The Teaching Of Homeopathy And Practices Within Brazilian Public Health System (sus) [o Ensino Da Homeopatia E A Prática No Sus]

This study focuses on training for homeopathic physicians as one of the actions developed for humanizing medical practice. In Brazil, this took place outside of university-level teaching institutions until 2003, when the specialization course on homeopathy was established at Jundiai School of Medicine, with teaching practice and attendance for public health service users. This study aimed to assess the training for homeopathic physicians at Jundiai and the perceptions of users, health professionals, course teachers and tutors and the school's academic board, regarding homeopathy and the course. The study was qualitative and used interviews, focus group techniques and questionnaires. Three analytical categories emerged from the data: a) knowledge of reference points for homeopathy; b) homeopathy as a new paradigm for teaching and attendance within public health; and c) general course structure. It was concluded that teaching homeopathy in university-level institutions is viable as a public health-oriented clinical teaching activity.1225247266(2004) Federadas cadastradas na AMHB, , www.amhb.org.br, ASSOCIAÇÃO MÉDICA HOMEOPÁTICA BRASILEIRA, Disponível em:, Acesso em 30 mar. 2005BARDIN, L. Análise de conteúdo. Trad. Luís A. Reto e Augusto Pereira. Lisboa: Edições 70, 1977BARROS, N. F. A construção de novos paradigmas na medicina: a medicina alternativa e a medicina complementar. In: CANESQUI, A. M. (Org.). Ciências sociais e saúde para o ensino médico. São Paulo: Hucitec, 2000. p.119-127BRASIL. MINISTÉRIO DA SAÚDE. Política Nacional de Práticas Integrativas e Complementares - PNPIC. Brasília, 2006. Disponível em: <www.saude.gov.br e www.amhb.org.br〉. Acesso em: 5 maio 2006CAMPELLO, M.F., (2001) A relação médico-paciente na Homeopatia: Convergência de representações e práticas, p. 2001. , Dissertação Mestrado, Universidade Estadual do Rio de Janeiro, Rio de JaneiroCOMUS. CONSELHO MUNICIPAL DE SAÚDE. Ata da 6a reuniao extraordinária. Jundiai, 2004GALHARDI, W.M.R A formação do médico homeopata na Faculdade de Medicina de Jundiaí: uma prática de ensino no SUS. 2005. Dissertação (Mestrado) - Faculdade Ciências Médicas, Universidade Estadual de Campinas, Campinas. 2005GALVÃO, G.G., (1999) Outros modelos de atenção à saúde: A medicina homeopática na rede p-blica, p. 1999. , Dissertação Mestrado, Universidade do Estado do Rio de Janeiro, Rio de JaneiroHAHNEMANN, C.F.S. Exposição da doutrina Homeopática ou Organon da arte de curar. Trad. Grupo de Estudo Benoit Mure. [6.ed. alemã]. 2.ed. São Paulo: Artes Gráficas Giramundo, 1984LÜDKE, M., ANDRÉ, M.E.D., (1986) Pesquisa em educaçã o: Abordagens qualitativas, , São Paulo: EPULUZ, H.S., O conselho de entidades formadoras de especialistas em Homeopatia, suas metas e perspectivas. (1999) Rev. Homeopat. AMHB, (3), pp. 113-118LUZ, MT. Medicina e racionalidades médicas: estudo comparativo da medicina ocidental, contemporânea, homeopática, tradicional chinesa e ayurvédica. In: CANESQUI, A.M. (Org.). Ciências sociais e sa-de para o ensino. São Paulo: Hucitec, 2000. p. 181 -200LUZ, H.S., (1996) A arte de curar versus a ciência das doenças: História social da homeopatia no Brasil, , São Paulo: Dynamis EditorialMINAYO, M.C.S., (2004) O desafio do conhecimento: Pesquisa qualitativa em saúde, , São Paulo: HucitecMOREIRA NETO, G. Homeopatia em Unidade Básica de Saúde (UBS): um espaço possível. 1999. Dissertação (Mestrado) - Faculdade Sa-de P-blica, Universidade de São Paulo, São Paulo, 1999ROSENBAUM, P., Homeopatia - medicina sob medida Entrevista - Jornal da USP, , http://www.usp.br/jorusp/progs/search.php, online, 2006. Disponível em:, Acesso em: 12 mar. 2006QUEIROZ, M.S. O sentido do conceito de medicina alternativa e movimento vitalista: uma perspectiva teórica introdutória. In: NASCIMENTO, M.C. (Org.) As duas faces da montanha estudos sobre medicina chinesa e acupuntura. São Paulo: Hucitec, 2006. p. 19-39SALLES, S.A.C., Perfil do médico homeopata. 2001 (2001) Tese (Mestrado) - Departamento de Práticas em Serviços de Saúde, Faculdade de Saúde Pública, , Universidade de São Paulo, São PauloSÓLON, L.R., Contradições sociais da Homeopatia: Desafios para os homeopatas enquanto sujeitos históricos. (2002) Rev. Homeopat, 67 (1-2), pp. 47-54TOBAR, F., YALOUR, M.R., (2001) Como fazer teses em saúde pública: Conselhos e ideias para formular projetos e redigir teses e informes de pesquisas, , Rio de Janeiro: Fiocru

O corpo negado pela sua “extrema subjetividade”: expressões da colonialidade do saber na ética em pesquisa

In the quest to understand the (in)visibility of non-heteronormative bodies in medical education, a process that systematically grounds its institutional discourse on the biological coherence, I looked at my gay body both as a doctor and professor to understand this culture and its consequences. The objective of the article is to discuss the initial institutional confrontations faced by an autoethnographic research regarding homoaffectivity in medical education and practice. This work is aimed towards understanding the silencing imposed on subjectivity, existence and participation as a subject-researcher in “Science”. Thus, amidst a muted cry of a denied body, “misunderstood” for its “extreme subjectivity,” this text represents the audacity in speaking and breaking with the mortifying silence imposed by the supposed “scientific” hegemony23COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPES88881.188456/2018-01Buscando compreender as (in)visibilidade dos corpos não heteronormativos na educação médica, a qual sistematicamente sustenta seus discursos institucionais baseados na coerência biológica, olhei para o meu corpo gay , de médico e de professor, para compreender essa cultura e seus desdobramentos. O objetivo deste trabalho é discutir os enfrentamos institucionais iniciais para a realização de uma pesquisa autoetnográfica sobre a homoafetividade na formação e prática médicas. Compreendemos, com esse trabalho, o silenciamento imposto à subjetividade, à existência e à participação enquanto pesquisador-sujeito na “Ciência”. Assim, em meio a um grito emudecido de um corpo negado, com “entendimentos errôneos” pela sua “extrema subjetividade”, este texto representa uma ousadia em falar e romper com o silêncio mortificante que a suposta hegemonia “científica” impõ

Souza An, Pitanguy J. Saúde, Corpo E Sociedade. Rio De Janeiro:editora Ufrj; 2014

205750951

The Mais Médicos (more Doctors) Program In Mato Grosso State, Brazil: Implementation Analysis

Although the 224 health professionals engaged by the More Doctors for Brazil Project (Projeto Mais Médicos para o Brazil, PMMB) to strengthen the National Primary Health Care Policy (Política Nacional de Atenção Básica, PNab) in 104 municipalities of Mato Grosso (MT) State have encountered significant problems in the work process, important advances have resulted in the health of populations served by the More Doctors Programme (Programa Mais Médicos, PMM). This article analyses the implementation and development of the PMM in MT, from 2013 to 2015, on the basis of primary data from focus groups and interviews of social stakeholders at the institutions involved and secondary data from reports by supervisors, tutors, managers and institutions on the MT State Coordinating Committee (CCE) of the PMM. Despite political difficulties in managing implementation, the results show that the endeavour was beneficial in that it surmounted previous obstacles, afforded users greater access, prompted discussion of the problem and proposed and experimented with ways to strengthen primary health care. We conclude that there is a need for broader academic discussion of the provision and training of doctors, of the model of care and of human resource capacity-building by continuing professional development with integration among teaching, service and community. © 2016, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.2192879288

Evidence-based Medicine And Prejudice-based Medicine: The Case Of Homeopathy [medicina Baseada Em Evidência E Medicina Baseada Em Preconceito: O Caso Da Homeopatia] [medicina Basada En La Evidencia Y Medicina Basada En El Prejuicio: El Caso De La Homeopatía]

In recent decades an important social movement related to Complementary and Alternative Medicine has been identified worldwide. In Brazil, although homeopathy was recognized as a specialist medical area in 1980, few medical schools offer courses related to it. In a previous study, 176 resident doctors at the University of Campinas Medical School were interviewed and 86 (49%) rejected homeopathy as a subject in the core medical curriculum. Thus, this qualitative study was conducted to understand their reasons for refusing. 20 residents from 15 different specialist areas were interviewed. Very few of them admitted to a lack of knowledge for making a judgment about homeopathy; none of them made a conscientious objection to it; and the majority demonstrated prejudice, affirming that there is not enough scientific evidence to support homeopathy, defending their position based on personal opinion, limited clinical practice and on information circulated in the mass media. Finally, resident doctors’ prejudices against homeopathy can be extended to practices other than allopathic medicine.301123682376Ernst, E., The fascination of complementary and alternative medicine (CAM) (2007) J Health Psychol, 12, pp. 868-870Pittler, M.H., Abbot, N.C., Harkness, E.F., Ernst, E., Location bias in controlled clinical trials of complementary?Alternative therapies (2000) J Clin Epidemiol, 53, pp. 485-489Sood, A., Knudsen, K., Sood, R., Wahner-Roedler, D.L., Barnes, S.A., Bardia, A., Publication bias for CAM trials in the highest impact factor medicine journals is partly due to geographical bias (2007) J Clin Epidemiol, 60, pp. 1123-1126Sierpina, V.S., Kreitzer, M.J., The continuing bias against complementary and integrative healthcare education (2010) Explore (NY), 6, pp. 54-56Santos, B.S., (2004) Conhecimento Prudente Para Uma Vida Decente, , São Paulo: Editora CortezPolich, G., Dole, C., Kaptchuk, T.J., The need to act a little more ‘scientific’: Biomedical researchers investigating complementary and alternative medicine (2010) Sociol Health Illn, 32, pp. 106-122Teixeira, M.Z., Chin, A.L., Martins, M.A., Homeopathy and acupuncture teaching at Faculdade de Medicina da Universidade de São Paulo: The undergraduates attitudes (2005) São Paulo Med J, 123, pp. 77-82Teixeira, M.Z., Homeopatia: Desinformação e preconceito no ensino médico (2007) Rev Bras Educ Med, 31, pp. 15-20Soledad, G., Sigel, P., Barros, N.F., Educação médica e práticas não convencionais em saúde: Análise do nível de informação de acadêmicos de medicina sobre a homeopatia (2011) O Ensino De práticas Integrativas E Complementares: Experiências E percepções, pp. 99-113. , In: Barros NF, Siegel P, Otani MAP, editors, São Paulo: Editora HucitecBrotherton, S.E., Rockey, P.H., Etzel, S.I., US graduate medical education, 2003-2004 (2004) JAMA, 292, pp. 1032-1037Lebensohn, P., Campos-Outcalt, D., Senf, J., Pugno, P.A., Experience with an optional 4-year residency: The University of Arizona Family Medicine Residency (2007) Fam Med, 39, pp. 488-494Maizes, V., Silverman, H., Lebensohn, P., Koithan, M., Kligler, B., Rakel, D., The integrative family medicine program: An innovation in residency education (2006) Acad Med, 81, pp. 583-589Frenkel, M., Ben-Arye, E., Hermoni, D., An approach to educating family practice residents and family physicians about complementary and alternative medicine (2004) Complement Ther Med, 12, pp. 118-125Ashar, B.H., Rice, T.N., Sisson, S.D., Medical residents’ knowledge of dietary supplements (2008) South Med J, 101, pp. 996-1000Xu, S., Levine, M., Medical residents’ and students’ attitudes towards herbal medicines: A pilot study (2008) Can J Clin Pharmacol, 15, pp. 1-4Lie, D.A., Boker, J., Comparative survey of Complementary and Alternative Medicine (CAM) attitudes, use, and information-seeking behaviour among medical students, residents & faculty (2006) BMC Med Educ, 6, p. 58Marcuse, H., (1969) O Fim Da Utopia, , Rio de Janeiro: Paz e TerraDenzin, N.K., (2010) The Qualitative Manifesto: A Call to Arms, , Walnut Creek: Left Coast Press IncFiuza, A.R., Otani, M., Barros, N.F., A homeopatia e o ensino médico de graduação e residência (2011) O Ensino De práticas Integrativas E Complementares: Experiências E percepções, pp. 114-127. , In: Barros NF, Siegel P, Otani MAP, editors, São Paulo: Editora HucitecBroom, A., Using qualitative interviews in CAM research: A guide to study design, data collection and data analysis (2005) Complement Ther Med, 13, pp. 65-73Ulin, P.R., Robinson, E.T., Tolley, E.E., Investigación aplicada en salud pública: Métodos cualitativos (2007) Rev Inst Med Trop São Paulo, 49, p. 86Pope, C., Mays, N., (2009) Pesquisa Qualitativa Na atenção à saúde, , Porto Alegre: Editora ArtmedTeixeira, M.Z., Panorama da pesquisa em homeopatia: Iniciativas, dificuldades e propostas (2004) Diagn Tratamento, 9, pp. 98-104Salles, S., A presença da homeopatia nas faculdades de medicina brasileiras: Resultados de uma investigação exploratória (2008) Rev Bras Educ Méd, 32, pp. 283-290Frader, J., Bosk, C.L., The personal is political, the professional is not: Conscientious objection to obtaining/providing/acting on genetic information (2009) Am J Med Genet C Semin Med Genet, 151C, pp. 62-67Wicclair, M.R., Conscientious objection in medicine (2000) Bioethics, 14, pp. 205-227Gampel, E., Does professional autonomy protect medical futility judgments? (2006) Bioethics, 20, pp. 92-104http://educacao.uol.com.br?dicionarios?, Babylon Dictionary, accessed on 31/Jul/2014Adorno, T.W., (1972) Consignas, , Buenos Aires: AmorrotuMilgrom, L.R., The eternal closure of the biased mind? The clinical and scientific relevance of biophysics, infinitesimal dilutions, and the memory of water (2009) J Altern Complement Med, 15, pp. 1255-1257Jahoda, M., Ackerman, N.W., (1969) Distúrbios Emocionais E Anti-Semitismo, , São Paulo: Editora PerspectivaKleijnen, J., Knipschild, P., Ter Riet, G., Clinical trials of homoeopathy (1991) BMJ, 302, pp. 316-323Eskinazi, D., Muehsam, D., Is the scientific publishing of complementary and alternative medicine objective? (1999) J Altern Complement Med, 5, pp. 587-594Adorno, T.W., Horkheimer, M., (1973) Temas básicos De Sociologia, , São Paulo: CultrixWorld Health Organization, (2002) Tradicional Medicine Strategy: 2002-2005, , Geneva: World Health OrganizationJosefek, K., Alternative medicine’s roadmap to mainstream (2000) Am J Law Med, 26, pp. 295-310http://www.imconsortium.org?, accessed on 31/Jul/2014Ministério da Saúde, (2006) Política Nacional De Práticas Integrativas E Complementares No SUS-PNPICSUS, , Brasília: Ministério da SaúdeCrochik, J.L., (1997) Preconceito-indivíduo E Cultura, , São Paulo: Robe EditorialFrenk, J., Chen, L., Bhutta, Z.A., Cohen, J., Crisp, N., Evans, T., Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world (2010) Lancet, 376, pp. 1923-1958Broom, A., Tovey, P., (2008) Therapeutic Pluralism-Exploring the Experiences of Cancer Patients and Professionals, , London/New York: RoutledgeFoucault, M.O., (1988) Nascimento Da clínica, , 5a Ed. Rio de Janeiro: Forense UniversitáriaLuz, M.T., Barros, N.F., Racionalidades médicas e práticas integrativas em saúde: Uma análise sócio-histórica e suas relações com a cultura atual (2013) Tratado De saúde Coletiva. 2A Ed, pp. 317-340. , In: Campos GWS, Bonfim JRA, Minayo MCS, Akerman M, Drumond Júnior M, Carvalho YM, editors, São Paulo: Editora Hucite

Motivos Para Atuação E Formação Profissional: Percepção De Doulas

The discussion about professional practices in the Brazilian obstetric model becomes potent when it is possible to highlight the performance of each actor in this scenario. This study aimed to analyze the motivational factors for women seeking the formation of doula and to develop their professional activities. It is an exploratory-descriptive qualitative research, carried out with 13 doulas, specific training participants, through individual telephone interviews. After the analysis of the testimonies, two categories emerged: The reason for the formation in the doula course; and Reference groups as a perspective for the work of doulas. It was evidenced that individual experiences with the birth itself motivated women in the search for this formation and that the strengthening of professionalization through the constitution of groups is a form sought by the doulas to qualify their work in obstetrics. © 2016, Institute de Medicina Social da UERJ. All rights reserved.2641395140

Asymptotic description of solitary wave trains in fully nonlinear shallow-water theory

We derive an asymptotic formula for the amplitude distribution in a fully nonlinear shallow-water solitary wave train which is formed as the long-time outcome of the initial-value problem for the Su-Gardner (or one-dimensional Green-Naghdi) system. Our analysis is based on the properties of the characteristics of the associated Whitham modulation system which describes an intermediate "undular bore" stage of the evolution. The resulting formula represents a "non-integrable" analogue of the well-known semi-classical distribution for the Korteweg-de Vries equation, which is usually obtained through the inverse scattering transform. Our analytical results are shown to agree with the results of direct numerical simulations of the Su-Gardner system. Our analysis can be generalised to other weakly dispersive, fully nonlinear systems which are not necessarily completely integrable.Comment: 25 pages, 7 figure

Controle Da Dengue: Os Consensos Produzidos Por Agentes De Combate às Endemias E Agentes Comunitários De Saúde Sobre As Ações Integradas

Dengue is one of Brazil’s most important public health challenges. Activities for its prevention and control have been based on the strategy of integrated management proposed in health policies, in which the central actors are the Endemic Disease Control Agent(ACE) and the Community Health Agent (ACS). This study analyzes consensus opinions produced by ACSs and ACEs on theactions for incorporating ACEs into the teams of the Family Health Strategy (ESF). It is a qualitative study from a large municipality in Brazil in which dengue is endemic, using a focus group of professionals that is subsequently analyzed using Collective Subject Discourse Analysis, supported by WebQDA. The results indicate consensus positions in relation to the following subjects: I) difficulty in the process of integration of ACSs and ACEs for control of dengue; II) inclusion of ACEs in the primary healthcare of the ESF; and III) absence of monitoring and assessment of the integrated actions. In conclusion, there are needs: to make participants more aware, seeking changes in behavior; to offer an environment of support to those involved with training courses about dengue; and to monitor the process of integration, and evaluate it periodically, creating indicators of quality and quantity. © 2016, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.2182329233

Uso De Práticas Integrativas E Complementares Por Doulas Em Maternidades De Fortaleza (ce) E Campinas (sp)

This study aimed to analyze the Integrative and Complementary Practices (ICP) applied by doulas in the cities of Fortaleza (CE) and Campinas (SP). This is a qualitative study encompassing fifteen doulas: nine from Fortaleza and six from Campinas. The data were collected in the second half of 2010 by conducting semi-structured and pre-organized interviews following the procedures of thematic content analysis. The interpretations of the results were based on the idea that institutionalization of knowledge and practices happen through the conformation of nuclei and fields. The nucleus demarcates the identity of an area of knowledge and the professionals’ practices, and the field demarcates the blurred limits among disciplines that can be submitted to conflicts. We observed that the support offered by doulas permeates a variety of practices framed in traditional medicine as well as in complementary and alternative medicine. ICP was associated with decreases in length of labor, superior pain management, ability of making decision and empowering of women. It is understood that the range of activities offered by doulas and the use of ICP converge to the uniqueness, respect and autonomy of women. Furthermore, it proposes a new model of awareness and practices centered on the importance of the natural process of childbirth. © 2016, UNIV SAOPAULO. All rights reserved.25110812

SNO+: predictions from standard solar models and spin flavour precession

Time variability of the solar neutrino flux especially in the low and intermediate energy sector remains an open question and, if it exists, it is likely to be originated from the magnetic moment transition from active to light sterile neutrinos at times of intense solar activity and magnetic field. We examine the prospects for the SNO+ experiment to address this important issue and to distinguish between the two classes of solar models which are currently identified as corresponding to a high (SSM I) and a low (SSM II) heavy element abundance. We also evaluate the predictions from these two models for the Chlorine experiment event rate in the standard LMA and LMA+Spin Flavour Precession (SFP) scenarios. It is found that after three years of SNO+ data taking, the pep flux measurement will be able to discriminate between the standard LMA and LMA+SFP scenarios, independently of which is the correct solar model. If the LMA rate is measured, SFP with $B_0 \sim 280kG$ for the resonant $\Delta m^2_{01}$ can be excluded at more than $4\sigma$. A low rate would signal new physics, excluding all the 90% allowed range of the standard LMA solution at 3$\sigma$, and a time variability would be a strong signature of the SFP model. The CNO fluxes are the ones for which the two SSM predictions exhibit the largest differences, so their measurement at SNO+ will be important to favour one or the other. The distinction will be clearer after LMA or SFP are confirmed with pep, but still, a CNO measurement at the level of SSM I/LMA will disfavour SSM II at about $3 \sigma$. We conclude that consistency between future pep and CNO flux measurements at SNO+ and Chlorine would either favour an LMA+SFP scenario or favour SSM II over SSM I.Comment: 20 pages. Sections 1 and 2 extended, section 4.4 added, references added and updated. Final version to be published in JHE