Conhecimento e uso da medicina alternativa entre alunos e professores de primeiro grau Knowledge and use of alternative medicine by elementary school children and teachers

Como parte de um Projeto de Educação em Saúde, investigou-se o conhecimento e como são utilizadas as práticas populares de cura, de modo a desenvolver e ampliar na escola, as possibilidades já existentes de discussão crítica e construtiva dentro do programa de saúde. Espera-se com isso poder resgatar saberes e valorizar esse conhecimento não sistematizado, presente na prática das populações ainda de forma marginalizada e controvertida. Foram aplicados questionários entre 110 professores e 162 alunos das 1ª à 4ª séries do 1&deg; grau de quatro escolas (P.L.S.L., P.H.A., P.A.M.M. e A.M.G.) da periferia de Belo Horizonte. Sendo que, as questões apresentadas foram respondidas somente por 105 docentes. Vinte e três (32,4%) (entre 71 (67,6%)) acreditam em dons especiais de cura; dos 105 (95,4%) que responderam sobre se acham que certas doenças podem ser tratadas com remédios caseiros, somente 69 (65,7%) acreditam que sim; 54 (78,3%) dentre esses, associaram a cura da doença com a planta medicinal e 15 (21,7%) indicam o remédio sem associação com a doença; 36 (34,3%) professores citaram a doença sem relacionar as ervas medicinais. Já, 101 (62,3%) alunos acreditam que os remédios caseiros são positivos para algumas doenças. Entre os alunos e professores foram mencionadas doenças diversas, sintomas e órgãos que podem ser curados por plantas medicinais, rezas ou benzedeiras. Um pouco mais de 50% dos dois grupos de alunos (1ª, 2ª, 3ª e 4ª séries) vivem entre famílias que procuram benzedeiras como alternativa de cura. Foram indicadas pelos professores e alunos mais de 50 plantas ou composições de partes de plantas. Conclui-se, que a medicina alternativa é conhecida e utilizada pela amostra estudada.<br>The knowledge and use of popular cures was investigated as part of health education project in such a way as to develop and expand the existing possibilities for critical and constructive discussion in the school within the health program. It was hoped that this would result in the retrieval and in an increase in the value attributed to information concerning this nonsystematized knowledge present in a controversial and poorly accepted form In the practices of the population. One hundred and five teachers and 162 students of the 1st to 4th grades of the four primary schools on the outskirts of Belo Horizonte were interviewed. One hundred and five of the teachers answered the questions put. Twenty-three (32,4%) of the teachers said they believed in special cures, 69 (65,7%) thought that certain diseases could be treated with homemade remedies for these, 54 (78.3%) were able to associate a particular disease whit a particular medicinal plant and 15 (21.7%) prescribed a treatment without any association with a particular disease, 36 (34.3%) cited a disease without relating this to a particular herb. One hundred and one (62,3%) of the students believed that homemade remedies are effective for certain diseases. Amongst the teachers and students various diseases were mentioned as well as different symptoms and organs that can be cured by medicinal plants, roots or traditional healers. A little more than 50% of the two groups of students (1st and 2nd grade, 3rd and 4th grade) live in families who make use of traditional healers to provide alternative cures. More than 36 plants or preparations of parts of plants were indicated by the teachers and students. It is conclude that these individuals possess knowledge of and do in fact make use of alternative medicine

Etnobotânica nordestina: estudo comparativo da relação entre comunidades e vegetação na Zona do Litoral - Mata do Estado de Pernambuco, Brasil Northeast Ethnobotany: links between communities and vegetation of the Coast Zone of the Mata Region in Pernambuco State, Brazil

O trabalho visa determinar as relações entre comunidades e vegetação na Zona da Mata de Pernambuco. A comunidade da Usina São José (Igarassu - Ig) é formada por vilas rurais, vizinhas da Reserva Ecológica da Mata da Usina São José. Jaguarana (Paulista-Pa) é uma comunidade urbana, próxima à Reserva Ecológica da Mata de Jaguarana. Levantou-se as plantas úteis para estas comunidades por meio de 38 entrevistas não-estruturadas, enquadrando-as nas categorias de uso alimentação, comércio, construção, mágico, medicinal, tecnológico e outros. Foram registradas 334 espécies, nativas e cultivadas. Comparou-se as comunidades, através do Quociente de Similaridade de Sørensen (Qs), obtendo-se maiores índices para plantas alimentícias (QsIgPa= 0,71), predominantemente cultivadas, e medicinais (QsIgPa= 0,56), 45,1% delas nativas, predominantemente herbáceas. A vegetação nativa constitui uma fonte importante de recursos medicinais mas é subutilizada como fonte de alimento e tem pouca relevância na visão cosmológica das comunidades. Os vegetais não têm relevância na atividade de comércio, servindo como complemento de renda para as famílias (QsIgPa= 0,30). Na categoria construção enquadram-se, majoritariamente, espécies nativas (87,8%) e arbóreas (92,7%). Em tecnologia têm maior representatividade espécies nativas (85,7%) e arbóreo/arbustivas (84,1%). As comunidades utilizam diferentes fontes vegetais para as categorias construção, mágica, tecnologia e outros, decorrentes tanto das principais atividades que nelas exercem seus moradores, como dos recursos naturais à sua disposição.<br>The objective of this work is to determine the social behaviour concerning the consumption of vegetal species by local communities. The involved localities are: the Usina São José (Igarassu - Ig), which involves rural communities in the surroundings of the Ecological Reserve of the Usina São José and the Jaguarana (Paulista - PE), an urban settlement located in the neighbourhoods of the Ecological Reserve of Jaguarana. Structured interviews were applied to these social groups, addressing 38 people, in order to identify the most useful plants and the correspondent use. These were classified into categories food, commerce, constrution, ritualistic, medicinal, technological and "others". Among these types, 334 native and introduced species were registered. The different communities were analysed and compared through the Sørensen Similarity Quotient (Qs). The higher incidence is of feeding plants (QsIgPa= 0.71), predominantly cropped and medical plants (QsIgPa= 0.56), from which 45.1% are natives and herbaceous. The native vegetation constitutes an important source of medicines. However, it has no relevance as food within the cosmological view of the community. Vegetables are irrelevant as timber in the trade sector, for income generation (QsIgPa= 0.30). For building proposals most species are native (87.8%) and tree (92.7%). For technological purpose the native species (85.7%) and the tree/shrub (84.1%), are the most representative category. The communities use different types of vegetal resource for the construction, ritualistic and technology among other categories, as a result of their main activities and of the available natural resources

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P &lt; 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients