SS1 questionnaire, before and after instruction. There was significant difference between two groups in the four subscales of stress [Wilks' Lambda = 0/992, F[4, 163] = 3/47, P<0/01, eta[2] = 0/078], there was not meaningful difference between men and women in the four subscales of stress [Wilks' Lambda - 0/991, F[4, 163] - 0/380, P<0/823, eta[2] - 0/009] there was not significant interaction between membership in group and gender [F[l, 166] = 0/318, P<0/574, eta[2]= 0/002]. In comparison with control group, in experimental group Quran instruction has reduced stress in significant level. There was not significant difference between men and women in the four subscales of stress. There was not significant interaction between membership in group and gender

Mental health, depression, and anxiety in patients on maintenance dialysis

Depression and anxiety are among the most common comorbid illnesses in people with end-stage renal disease [ESRD]. Patients with ESRD face many challenges which increase the likelihood that they will develop depression or anxiety or worsen these conditions. These include a general feeling of unwellness; specific symptoms caused by ESRD or the patient's treatment; major disruptions in lifestyle; the need to comply with treatment regimens, including dialysis schedules, diet prescription, and water restriction; ancillary treatments and hospitalizations; and the fear of disability, morbidity, and shortened lifespan. Depression has been studied extensively in patients on maintenance dialysis, and much effort has been done to validate the proper screening tools to diagnose depression and to define the treatment options for patients on maintenance dialysis with depression. Anxiety is less well studied in this population of patients. Evidence indicates that anxiety is also common in maintenance dialysis. More attention should be paid to measuring the incidence and prevalence and developing methods of diagnosis and treatment approaches for anxiety in patients with ESRD. In this review, we attempted to underscore those aspects of depression and anxiety that have not been investigated extensively, especially with regard to anxiety. The interaction between racial/ethnic characteristics of patients on maintenance dialysis with depression and anxiety needs to be studied more extensively, in order to assess better approaches to healthcare for these individuals

Visiting holy shrines; a survey to assess the common reasons by devotees in Karachi, Pakistan

There are frequent visits of the devotees to the holy shrines mainly for the purpose of mental healing. The people with various beliefs and religions attribute divine powers to the graves of their saints. This study surveyed the purpose of the visits to shrines, their beneficial effects, and also the sanctity violated by drug addicts and others. 1] To assess the common reasons of visiting holy shrines. 2] To determine the use / misuse of these visits. Cross-sectional. One most commonly visited shrine in Karachi. 01-06-2008 to 30-07-2008. 120 visitors. Visitors of 20 years age or older, who consented to participate. Visitors of less than 20 years age and who did not agree to participate. Total number of study subjects was 120, with male to female ratio of 58: 42. Their age varied from 20 to 80 years. They belonged to various socioeconomic and ethnic groups with varying educational level. Majority of the visitors come frequently. The purpose of visits included reward [swab], poverty, domestic problems, infertility, ill health, in addition to see lovers to have an access to commercial sex workers and narcotics. Some devotees had a mishap during the visit. Most of the visitors come for mental healing and relaxation with the hope of getting solutions for their problems, and a few use these sacred places for their wrong doings

impact of Arab culture on psychiatric ethics

The belief of the universality of implementing similar ethical codes in all cultures and societies is a mirage. Informed consent, involuntary admission and confidentiality are not so empowering in some traditional and Eastern societies, representing two thirds of the World population. Autonomy versus family centered decision is one of the main connectors of differences between Western and Eastern Societies. The influence of managed care and the third party in mental health services have changed not only Doctor-patient relationship, but also the disclosure of information. Informed consent in therapeutic alliances and research became a basic human right and has been emphasized in the WPA declaration of Madrid and its specific guidelines.. In what ways does acculturation change the beliefs of patients of various ethnicities? Whether we like it or not, the encounters between psychiatry and law keep bringing us back to our conflicting conceptions of the value of health on the one hand and the value of liberty, integrity and autonomy on the other. In traditional cultures, social integration is emphasized more than autonomy; that is, the family, not the individual, is the unit of society. Dependence is more natural and infirmity is less alien in these cultures. When affiliation is more important than achievement, how one appears to others becomes vital an shame. How can we practice without showing disrespect or disregard for local values? On the other hand, how can we ensure that respect for the local culture does not become a pretext for bypassing ethical guidelines, to the detriment of the patients' rights?

Management of perceived mental health problems by spiritual healers : a Nigerian study

Objective : Anecdotal reports and research findings have suggested that religious healers are widely consulted by many Nigerians in time of mental health crisis. The study aimed at examining the knowledge; attitude and practice of mental health care among a syncretic Church's healers; and their readiness to cooperate with Psychiatrists. Method : A modified; pilot-tested; self-completed questionnaire was used to obtain information from consenting spiritual healers who satisfy the inclusion criteria. Focus group discussions (FGDs); Participatory Observation (PO) and Key Informant Interviews (KII) were used to corroborate or refute the findings. Results : The respondents' knowledge of mental disorders was limited to psychotic disorders; their explanatory model was similar to beliefs of the populace. In practice; they combined some modern medical approach; some native methodology and some eclectic religious practices such as prophecy; trance and dream. Only 6of them ever referred their clients to medical practitioners. Conclusion : Religious healers still constitute an important route to access mental health care providers to some Nigerians

Chamanismo: consideraciones históricas y contemporáneas / Shamanism: historical and contemporary considerations

Se revisan las principales características del chamanismo tradicional histórico, ejemplificadas mediante el relato de 3 casos obtenidos en la literatura especializada (mapuche, andino y mazateco). Luego se analizan ciertas características adquiridas por el chamanismo tradicional actual en la región hispanoamericana, según 2 casos de conocimiento directo del autor (machi migrado a Santiago y sanador espiritualista trinitario mariano, de Chiapas, México). En tercer lugar se agregan otras referencias generales a desarrollos chamánicos actuales no tradicionales, obtenidas de diferentes fuentes bibliográficas (también denominados genéricamente neochamanismo). Luego de esta revisión, se proponen algunas consideraciones sobre el actual estado de la actividad.

Implicaciones del tiempo de instrucción en la formación del residente de anestesia / Implications of the time of instruction in the formation of the resident of anesthesia

Durante mucho tiempo los médicos en entrenamiento para especialidades fueron considerados personal de disponibilidad completa sin tener en cuenta si estos tenían otras actividades académicas, socio culturales o si simplemente necesitaban descansar; de esa concepción surge la denominación médico residente (residente en el hospital). La muerte de un paciente de 18 años en un hospital universitario bajo el cuidado de un médico interno (el internado corresponde al primer año de residencia en los programas de especialidad de Estados unidos) luego de 18 horas de trabajo continuas y la posterior denuncia de su padre, columnista de un periódico en la ciudad, alegando cuidado subóptimo, por parte del residente, debido a fatiga y falta de supervisión por su docente, llevaron a que se tomaran medidas, las cuales se denominaron conclusiones de la comisión BELL; básicamente sugiriendo una limitación en las horas de trabajo y una mejora en la supervisión de los residentes por parte de los docentes; posteriormente estas recomendaciones fueron asumidas por 3 cuerpos reguladores educativos en los Estados Unidos. Accreditation Council for Graduate Medical Education (ACGME), Association of American Medical Colleges (AAMC) y American Medical Association (AMA).1,2,3...

Cupping or Hejaama: a medical procedure in use by Yemenis to treat various ailments

The Republic of Yemen has a long history of plural medical systems since thous and s year's age. Hejaama, an Arabian term for cupping and bloodletting, is one of medical procedure which still has been using to treat various ailments in Yemen since the pre-Islamic period. In this article, Hejaama is described as ethnic medical practice based on the anthropological study in Sana'a, Yemen, and is discussed from the cultural point of view. The findings, which are mainly collected from the participant observation in the female practitioner's clinic and interviews to female patients, lead to the following conclusions. First, the Yemenis' concept of blood or blood related illness is closely linked to the treatment of Hejaama. Yemenis believe that "bad blood" is accumulated in a specific place of their body and it causes pain. The Hejaama practice is very effective to relieve the pain because it can be removed such "bad blood" from the body. Moreover, Hejaama is recognized as the treatment for the people who have chronic pain, and not an all-purpose treatment. Patients choose the Hejaama practice by themselves for the relief of their pain from the various alternative medical procedures. Furthermore, Hejaama is understood as a religious activity, even though the practice may be not exactly Islamic in origin. In addition, Hejaama can be acted as the group therapy to ultimately relieve suffering. Hejaama is even now in dem and by many people of Yemen, as the quick and simple treatment for chronic pain.

Patients' views about physicians' spiritual role in medical practice

To study patient perceptions with regard to spirituality in medical practice. Design: A questionnaire-based survey. Place and Duration of Study: Family Practice Center of Aga Khan University Hospital, Karachi, Pakistan, during July 2003. Subjects and Family practice patients were interviewed using a questionnaire which included data on demographic profile of the patient and perceptions on spirituality in medical practice. The study investigators administered the questionnaire without using systematic randomization. Ethical requirements including the administration of a written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management. One hundred patients were interviewed. A majority was married men, in the 20-40 years age group being of grade XII and above educational status. Ninety-two [92%] respondents believed in physicians having healing powers given by God, 78 [78%] felt that physicians should consider religious needs of the patient during treatment and 44 [44%] believed it is the competence of a physician that results in his/her healing ability. Thirty [30%] respondents sought treatment from faith healers and believed that medical care should include faith healing. Ninety-four [94%] respondents believed that praying and reciting the Quran helps in healing. Patient expectation that a physician be regular with regard to prayers, fasting, zakat donation and avoiding riba were reported by 91 [91%], 89 [89%], 97 [97%] and 63 [63%] respondents respectively. The findings of the study are not representative and have no statistical reliability. We have documented patient perceptions with regard to spirituality in medical practice. Such information has important implications for patient care and we strongly recommend further debate and research on the issue

El alma, razón o no de un ejercicio médico / The soul, reason or not of an exercise physician

La medicina tiene como propósito principal lograr una mejor calidad de vida en los pacientes. Para que esto sea posible no es suficiente conformarse con estudiar y tratar el aspecto físico de estos, también es igualmente importante tener la posibilidad de curar su alma. Luego de explicar y analizar diferentes conceptos y realidades de lo que son el alma y el espíritu, notamos que es perfectamente posible para el médico mejorar la calidad de vida espiritual de su paciente una vez que acepte que, aunque no es algo científicamente comprobable, el alma y el espíritu existen y son esenciales para la óptima sanidad y cura de todo ser humano