Buying MDMA pills Yllas

__________________________

📍 Verified store!

📍 Guarantees! Quality! Reviews!

__________________________

▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼ ▼▼

▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲ ▲▲

Buying MDMA pills Yllas

Official websites use. Share sensitive information only on official, secure websites. Corresponding Author: Sally L. Haack, Drake University, University Ave. Tel: E-mail: sally. To establish and maintain successful global pharmaceutical and health care partnerships, pharmacists, pharmacy educators, and students should first learn more about the political, cultural, economic and health care dynamics that affect all of the parties involved in these arrangements. This paper explores Latin America within the context of transnational pharmacy and health-based engagement, including pharmacy-related concepts, health care and cultural considerations, behavioral health perspectives, and common misconceptions. Expert knowledge and experience were used to support and corroborate the existing literature about cultural dynamics of health. Recommendations are provided for how schools and colleges of pharmacy can enhance engagement in culturally sensitive partnerships within Latin America. Health-based profiles of Argentina, Brazil, Ecuador, Guatemala, and Mexico are presented to serve as models for establishing, enhancing, and maintaining partnerships across Latin America. Schools and colleges of pharmacy in the United States have demonstrated an increased interest in global health. Little information is available in the pharmacy literature regarding how students should prepare to provide culturally appropriate care in these settings, despite the importance of having cultural sensitivity and humility. Latin America consists of predominantly Spanish- and Portuguese-speaking nations. There are differences between countries and even within countries with respect to the cultural beliefs, values and customs, languages, socioeconomic status, and education of the people. The examples provided in this paper may not be generalizable to all cultural groups and individuals in Latin America. These North, Central, and South American nations were selected to demonstrate the cultural and linguistic diversity of the region and to provide comparisons in population, education, political stability, spending designated to health, and additional factors that influence national health outcomes. Although Spanish-speaking Caribbean countries are not the focus of this paper, some of the cultural considerations discussed can serve as a guide for further exploration of those countries. Information about Puerto Rico can be found within the Caribbean review in this themed issue. Countries in Latin America Ranked by Population 5. This paper was developed using mixed methodologies which are described in the introduction article of this special theme. The Argentine Republic, more commonly called Argentina, covers a surface area of 2. Major industries in Argentina are in food processing, vehicle manufacturing, oil refinery, machinery and equipment, textiles, and chemical and petrochemical products. Soybeans and soybean derivatives, petroleum and gas, vehicles, corn, and wheat are the chief export commodities. The Argentine Republic is a federation consisting of 23 largely independent provinces and the federal capital of Buenos Aires. The country had decades of political instability until it ushered in democratic rule in Covering a surface area of 8. The majority of the underserved, low-income, and marginalized people, mostly descendants of former slaves, live in the favelas ghettos. It has the largest economy in Latin America and the second largest in the Americas after the United States. Ecuador is a geographically diverse country with Amazonian jungles, central highlands with the Andes Mountains, a coastal plain, and the Galapagos Islands. Ecuador is governed by a presidential republic through a seat, unicameral National Assembly. The country exports many agricultural goods, including bananas, cocoa, coffee, and flowers. Guatemala is the most populous country in Central America with over 15 million people. Guatemala is a multicultural and multilingual country. The current government is a presidential republic, but Guatemala has scars from a year civil war during which an estimated , people were massacred and approximately one million Maya were forced to leave or chose to flee between and Mexico ranks 11 th in world population There are several challenges to accessing health care in Latin America, including education, socioeconomics, transportation, and organizational structure. Additionally, cultural barriers can be identified from four areas: the structure or system, the establishment or health space, the personnel providing health services, and the patient population. In many Latin American countries, public health care systems are organized in a hierarchical manner with primary health care at the base from which patients are referred to secondary and tertiary hospitals as needed. Private hospitals are generally better equipped and more sophisticated than public hospitals, but significantly more expensive. Although many Latin American countries have made progress in expanding government-funded insurance coverage, the demand for services is high, and there is a lack of sufficient human and economic resources. Health disparities are also evident between indigenous and nonindigenous populations. Latin America has been the victim of severe natural disasters that have caused devastating losses in terms of lives and infrastructure. In June , a volcano eruption in Guatemala, and in September , an earthquake in Mexico and Hurricane Maria in the Caribbean Islands affected thousands of residents and required massive rebuilding efforts. The countries faced severe challenges following these natural disasters including poverty, inadequate communication, and lack of infrastructure. Both public and private hospitals and clinics are distributed throughout Argentina, but access is more difficult in rural areas and in the Andean northwest of the country. However, rising unemployment rates have resulted in fewer people covered by this system. Health plans are also offered to the public by some of the larger private hospitals. Private health care is paid for by employer-sponsored health insurance or some other private insurance. A PSF team consists of a family doctor, a nurse, a nursing assistant, and six community health workers. Each team is responsible for the basic health care needs of up to 4, community residents. Family Health Support Centers, which house specialists and pharmacists, provide the PSF with the support needed to handle more complex patient cases. Ecuador has had 20 constitutions since its formation in The Ecuadorian Institute of Social Security provides care to the unemployed and their dependents. The result is an often-fragmented health care system in which many citizens do not have access to high quality care. Health care expenditures as a percentage of the GDP continue to climb, reaching 8. Guatemala has the largest economy in Central America, but also rates among the highest in economic inequality in Latin America. The health care system has undergone multiple transitions over the past two decades as a result of post-war recovery. Uncertainty remains about how to create a more stabilized, fully financed system. According to the legal framework, MSPAS must be carried out in the health system and has constitutional obligations to provide health promotion, prevention, healing, rehabilitation, and follow-up services. The health system is nationally complemented by autonomous; semi-autonomous municipal, private, and social service institutions, such as the Guatemalan Social Security Institute IGSS ; Catholic and other church parish clinics; municipal clinics and organizations; NGOs; international government aid; religious and secular medical missions; the Military Hospital; and the National Police Hospital. Health services provided by organizations other than the Guatemalan government are critical considering national health concerns and the low health budget. In , Private insurance, which is very uncommon, includes not only for-profit clinics and hospitals, but also not-for-profit organizations, such as NGOs and faith-based organizations. Access to health care is poor because of a shortage in health care workers and major population dispersion in rural areas, especially in southwestern Guatemala. The WHO recommends a ratio of In Guatemala, urban areas have average ratios of There are health disparities among indigenous and nonindigenous women, particularly in rural regions and where Maya reside. The IMSS, which insures approximately 58 million people, provides benefits to workers in traditional employment positions as well as to the families of workers and retirees. Although the intention of Seguro Popular is to reduce the gaps in health care inequalities, challenges remain in achieving this goal. According to the OECD assessment of the Mexican health care system, distinct subsystems, which provide inequitable care, have resulted in serious challenges to effectiveness and efficiency. Some of the most common patient complaints when accessing health services regarding attitudes of indifference, dehumanization, depersonalization, and discrimination from medical and nursing professionals. Among vulnerable groups, there is concern that their traditional beliefs and practices about health and illness will be disregarded. While the prevalence of overweight and obesity in adults combined is In general, more medications are available without a prescription in Latin American countries than in the United States. Thus, many patients turn to their local pharmacist for advice about self-medication. In many countries, auxiliary staff members play a larger role in advising patients, while professionally trained pharmacists are less available. Complementary and alternative medicine use and practice are popular in Latin America and go side-by-side with allopathic medicine. While there are some examples in Latin America where pharmacists are integrated into the health care team, generally they work in relative isolation and are underutilized because other professionals do not value their contributions as a health care provider. Argentina has four essential lists of medicines that are provided free of charge to patients; any drugs prescribed that are not on one of these lists are paid out of pocket by the patient or by supplemental insurance. Finally, there is an essential drug list for the Compulsory Medical Program PMO , which caters to the prepaid private sector as well as the mutuals. There are 18 public and private pharmacy programs in Argentina, all are five-year undergraduate degree programs. Chief among them were lack of time, lack of specific training, and the lack of communication skills. The National Agency for Regulation, Control, and Surveillance of Health established a schedule for on-call pharmacies that requires them to provide overnight and weekend coverage. These employees are only required to complete secondary school and a special course on handling medications to obtain a permit card that allows them to work in this capacity. There are six pharmacy schools in Ecuador; however, there is no accrediting body for pharmacy education. As part of the academic program, students must complete a thesis and a practice requirement. A government mandated community service experience is also required. No national licensure examination is required before starting practice. Graduates work in laboratories, community and hospital pharmacies, industry, and academia. While Ecuador is not a large country, at least four US pharmacy programs had ties to Ecuador in About 10, pharmaceutical-related businesses, including product and drug manufacturers, pharmaceutical distributors, and pharmacies, are located in Guatemala. There is also no active national system for monitoring retail medication prices, and there are no regulations requiring that medication costs be publicly accessible. Therefore, statistical studies on cost of medications are not available. These exist only at the level of individual health areas and MSPAS hospitals and not at the private sector. Pharmacies are divided into two classes, which determine the types of prescriptions that can be purchased there. First-class pharmacies can sell narcotics and psychotropic medications and are staffed, at least part of the time, by a pharmacist. However, health centers and posts, which provide basic health care and family planning in rural areas, often lack the necessary medications. If a patient has been hospitalized, home visits promoting adherence to therapy are carried out as a way to reduce antifungal and antibacterial resistance. There are four universities in Guatemala that offer professional pharmacy programs. Many pharmacy staff members have not completed a formal, professional training program. Mexico has seen an increase in community pharmacy chains and a decrease in traditional, independently owned, community pharmacies. Chain pharmacies frequently offer lower prices and a wider range of stock. Only pharmacies that sell controlled substances are required to hire a pharmacist with a Chemist, Pharmacist, Biologist QFB degree. Seventy-eight percent of these programs confer the QFB degree. The majority of QFB graduates pursue those fields rather than clinical pharmacy or dispensing roles. The degree requires from 8 to 10 semesters of university education following high school. All Mexican university students are also required to complete hours of service prior to graduation, regardless of their field of study, but the number of hours depends on the degree. For health degrees, a year of service is commonly required. Pharmacy clerks often complete dispensing tasks in community pharmacies. They are unsupervised and do not commonly have educational prerequisites beyond completion of high school. Clerks can be very influential in making drug therapy recommendations. The proximity of the two countries makes for a logical global partnership, yet differences in professional training and practice have limited the number of exchanges. A survey of 20 US colleges and schools of pharmacy with global programs found that only two had programs in Mexico. Despite significant cultural and linguistic diversity within Latin America, researchers studying these populations in the context of behavioral health have identified commonalities. Personalismo describes a value of individualism based on internal characteristics rather than on achievement as is often seen in the United States. Both concepts are tied up with amabilidad amiability or kindness. A clinician may find that a relational style that integrates these concepts and favors interpersonal warmth and politeness, use of small talk, and genial self-disclosure will facilitate good rapport and trust with patients. Also important are the constructs of dignidad and respeto. Dignidad refers to a high value placed on personal dignity, and respeto to a system of hierarchical respect, where elders particularly parents and grandparents are owed respectful deference by younger people. There are important linguistic and cultural communication factors to recognize in delivering practice recommendations and in providing effective patient care and counseling. While Spanish is the official language in most of Latin America, there are Latin Americans, particularly indigenous residents, who do not speak Spanish or have limited knowledge of the language. Latinos respect health care providers and may view them as authority figures. In addition to respecting authority figures, patients valuing simpatia may agree to treatment plans too readily, without fully understanding the implications, in order to avoid conflict. This will help foster interpersonal relationships that are critical for building trust between patients and health care providers. Additionally, social stratification can be extensive between the following groups: urban dwellers and individuals from certain subgroups such as rural or indigenous populations, those with and those without power, and women and men. Once a clinical relationship is established, a health care worker might find other Latin American constructs to be challenging; those same constructs, however, can be reframed and used for effective patient-health care provider relationships. Machismo can be understood as a definition of manhood that values dominance, virility, and physical courage. A man exemplifying machismo who is a husband and father would be seen as the authority and decision-maker in his family. He may display masculine pride and a patriarchal condescension toward women, but at the same time feel a deep sense of obligation to protect and provide for his family. Nevertheless, these patterns remain and family systems reinforce them. If understood well, these constructs can actually be used to create more effective patient-practitioner relationships. Likewise, although marianismo can limit and damage the boundaries of femininity, its definition of women as precious and indispensable can be helpful in getting a family to coalesce around a female relative to support her medical care. The value of self-sacrifice implicit in marianismo can be used to reframe the effort and discomfort of pursuing diagnosis or treatment: a mother, sister, or daughter may persist in her nurturing role, even if it means caring for her own health in ways that she finds inconvenient or awkward. Latin American patients may also demonstrate a perspective of fatalism. Clinicians should bear in mind that their patients are not simply being obstinate or pessimistic, but this approach to difficulties is an effective coping strategy in the face of oppression and forces outside their control. When working with patients who seem unable to adhere to treatment because of a fatalistic attitude, it may be helpful for clinicians to reframe treatment as the difficulty the patient must endure instead of the illness. In this way a clinician may encourage the patient to adhere to treatment without challenging their perspective. Despite the vast diversity within Latin America, those not familiar with the region tend to view the region as monolithic and its population as homogenous. Visitors should consider the unique sociocultural history and context of each location and make an effort to learn the meanings of group names relevant to each place. For instance, although some people of Latin American heritage living in the United States might refer to themselves using an umbrella term such as Hispanic or Latino, if a visiting health care provider applied those terms to patients in Latin America it would be inappropriate and disregard their national and local identity, which are more likely to be relevant to their self-concept. Nationals of Latin American countries living in the United States might adopt the terms Hispanic or Latino to provide unity for the sake of political power or to cooperate with the expectations of the Caucasian racial majority. Health practices are influenced by religion and folk beliefs. The most frequently held religious affiliation in Latin America is Roman Catholicism, followed by Protestant denominations and other indigenous beliefs. This has been associated with beneficial effects on health, such as the reduction of symptoms of depression and successful aging in the elderly. Perceptions of science can impact understanding and acceptance of disease, illness, and medicine. These concepts can also influence preference to seek modern medicine, use traditional practices, or rely on religious beliefs. The rest expressed a lack of interest because they did not understand these issues. Visiting health care workers should consider that Latin American patients may frame symptoms in a different context than that found in Western medicine. Patients may present with physical health conditions that the patient may perceive as being of spiritual origin based on cultural beliefs. Hence, these beliefs may affect how patients access the health care system and their degree of adherence to allopathic medical treatment. Mal de ojo evil eye , ataque de nervios or nervios nervous attack , susto fright , and empacho gastrointestinal distress syndrome are only a few examples of these cultural health beliefs. Latin Americans may seek out folk healers for the treatment of their conditions, alone or in combination with conventional medicine. Folk healing is more common among, but not confined to, those of lower socioeconomic and educational status. It may be practiced with greater secrecy among the educated and wealthier class because of the stigma attached to it. Other folk healers may be called brujos witch doctors. In Ecuador, a sobador is another type of healer that uses massage. Traditional medicines and treatments are used throughout Latin America. An example of this is the consumption of cloves during pregnancy in Guatemala, which can result in increased abortions and maternal and infant deaths. Appendix 1 provides an example of the wide variety of common health and healing practices in Mexico. Traditional healers are a prevalent alternative medicine style well documented in nations such as Ecuador and Mexico. Other types of practices may include cleansing, massage, adjustments, pinching, punctures with different types of thorns, and suctions, among others. Traditional procedures are heavily linked to the region in which they are practiced. Healers will commonly treat patients in unconventional offices in their own home, adorned with religious imagery, stamping, effigies, and altars. Objects of perceived power, both energetic and magical, include talismans, quartz, water, garlic, onions, statuettes, herbs, lotions, potions, droplets, and ointments, among others. Other traditional rituals or treatments may include the use of cold and moisture through mud or the use of heat through temazcals steam baths or cataplasmas body wraps to purify the body or cure illness, such as a fever. Given the vast religious, cultural, and social diversity in communities where culture-bound ailments are deeply ingrained, integrative and inclusive health programs should be considered to reduce inequities among community healers and health care providers. Examples of inclusive health models have been initiated in Guatemala, Mexico, and Ecuador where emphasis is placed on including these ailments in the health care system, not as medical diagnoses, but rather as a way of empowering patients with the intention of strengthening physician-patient relationships. This perspective is likely to improve clinical rapport, which in turn is likely to improve patient adherence with medical advice including other traditional healers, community health workers, or midwives. When hosting Latin American visitors, the hosts should be mindful of cultural differences and expectations. Latin America is a diverse region that contains varied cultures. Thus, recommendations for culturally sensitive engagement are not uniform across or even within Latin American countries. Some cultural aspects to consider include differences in greetings, proxemics, and chronemics between people in Latin America and those in other regions of the world. This is especially true in the work environment, where a kiss on the cheek would likely be viewed as inappropriate in the United States. What is considered a comfortable distance between colleagues or friends also differs between regions. Latin American colleagues may sit or stand closer to each other than their counterparts in the United States. Those not accustomed to a reduced personal space may display discomfort with body language or even move to create distance. Time tends to be more fluid in Latin America. Therefore, when hosting visitors, clarity about the need for punctuality for meetings or activities may help prevent delays. Also, working lunches are typically less common in Latin America than in the United States, as Latin Americans may see lunch as an important time to interact socially rather than to work to stay on schedule. Scheduling time for networking and socializing during events may also be important to Latin American guests. These examples demonstrate the importance of personalismo in Latin American culture. Communication styles also vary within and between Latin American nations. This is particularly common in Maya cultures and could interfere with health outcomes and data collection. Even within languages, there is a more formal way to refer to superiors and elders. Latin America is a culturally rich region of the world with diverse perspectives on health. This article focuses on general themes seen in Latin American lifestyle, culture, and health care, and the reader should realize that each region has distinct subcultures too numerous to be discussed or summarized in a single document. Socioeconomic and marital status, education level, age, gender, and sexual orientation, as well as the regional perceptions of each of these, are a few of the many factors that contribute to cultural identity. Latin Americans may be influenced by many, some, or only a few of the factors discussed in this paper. During cross-cultural engagements, guests and hosts should keep in mind that each person is unique regardless of where he or she is from as this will help them to avoid making assumptions and forming stereotypes about one another. This article is not a checklist to follow or an exhaustive list of all possible cultural dynamics of health or intercultural interactions, but rather a starting point for understanding this region of the world, its people, and health dynamics. Cultural considerations can be patterned after this framework to gain a deeper cultural understanding of additional countries in the region. The framework provided here can serve as a template for exploring other countries in this region of the world. Special thanks to Jeanine Abrons University of Iowa for her collaboration and input in the planning phase. Western alternative and allopathic medicine: Biological chemical therapy Homeopathy, aromatherapy, cell therapy, enzyme therapy , Movement and manipulation of the body Chiropractic, osteopathy, chiropractic, Swedish massage, equine therapy , Mind-Body Family constellations, biofeedback, music therapy , Mind-Mind cognitive therapy , Biocampo-energy Bioresonance, magnetotherapy, phototherapy , and Diagnosis iridology. Chinese traditional medicine: Acupuncture stimulation reflexotherapy, auriculotherapy , Energy Reiki , Balance with the environment-Energy Feng Shui. As a library, NLM provides access to scientific literature. Am J Pharm Educ. Find articles by Sally L Haack. Find articles by Inbal Mazar. Find articles by Erin M Carter. Find articles by Joyce Addo-Atuah. Find articles by Melody Ryan. Find articles by Laura Leticia Salazar Preciado. Find articles by Aliz Lorena Barrera Ralda. Received Jun 19; Accepted Nov 6. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.