Utilization of traditional healing practices from Mexico by U. S. women of Mexican origin: A systematic review.

Hispanics are 18.7 % of the U.S. population, and people of Mexican origin are 61.4 % of that Hispanic community. National health surveys indicate that utilization of traditional medicine among Hispanics is low compared to non-Hispanic Whites. However, many researchers have described their use in Hispanic populations as commonplace. OBJECTIVE: This review analyzed studies about traditional healing practices from Mexico (THPM) used by women of Mexican origin in the U.S. for a greater understanding of traditional health practices within U.S. communities of Mexican origin. DATA SOURCES: Journal databases were searched for studies between January 1, 1990 and December 31, 2020. STUDY SELECTION: The Whittemore and Knafl and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) methods were used to analyze the studies. DATA EXTRACTION: Seven themes emerged: A) foundations, B) medical pluralism, C) non-disclosure and patient satisfaction, D) remedies and rituals, E) healers, F) affinity, and G) what clinicians need to know. Four subthemes were identified: G1) cultural sensitivity, G2) communication skills, G3) leveraging the influence of THPM, and G4) scientific inquiry. DATA SYNTHESIS: U.S. women of Mexican origin reported continued use of THPM for health promotion, influenced by their understanding of health and illness, community ties, and personal experiences. Study authors recommended strategies for improving patient-provider communication and understanding patients' use of traditional health and healing practices. CONCLUSION: Further explorations of THPM are needed to build awareness of culturally-tied health beliefs and behaviors that improve medical care experiences and quality for Hispanics of Mexican origin.

Uma análise do projeto de educação nos documentos do MST (1990-2014): a cultura corporal em debate / n analysis of the education project in the MST documents (1990-2014): corporal culture in debate / Un análisis del proyecto educativo en los documentos del MST (1990-2014): cultura corporal en debate

No presente estudo, referenciamos o debate sobre Educação e Movimentos Sociais, através das contribuições do Movimento dos Trabalhadores Rurais Sem Terra (MST). Desse modo, buscamos apresentar mediações entre o Projeto de Educação do MST e a Cultura Corporal, a partir do seguinte problema: Se e como a Cultura Corporal está retratada no projeto de Educação do MST? O objetivo é caracterizar a concepção de Cultura Corporal com base nos textos/documentos sobre Educação sistematizados pelo MST. Para subsidiar a análise, trazemos as contribuições teóricas de Antonio Gramsci, sobre cultura, princípio educativo, escola unitária e o conceito de intelectual, bem como o Coletivo de Autores sobre a perspectiva de Cultura Corporal (AU).

In the present study, we aim to the debate on Education and Social Movements, through the contributions of the Landless Rural Workers Movement (MST). In this way, wes eek to present mediations between the MST Education Project and Corporal Culture, base don't he following problem: I fan dhow is Corporal Culture portrayed in the MST education project? The object ivies to characterize the concept of Corporal Culture from the texts/documents on education systematized by the MST. To support he analysis, we bright et he oretical contributions of Antonio Gramsci, on culture, educational principle, unitary school and the concept of intellectual, as well as the Coletivo de Autores on the perspective of Corporal Culture (AU).

En este estudio nos referimos al debate sobre Educación y Movimientos Sociales, a través de los aportes del Movimiento de Trabajadores Rurales Sin Tierra (MST). Así, buscamos presentar mediaciones entre el Proyecto Educativo MST y la Cultura Corporal, partiendo del siguiente problema: ¿Si y cómo se retrata la Cultura Corporal en el proyecto educativo MST? El objetivo es caracteriza el concepto de Cultura Corporal a partir de los textos/documentos sobre educación sistematizados por el MST. Para sustentar elanálisis, traemoslos aportes teóricos de Antonio Gramsci, sobre cultura, principio educativo, escuela unitaria y el concepto de intelectual, así como el Coletivo de Autores en la perspectiva de la Cultura Corporal (AU).

Pilot clinical trial of a clinical meditation and imagery intervention for chronic pain after spinal cord injury.

OBJECTIVE: To assess the feasibility and potential benefits of clinical meditation and imagery (CMI) for people with chronic spinal cord injury (SCI) and chronic pain. DESIGN: Pilot randomized, controlled trial. SETTING: Outpatients with SCI in the United States. PARTICIPANTS: 24 adults with chronic SCI (>1 year) and a >3 month history of pain rated ≥4/10 on average over the last week. INTERVENTIONS: 4-week program of once-weekly 2-hour group classes, offered in-person and online. CMI group participants were taught mindfulness, mantra meditation, and guided imagery practices. Control group participants received education on topics related to health and function after SCI. OUTCOME MEASURES: Pain interference (primary outcome), pain cognitions, pain intensity/unpleasantness, depressive symptomology, perceived stress. RESULTS: Pain interference decreased to a greater extent in the control group at both Day 42 and Day 70, with a large effect size (d > 1.0). Several secondary outcome measures showed changes consistent with more favorable outcomes in the CMI group at both Day 42 and Day 70, with a large effect size d > 0.80, including worst pain intensity over the last week, depressive symptomology, belief in pain as a sign of harm and perceived control over pain. Perceived stress improved to a greater extent in the control group (d = 1.16 at Day 42, d = .20 at Day 70). CONCLUSION: CMI is feasible and acceptable to implement with people with SCI and chronic pain. Further study is warranted to assess potential benefits for pain-related outcomes.

Cafecitos Supporting Nurses in the Time of COVID-19: A Commentary From the NAHN-Westchester and NAHN-New York Chapters.

Nurses have been called superheroes during this pandemic because of our compassion for our patients, but we need compassion, too. Through this state of emergency, quarantine, and isolation, the Cafecitos in the virtual world let us navigate this shared experience together.

Donor incentives improve cardiovascular disease risk profile and donation rates.

BACKGROUND: Blood centers may offer point-based reward systems or cardiovascular disease (CVD) screening to incentivize donors. However, combining these incentives to improve CVD risk and blood donation rates has not been studied. STUDY DESIGN AND METHODS: Study was a three-arm prospective controlled trial: Group 1, control (routine points, no CVD screening); Group 2, CVD screening with routine points; and Group 3, CVD screening plus incentive double points. The primary objective was to determine if double versus routine incentive points led to improvement or maintenance of CVD risk profile assessed using self-reported changes in 1) reading food labels for calorie and fat content, 2) exercising daily, 3) reduced fat intake, and 4) increase in eating fruits and vegetables. Outcomes were compared at first and final (2-year) follow-up visits. As secondary outcome, median blood donation rates before enrollment and during study were compared. RESULTS: A total of 570 donors (290 in Group 1, 134 in Group 2, 146 Group 3) were selected. At first follow-up visit, 71.4% in Group 3 versus 62.0% in Group 2 subjects reported at least one of four positive behavioral changes (p < 0.001). Increase in reading food labels for calorie and fat content was the most common change and higher in Group 3 (Group 3 from 60.9% to 79.1%; Group 2 from 67.6% to 77.5%; p < 0.001). Final evaluation showed significant increase in self-reported exercise in Group 3 only (from baseline 52.9% to 68.3%; p < 0.05). Group 3 reported higher increase in median number of donations/year during study enrollment (6.8 [IQR, 4.3-12] vs. baseline 4.6 [IQR, 3.2-7.1] donations/year) than Group 2 (5.6 [IQR, 4.2-10.5] vs. baseline 4.9 [IQR, 3.5-10.2]) and Group 1 (4.4 [IQR, 2.7-8.0] vs. baseline 4.4 [IQR, 2.5-6.0] donations/year; p < 0.001). CONCLUSION: Positive donor reinforcement (double vs. routine points) resulted in better self-reported health maintenance behavior and increased donation rates.

A Randomized Trial of a Group-Based Integrative Medicine Approach Compared to Waitlist Control on Irritable Bowel Syndrome Symptoms in Adults.

INTRODUCTION: Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder that affects a large proportion of the general population. Dietary and mind-body approaches have shown some effectiveness in reducing IBS symptoms. OBJECTIVES: The purpose of this project was to test the feasibility of a low cost, group-oriented integrative medicine approach to IBS, and to explore whether such an approach improves participant outcomes. METHODS: This was a randomized-controlled trial involving a 4-week group-oriented treatment intervention combining dietary intervention and mind-body therapies followed by 8-weeks of telephonic health coaching. Differences between the intervention and control groups on IBS-specific measures were examined at baseline, 4, 8, and 12-week. RESULTS: Fifty-two participants completed the study, 30 in the control group and 22 in the intervention group. On the IBS Symptom Severity Score, at 4 weeks the intervention group showed statistically significant improvement compared to the control group (p < .02), which was sustained at the 8 and 12-week data points as well, with the proportion of the intervention group experiencing moderate to severe symptoms decreasing from 81.3% at baseline to 45% at week 4 and 54.5% at week 12. A statistically significant improvement was also seen on the CES-D measure of depression between baseline and week 12 in the intervention group compared to controls. On the IBS Quality of Life measure we did not observe a statistically significant difference between the groups. CONCLUSIONS: This low-cost, group-oriented intervention approach offers a strategy to address the challenge of access to this type of integrative approach for patients of low socioeconomic status or limited means.

Pharmacological Management of Anxiety Disorders in the Elderly.

Anxiety disorders are common in the elderly. Additionally, anxiety symptoms often accompany co-morbid psychiatric, medical, as well as neurodegenerative diseases in the older population. Anxiety in the elderly, often accompanied by depression, can lead to worsening physical, cognitive and functional impairments in this vulnerable population. Antidepressants are considered first line treatment. Both SSRIs and SNRIs are efficacious and well-tolerated in the elderly. Some SSRIs are strong inhibitors of the cytochrome P450 hepatic pathway whereas others have less potential for drug interaction. Those antidepressants with more favorable pharmacokinetic profiles should be considered first-line in the treatment of anxiety. Mirtazapine and vortioxetine are also considered safe treatment options. Buspirone may have benefit, but lacks studies in elderly populations. Although tricyclic/tetracyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) may be effective in the elderly, their side effect and safety profiles are suboptimal and thus are not recommended in late-life. Benzodiazepines and beta blockers should generally be avoided when treating anxiety in the elderly. There is not enough evidence to support the use of antipsychotics or mood stabilizers given their risk of problems in both the long and short term. In addition, antipsychotics have a black box warning for increased mortality in elderly patients with dementia.

The integration of high-throughput testing of blood donors for cardiovascular disease risk assessment and prevention.

BACKGROUND AND OBJECTIVES: Some blood centers provide health screening as a public health measure and to encourage donation. The goal of the current study was to provide cardiovascular disease (CVD) screening to donors using high-throughput testing and web-based communications. MATERIALS AND METHODS: CVD risk screening was offered to donors at selected mobile drives in a large metropolitan area. Risk factors were determined by donor questionnaire, laboratory testing (total cholesterol, HDL levels and hemoglobin A1c), and blood pressure measurement. Results were reported to participants via mail and website. A 60-day follow up web-based survey was sent to participants via email to assess the impact of the program on donor's behavior. RESULTS: 9435 donors, 17-75 years old participated with the following risk factors: 61.3% BMIs>25, 28.8% high total cholesterol, and 31.4% lower than recommended HDL levels. 25.3% of donors that responded to the follow up survey went to see their health care provider based on screening results and 9% of these received new or modified treatment. CONCLUSION: In our sample, blood donors are healthier than the general population, but many still have CVD risk factors, particularly obesity. CVD screening can be successfully used to make donors aware of this important health information and some donors act on this information.

Cardiovascular disease risk assessment and prevention in blood donors.

BACKGROUND: Blood centers have implemented public health initiatives, including cardiovascular disease (CVD) screening, to improve donor and community health and serve as an incentive to donate. STUDY DESIGN AND METHODS: CVD risk screening and counseling were performed at mobile blood drives in diverse neighborhoods. Risk factors were determined by point-of-care testing (total cholesterol, high-density lipoprotein, and hemoglobin A1c levels), interviews, and physical examinations (body mass index, waist circumference, and blood pressure). Results were confidentially relayed to participant by health counselors. A 60-day follow-up survey was sent to some participants. RESULTS: Over 11 months, 2406 participants (44% male; mean age 28 ± 16; 67% minority racial/ethnic group) were screened at 290 mobile drives. A total of 92% of participants had medical insurance. A total of 14% had none, 26% one, 33% two, and 27% three or more risk factors. A total of 72% of teenage participants had at least one risk factor. A total of 18% of participants who were taking medications for risks were poorly controlled. A total of 15% had newly identified risks. A total of 711 participants completed follow-up survey: 21% sought medical care, 51% were motivated to change their lifestyle, 81% were pleased with screening, 48% were more likely to donate, and 62% recommended donation to friends and family because of the screening. CONCLUSION: CVD risk screening and counseling can occur during a mobile blood drive. A majority of participants screened had risk factors. Follow-up surveys showed that the program was well received. Further studies are planned to evaluate long-term effects of the program on donor health and donor return rates.