The accreditation role of Councils on Chiropractic Education as part of the profession's journey from craft to allied health profession: a commentary.

BACKGROUND: Chiropractors see themselves as well positioned to provide safe, effective and economical care for the on-going financial burden that spinal pain imposes. However, in many places of the world, the chiropractic profession continues to find itself struggling to gain acceptance as a mainstream allied health care provider. There is evidence of the existence of undesirable chiropractic practice patterns and it is in part due to some of the world's accredited chiropractic programs. This indicated a need for scrutiny of international chiropractic educational accreditation standards, which are the responsibility of Councils on Chiropractic Education (CCEs). To this end we reviewed an emerging body of evidence about the chiropractic educational system in order to identify issues and make recommendations that may enhance professional acceptance through improved graduate outcomes and hopefully the quality of patient care. This commentary summarises the findings of that research. MAIN TEXT: We reviewed recent relevant studies, including our own, into the role and function of CCEs and found that there is sufficient evidence to identify areas of concern that could be addressed, at least in part, by improvements to CCEs' educational standards and processes. Areas included a lack of definitions for key terms such as, 'chiropractic', 'diagnosis', and 'competency', without which there can be no common understanding at a detailed level to inform graduate competencies and standards for a matching scope of practice. Further, there is some evidence to suggest that in some cases this level of detail is avoided in order to enable a "big tent" approach that allows for a diversity of approaches to clinical care to co-exist. This combined with the held view that chiropractic is "unique", highly valued, and best understood by other chiropractors, explains how students and practitioners can cling to 'traditional' thinking. This has implications for public safety and patient quality of care. CONCLUSION: If chiropractic care is to gain mainstream acceptance worldwide then it needs to adopt, through revitalised CCE accreditation standards and processes, those of other allied healthcare professions and wholeheartedly embrace science, evidence-based practice and patient centred care.

[Current practice patterns of preoperative bowel preparation in elective colorectal surgery: a nation-wide survey of Chinese surgeons].

Objective: To understand the current practice of preoperative bowel preparation in elective colorectal surgery in China. Methods: A cross-sectional questionnaire survey was conducted through wechat. The content of the questionnaire survey included professional title of the participants, the hospital class, dietary preparation and protocol, oral laxatives and specific types, oral antibiotics, gastric intubation, and mechanical enema before elective colorectal surgery. A stratified analysis based on hospital class was conducted to understand their current practice of preoperative bowel preparation in elective colorectal surgery. Result: A total of 600 questionnaires were issued, and 516 (86.00%) questionnaires of participants from different hospitals, engaged in colorectal surgery or general surgeons were recovered, of which 366 were from tertiary hospitals (70.93%) and 150 from secondary hospitals (29.07%). For diet preparation, the proportions of right hemicolic, left hemicolic and rectal surgery were 81.59% (421/516), 84.88% (438/516) and 84.88% (438/516) respectively. The average time of preoperative dietary preparation was 2.03 days. The study showed that 85.85% (443/516) of surgeons chose oral laxatives for bowel preparation in all colorectal surgery, while only 4.26% (22/516) of surgeons did not choose oral laxatives. For mechanical enema, the proportions of right hemicolic, left hemicolic and rectal surgery were 19.19% (99/516), 30.04% (155/516) and 32.75% (169/516) respectively. Preoperative oral antibiotics was used by 34.69% (179/516) of the respondents. 94.38% (487/516) of participants were satisfied with bowel preparation, and 55.43% (286/516) of participants believed that preoperative bowel preparation was well tolerated. In terms of preoperative oral laxatives, there was no statistically significant difference between different levels of hospitals [secondary hospitals vs. tertiary hospitals: 90.00% (135/150) vs. 84.15% (308/366), χ(2)=2.995, P=0.084]. Compared with the tertiary hospitals, the surgeons in the secondary hospitals accounted for higher proportions in diet preparation [87.33% (131/150) vs. 76.78% (281/366), χ(2)=7.369, P=0.007], gastric intubation [54.00% (81/150) vs. 36.33% (133/366), χ(2)=13.672, P<0.001], preoperative oral antibiotics [58.67% (88/150) vs. 24.86% (91/366), χ(2)=12.259, P<0.001] and enema [28.67% (43/150) vs. 15.30% (56/366), χ(2)=53.661, P<0.001]. Conclusion: Although the preoperative bowel preparation practice in elective colorectal surgery for most of surgeons in China is basically the same as the current international protocol, the proportions of mechanical enema and gastric intubation before surgery are still relatively high.

Antifungal susceptibility testing practices in mycology laboratories in France, 2018.

A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation.

The experiences of midwives in integrated maternity care: A qualitative metasynthesis.

OBJECTIVES: To conduct a metasynthesis of eight qualitative studies of the experiences of midwives in integrated maternity practice; to identify common motifs among the eight studies through a thematic interpretive integration known as reciprocal translation; and to explore the effects on midwifery processes of care in the setting of integrated maternity practice. DESIGN: A qualitative metasynthesis to analyze, synthesize, and interpret eight qualitative studies on the experiences of midwives and the effect on the midwifery processes of care in the setting of integrated maternity practice. SAMPLE AND SETTING: Participants from the primary studies included a total of 160 midwives providing hospital-based intrapartum care. All primary studies were conducted in settings with midwives and obstetricians working together in an integrated or collaborative manner. FINDINGS: Three overarching themes emerged from the data: professional dissonance, functioning from a position of risk, and practicing down. KEY CONCLUSIONS: The findings indicated that integrated maternity practice affects the professional experience of midwives. Through a qualitative exploration, a clear process of deprofessionalization and deviation from the midwifery model of care is detailed. Midwives experienced decreasing opportunity to provide the quality woman-centered physiologic care that evidence shows benefits childbearing women. IMPLICATIONS FOR PRACTICE: Integrated maternity practice, where low-risk and high-risk pregnancies are managed by midwife/physician teams, have proliferated as a solution to the need for quality, safe, and efficient health care. Insufficient evidence exists detailing the success or failure of this model of care. Qualitative studies suggest that the increasing medicalization occurring in integrated maternity practices minimizes the profession of midwifery and the ability to provide evidence-based quality midwifery care.

How will clinical practice be impacted by artificial intelligence?

Currently, artificial intelligence (AI) heavily impacts all human activities, including medicine, where needs for data analysis and interpretation are high and where technology opens new perspectives. Considering that current treatments do not always cure all patients and may even harm certain of them, we have to recognize that AI may fill a great medical need, potentially supporting physicians' efforts to refine diagnosis and to improve the relevance of the clinical diagnosis for each patient. As in other industries, this challenge implies changes in the repartition of medical and paramedical tasks. As repetitive tasks will disappear in the wake of automation, health care providers will ultimately regain truly an opportunity to focus on medicine, thereby ensuring an individual and holistic approach to each patient.

Evaluating the Strength of the Association Between Industry Payments and Prescribing Practices in Oncology.

BACKGROUND: Financial relationships between physicians and the pharmaceutical industry are common, but factors that may determine whether such relationships result in physician practice changes are unknown. MATERIALS AND METHODS: We evaluated physician use of orally administered cancer drugs for four cancers: prostate (abiraterone, enzalutamide), renal cell (axitinib, everolimus, pazopanib, sorafenib, sunitinib), lung (afatinib, erlotinib), and chronic myeloid leukemia (CML; dasatinib, imatinib, nilotinib). Separate physician cohorts were defined for each cancer type by prescribing history. The primary exposure was the number of calendar years during 2013-2015 in which a physician received payments from the manufacturer of one of the studied drugs; the outcome was relative prescribing of that drug in 2015, compared with the other drugs for that cancer. We evaluated whether practice setting at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, receipt of payments for purposes other than education or research (compensation payments), maximum annual dollar value received, and institutional conflict-of-interest policies were associated with the strength of the payment-prescribing association. We used modified Poisson regression to control confounding by other physician characteristics. RESULTS: Physicians who received payments for a drug in all 3 years had increased prescribing of that drug (compared with 0 years), for renal cell (relative risk [RR] 1.81, 95% confidence interval [CI] 1.58-2.07), CML (RR 1.22, 95% CI 1.08-1.39), and lung (RR 1.69, 95% CI 1.58-1.82), but not prostate (RR 0.97, 95% CI 0.93-1.02). Physicians who received compensation payments or >$100 annually had increased prescribing compared with those who did not, but NCI setting and institutional conflict-of-interest policies were not consistently associated with the direction of prescribing change. CONCLUSION: The association between industry payments and cancer drug prescribing was greatest among physicians who received payments consistently (within each calendar year). Receipt of payments for compensation purposes, such as for consulting or travel, and higher dollar value of payments were also associated with increased prescribing. IMPLICATIONS FOR PRACTICE: Financial payments from pharmaceutical companies are common among oncologists. It is known from prior work that oncologists tend to prescribe more of the drugs made by companies that have given them money. By combining records of industry gifts with prescribing records, this study identifies the consistency of payments over time, the dollar value of payments, and payments for compensation as factors that may strengthen the association between receiving payments and increased prescribing of that company's drug.

Quality of antenatal care services in Rwanda: assessing practices of health care providers.

BACKGROUND: Although most pregnant women in Rwanda visit antenatal care (ANC) clinics, little has been studied about the quality of services being provided. We investigated the ANC providers' (HCPs) current practices in relation to prevention, management and referral of maternal conditions as well as the information provided to pregnant women attending ANC services in Rwanda. METHODS: This facility-based, cross-sectional study included 312 ANC providers as participants and a review of 605 ANC medical records from 121 health centers. Data collection was performed using an interviewer-administered questionnaire and a structured observation checklist. For the analyses, descriptive statistics and bi-and multivariable logistic regression were used. RESULTS: Nurses and midwives in ANC services failed to report a number of pregnancy-related conditions that would need urgent referral to a higher level of health care. Midwives did somewhat better than nurses in reporting these conditions. There was no statistically significant difference in how nurses and midwives informed pregnant women about pregnancy-related issues. Ever been trained in how to manage a pregnant woman exposed to violence was reported by 14% of the participants. In 12, 13 and 15% of the medical records there was no report on tetanus immunization, anthelmintic treatment and syphilis testing, respectively. CONCLUSION: The providers in ANC clinics reported suboptimal practices on conditions of pregnancy that needed urgent referral for adequate management. Information to pregnant women on danger signs of pregnancy, recommended medicines and tests do not seem to be consistently provided. Midwifery training in Rwanda should be expanded so that most of staff at ANC clinics are trained as midwives to help lower maternal and child mortality and morbidity.

Predicting performance in health professions education programs from admissions information - Comparisons of other health professions with pharmacy.

BACKGROUND: The goal of the present review was to assess the state of performance prediction in healthcare programs generally, versus performance prediction in pharmacy schools, using didactic and non-didactic admissions measures. This is important because clinical success represents a combination of skills that are not fully predicted by either type of measure alone. METHODS: PubMed searches were conducted focusing on work published from 2000 onwards, since it is during this period that non-didactic admissions measures have come to be incorporated into the applicant evaluation process. Relevant free full text papers available were used. When these papers were not available by direct import into EndNote, we went directly to the journal to try to retrieve the paper. RESULTS: We acknowledge that health professions programs have been successful in recruiting excellent candidates into their schools. However, based on the modest amount of healthcare program performance accounted for by didactic measures, admissions committees should consider expanding their holistic evaluation of applicants. Schools would benefit from using two-step screening phases in the application process - perhaps evaluating didactic potential in phase 1 and experiential in phase 2. Using combination measures throughout the admission process should help ensure admission of students more likely to be successful throughout their healthcare practice. IMPLICATIONS: Future investigations of the prediction of healthcare program performance by formal combinations of didactic and non-didactic admissions measures are imperative. In addition, it is likely that combination admission measures will incorporate more metrics of critical thinking than do simpler approaches. Furthermore, systematic evaluation of the usefulness of the two-step screening approaches to admissions used by most competitive health professions programs also needs to be done.

Performance and self-perceived competencies of enrolled nurse/midwives: a mixed methods study from rural Tanzania.

BACKGROUND: Tanzania is experiencing a severe shortage of human resources for health, which poses a serious threat to the quality of health care services particularly in rural areas. Task shifting has been considered a way to address this problem. However, since a large percentage of health care providers in rural setting is comprised of Enrolled Nurse/Midwives (ENMs), most of the health care tasks are shifted to them. This article analyzes the performance and self-perceived competencies of ENMs at the dispensary level; the lowest health facility in Tanzania. Performance refers to routine duties performed by ENMs, and self-perceived competence means self-perceived proficiency in performing nursing/midwifery and medical duties. METHODS: This was a mixed methods study conducted in rural Tanzania. A purposeful sample of twelve (12) informants (six ENMs; two Community Leaders [CLs] and four Dispensary In-charges [DIs]) was recruited for semi-structured interviews. The interviews were supplemented with quantitative data from 59 ENMs. Both thematic and descriptive analysis approaches were used. RESULTS: Three themes emerged: (1) 'Approval of the performances of ENMs in meeting community health needs' underscores important services the community members got from ENMs at dispensaries. (2) 'Experienced difficulties of meeting community health needs' indicate the problems ENMs encountered while providing services to the community. In striving to serve a large number of demanding clients without adequate medical equipment and supplies, sometimes the ENMs ended up with prescription errors (3) 'Appreciating the performances and competencies of ENMs' shows the acknowledgement of community members towards ENMs' performance and competencies within and beyond their scope of practice. The community members as well as ENMs and their supervisors knew that ENMs must sometimes provide care that is outside their scope of training and competency. Overall, the performance among ENMs above 38 years of age (P < 0.05) and participants of professional development courses (P < 0.01) was high. CONCLUSIONS: The results highlight performance and self-perceived competencies of ENMs in struggling to meet community health needs. Additionally, these results highlight the health care system shortfalls in supporting and developing an adequate number of qualified health care professionals so that health care needs of all citizens, including those in rural areas, are met.

Implementation of the Western Australian Osteoporosis Model of Care: a fracture liaison service utilising emergency department information systems to identify patients with fragility fracture to improve current practice and reduce re-fracture rates: a 12-month analysis.

Fracture liaison service linked to an emergency department database effectively identifies patients with OP, improves best practice care, reduces recurrent fractures, and improves quality of life (QoL). The next step is to establish cost-effectiveness. This should be seen as the standard model of care. INTRODUCTION: The Western Australian Osteoporosis Model of Care recommends implementation of a fracture liaison service (FLS) to manage patients with minimal trauma fractures (MTFs). This study evaluates the efficacy of a FLS linked to a tertiary hospital emergency department information system (EDIS) in reducing recurrent fractures. METHODS: Patients aged ≥ 50 years with MTF identified from EDIS were invited to the FLS. Patient outcomes were compared to routine care (retrospective group-same hospital, and prospective group-other hospital) at 3- and 12-month follow-up. RESULTS: Two hundred forty-one of 376 (64.1%) eligible patients participated in the FLS with 12 months of follow-up. Absolute risk of recurrent MTF at 12 months was reduced by 9.2 and 10.2% compared with the prospective and retrospective controls, respectively. After age/sex adjustment, FLS participants had less MTF at 12 months vs. the retrospective controls, OR 0.38 (95%CI 0.18-0.79), but not the prospective controls, OR 0.40 (95%CI 0.16-1.01). FLS patients were more likely to receive the 'best practice' care, i.e. awareness of osteoporosis, investigations, and treatment (all p < 0.05). 'Fallers' (OR 0.48 (95%CI 0.24, 0.96)) and fall rates were lower in the FLS (p = 0.001) compared to the prospective control. FLS experienced the largest improvement in QoL from 3 to 12 months as measured by the EuroQoL 5-domain (EQ-5D) UK weighted score (+ 15 vs. - 11 vs. - 16%, p < 0.001) and EQ-5D Health State visual analogue scale (+ 29 vs. - 2 vs. + 1%, p < 0.001). CONCLUSION: Patients managed in a linked EDIS-FLS were more likely to receive the 'best practice' care and had lower recurrent MTF and improved QoL.

Sickle cell disease in southwestern Nigeria: assessment of knowledge of primary health care workers and available facilities.

Background: Patients with sickle cell disease (SCD) benefit optimally from comprehensive care. In Nigeria, despite the huge burden, involvement of community health workers (CHWs) in the management of SCD is poor. Methods: This community-based study assessed SCD-related knowledge of 182 CHWs from the 46 primary health care (PHC) centres in Ilesa, southwestern Nigeria. Available facilities and management practices for SCD care at these centres were also evaluated using pretested self-administered questionnaires and observational checklists. Results: The majority of CHWs (167/182 [91.8%]) knew that SCD is an inheritable blood disorder. However, only 32.4% and 26.4% knew that SCD can be diagnosed in the prenatal and neonatal periods, respectively. Also 37.4%, 49.5% and 67.6% knew about the role of chemoprophylaxis (folic acid/penicillin), adequate fluids and malaria prevention, respectively, in SCD care. Overall, 37.9% had good knowledge on the nature and care of the disease. Just 2/46 (4.3%) PHC centres treat patients with SCD. SCD-targeted nutritional counselling and referral to secondary/tertiary hospitals were poor and unorganized. No centre offered SCD screening, home visits or recordkeeping. Conclusions: The level of SCD care and knowledge of CHWs at PHC centres in southwestern Nigeria of early SCD diagnosis and crisis prevention is poor. CHWs should be regularly trained and equipped for basic SCD management, including early detection, crisis prevention, prompt referral and provision of basic genetic counselling, to dispel associated myths and stigma.

Evaluating Integrative Cancer Clinics With the Claim Assessment Profile: An Example With the InspireHealth Clinic.

BACKGROUND: The evaluation of freestanding integrative cancer clinical programs is challenging and is rarely done. We have developed an approach called the Claim Assessment Profile (CAP) to identify whether evaluation of a practice is justified, feasible, and likely to provide useful information. OBJECTIVES: A CAP was performed in order to (1) clarify the healing claims at InspireHealth, an integrative oncology treatment program, by defining the most important impacts on its clients; (2) gather information about current research capacity at the clinic; and (3) create a program theory and path model for use in prospective research. STUDY DESIGN/METHODS: This case study design incorporates methods from a variety of rapid assessment approaches. Procedures included site visits to observe the program, structured qualitative interviews with 26 providers and staff, surveys to capture descriptive data about the program, and observational data on program implementation. RESULTS: The InspireHealth program is a well-established, multi-site, thriving integrative oncology clinical practice that focuses on patient support, motivation, and health behavior engagement. It delivers patient-centered care via a standardized treatment protocol. There arehigh levels of research interest from staff and resources by which to conduct research. CONCLUSIONS: This analysis provides the primary descriptive and claims clarification of an integrative oncology treatment program, an evaluation readiness report, a detailed logic model explicating program theory, and a clinical outcomes path model for conducting prospective research. Prospective evaluation of this program would be feasible and valuable, adding to our knowledge base of integrative cancer therapies.

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area.

BACKGROUND: Phototherapy (PT) is widely used to prevent and treat severe hyperbilirubinemia and its associated risks for both acute and chronic bilirubin encephalopathy. Intensive PT, recommended for inpatient treatment of hyperbilirubinemia in term and near-term infants, is defined as having a spectral irradiance of ≥30 µW/cm2/nm. OBJECTIVES: We aimed to assess local PT practices by measuring the irradiance of PT devices in local neonatal intensive care units and newborn nurseries. METHODS: The irradiance footprint, including maximum irradiance at the center of the footprint, of 39 PT devices in 7 area hospitals was measured according to current practice in these facilities. RESULTS: The mean ± SD (range) footprint irradiance was 20.7 ± 5.8 (8.8-29.4) µW/cm2/nm. The mean ± SD maximum irradiance at the footprint center for all devices at a mean clinically used treatment distance of 33.1 ± 9.3 (25.5-60.0) cm was 27.8 ± 7.0 (14.7-42.0) µW/cm2/nm. Sixty-two percent of the devices did not meet the minimum recommended spectral irradiance for intensive PT. For the sites without irradiance-based protocols, the maximum irradiance of the devices (n = 33) at the treatment distances was 25.8 ± 6.1 µW/cm2/nm. CONCLUSIONS: Despite established PT guidelines, local protocols and practices vary. Based on an assessment of 7 local hospitals, intensive PT was suboptimal for 62% of devices. Straightforward changes, such as decreasing the distance between an infant and the light source and establishing a consistent irradiance-based protocol, could substantially improve the quality of the intervention.

The use of drama within midwifery education to facilitate the understanding of professional behaviour and values.

OBJECTIVE: to develop student midwife understanding of professional values and the application of these in clinical practice, prior to commencing their first clinical placement. DESIGN: an action research project. SETTING: a Simulation Suite environment within a University setting. PARTICIPANTS: 6 year 3 drama students and a cohort of 36 midwifery students. FINDINGS: the students were supportive of the idea of collaborative projects as this permitted the facilitation of student understanding of key professional values and their application in the clinical setting. KEY CONCLUSIONS: the students felt that the move away from a didactic approach to learning and teaching towards a more experiential model of teaching, enabled a more in depth reflection on the importance of professional standards and behaviour when providing care to pregnant women.

Reflections: Spirituality and Cancer Researchers.

Spirituality is increasingly acknowledged as an essential element to consider within care for cancer and other chronic health conditions. As our colleagues in frontline healthcare roles integrate these concepts into their professional practice, it seems timely for the cancer research community to reflect on the place of spirituality within our work. This reflections article discusses challenges and opportunities for researchers considering spirituality in their own work roles and within broader discussions about health needs, care and research agendas.

The impact of an intervention to improve diabetes management in primary healthcare professionals' practices in Brazil.

AIMS: To evaluate the results of a structured intervention in primary healthcare to improve type 2 diabetes management. METHODS: The intervention was implemented in 2011-2012 in two cities in the State of Pernambuco, Brazil, and evaluated in 2013 by interviewing healthcare professionals about their practices in all primary care facilities of these two cities (intervention group), and of two paired control cities (control group). Comparisons between the intervention and control groups were made using standard parametric tests. RESULTS: The percentage of professionals who measured adherence to treatment, developed educational actions to control high-risk situations or prevent complications, or declared that they "explained" the disease to the patients, was higher in the control group (p<0.05). Multidisciplinary involvement, requests for electrocardiograms and referrals to specialists were also more frequent in the control group (p<0.01). The only differences favoring the intervention group were the higher proportion of nurses (p<0.05) and community health workers (p<0.01) trained for diabetes management and a greater frequency of discussing the cases of diabetic patients at team meetings (p<0.01). CONCLUSIONS: These negative results raise questions about the effectiveness of actions aiming to improve diabetes management in primary care, and reinforce the need for careful evaluation of their impact.

Impact of Professional Nursing Practices on Patient/Nurse Outcomes: Testing the Essential Professional Nursing Practices Instrument.

Increasing patient and healthcare system complexity and the need to accurately measure the engagement of clinical nurses (CNs) in holistic, professional nursing practice indicates that an update to the Essentials of Magnetism instrument is needed. The purposes of this research were to critique and weight items, assess the value and psychometric properties of the newly constructed Essential Professional Nursing Practices (EPNP) instrument, and establish relationships between EPNPs and CN job, practice, and nurse-assessed patient satisfaction.

Origem e desenvolvimento da Naturologia no Brasil: aspectos conceituais, históricos e políticos / Origin and development of Naturology in Brazil: conceptual, historical and political aspects

O primeiro bacharelado reconhecido pelo MEC de Naturologia completa 20 anos em 2018. A naturologia é uma profissão recente no Brasil, a qual busca entender o ser-humano multidimensionalmente e respeitar a singularidade humana na busca de bem-estar, qualidade de vida e saúde através da relação de interagência e das Práticas Integrativas e Complementares. Este texto aborda um breve histórico das Práticas Integrativas e Complementares e Naturologia no Brasil, o processo de reconhecimento da ocupação e regulamentação da profissão. O texto também explora os campos de atuação do naturólogo, órgãos de representação profissional, principais eventos científicos e publicações importantes da área.(AU)

The first course recognized bu the Ministry of Education of Naturology completes 20 years in 2018. Naturology is a new profession in Brazil, one which seeks to understand the human being in a multi-dimensional way, and respect human singularity in its search for well-being, quality of life and health trough a relationship of interagency and Complementary and Intrgrative Pratices. The present article addresses a brief history of Comlementary and Integrative Pratices and Naturology in Brazil, the process of recognizing the occupation and regulation of the profession. The paper also explores the fields in which the naturologist is active, the bodies of professional representation, the main scientific events and important publications in the field.(AU)