The reluctant and the envious: Therapeutic subalternity and the practice of homeopathy in North America.

This work presents a neo-Gramscian theorization of therapeutic hegemony and subalternity, deployed with reference to the practice of homeopathy in North America by two increasingly-professionalized but unorthodox health occupational groups: Homeopaths and Naturopaths. Despite both occupations' contemporary sociopolitical subordination to dominant biomedicine, the continent's Homeopaths have been less successful in their professionalization efforts, owing partly to homeopathy-their primary therapeutic modality-being widely considered incommensurable with biomedical science. For Naturopaths, who increasingly align themselves with biomedical evidentiary norms, homeopathy represents but one among several central therapeutic modalities. Using survey (n = 588) and interview (n = 31) data from an empirical case involving Homeopaths and Naturopaths in Ontario, Canada-a jurisdictional outlier in which both groups are regulated by the state-the author employs the theory of therapeutic subalternity to illuminate the internal struggles faced by homeopathy-practising occupations in a biomedically-dominant context. Despite their regulated standing, Homeopaths' negative media characterization and ongoing lack of access to third-party insurance reimbursement contribute to ongoing frustration among practitioners, expressed as displaced envy toward the province's more elite, homeopathy-practising Naturopaths. However, while most Naturopaths express appreciation for homeopathy's clinical merits, many appear increasingly reluctant to use or discuss the practice to prevent compromise to their profession's therapeutic legitimation.

Probiotics Evaluation in Oncological Surgery: A Systematic Review of 36 Randomized Controlled Trials Assessing 21 Diverse Formulations.

BACKGROUND: Objectives were to evaluate probiotics safety and efficacy in oncological surgery. METHODS: Systematic review methodology guided by Cochrane, PRISMA, SWiM, and CIOMS. Protocol registered on PROSPERO (CRD42018086168). RESULTS: 36 RCTs (on 3305 participants) and 6 nonrandomized/observational studies were included, mainly on digestive system cancers. There was evidence of a beneficial effect on preventing infections, with 70% of RCTs' (21/30) direction of effect favoring probiotics. However, five RCTs (17%) favored controls for infections, including one trial with RR 1.57 (95% CI: 0.79, 3.12). One RCT that changed (balanced) its antibiotics protocol after enrolling some participants had mortality risk RR 3.55 (95% CI: 0.77, 16.47; 7/64 vs. 2/65 deaths). The RCT identified with the most promising results overall administered an oral formulation of Lactobacillus acidophilus LA-5 + Lactobacillus plantarum + Bifidobacterium lactis BB-12 + Saccharomyces boulardii. Methodological quality appraisals revealed an overall substantial risk-of-bias, with only five RCTs judged as low risk-of-bias. CONCLUSIONS: This large evidence synthesis found encouraging results from most formulations, though this was contrasted by potential harms from a few others, thus validating the literature that "probiotics" are not homogeneous microorganisms. Given microbiome developments and infections morbidity, further high-quality research is warranted using those promising probiotics identified herein.

Laboratory Test Ordering Patterns in Pediatrics From Naturopaths and General Practitioners.

OBJECTIVES: Naturopathic medicine emphasizes prevention and the self-healing process through natural therapies. Naturopathic doctors (NDs) use clinical laboratories as frequently as traditionally trained physicians. Here we evaluated the test-ordering patterns of NDs and general practitioners (GPs). METHODS: A retrospective analysis was performed from a tertiary pediatric hospital. We analyzed tests ordered by NDs who used laboratory services and compared the test ordering patterns with GPs from adolescent medicine, family medicine, or pediatric clinics. Requests were categorized into 10 groups. We determined the tests with the highest ordering frequencies, as well as the percentage of tests that had an abnormal result. RESULTS: NDs ordered more tests per patient per date of specimen collection compared with GPs. The most frequently ordered tests by NDs were trace elements and toxic metals (23.2% of total), allergens (21.8%), and general chemistry (15.3%). For the same test, the percentage of tests with an abnormal result was significantly lower for NDs than GPs. CONCLUSIONS: We observed different ordering patterns between NDs and GPs. NDs ordered more esoteric tests and had lower rates of abnormal test results compared with GPs. Understanding the patterns of testing from different providers' specialties is useful to choose effective laboratory stewardship interventions.

Perfil socioeconômico profissional dos naturólogos do Brasil / Professional social and economic profile of Brazilian naturologists

Objetivo: A pesquisa objetivou descrever o perfil sócio econômico profissional dos naturólogos do Brasil. Materiais e método: Tratou-se de um estudo com abrangência nacional, classificado como pesquisa descritiva, de natureza quantitativa e de levantamento. Para a coleta de dados foi utilizado um questionário desenvolvido pelos autores. Os sujeitos da pesquisa foram 386 bacharéis em naturologia formados por instituições brasileiras até o ano de 2014 e a coleta de dados realizada entre fevereiro a maio de 2015. Resultados: Segundo os dados obtidos, observa-se que atualmente a Naturologia é uma profissão de predominância feminina (82,5%), cuja idade variou entre 21 e 64 anos, com média de 31 anos. A prevalência dos profissionais concentra-se no estado de São Paulo (45,6%), seguido por Santa Catarina (30,5%). Dentre os respondentes, a maioria (60,6%) atua com a Naturologia, predominando os que atuam no setor privado (78,9%), sendo as práticas mais utilizadas a aromaterapia (85,3%), a terapia floral (77,4%) e a massoterapia (76,1%). Considerações finais: A inserção de naturólogos dentro do Sistema Único de Saúde ainda é baixa, necessitando de maior estimulação para que a atuação deste profissional não corra o risco de se restringir a uma determinada classe social.(AU)

Objective: This work had as objective describing the social and economic profile of professional naturologists from Brasil. Materials and Method: It was a nation-wid study, classifiel as as descritive study, of quantitative and investigative natuure. For data acquiring was developed a questionnaire by the authors. Subjects were 386 professionals of Naturology graduated from brazilian colleges up to 2014 and was conducted between february and april of 2015. Results: According to data obtained, to this date Naturology is a profession majorly selected by women (82,5%), aging from 21 to 64 years, being 31 years the meddium age. Most professional are residents in São Paulo (41,6%), followed by Santa Catarina (30,5%). Amongst the subjects, the majority (60,6%) Works actually in the field of Naturology, mostly in the privat pratices (78,9%), beign aromatherapy (85,3%), floral therapy (77,4%) and masotherpy (76,1%) the most common pratices. Final Considerations: The insrtion of natutrologists in the public healthy system system is still low-profile, needing more stimuli so that the naturologists´ fiels of work does not become restriceted to a determinated social class.(AU)