Complementary and Integrative Medicine in academic health education.

OBJECTIVE: To analyze academic education in Complementary and Integrative Medicine (CIM) according to university students from the health area. METHODS: Cross-sectional study with 1399 students from six public and private Brazilian universities, with online and in-person collection of socioeconomic, demographic, educational and academic data, carried out in 2019. The bivariate analysis was applied for the outcome "presence of CIM in academic health education", using the SPSS Statistic program, version 23.0™. RESULTS: The prevalence of the presence of CIM in academic health education was 52.3%, being 31.1% in the compulsory and 8% in the non-compulsory curricular education, 2.0% in scientific research and 4.7% in university extension activities. There was an association of the outcome with knowledge of the national CIM policy (OR = 5.258; p = 0.000), of which knowledge can be indicated and used in one's professional area (OR = 4.836; p = 0.000), interest and/or use of CIM by the teachers/tutors of the course (OR = 3.955; p = 0.000), stimulus by the university to carry out scientific research (OR = 3.277; p = 0.000) and university extension projects with CIM (OR = 3.686; p = 0.000). CONCLUSION: Academic education using CIM in health area courses is not very prevalent in teaching, research and university extension in Brazil, but when present in the curricular and non-curricular educational processes, it shows a significant association with knowledge, skills and their use by university students. The creation of a National Educational Planning in CIM is a vital imperative.

Burnout and quality of life among correctional officers in a women's correctional facility.

INTRODUCTION: The correctional officer career is considered a stressful and risky occupation that can affect the mental health of workers due to stress and burnout; this syndrome presents itself with physical, psychological, behavioral, and defensive symptoms, ultimately affecting quality of life. OBJECTIVES: To evaluate the sociodemographic profile, burnout levels, and quality of life of female correctional officers in a women's correctional facility, as well as to verify possible correlations between these variables. METHODS: This is a descriptive cross-sectional study performed in a women's correctional facility located in Aquiraz, in the state of Ceará, through the use of 3 evaluation instruments: the Maslach Burnout Inventory-General Survey, the abbreviated version of the World Health Organization Quality of Life instrument, and a general information questionnaire. RESULTS: Most of the correctional officers were married or cohabiting, aged between 31 and 40 years old, with complete or partial undergraduate education, and at least 1 child. In the burnout investigation, mean scores were 1.9±1.43, indicating a moderate level of burnout. Regarding quality of life, the environment domain presented the lowest scores (57.34%). We observed a correlation between burnout and quality of life, in which the higher the burnout scores, the lower the quality of life reported by correctional officers. CONCLUSIONS: Our data demonstrate that correctional officers face a risk of developing burnout, thus affecting their quality of life; therefore, preventive health care measures are required for these professionals.

Auriculoterapia no tratamento da obesidade: uma revisão sistemática / Auriculotherapy on treatment of obesity: a systematic review

A obesidade pode ocasionar a morte prematura dos individuos acometidos por esta disfunção. Na tentativa de amenizar as desordens dessa doença, a auriculoterapia surge como um tratamento que visa promover a perda de peso e melhor qualidade de vida. OBJETIVO: Identificar a eficácia da auriculoterapia no controle do peso de indivíduos obesos. METODOLOGIA: Realizou-se uma revisão sistemática (CRD42020198862) segundo as recomendações PRISMA, nos bancos de dados PubMed, Lilacs, Scielo e PEDro, no periodo de julho a outubro de 2016, com descritores Obesity e auriculotherapy. Foram incluídos Ensaios Clínicos Controlados publicados até 2015, em português, inglês e espanhol, e contendo as palavras chaves no título ou resumo. Na análise foram considerados como desfecho primário: Índice de Massa Corporal e peso corporal, e desfecho secundário: circunferência da cintura e leptina. RESULTADOS: No total foram incluídos cinco estudos. Desses, quatro artigos estudaram o efeito da auriculoterapia na obesidade e apresentaram redução estatisticamente significante nos grupos de intervenção, assim como nos dois estudos que avaliaram o peso corporal. Dois estudos analisaram a circunferência da cintura e apresentaram decréscimo estatisticamente significativo para o grupo de intervenção, já nos três estudos que avaliaram a leptina, em dois houve redução ao final do tratamento, sendo que no terceiro não houve diferença em nenhum dos grupos. CONCLUSÃO: A auriculoterapia associada a dieta pode ser eficaz no controle do peso de paciente obesos, assim como nas medidas antropometricas e nos níveis de leptina.

Obesity can cause premature death of individuals affected by this dysfunction. In an attempt to alleviate the disorders of this disease, auriculotherapy appears as a treatment that aims to promote weight loss and better quality of life. OBJECTIVES: Identify the efficacy of auriculotherapy in weight control of obese individuals. METHODOLOGY: A systematic review (CRD42020198862) was carried out according to PRISMA recommendations in the PubMed, Lilacs, Scielo and PEDro databases, from July to October 2016, with descriptors Obesity and auriculotherapy. Were included Ramdomized Clinical Trials published until 2015, in Portuguese, English and Spanish, and containing the key words in the title or abstract. In the analysis, the following were considered as primary outcome: Body Mass Index and body weight, and secondary outcome: waist circumference and leptin. RESULTS: Four articles studied the effect of auriculotherapy on obesity and showed a statistically significant reduction in the intervention groups, as well as in the two studies that evaluated body weight. Two studies analyzed waist circumference and showed a statistically significant decrease for the intervention group, while in the three studies that evaluated leptin, in two there was a reduction at the end of treatment, and in the third there was no difference in any of the groups. CONCLUSION: Auriculotherapy associated with diet may be effective in controlling the weight of obese patients, as well as anthropometric measurements and leptin levels.

Propriedades psicométricas do WHODAS para uso em pessoas com chikungunya no Brasil / Propiedades psicométricas de WHODAS para uso en personas con chikungunya en Brasil / Psychometric properties of WHODAS for use in patients with chikungunya in Brazil

RESUMO O objetivo deste estudo é validar um instrumento de aferição da funcionalidade segundo a proposta conceitual da Classificação Internacional de Funcionalidade, Incapacidade e Saúde, para uso em pessoas pós-chikungunya. Este é um estudo de validação com indivíduos >17 anos, de ambos os sexos, em atendimento para manejo clínico da chikungunya. A coleta de dados foi realizada por meio de entrevistas coletando informações sobre funcionalidade (WHODAS), qualidade de vida (WHOQOL-bref) e sociodemográficas. A análise estatística usou o coeficiente alfa de Cronbach (consistência interna) e coeficiente de correlação de Spearman (validade convergente), médias e desvios-padrão para a determinação do perfil de qualidade de vida, com nível de significância de 5%. A amostra foi composta por 68 indivíduos. Os valores médios das pontuações dos instrumentos foram: 45,4 (±16,38) para o WHODAS e 12,1 (±2,10) para o WHOQOL-bref. O alfa de Cronbach do valor total foi de α=0,93; todos os domínios do WHODAS apresentaram valores acima de 0,75. O valor total do WHODAS 2.0 apresentou forte correlação com o domínio físico (r=−0,74) e moderada correlação com os domínios psicológico (r=−0,68) e social (r=−0,42) do WHOQOL-bref. Os resultados indicam que o WHODAS 2.0 é um instrumento válido para a mensuração da autopercepção de alteração da funcionalidade em pacientes acometidos pela chikungunya, capaz de fornecer dados que podem ajudar a construir um perfil de impacto da doença no perfil de funcionalidade dessa população.

RESUMEN El objetivo de este estudio es validar un instrumento de evaluación del funcionamiento de acuerdo con la propuesta conceptual de la Clasificación Internacional del Funcionamiento de la Discapacidad y de la Salud (CIF), para su uso en personas postchikungunya. Se trata de un estudio de validación con individuos >17 años, de ambos sexos, en atención para el manejo clínico de chikungunya. La recolección de datos se realizó mediante entrevistas, que reunieron informaciones sobre el funcionamiento (WHODAS), la calidad de vida (WHOQOL-bref) y los datos sociodemográficos. El análisis estadístico utilizó el coeficiente alfa de Cronbach (consistencia interna) y el coeficiente de correlación de Spearman (validación convergente), medias y desviaciones estándar para determinar el perfil de la calidad de vida, con un nivel de significación del 5%. La muestra consistió en 68 individuos. Los valores medios de las puntuaciones fueron: 45,4 (±16,38) para WHODAS; y 12,1 (±2,10) para WHOQOL-bref. El alfa de Cronbach del valor total fue α=0,93; Todos los dominios WHODAS presentaron valores superiores a 0,75. El valor total de WHODAS 2.0 tuvo una fuerte correlación con el dominio físico (r=−0,74) y una correlación moderada con los dominios psicológico (r=−0,68) y social (r=−0,42) del WHOQOL-bref. Los resultados indican que WHODAS 2.0 es un instrumento válido para medir la alteración del funcionamiento autopercibido en pacientes afectados por chikungunya, siendo capaz de proporcionar datos que pueden ayudar a construir un perfil de impacto de la enfermedad en el perfil de esta población.

ABSTRACT The aim of this study is to validate an assessment tool for functioning and health according to the conceptual proposal of the International Classification of Functioning, Disability and Health (ICF), for its use in post-chikungunya patients. This is a validation study with individuals >17 years old of both sexes. Data collection was performed through interviews, gathering information on functioning (WHODAS), quality of life (WHOQOL-bref) and socio-demographic data. Statistical analysis used the Cronbach alpha coefficient (internal consistency) and Spearman correlation coefficient (convergent validation), means and standard deviations, with significance level of 5%. The sample consisted of 68 individuals. The mean values of scores were: 45.4 (±16.38) for WHODAS and 12.1 (±2.10) for WHOQOL-bref. The Cronbach's alpha of the total value was α=0.93; all WHODAS domains presented values ≥0.75. The total value of WHODAS 2.0 had strong correlation with the physical domain (r=−0.74) and moderate correlation with the psychological (r=−0.68) and social (r=−0.42) domains of the WHOQOL-bref. The results indicate that WHODAS 2.0 is a valid instrument for the measurement of self-perceived functioning alteration in patients affected by chikungunya.

Dos desafios às estratégias de superação do fisioterapeuta do NASF: um olhar do residente / From challenges to coping strategies of FHSC physical therapists: a resident's look / De los desafíos a las estrategias de superación del fisioterapeuta del NASF: la mirada de un residente

Como parte do Núcleo Ampliado de Saúde da Família (Nasf), o fisioterapeuta, na atenção primária, deve desenvolver ações de promoção da saúde e prevenção de doenças que perpassam práticas de matriciamento, planejamento estratégico, análise situacional, territorialização, atendimentos individuais, compartilhados, visitas domiciliares etc. Objetiva-se descrever as competências e discutir as dificuldades de execução das atribuições do fisioterapeuta do Nasf diante da realidade de um município cearense com base na ótica de um fisioterapeuta residente em saúde da família. Trata-se de relato de experiência em que foi utilizado o método narrativo-analítico com base nos relatos e no cotidiano vivenciados pelo autor no município de Horizonte, CE. Para se executar adequadamente essas atribuições, o profissional necessita de um aparato técnico e logístico que muitos municípios não conseguem ofertar, tais como material para intervenção prática, meio de transporte adequado e uma equipe multiprofissional que contemple as necessidades da área. Em Horizonte, tendo em vista sua demografia e sua recente de fundação, não houve possibilidade de realização das atribuições já explanadas. Pode-se relatar a dificuldade na utilização do transporte para as visitas domiciliares e demais atividades externas, o rigor da formação do fisioterapeuta com foco clínico e barreiras na realização do apoio matricial. Contudo, o profissional busca criar estratégias para realização do serviço de modo adequado e para gerenciar grupos e atividades de intervenção multidisciplinar. Para reduzir as dificuldades, faz-se necessário que os gestores forneçam apoio institucional a fisioterapeuta, convoque por concurso público mais profissionais de modo a cobrir o território e oferte capacitação específica conforme a linha de cuidado do Nasf.

As a part of the Family Health Support Center (FHSC), the Primary Healthcare physical therapist should promote health and prevent diseases, which includes actions of matrix support, strategic planning, situational analysis, territorialization, individual, shared visits, home visits, among others. We seek to describe the skills and discuss the challenges of performing physical therapy assignments of the FHSC according to the reality of a county in Ceará, based on the perspective of a physical therapist resident in Family Health. This experience report used the narrative-analytical method based on the reports and the daily life experienced by the author in the city of Horizonte, Ceará. In order to properly perform these tasks, the professional needs a technical and logistical apparatus that many municipalities cannot offer, such as material for practical intervention, adequate means of transport and a multiprofessional team that meets the needs of the area. In Horizonte, considering its demography and its recently-founded nature, there was no possibility of performing the previously mentioned attributions. One can report the difficulty in using transportation for home visits and other external activities, the rigor of the physical therapist's training with a clinical focus, and barriers in performing the matrix support. However, the professional created strategies for performing the service adequately and managed multidisciplinary intervention groups and activities. In order to minimize these challenges, it is necessary for managers to provide institutional support to the physical therapist, to call for a more competitive public tender to cover the territory, and to offer specific training according to the FHSC healthcare guidelines.

Una vez parte del Núcleo Ampliado de la Salud de la Familia (NASF), el fisioterapeuta debe desarrollar acciones de promoción de la salud y prevención de enfermedades en la atención primaria, las cuales atraviesan acciones matriciales, planificación estratégica, análisis situacional, territorialización, atención individual, compartida, visitas domiciliarias, etc. El objetivo de este artículo es describir las habilidades y discutir las dificultades de ejecución de las atribuciones del fisioterapeuta del NASF frente a la realidad de un municipio de Ceará (Brasil) desde la perspectiva de un fisioterapeuta residente en salud de la familia. Es un relato de experiencia, en el que se utilizó el método narrativo-analítico con base en los relatos y el cotidiano vivenciados en el municipio de Horizonte/CE. Para ejecutar adecuadamente esas atribuciones, el profesional necesita un soporte técnico y logístico que muchos municipios no logran ofertar, tales como material para intervención práctica, medio de transporte adecuado y un equipo multiprofesional que contemple las necesidades del área. Teniendo en cuenta la demografía y el carácter reciente de fundación del municipio Horizonte, no hubo posibilidad de realización de las atribuciones ya explicadas. Se puede relatar la dificultad en la utilización del transporte para las visitas domiciliarias y demás actividades externas, el rigor de la formación del fisioterapeuta con enfoque clínico y barreras en la realización del apoyo matricial. Sin embargo, el profesional buscaba crear estrategias para la realización del servicio de manera adecuada y administrar grupos y actividades de intervención multidisciplinaria. Para reducir las dificultades, es necesario que los gestores proporcionen apoyo institucional al fisioterapeuta, contraten más profesionales para cubrir el territorio mediante la contratación pública y ofrezcan capacitación específica conforme a la línea de cuidado del Nasf.

[The use, care and policy of complementary and integrative practices in primary health care]. / Uso, cuidado e política das práticas integrativas e complementares na Atenção Primária à Saúde.

The use of Complementary and Integrative Practices (CIP) is on the increase and its institutionalization in Primary Health Care (PHC) is a challenge. This article discusses the use, care, and policies of CIP at international and national levels found in the indexed literature. A review of the literature in PubMed/Medline and the Virtual Health Library was conducted using the key search words "Homeopathy", "Acupuncture", "Herbal Medicine", "Body Practices", "Primary Health Care" and other related terms in English, Spanish and Portuguese between 2002 and 2011. The use in the literature of CIP for the treatment of specific diseases from a biomedical perspective was observed, as well as evaluations of its use for the treatment of specific diseases focused on the reaction of the users and professionals and the analysis of the political, economic and social viability of CIP in health services. The conclusion drawn is that what is predominant in the literature is the quest for the scientific validation of CIP and a biomedical methodological bias in the designs of the studies, which does not contribute to clarifying the potential care of CIP in PHC.

Uso, cuidado e política das práticas integrativas e complementares na Atenção Primária à Saúde / The use, care and policy of complementary and integrative practices in primary health care

ResumoO uso das Práticas Integrativas e Complementares (PIC) é crescente e sua institucionalização na Atenção Primária à Saúde (APS) um desafio. Este artigo discute o uso, o cuidado e as políticas das PIC na esfera internacional e nacional, por meio da literatura indexada. Foi realizada revisão da literatura no PubMed/Medline e na Biblioteca Virtual da Saúde com os unitermos "Homeopatia", "Acupuntura", "Fitoterapia", "Práticas Corporais", "Atenção Primária à Saúde" e correlatos, nas línguas inglesa, espanhola e portuguesa, entre 2002 e 2011. Observou-se na literatura avaliações do uso das PIC para o tratamento de patologias específicas, com perspectiva biomédica; avaliações do seu uso para o tratamento de patologias específicas, porém focadas nos sentidos atribuídos pelos usuários e profissionais; análise da viabilidade política, econômica e social das PIC nos serviços de saúde. Conclui-se que predomina na literatura a busca pela validação científica das PIC e um viés metodológico biomédico no desenho dos estudos, o qual não contribui para esclarecer o potencial de cuidado das PIC na APS.

AbstractThe use of Complementary and Integrative Practices (CIP) is on the increase and its institutionalization in Primary Health Care (PHC) is a challenge. This article discusses the use, care, and policies of CIP at international and national levels found in the indexed literature. A review of the literature in PubMed/Medline and the Virtual Health Library was conducted using the key search words "Homeopathy", "Acupuncture", "Herbal Medicine", "Body Practices", "Primary Health Care" and other related terms in English, Spanish and Portuguese between 2002 and 2011. The use in the literature of CIP for the treatment of specific diseases from a biomedical perspective was observed, as well as evaluations of its use for the treatment of specific diseases focused on the reaction of the users and professionals and the analysis of the political, economic and social viability of CIP in health services. The conclusion drawn is that what is predominant in the literature is the quest for the scientific validation of CIP and a biomedical methodological bias in the designs of the studies, which does not contribute to clarifying the potential care of CIP in PHC.

[The Yin and Yang movement in the cosmology of Chinese medicine]. / O movimento Yin e Yáng na cosmologia da medicina chinesa.

After being developed in the East, based on Taoist cosmology, Chinese medicine has been practiced in the West based on scientific foundations and biomedical paradigms. Some traditional elements of this philosophy were abandoned, such as the theory of Yin and Yang, knowledge that is essential for understanding the health-disease process resulting from the circulation of the body's energy flow. This article studies the movement of the dual elements of Yin and Yang in Chinese medical teaching, seeking to understand how this line of thought developed and how it has contributed towards establishing a system of diagnosis and therapy. The methodology employed was to analyze literature on the subject, based on theoretical references to Taoist thought and traditional Chinese medicine.

O movimento Yin e Yáng na cosmologia da medicina chinesa / The Yin and Yang movement in the cosmology of Chinese medicine

Após ter se desenvolvido no Oriente, embasada pela cosmologia taoista, a medicina chinesa vem sendo praticada no Ocidente baseada na fundamentação científica e no paradigma biomédico, abandonando alguns elementos tradicionais dessa racionalidade, como a teoria Yīn e Yáng, conhecimento essencial para o entendimento do processo saúde-doença decorrente da circulação do sopro vital pelo corpo. Este artigo estuda o movimento da dupla Yīn e Yáng na doutrina médica chinesa, buscando conhecer como se desenvolveu essa linha de pensamento e a sua contribuição na elaboração do sistema diagnóstico e terapêutico. A metodologia utilizada foi a análise da literatura que aborda o objeto a partir do referencial teórico do pensamento taoista e da medicina tradicional chinesa.

After being developed in the East, based on Taoist cosmology, Chinese medicine has been practiced in the West based on scientific foundations and biomedical paradigms. Some traditional elements of this philosophy were abandoned, such as the theory of Yin and Yang, knowledge that is essential for understanding the health-disease process resulting from the circulation of the body’s energy flow. This article studies the movement of the dual elements of Yin and Yang in Chinese medical teaching, seeking to understand how this line of thought developed and how it has contributed towards establishing a system of diagnosis and therapy. The methodology employed was to analyze literature on the subject, based on theoretical references to Taoist thought and traditional Chinese medicine.