Estudio etnobotánico de la flora medicinal de la provincia de Trujillo, Perú / Ethnobotanical study of the medicinal flora of the province of Trujillo, Peru

Trujillo, one of the main provinces of Peru, is home to a multicultural population, coming from the Coast, Sierra and Selva; of different ideologies, cultures, and ancestral knowledge about the correct use of medicinal flora. In this sense and in an effort to rescue this ancestral knowledge, the ethnobotanical study of the medicinal flora of the province of Trujillo was carried out. For which 96 semi - structured interviews were applied, using the "snowball" technique; followed by the collection, taxonomic determination and calculation of ethnobotanical indices: Use Value Index (IVU) and Informant Consensus Factor Index (FCI). It is concluded that the inhabitants of Trujillo make use of 102 species of medicinal flora, distributed in 95 genera and 46 families for the treatment and/or cure of 62 diseases. Of the total species, 24 turned out to be the most important (according to their IVU) for the cure of diseases of the Trujillo po pulation.

Trujillo, una de las principales provincias de Perú, alberga una población pluricultural, procedente de la Costa, Sierra y Selv a; de distintas ideologías, culturas, y saberes ancestrales sobre el correcto uso de la flora medicinal. En tal sentido y en el afán de rescatar ese conocimiento ancestral, se realizó el estudio etnobotánico de la flora medicinal de la provincia de Trujill o. Para lo cual se aplicaron 96 entrevistas semiestructuradas, empleando la técnica "bola de nieve"; seguido de la colecta, determinación taxonómica y cálculo de Índices etnobotánicos: Índice de valor de Uso (IVU) e Índice de Factor de Consenso del Informa nte (FCI). Se concluye que los pobladores trujillanos hacen uso de 102 especies de flora medicinal, distribuidas en 95 géneros y 46 familias para el tratamiento y/o cura de 62 enfermedades. Del total de especies, 24 resultaron ser las más importantes (segú n su IVU) para la cura de enfermedades del poblador Trujillano.

Changes in Medical Charges Following Intensive Multidisciplinary Intervention for Pediatric Gastrostomy Tube Dependence.

OBJECTIVE: Intensive multidisciplinary intervention (IMI) is the most evidence-based approach to treat pediatric feeding disorders. The goal of this exploratory study was to assess changes in health care charges for patients with gastrostomy tube dependence following participation in IMI compared to a waitlist control. METHODS: Medical charges were assessed for 9 families who participated in IMI compared to 6 control families on a multi-year waitlist for IMI. The IMI and control groups were compared on raw charges submitted as well as individual year-over-year changes in medical charges. RESULTS: The IMI group decreased health care charges by 71% on average in the year following IMI compared to the control group increasing charges by 22% over the same period. CONCLUSIONS: IMI also holds potential cost-savings in the year following treatment compared to children who do not receive treatment and adds to previous research focusing on long-term cost effectiveness of IMI.

Valor de uso medicinal de la flora empleada por la Comunidad Andina de Jesús, Cajamarca, Perú / Medicinal use value of the flora used by the Andean Community of Jesús, Cajamarca, Peru

The medicinal flora plays a valuable role in improvingthe quality of life; ancestral knowledge that constitutes a legacy inherited by the Andean-Amazonian communities. The research was focused on determining the medicinal use value of the flora used by the Andean Community of Jesús. 96 semi-structured interviews were applied, using the "snowball" technique. The population of the Andean Community employs 84 species of flora, distributed in 80 genera and 45 families; where the Asteraceae, Lamiaceae, Rutaceae and Fabaceae were the most representative. Likewise, they suffer from 56 diseases, grouped into 11 categories, being the diseases of the Systems: respiratory (FCI=0.68), digestive and gastrointestinal (FCI=0.57), urinary (FCI=0.57), cardiovascular (FCI=0.56), reproductive (FCI=0.54) and Nervous (FCI=0.53), the most treated. Finally, the Andean Community attributes great importance to 54 species of medicinal flora; Therefore, it is urgent to implement projects and research that promote their sustainability.

La flora medicinal juega un valioso rol en la mejora de la calidad de vida; saber ancestral que se constituye en un legado heredado por las comunidades Andino-amazónicas. La investigación se abocó a determinar el valor de uso medicinal de la flora empleada por la Comunidad Andina de Jesús. Se aplicaron 96 entrevistas semiestructuradas, empleando la técnica "bola de nieve". El poblador de la Comunidad Andina emplea 84 especies de flora, distribuidas en 80 géneros y 45 familias; donde las Asteraceae, Lamiaceae, Rutaceae y Fabaceae, fueron las más representativas. Asimismo, padecen 56 enfermedades, agrupadas en 11 categorías, siendo las enfermedades de los Sistemas: respiratorio (FCI=0,68), digestivo y gastrointestinal (FCI=0,57), urinario (FCI=0,57), cardiovascular (FCI= 0,56), reproductivo (FCI=0,54) y Nervioso (FCI=0,53), las mayormente tratadas. Finalmente, la Comunidad Andina atribuye gran importancia a 54 especies de flora medicinal; por lo que urge implementar proyectos e investigaciones que fomenten la sustentabilidad de las mismas.

Randomized trial of a self-administered parenting intervention for selective eating in young children.

Selective eating is a common childhood feeding problem associated with family stress and micronutrient deficiencies. While there are empirically-supported behavioral strategies for addressing selective eating, there are significant systems-level barriers to implementing them. The aim of this study was to develop and test a self-administered intervention for parents of children with selective eating. Participants were 156 parents of children with selective eating ages 18 months-6 years who were randomly assigned to either the handout + video condition (8-module video intervention and detailed handout) or handout condition (detailed handout only). Outcome measures were administered pre-intervention and 4 weeks post-intervention. Only 23 % of participants in the handouts plus video condition played more than one video module. Both groups had significant decreases in maladaptive mealtime parenting practices, undesired child mealtime behaviors, and number of foods offered. No significant effect of study condition was found on the outcome measures. Further research is needed to determine how to encourage engagement of parents with self-administered intervention materials.

Predictors of Treatment Response to Multidisciplinary Care for Persistent Symptoms after Pediatric Concussion.

PURPOSE: To assess which pediatric patients experiencing persistent post-concussive symptoms (PCS) benefit most from multidisciplinary treatment including specialists in Neurology, Neuropsychology, Physical Therapy, and Athletic Training, and to explore the effectiveness of this approach. METHODS: A retrospective chart review of 56 adolescents 10-20 years old (M = 15.0 ± 2.1) receiving multidisciplinary care for PCS (>30 days) was conducted. RESULTS: Systolic blood pressure and Body Mass Index predicted time to concussion resolution (p < .05), such that higher values were associated with slower resolution. PCS scores significantly decreased between participants' initial and final clinic visits, p < .01, and among the 25 participants for whom pre-intervention PCS scores were available, symptom severity scores significantly declined following multidisciplinary intervention compared to pre-referral values (p < .01). CONCLUSIONS: Exploratory analyses reveal that multidisciplinary treatment is a promising approach for reducing symptoms among adolescents with PCS, and that those with greater levels of physical fitness may benefit most.

Aspectos etnobotánicos de Cuspón, Perú: Una comunidad campesina que utiliza 57 especies de plantas en sus diversas necesidades / Ethnobotanical aspects of Cuspon, Peru: A peasant community that uses 57 species of plants in its various needs

Se sabe que las comunidades Andino-Amazónicas a través de la historia han hecho un correcto y eficaz uso de sus recursos florísticos, que al domesticarlas inteligentemente se han constituido en verdaderos aportes del Perú para la humanidad. Por ello esta investigación se avocó a determinar los aspectos etnobotánicos de las especies empleadas por la Comunidad Campesina de Cuspón. Se aplicaron 150 entrevistas semi-estructuradas, para recabar información referente a: taxonomía, nombres vulgares, hábito o porte, hábitat, forma de propagación, parte utilizada y uso etnobotánico, para luego determinar el Índice Cultural (IC). La comunidad de Cuspón utiliza en sus más diversas necesidades 57 especies de plantas distribuidas en 48 géneros y 30 familias; siendo las más representativas las Asteraceaes (11), solanaceae (4), Euphorbiaceae (3), Malvaceae (3), Onagraceae (3) y Urticaceae (3); y las especies más importantes: Solanum tuberosum L. "papa" (IC = 1,33), Zea mays L. "maíz" (IC = 1,31), Chenopodium quinoa Willd. "quinua" (IC = 1,06), Caesalpinia spinosa (Molina) Kuntze "talla" (IC = 0,97), Capsicum pubescens Ruiz & Pav. "rocoto" (IC = 0,95), Juglans neotropica Diels "nogal" (IC = 0,92), Alnus acuminata Kunth "aliso" (IC = 0,86), Cestrum auriculatum L'Hér. "hierba santa", Minthostachys mollis (Benth.) Griseb. "muña" (IC = 0,85).

Valor de uso etnomedicinal de la flora del Cerro "La Botica" empleada por la Comunidad Andina de Cachicadán - Perú / Ethnomedicinal use value of the flora of the Hill "La Botica" used by the Andean Community of Cachicadán - Perú

La presente investigación se avocó a determinar el valor de uso etnomedicinal dado a la flora del Cerro "La Botica", por la Comunidad Andina de Cachicadán, Santiago de Chuco, Perú. Se aplicaron 96 entrevistas semiestructuradas, siguiendo la técnica "bola de nieve". Se realizaron colectas mediante exploraciones botánicas. Para cada una de las especies se detallaron los datos de familia, nombre científico y común, parte utilizada, enfermedad o dolencia tratada, ubicación en UTM e índice de valor de uso (IVU). Se reportan 48 especies empleadas etnomedicinalmente por la Comunidad Andina de Cachicadán, distribuidas en 46 géneros y 26 familias, de las que destacan por su número de especies: Asteraceae (10), Rosaceae (5) y Lamiaceae (3). De estas, el 72 % (35 especies) resultan muy importantes para la cura o tratamiento de sus enfermedades, según su valor de uso (IVU). Además los pobladores de la Comunidad Andina de Cachicadán, refieren padecer de 38 enfermedades o dolencias; agrupadas en 10 categorías, donde prevalecen, las de los sistemas: respiratorio (FCI=0.88), digestivo y gastrointestinal (FCI=0.85), reproductivo (FCI=0.84), urinario (FCI= 0.84), nervioso (FCI=0.83), Músculo-esquelético (FCI=0.82), cardiovascular (FCI=0.82) y rituales (FCI=0.81).

The present investigation was aimed at determining the value of ethnomedicinal use that is given to the flora of the Hill "La Botica", by the Andean Community of Cachicadán, Santiago de Chuco, Perú. 96 semi-structured interviews were applied, following the "snowball" technique. Collections were made by botanical explorations.For each of the species, family data, scientific and common name, part used, disease or disease treated, location in UTM and use value index (IVU) were detailed. 48 species of flora are used ethnobotanically by the Andean Community of Cachicadán, distributed in 46 genera and 26 families, of which they stand out for their number of species: Asteraceae (10), Rosaceae (5) and Lamiaceae (3). Of these, 72% (35 species) are very important for the cure or treatment of their diseases, according to their use value (IVU). In addition the inhabitants of the Andean Community of Cachicadán, report suffering from 38 diseases or ailments; grouped into 10 categories, where they prevail, those of the systems: respiratory (FCI = 0.88), digestive and gastrointestinal (FCI = 0.85), reproductive (FCI = 0.84), urinary (FCI = 0.84), nervous (FCI = 0.83), Musculoskeletal (FCI = 0.82), cardiovascular (FCI = 0.82) and rituals (FCI = 0.81).

Papas nativas con potencial antioxidante, cultivadas en el norte del Perú / Native potatoes with antioxidant potential, grown in northern Peru

Peru is not only megadiverse in flora and fauna, but also in "native varieties of potatoes" that have been used by pre-Inca civilizations. In this context, "native potatoes" not only have a high nutritional value in antioxidants, but also a high capacity to cure and/or alleviate diseases; providing quality of life that is reflected in the longevity of the Andean population. However, in the absence of documentation and dissemination, many varieties and their ethnobotanical knowledge is being lost. To preserve and disseminate this valuable ancestral knowledge, a taxonomic, phytogeographic and ethnobotanical inventory was carried out, based on periodic botanical explorations during the period 1997-2017. The information obtained was complemented with other researches and reports by other authors. 317 "varieties of native potato" are reported for the North of Peru, of which 86, are "native varieties of colored pulp".

El Perú no sólo es megadiverso en flora y fauna, sino también en "variedades nativas de papas" que han sido utilizadas desde las civilizaciones preincas. En este contexto las "papas nativas" no sólo poseen un elevado valor nutricional en antioxidantes, sino también una alta capacidad de curar y/o aliviar enfermedades; brindando calidad de vida que se refleja en la longevidad de la población andina. Sin embargo, ante la falta de documentación y difusión, muchas variedades y su conocimiento etnobotánico se está perdiendo. Para preservar y difundir este valioso conocimiento ancestral, se llevó a cabo un inventario taxonómico, fitogeográfico y etnobotánico, en base a exploraciones botánicas periódicas durante el período 1997-2017. La información obtenida se complementó con otras investigaciones y reportes de otros autores. Se reportan para el Norte del Perú 317 "variedades de papa nativa", de las cuales 86, son variedades "nativas de pulpa de color".

Plantas utilizadas para el tratamiento del cáncer expendidas en los principales mercados de la provincia de Trujillo, Perú, 2016 ­ 2017 / Plants used for the treatment of cancer expanded in the main markets of the province of Trujillo, Peru, 2016 - 2017

Between 2016 and 2017, we conducted structured interviews with herbalists in market stands in the providence of Trujillo, La Libertad, Peru in order to create a catalog of plants with anticarcinogenic properties. Herbalists shared information about species they use in cancer treatment, including common names, part of the plant used, methods of preparation, plant state, and frequency and method of administration as medicine. We combined this information with the Shannon-Wiener diversity and evenness index to complete a quantitative analysis of the anticarcinogenic species. Our results demonstrate that 46 different species representing 24 genera and 19 families are locally used in cancer treatment, with a Shannon-Wiener index of 3.6 and 0.9 respectively. Our catalog thus represents a great variety of species and source of potentially useful knowledge for fighting cancer.

Con el objetivo de registrar las plantas con propiedades anticancerígenas distribuidas en la provincia de Trujillo, La Libertad, durante el 2016 y 2017, realizamos entrevistas estructuradas a hierbateros con puesto de venta en los mercados de abastos, quienes brindaron información sobre las especies usadas para el tratamiento del cáncer, detallando nombres vulgares, parte del vegetal utilizado, formas de preparación, estado de la plantas, frecuencia y forma de administración; así mismo aplicando los índices de diversidad Shannon- Wiener y Equidad se hizo el análisis cuantitativo de los datos encontrados. Se evidenció que para el tratamiento del cáncer se usan 46 especies, representadas 24 géneros y 19 familias; valor que refleja un Índice de Diversidad y de Equidad de 3.6 y 0.9 respectivamente, indicando que existe una gran variedad de especies y un conocimiento potencialmente valioso para combatir esta enfermedad.

Timely Access to Mental Health Services for Patients with Pain.

Efficient access to pediatric mental health services is a growing concern as the number of patients increases and outpaces efforts to expand services. This study outlines interventions implemented using quality improvement (QI) science and methodology to demonstrate how a clinic embedded in a large children's hospital can improve access to the first appointment for a population seeking pain management services. METHODS: A process improvement project started with a QI team, whose members designed interventions to change scheduling practices. Initial changes involved decreased time between calls to families, and efforts to streamline notifications among clinicians. Additional interventions included a close examination of waitlist assignment based on appropriateness and assessing patient interest in treatment. RESULTS: Within 3 months of implementation, a significant decline in wait time occurred for patients seeking services for pain management, from 106 to 48 days. This change remained stable for 6 months. In light of a sharp increase in referrals and wait time during the study period, efforts to engage additional clinicians in managing referrals resulted in wait time to stabilize at an average of 63 days to the first appointment. This change remained for 10 months. Scheduling changes did not negatively affect other providers. CONCLUSIONS: This study demonstrates the application of QI science to improve patient access to mental health care. Future directions will focus on enhancing the use of the electronic health record, along with previsit family engagement.

Implementation of an Outcome Measure in Pediatric Behavioral Health: A Process Improvement Initiative.

INTRODUCTION: Efforts to monitor outcomes in pediatric behavioral health are becoming a quality, financial, and regulatory imperative. The implementation of a broad-based measure to assess patient functioning at the start of pediatric psychology services, as well as at subsequent visits, has not been demonstrated. This article describes the systematic implementation of a measure of health-related quality of life (HRQOL) to assess functional impairment across an entire clinic population using quality improvement science and methodologies. METHODS: The Pediatric Quality of Life Inventory Generic Core 4.0 (PedsQL) was administered at initial and subsequent visits for all patients seeking treatment at a large, tertiary care pediatric psychology clinic in an academic pediatric medical center (Nationwide Children's Hospital, Columbus, Ohio). The goal of this project was to design a process change to support a 90% completion rate of this measurement tool by all clinicians. RESULTS: Within 16 months, the completion rate of the PedsQL increased from a baseline of 39% to the identified goal of 90%. This process change was within control limits (over 80%) for over 12 months. CONCLUSION: This study demonstrates the implementation of a systematic process for collection of outcome measures in a pediatric behavioral health care setting. Successful administration of an outcome measure at multiple time points during the care of children and adolescents in a large psychology clinic can allow for quantitative assessment of treatment progress and identify a pathway for administration of additional measures.

Privacy and security in the era of digital health: what should translational researchers know and do about it?

The rapid growth in the availability and incorporation of digital technologies in almost every aspect of our lives creates extraordinary opportunities but brings with it unique challenges. This is especially true for the translational researcher, whose work has been markedly enhanced through the capabilities of big data aggregation and analytics, wireless sensors, online study enrollment, mobile engagement, and much more. At the same time each of these tools brings distinctive security and privacy issues that most translational researchers are inadequately prepared to deal with despite accepting overall responsibility for them. For the researcher, the solution for addressing these challenges is both simple and complex. Cyber-situational awareness is no longer a luxury-it is fundamental in combating both the elite and highly organized adversaries on the Internet as well as taking proactive steps to avoid a careless turn down the wrong digital dark alley. The researcher, now responsible for elements that may/may not be beyond his or her direct control, needs an additional level of cyber literacy to understand the responsibilities imposed on them as data owner. Responsibility lies with knowing what you can do about the things you can control and those you can't. The objective of this paper is to describe the data privacy and security concerns that translational researchers need to be aware of, and discuss the tools and techniques available to them to help minimize that risk.