PurposeThe use of traditional complementary/alternative medicine (TCAM) among children with cancer has been well documented. South America has a rich history of traditional healers and medicinal resources; however, little is known about the use of TCAM among children with cancer. We sought to investigate patterns, beliefs, and determinants of TCAM use among South American children with cancer.MethodsA cross-sectional survey was administered to 199 children treated for cancer at institutions located in Buenos Aires, Argentina, and Montevideo, Uruguay. Participants were queried about the type of TCAM and strength of beliefs associated with its use. Logistic regression analysis was used to estimate the odds ratios with 95% CIs.ResultsWe found that the use of TCAM was common in both Argentina (47%) and Uruguay (76%). Variations in the forms of TCAM used were observed between the countries; however, both countries used TCAM primarily for supportive care. Mother’s education, wealth index, and TCAM belief system were significant predictors of TCAM.ConclusionTo our knowledge, this study is the first to report on the use of TCAM in pediatric oncology in South America. The study identifies several predictors of TCAM use, which may serve as target variables for educational and research initiatives. The finding that most families use TCAM for supportive care suggests that future efforts could evaluate the role of TCAM to enhance existing supportive care regimens, particularly in settings where access to conventional medications are limited.
BACKGROUND: Children with cancer in high-income and low-income countries often use traditional complementary/alternative medicine (TCAM). With efforts by the World Health Organization and international twinning programs improving access to conventional care for patients with childhood cancer, understanding the global use of TCAM is important because reliance on TCAM may affect time to presentation, adherence, and abandonment of care. In the current study, the authors describe the process and validation of an international survey documenting the use of TCAM among children with cancer. METHODS: The survey was designed to collect information on TCAM use and associated factors through both open-ended and close-ended questions. During the period between June 2012 and December 2013, the survey was administered to 300 children and adolescents (or their parents) who were undergoing treatment for cancer at a collaborating institution located in Mexico, Uruguay, and Nicaragua. RESULTS: For the majority of constructs, the survey demonstrated strong test-retest reliability as evidenced by an intraclass correlation of at least 0.79 in each of the participating countries. The survey demonstrated good internal consistency and reliability across countries (a range from. 77 to. 85 for the belief scale; and an a range from. 60 to. 86 for the cause scale) and convergent validity between TCAM beliefs and behavior constructs (adjusted correlation range, 0.35-0.60). CONCLUSIONS: The results of the current study demonstrate the successful development of a cross-cultural survey that produced results that were reliable and valid. These findings will aid investigators in providing guidelines concerning TCAM, support the development of education and research priorities, and identify variables associated with TCAM that are region-specific. Cancer 2015;121:1492-8. V C 2014 American Cancer Society.KEYWORDS: pediatric oncology, complementary/alternative medicine, supportive care, survey design, twinning programs. INTRODUCTIONThe differential mortality outcomes in childhood and adolescent cancer between developed and developing countries have become increasingly apparent. Greater than 80% of children with cancer reside in developing countries, in which survival rates are estimated to be approximately 35%, which is in stark contrast to the overall survival rate of 70% observed for children residing in developed countries.1,2 Although improved access to drugs, political stability, and the availability of locally trained health care providers have been crucial in expanding the delivery of Western care, the role of traditional complementary/alternative medicine (TCAM) in regions with diverse medical systems is less understood. Understanding the application and role of TCAM in other pediatric conditions, including human immunodeficiency virus/acquired immunodeficiency syndrome and severe malaria, has helped to bridge the gap in communication among traditional healers and conventional health care providers and improve access to medical care in child...
O presente artigo pretende apontar alguns dos aspectos que se estabeleceram na cena teatral a partir de transformações e revoluções pós-final do século XIX, período no qual pôde ser observado o entrelaçamento entre artes plásticas, música, dança, cinema, vídeo e performance, oportunizando uma pluralidade estética que transborda e excede o texto dramático. Tais experimentações estimularam novos modos de compreender como a voz emancipou-se de uma compilação de signos vinculados ao texto dramático, reverberando em novos modos de acionamento para as práticas e poéticas que tangenciam a voz. A partir desse panorama, serão apresentados relatos das práticas vocais na montagem de algumas peças curtas do autor irlandês Samuel Beckett desenvolvidas com intérpretes de Brasília.
IntroductionThe quality of the protein availability is related to the amount of essential amino acid (EAA) that food contains. Energy and protein intake have a potent regulator to increase the fat‐free mass (FFM) synthesis, body composition measure should be considerate to the exercise performance. Athletes protein intake should be 1.5–2 g protein/kg/d.ObjectiveTo determinate the effect of EAA on body composition status in college athletesMethodologyInformation of the dietary intake was obtained by 24‐hour recall. This information was compared with the requirements for sports competitors. Nutrient intake values amounts were calculated using US Department of Agriculture database. Air Displacement Plethysmography was used to determinate FM and FFM percentages. Statistical analysis included a paired t test, to determinate the differences between the intake amount and the suggested; and linear regression analysis to determinate the effect of the EAA in the FFM.ResultsThirty athletes (18 males and 12 females) were evaluated. The mean amount of energy, fat, protein, and carbohydrates were 2493.1 kcal/d (SD=1278.83), 76.7 gr/d (SD=46.66), 115.43 gr/d (SD=62.95) and 301.07 gr/d (SD=160.37), respectively; and the 20% of deficient protein intake was showed. The amount of iron, 27.9 mg/d (SD=23.5). The protein and energy intake were lower than the requirement for sports competitors (p=0.0166 and p<0.0001). FFM was entered into the linear regression model as a continuous variable, the EAA were not significant (p=0.4961)ConclusionThis nutritional dietary analysis indicate a high protein deficit, 20%, that included the EAA, the synthesis of those EAA makes available a free pool to replace the protein degradation when the amount FFM is adequate. Therefore the nutritional intake recommendation has to be monitored by sports specialist using validated instruments. Despite of the result, the FFM has been not affected. Further research must be done in order to link the decrease inmuno‐malnutrition diseases.
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