El Curandero Actual: Preserving Indigenous Identity Through Mexican Folk Healing’s Chants

Copyright © 2016, The Honors Undergraduate Research Journal, University of Oklahoma. All rights revert to authors.Curanderismo is a syncretic form of Mexican folk healing whose origins date back to the Spanish colonization of the Americas. This medical system, drawing from both indigenous healing practices and Catholic spirituality, has been preserved throughout history by marginalized indigenous groups lacking access to biomedical healthcare. Today, variations of curandero practices are commonly practiced throughout Mexico as far south as the states of Oaxaca and Morelos and spanning far north, past the Rio Grande and even into Colorado. These practices coexist with modern biomedicine despite a long history of the repression of indigenous peoples by Europeans, and thus represent a reconciliation between these two cultures.This paper seeks to analyze the extent of the reconciliation between indigenous practices and Western Catholicism present in modern curandero practices. Specifically, this investigation will focus on the role of chants, prayer, and music used by modern curanderos as facilitators of healing. Likewise, it will examine the proper historical and cultural contexts of modern curandero movements which celebrate specific healers who have died but whose practices and methods have been preserved. Finally, this analysis will be tied with the resurgence of indigenous identity promoted by the indigenismo movement for social change and activism in Mexico.The Honors Undergraduate Research Journal (THURJ) is a publication of the Joe C. and Carole Kerr McClendon Honors College at the University of Oklahoma. The views expressed in THURJ are solely those of the contributors and should not be attributed to the Editorial Staff, the Honors College, or the University of Oklahoma.undergraduat

Perceived Organizational and Social Support as Probable Mitigators of Burnout Among Medical Trainees and Providers

BACKGROUND: National trends show that employees and trainees in the medical field are susceptible to burnout. To our knowledge, no studies have been published on burnout moderators, such as perceived support and lifestyle behaviors. This study is part of a larger, longitudinal investigation examining the relationships among burnout, levels of perceived stress, levels of perceived support (social and organizational), and several lifestyle behaviors for faculty, staff, residents, fellows, and students at the OU-TU School of Community Medicine (OUSCM). METHODS: Investigators sent an email survey to every member of the OUSCM in April 2019. It included validated measures such as the Maslach Burnout Inventory (MBI), University of Delaware Survey of Perceived Organizational Support, and the Multidimensional Scale of Perceived Social Support, alongside questions about lifestyle behaviors. MBI subscores of exhaustion and cynicism were stratified in the analysis. SPSS software was used to conduct Pearson correlations among these variables. RESULTS: 318 responses were collected (35% response rate), with respondents’ demographic data representing the white (67.7%), women (78.1%), and staff (57.2%) members of the population. Among the whole sample, levels of perceived organizational support had a moderate negative correlation relative to burnout subscores of exhaustion (r=-.556, p<0.001) and cynicism (r=-.558, p<0.001). Likewise, levels of perceived social support had a weak negative correlation to exhaustion (r= -.169, p = 0.008) and cynicism (r= -.233, p<0.001). Among the disaggregated subgroups of students and faculty, moderate negative correlations were found between perceived social support and burnout subscores. Social support had a moderate negative correlation only with cynicism among students (r= -.453, p=0.006), while social support had moderate negative correlations with both exhaustion (r=-.514 p<0.001) and cynicism (-.555, p<0.001) among faculty. There were no significant relationships found between these two variables among staff members and resident physician subgroups. CONCLUSION: Because of a low response rate, our sample’s demographics may not be representative of our populations and may potentially limit generalization based on these results. However, the significant correlations found in whole sample analysis between perceived organizational and social support relative to burnout suggest that these variables may lessen the effects of burnout in our population. Moreover, subgroup analysis suggests that social support is a more important potential mitigator of burnout only in students and faculty, when compared to staff and residents. Furthermore, this finding supports that burnout levels within distinct subgroups of our population may be mitigated by different variables

Cluster Analysis as More Precise Measure of Burnout Among Healthcare Providers

BACKGROUND: The study of burnout among physicians and medical trainees has become a focus of many professional societies, academic institutions, and hospital systems in recent years, given the high prevalence of burnout in these populations and its implications for poor patient outcomes. However, physician burnout, widely assessed via abbreviated versions of the Maslach Burnout Inventory (MBI), has been largely considered a monolithic, syndromic condition, neglecting multidimensional aspects of the psychometric measure. This study seeks to identify the presence of distinct burnout “clusters” among academic medical professionals and trainees based on respondents’ MBI subscores of exhaustion, cynicism, and professional inefficacy, according to the analytic framework of the MBI’s developers. METHODS: This secondary data analysis was conducted using a large dataset from the 2019 OUSCM’s well-being survey, which included the MBI among other social construct measures. Per a new analytic approach recommended by creators of the MBI, we conducted additional cluster analysis on the dataset to better characterize our population. TwoStep cluster analysis via SPSS was utilized to analyze mean scores of the 3 MBI subscales and to understand similarities, differences, and clusters that existed within the dataset. RESULTS: A total of 272 burnout subscores were included in TwoStep Cluster analysis. Sample demographics included: mean age 39.4, 78.0% female, 75.1% white, 57.2% staff. Preliminary results of the cluster analysis indicated 4 distinct clusters, at fair cluster quality, with all 272 individuals included. Four distinct clusters were identified: 1) respondents with high subscores in both cynicism and exhaustion, 105 (38.6%); 2) respondents with high scores of exhaustion only, 62 (22.8%); 3) those with high scores of inefficacy only, 58 (21.3%); and 4) those with low scores in all areas, 47 (17.3%). DISCUSSION: The emergent four-cluster pattern is consistent with preliminary cluster analysis on burnout subscores among mental health professionals, as elicited by the psychologists who developed the MBI. This method identifies individuals who share similar patterns of burnout subscores, previously considered outliers. Identifying specific dimensions of burnout within a population provides greater understanding of how individuals experience burnout and how their environments contribute to burnout. Our sample restricted to the OUSCM limits assessment of burnout clusters among medical professionals and trainees at large. Extending cluster analysis to samples from multiple academic medical institutions would validate the identification of burnout clusters and provide evidence for the development of more precise interventions to mitigate burnout among medical providers and trainees. Media Link: https://youtu.be/-SnGGFsZFQ

Predictive Factors of Follow-Up in Early Lifestyle Intervention for Childhood Obesity

BACKGROUND: The Early Lifestyle Intervention (ELI) Clinic is an OU Physicians Pediatrics specialty clinic dedicated to helping children achieve healthier weights via behavioral modification through a multidisciplinary team approach. Children between 2–18 years of age from North Eastern Oklahoma are eligible for ELI referral if their BMI is at the 95th percentile or above. It is estimated that 30–40% of patients never make their ELI appointments after referral. This study explored predictive factors of patient follow-up to these appointments. METHODS: A retrospective chart review of 121 pediatric patients with ELI referrals made between January 2010 and March 2018 was conducted. Patients were grouped into three categories based on follow-up status for this intervention: immediate (attended first ELI appointment made at time of referral), late (did not attend first ELI appointment but eventually saw ELI provider), and never attended an ELI appointment. Demographic, medical, and social data were extracted from each patient’s medical record, including comorbid conditions such as musculoskeletal pain and past medical interventions such as obesity counseling. Reported comorbidities and conditions in family medical histories were documented for each patient according to the organ system affected. Associations between clinical and family factors and follow-up status were evaluated using the χ2 test, Fisher exact test, 1-way analysis of variance, and Kruskal-Wallis H test in SPSS. RESULTS: The majority of patients were Hispanic (n=73, 60.3%) and male (n=65, 53.7%), with an average age of 7.81 years (+ SD, 3.82 yrs). Frequency of obesity counseling from a healthcare provider and reported musculoskeletal pain differed significantly among groups. 31% of patients with timely follow-up experienced musculoskeletal pain compared to 3% of those with no follow-up and late follow-up. In addition, patients in the timely follow-up group had the highest frequencies of obesity counseling. The organ systems-based approach of conditions in family histories showed cardiovascular disease and endocrine disorders to be present in all patient groups with no significant difference across groups. CONCLUSION: The results suggest that providers who document counseling their patients about childhood obesity more frequently prior to ELI referral can improve their patients’ follow-up rates. Additionally, musculoskeletal pain was the only comorbidity significantly associated with attending ELI clinic. This suggests that most comorbid conditions associated with childhood obesity have a limited effect on motivating parent/patient behavior to seek longitudinal intervention.N