Narratividade na promoção da saúde: limites e possibilidades da racionalidade médica homeopática no cuidado centrado no sujeito / Narrativity in promoting health: limits and possibilities of homeopathic medical rationality in subject-centered care

Este artigo tem como objeto o papel da narração das histórias de vida dos pacientes durante a consulta homeopática na promoção da saúde e produção de autonomia dos sujeitos. Objetivos e Metodologia: A partir da abordagem sócio-histórica, foi realizada revisão de literatura narrativa, a fim de identificar os limites e as possibilidades do ato de narrar na racionalidade médica homeopática para a produção de subjetividades e autonomia na trajetória singular de cada indivíduo levar sua vida. Considerações Finais: Há atualidade e consonância de conceitos da racionalidade médica homeopática com o paradigma contemporâneo da promoção da saúde; as narrativas produzidas no ato da anamnese homeopática têm a potencialidade de ampliar a compreensão médica e do indivíduo para além da doença, analisando o fenômeno existencial do adoecimento. A anamnese homeopática, ao valorizar as experiências existenciais relatadas no âmbito de uma consulta, concorre para uma valorização dos sujeitos, o que contribuiria para a construção de sua subjetividade, autonomia e emponderamento.

This article focuses on the role of narrating patients' life stories during homeopathic consultations in promoting health and producing autonomy for subjects. Objectives and Methodology: Using a socio-historical approach, a narrative literature review was carried out in order to identify the limits and possibilities of the act of narrating in homeopathic medical rationality for the production of subjectivities and autonomy in the unique trajectory of each individual. your life. Final Considerations: The concepts of homeopathic medical rationality are current and consistent with the contemporary paradigm of health promotion; The narratives produced in the act of homeopathic anamnesis have the potential to expand medical and individual understanding beyond the disease, analyzing the existential phenomenon of illness. Homeopathic anamnesis, by valuing the existential experiences reported in the context of a consultation, contributes to an appreciation of the subjects, which would contribute to the construction of their subjectivity, autonomy and empowerment.

O cuidado em saúde promovido pelas religiões afro-brasileiras / Health care promoted by afro-brazilian religions / El cuidado en salud promovido por las religiones afrobrasileñas

No decorrer da história, sempre foram infindáveis os casos em que os sujeitos recorriam a centros espíritas ou terreiros de religiões de matrizes africanas em decorrência de problemas como doenças, desempregos ou amores mal resolvidos, com o objetivo de saná-los. Por conta disso, este artigo visa apresentar os resultados da pesquisa relacionados ao objetivo de mapear os processos de cuidado em saúde ofertados em três terreiros de umbanda de uma cidade do litoral piauiense. Para isso, utilizamos o referencial da Análise Institucional "no papel". Os participantes foram três líderes de terreiros e os respectivos praticantes/consulentes dos seus estabelecimentos religiosos. Identificamos perspectivas de cuidado que se contrapunham às racionalidades biomédicas, positivistas e cartesianas, e faziam referência ao uso de plantas medicinais, ao recebimento de rezas e passes e à consulta oracular. A partir desses resultados, podemos perceber ser cada vez mais necessário, portanto, que os povos de terreiros protagonizem a construção, implementação e avaliação das políticas públicas que lhe sejam específicas.(AU)

In history, there have always been endless cases of people turning to spiritual centers or terreiros of religions of African matrices due to problems such as illnesses, unemployment, or unresolved love affairs. Therefore, this article aims to present the research results related to the objective of mapping the health care processes offered in three Umbanda terreiros of a city on the Piauí Coast. For this, we use the Institutional Analysis reference "on Paper." The participants were three leaders of terreiros and the respective practitioners/consultants of their religious establishments. We identified perspectives of care that contrasted with biomedical, positivist, and Cartesian rationalities and referred to the use of medicinal plants, the prescript of prayers and passes, and oracular consultation. From these results, we can see that it is increasingly necessary, therefore, that the peoples of the terreiros lead the construction, implementation, and evaluation of public policies that are specific to them.(AU)

A lo largo de la historia, siempre hubo casos en los cuales las personas buscan en los centros espíritas o terreros de religiones africanas la cura para sus problemas, como enfermedades, desempleo o amoríos mal resueltos. Por este motivo, este artículo pretende presentar los resultados de la investigación con el objetivo de mapear los procesos de cuidado en salud ofrecidos en tres terreros de umbanda de una ciudad del litoral de Piauí (Brasil). Para ello, se utiliza el referencial del Análisis Institucional "en el Papel". Los participantes fueron tres líderes de terreros y los respectivos practicantes / consultivos de los establecimientos religiosos que los mismos conducían. Se identificaron perspectivas de cuidado que se contraponían a las racionalidades biomédicas, positivistas y cartesianas, y hacían referencia al uso de plantas medicinales, al recibimiento de rezos y pases y a la consulta oracular. Los resultados permiten concluir que es cada vez más necesario que los pueblos de terreros sean agentes protagónicos de la construcción, implementación y evaluación de las políticas públicas destinadas específicamente para ellos.(AU)

Um capítulo esquecido na história da psicologia? sexualidades desviantes, psicopatologia e normalidade / A forgotten chapter in the history of psychology? deviant sexualities, psychopathology, and normality / ¿Un capítulo olvidado en la historia de la psicología? sexualidades desviadas, psicopatología y normalidad

Este artigo tem como objetivo produzir uma análise histórica sobre as intersecções entre Psicologia e sexualidade desviantes da norma no Brasil, de fins do século XIX a meados da década de 1980. Esta temporalidade foi escolhida por abarcar o surgimento das pesquisas científicas sobre sexualidade e desvios sexuais, a consolidação dos estudos psicológicos sobre a temática e o processo mais recente de despatologização da homossexualidade. Em termos teóricos e metodológicos, foram adotados os pressupostos da História Social da Psicologia e da historiografia das homossexualidades no Brasil. Desse modo, buscou-se compreender como as ideias, concepções e práticas psicológicas foram mudando ao longo do tempo, em conexão com as transformações socioculturais e políticas que ocorreram durante o século XX. Para isto, foram utilizadas fontes primárias e secundárias de pesquisa com vistas à produção de interpretações sobre as conexões entre as ideias, os atores e os eventos narrados. Argumenta-se, ao longo do artigo, que as ideias e práticas psicológicas estão intrinsecamente conectadas aos contextos socioculturais e políticos de seu tempo, sendo os movimentos dinâmicos e os conflitos presentes nesses contextos fatores determinantes para a sua constituição.(AU)

This article aims to produce a historical analysis of the intersections between Psychology and sexualities that deviate from the norm in Brazil, from the late 19th century to the mid-1980s. This period was chosen because it encompasses the emergence of scientific research on sexuality and sexual deviations, the consolidation of psychological studies on the subject and the most recent process of de-pathologization of homosexuality. Theoretically and methodologically, the assumptions of the Social History of Psychology and the historiography of homosexualities in Brazil were adopted. Therefore, we sought to understand how psychological ideas, conceptions and practices have changed over time, in connection with the sociocultural and political transformations that occurred throughout the 20th century. For this, primary and secondary sources of research were used to produce interpretations about the connections between the ideas, the actors and the narrated events. It is argued, throughout the article, that the psychological ideas and practices are intrinsically connected to the sociocultural and political contexts of their time, being the dynamic movements and conflicts present in these contexts determining factors for their constitution.(AU)

Este artículo tiene como objetivo realizar un análisis histórico de las intersecciones entre la Psicología y las sexualidades desviadas de la norma en Brasil desde finales del siglo XIX hasta mediados de la década de 1980. Esta temporalidad fue elegida por abarcar el surgimiento de las investigaciones científicas sobre sexualidad y desvíos sexuales, la consolidación de los estudios psicológicos sobre el tema y el más reciente proceso de despatologización de la homosexualidad. En el marco teórico y metodológico, se adoptaron los presupuestos de la Historia Social de la Psicología y de la historiografía de las homosexualidades en Brasil. De esta manera, se pretende comprender cómo las ideas, concepciones y prácticas psicológicas han cambiado a lo largo del tiempo, en conexión con las transformaciones socioculturales y políticas ocurridas durante el siglo XX. Para ello, se utilizaron las fuentes de investigación primarias y secundarias con miras a generar interpretaciones sobre las conexiones entre las ideas, los actores y los eventos narrados. Se argumenta, a lo largo de este artículo, que las ideas y las prácticas psicológicas están intrínsecamente conectadas a los contextos socioculturales y políticos de su tiempo, y los movimientos dinámicos y los conflictos presentes en estos contextos fueron los factores determinantes para su constitución.(AU)

A coisa em psicanálise e o objeto no lísis de Platão / The thing in psychoanalysis and object in Plato's lysis / La cosa en psicoanálisis y el objeto en lisis de Platón

Este artigo propõe o estudo sobre o conceito de outro como semelhante e como objeto. Partindo de textos que interpelam a alteridade na psicanálise e remetendo aos temas do complexo semelhante, da satisfação, da perda, do luto, da negativa, da repetição; avalia o conceito de outro articulando textos de diversos autores. A partir da psicanálise freudiana, estuda o das Ding e a negação, discriminando com estes termos um objeto estruturante na origem do psiquismo. Aborda textos técnicos da psicanálise para delimitar o tema da repetição. Também a recordação e a repetição são vinculadas ao objeto e estudadas na perspectiva da filosofia moderna. São retomados temas do diálogo platônicos para definir o lugar do erótico e da amizade. No fim do presente artigo, propomos o termo clássico grego Oikos com valor equivalente ao da Coisa freudiana e como esta aparece em escritos psicanalíticos.(AU)

This article studies the concept of other as similar and object. It is based on texts that question the alterity in psychoanalysis and refers to the themes of otherness complex, loss, grief, negative, repetition, and evaluates the concept of other, using articles of diverse authors. Based on Freudian psychoanalysis, it studies the Thing and the denial and discriminates a structuring object in the origin of psychism. It approaches technical texts of psychoanalysis to delimitate the theme of repetition. The recordation and repetition are also linked to the object and studied from the perspective of modern philosophy. Themes of the platonic dialogues are resumed to define the place of the erotic and the friendship. In the end of the article, we propose the greek classic term Oikos, with equal value to the Freudian Thing, as this one appears in psychoanalytic writings.(AU)

Este artículo estudia el concepto Otro como semejante y como objeto. A partir de textos que interpelan la alteridad en psicoanálisis y que se refieren a temas del complejo semejante, de la satisfacción, de la pérdida, del duelo, de la negación, de la repetición, se evalúa el concepto de Otro articulando textos de diferentes autores. Basado en el psicoanálisis freudiano, se aborda Ding y la negación, discriminando con estos términos un objeto estructurante en el origen de lo psíquico. Se abordan textos técnicos del psicoanálisis para delimitar el tema de la repetición; el recuerdo y la repetición son vinculadas al objeto y estudiadas desde la perspectiva de la filosofía moderna; y se retoman temas de los diálogos platónicos para definir el lugar de lo erótico y la amistad. Al culminar este artículo se propone leer el término griego clásico Oikos con un valor equivalente al de la Cosa freudiana como aparece en los escritos psicoanalíticos.(AU)

Notas para decolonizar os estudos transpessoais no brasil: contribuições do pluriperspectivismo participativo / Notes for decolonizing transpersonal studies in brazil: contributions of participatory pluriperspectivism / Apuntes para la decolonización de los estudios transpersonales en brasil: aportes del pluriperspectivismo participativo

O campo dos estudos transpessoais tem avançado em diversas áreas no Brasil. Comemorou seus 40 anos com uma inserção ativa nas Instituições de Ensino Superior (IES) e uma ampliação de núcleos formativos e apoiadores de ensino, pesquisa e ações sociais, além de diálogos com o Sistema de Conselhos de Psicologia. Desafios são apresentados a partir do levantamento de uma série de questões importantes e ignoradas dentro da Psicologia Transpessoal no Brasil. Apresentamos o pluriperspectivismo participativo como possibilidade de decolonizar as matrizes eurocêntricas e estadunidenses, que dão suporte ao pensamento transpessoal brasileiro, buscando honrar nossas raízes históricas e incluir outras epistemologias e ontologias, que dão continuidade à crítica à lógica cartesiana moderna. Indicamos uma breve agenda de notas temáticas que carecem de um processo decolonizador no campo transpessoal: a) crítica às perspectivas de um pensamento hegemônico, em termos globais por meio da dominação Norte-Sul ou no campo das relações sociais; b) revisão das formas de "centrocentrismo"; c) questionamento da noção de universalismo das ciências e da ética; d) aprofundamento da análise crítica da supremacia restritiva da racionalidade formal técnico-científica em relação às formas de subjetividade, de vivências holísticas e integradoras e de valorização do corpo; e) revisão da noção de sujeito moderno desprovida da cocriação do humano com a comunidade, a história, a natureza e o cosmos.(AU)

The field of transpersonal studies has advanced in several areas in Brazil. It celebrated its 40th anniversary with an active insertion in Higher Education Institutions (HEI) and an expansion of training centers and supporters of teaching, research, and social actions, in addition to dialogues with the System of Councils of Psychology. Challenges are presented based on a survey of a series of important and ignored issues within Transpersonal Psychology in Brazil. We present participatory pluriperspectivism as a possibility to decolonize the Eurocentric and North American matrices that support Brazilian transpersonal thought, seeking to honor our historical roots and include other epistemologies and ontologies, which continue the critique of modern Cartesian logic. We indicate a brief agenda of thematic notes that lack a decolonizing process in the transpersonal field: a) criticism of the perspectives of a hegemonic thought, whether in global terms via North-South domination or in the field of social relations; b) review of the forms of "centrocentrism"; c) questioning of the notion of universalism of science and ethics; d) deepening of the critical analysis of the restrictive supremacy of the technical-scientific formal rationality in relation to the forms of subjectivity, of holistic and integrative experiences, and of valuing the body; e) review of the notion of the modern subject devoid of the co-creation of the human with the community, the history, the nature, and the cosmos.(AU)

El campo de los estudios transpersonales ha avanzado en varias áreas de Brasil. Se celebró su 40.º aniversario con una inserción activa en Instituciones de Educación Superior (IES) y una ampliación de los centros de formación y promotores de la docencia, la investigación y la acción social, además de diálogos con el Sistema de Consejos de Psicología. Los desafíos se presentan a partir de una encuesta de una serie de temas importantes e ignorados dentro de la Psicología Transpersonal en Brasil. Presentamos el pluriperspectivismo participativo como una posibilidad para decolonizar las matrices eurocéntrica y americana, que sustentan el pensamiento transpersonal brasileño, buscando honrar nuestras raíces históricas e incluir otras epistemologías y ontologías que continúan la crítica de la lógica cartesiana moderna. Indicamos una breve agenda de apuntes temáticos que carecen de un proceso decolonizador en el campo transpersonal: a) crítica de las perspectivas de un pensamiento hegemónico, ya sea en términos globales a través del dominio Norte-Sur o en el campo de las relaciones sociales; b) revisión de las formas de "centrocentrismo"; c) cuestionamiento de la noción de universalismo de la ciencia y la ética; d) profundización del análisis crítico de la supremacía restrictiva de la racionalidad formal técnico-científica en relación a las formas de subjetividad, de experiencias holísticas e integradoras y de valoración del cuerpo; e) revisión de la noción de sujeto moderno desprovisto de la cocreación de lo humano con la comunidad, la historia, la naturaleza y el cosmos.(AU)

Rationalization and the status of folk psychology.

Cushman's theory has implications for the philosophical debate about the nature of folk psychological states, for it entails realism about propositional attitudes. I point out a tension within his view and suggest a different view upon which rationalization emerges as a consequence of the adaptiveness of mentalizing. This alternative avoids the strong metaphysical implications of Cushman's theory.

The rationale of rationalization.

While we agree in broad strokes with the characterisation of rationalization as a "useful fiction," we think that Fiery Cushman's claim remains ambiguous in two crucial respects: (1) the reality of beliefs and desires, that is, the fictional status of folk-psychological entities and (2) the degree to which they should be understood as useful. Our aim is to clarify both points and explicate the rationale of rationalization.

Chestnut shells (Italian cultivar "Marrone di Roccadaspide" PGI): Antioxidant activity and chemical investigation with in depth LC-HRMS/MSn rationalization of tannins.

In Italy a particularly valuable chestnut is "Marrone di Roccadaspide", a protected geographical indication (PGI) product, deriving from a Castanea sativa cultivar, typical of Salerno province in Campania region. As chestnut industrial processes yield a large amount of shell by-products, in this study the possibility to retrain this waste food as potential source of bioactives was investigated. The ability of "Marrone di Roccadaspide" shell MeOH extract to modulate the pro-inflammatory transcriptional factor NF-κB after LPS stimulation, along with the antioxidant activity by a cell-based in vitro test, were evaluated. To correlate the NF-κB inhibition (67.67% at 5 µg/mL) and the strong antioxidant activity to the chemical composition, an analytical approach based on LC-ESI/LTQOrbitrap/MS/MSn along with NMR characterization of isolated compounds was developed. The identification of hydrolysable and condensed tannins, along with flavonoids, phenol glucosides, ellagic acid derivatives, and triterpenoids was accomplished. The most representative compounds were quantitatively analyzed by LC-ESI/QTrap/MS/MS, showing bartogenic acid as the compound occurring in the highest amount (103.08 mg/100 g shells). With the aim to explore the possibility to employ chestnut shells as suitable source of bioactives for the preparation of functional ingredients, the chemical composition and the antioxidant activity of "eco-friendly" extracts (EtOH and EtOH:H2O 7:3) was finally evaluated, showing a high superimposability of the EtOH:H2O (7:3) extract to the MeOH extract.

Folk standards of sound judgment: Rationality Versus Reasonableness.

Normative theories of judgment either focus on rationality (decontextualized preference maximization) or reasonableness (pragmatic balance of preferences and socially conscious norms). Despite centuries of work on these concepts, a critical question appears overlooked: How do people's intuitions and behavior align with the concepts of rationality from game theory and reasonableness from legal scholarship? We show that laypeople view rationality as abstract and preference maximizing, simultaneously viewing reasonableness as sensitive to social context, as evidenced in spontaneous descriptions, social perceptions, and linguistic analyses of cultural products (news, soap operas, legal opinions, and Google books). Further, experiments among North Americans and Pakistani bankers, street merchants, and samples engaging in exchange (versus market) economy show that rationality and reasonableness lead people to different conclusions about what constitutes good judgment in Dictator Games, Commons Dilemma, and Prisoner's Dilemma: Lay rationality is reductionist and instrumental, whereas reasonableness integrates preferences with particulars and moral concerns.

Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer's Disease and Related Dementia.

We aimed to explore the coping strategies utilized by Latino caregivers of people with Alzheimer's disease or related dementia (ADRD). We conducted 16 semi-structured interviews with Latinos family caregivers. The interviews explored the caregivers' experiences utilizing coping strategies. Coping strategies were identified based on a direct content analysis of the interviews. Participants were 50 to 75 years old, majority female, and from Mexico. The most common coping strategies adopted were: rationalization, social interactions, physical activity, and leisure activities. Other strategies used included avoidance, keeping busy, self-care, and spirituality or faith. Strategies such as using social interactions and spirituality and faith may be rooted in Latino cultural values such as familismo and fatalismo. The possible origin from cultural values might make some of the coping strategies more prevalent or effective in Latinos. Effective interventions aiming to reduce stress in Latino caregivers should prioritize culturally relevant problem-focused coping strategies.

Who Turns to Acupuncture? The Role of Mistrust of Rationality and Individualist Success.

OBJECTIVE: In this postmodern society, people tend to abandon conventional medicine for alternative medical systems, such as acupuncture. What are the reasons for this defiance regarding modern rationality and individualist success? Who turns to acupuncture? METHODS: This study (n=89) examined whether world views opposed to the predominance of rationality (i.e., mistrust of science, spirituality, paranormal beliefs) and individualist success or consumerism (i.e., power, achievement, and materialism), typically associated with the postmodern era, might explain this attraction toward acupuncture. Participants were recruited through Internet forums interested in complementary and alternative medicine and completed the questionnaire voluntarily. RESULTS: Attraction to acupuncture related negatively with materialism and achievement as well as positively with spirituality, paranormal beliefs, and mistrust in science. Spirituality, paranormal beliefs, and low achievement were the main predictors of attraction to acupuncture and explained 44% of the variance. The mistrust in science mediated the relationship between spiritual and paranormal beliefs and the attraction toward acupuncture. Low achievement explained the link between low materialism and positive attitudes toward acupuncture. CONCLUSION: The general mistrust of our rational and individualist modern society is indeed an important predictor of attraction toward acupuncture, in addition to demographic variables.

Unanswered prayers: religiosity and the god-serving bias.

Two self-report experiments examined how religiosity affects attributions made for a target person's death. Online adults (Study 1, N = 427) and undergraduate students (Study 2, N = 326) read about Chris who had a heart attack, used religious or health behaviors, and lived or died. Participants made attributions to Chris and God (both studies), and reported their emotions (Study 2). Participants made more attributions to Chris when he lived than when he died, but only when he used health behaviors. The highly religious made more attributions to God, but not when Chris used religious behaviors and died (the God-serving bias); they reported the most positive emotions when Chris lived after using religious behaviors (the Hallelujah effect). Directions for future research in terms of implicit religious beliefs and normative evaluations of religion are discussed.

MAPK pathway activation leads to Bim loss and histone deacetylase inhibitor resistance: rationale to combine romidepsin with an MEK inhibitor.

To identify molecular determinants of histone deacetylase inhibitor (HDI) resistance, we selected HuT78 cutaneous T-cell lymphoma (CTCL) cells with romidepsin in the presence of P-glycoprotein inhibitors to prevent transporter upregulation. Resistant sublines were 250- to 385-fold resistant to romidepsin and were resistant to apoptosis induced by apicidin, entinostat, panobinostat, belinostat, and vorinostat. A custom TaqMan array identified increased insulin receptor (INSR) gene expression; immunoblot analysis confirmed increased protein expression and a four- to eightfold increase in mitogen-activated protein kinase (MAPK) kinase (MEK) phosphorylation in resistant cells compared with parental cells. Resistant cells were exquisitely sensitive to MEK inhibitors, and apoptosis correlated with restoration of proapoptotic Bim. Romidepsin combined with MEK inhibitors yielded greater apoptosis in cells expressing mutant KRAS compared with romidepsin treatment alone. Gene expression analysis of samples obtained from patients with CTCL enrolled on the NCI1312 phase 2 study of romidepsin in T-cell lymphoma suggested perturbation of the MAPK pathway by romidepsin. Immunohistochemical analysis of Bim expression demonstrated decreased expression in some skin biopsies at disease progression. These findings implicate increased activation of MEK and decreased Bim expression as a resistance mechanism to HDIs, supporting combination of romidepsin with MEK inhibitors in clinical trials.

Rational design and characterization of platelet factor 4 antagonists for the study of heparin-induced thrombocytopenia.

Patients with heparin-induced thrombocytopenia (HIT) remain at risk for recurrent thromboembolic complications despite improvements in management. HIT is caused by antibodies that preferentially recognize ultralarge complexes (ULCs) of heparin and platelet factor 4 (PF4) tetramers. We demonstrated previously that a variant PF4(K50E) forms dimers but does not tetramerize or form ULCs. Here, we identified small molecules predicted to bind PF4 near the dimer-dimer interface and that interfere with PF4 tetramerization. Screening a library of small molecules in silico for binding at this site, we identified 4 compounds that inhibited tetramerization at micromolar concentrations, designated PF4 antagonists (PF4As). PF4As also inhibited formation of pathogenic ULCs, and 3 of these PF4As promoted the breakdown of preformed ULCs. To characterize the ability of PF4As to inhibit cellular activation, we developed a robust and reproducible assay that measures cellular activation by HIT antibodies via FcγRIIA using DT40 cells. PF4As inhibit FcγRIIA-dependent activation of DT40 cells by HIT antibodies as well as platelet activation, as measured by serotonin release. PF4As provide new tools to probe the pathophysiology of HIT. They also may provide insight into the development of novel, disease-specific therapeutics for the treatment of thromboembolic complications in HIT.

Filosofía, medicina y razonamiento diagnóstico. Segunda parte / Philosophy, medicine and clinical reasoning. Part II

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Reconciling beauty and utility in early city planning: the contribution of John Nolen.

In the history of city planning, the dichotomy between the aesthetic aspirations of the City Beautiful and City Practical movements is overstated. The aesthetic impulse did not disappear but persisted as an important thread through the development of comprehensive planning approaches into the 1920s. The nexus between beauty and utility was negotiated and expressed across four main discourses: broad social improvement, aesthetic functionality, economic rationality, and holistic design. Ultimately, beauty became wedded to utility within the very nature of the comprehensive city plan itself. The work of the leading city planner John Nolen is central to an understanding of these historic continuities and informed the early evolution of city planning theory and practice. Nolen's challenge to the City Beautiful paradigm, while still retaining an artistic sensibility, reaestheticizes scholars' appreciation of the City Practical.

'It's not me, it's them': How lesbian women make sense of negative experiences of maternity care: a hermeneutic study.

AIM: The paper is a report of one aspect of a hermeneutic study of lesbian women's experiences of maternity care, specifically interpretations of negative experiences. BACKGROUND: There is a growing body of literature in relation to lesbian women's experiences of maternity care. Although most commentators discuss the negative experiences encountered by lesbian mothers, there has been no contextual analysis of these expressions of negativity in an increasingly positive environment. METHODS: The study was undertaken using a qualitative approach using an adapted Gadamerian hermeneutic phenomenology using unstructured interviews with eight women. The interviews took place between November 2007 and March 2008. All of the participants had disclosed their sexual orientation in pregnancy. Snowball sampling was used. The data were then analysed using an iterative hermeneutic framework. FINDINGS: The participants not only described their experiences of maternity care as being positive but also offered examples of negative experiences. These were analysed separately to explore the ways in which the women made sense of them in the context of an otherwise positive experience. These experiences were expressed in ways that distanced the negative and that seemed to rationalize behaviour or ascribe it to the health professional. CONCLUSIONS: Negative encounters with health professionals are processed by women in a way that protects their overall experience. Health professionals in maternity care should consider the impact of negative responses to lesbian mothers and the effect that it has in reducing the overall quality of this significant life event.

A stranger in the looking glass: developing and challenging a hypnotic mirrored-self misidentification delusion.

This article describes a study that used hypnosis to temporarily re-create mirrored-self misidentification, which is the delusional belief that the person one sees in the mirror is a stranger. Following a hypnotic suggestion to see a stranger in the mirror, high hypnotizable subjects described seeing a stranger with physical characteristics different to their own. Whereas subjects' beliefs about seeing a stranger were clearly false, they had no difficulty generating sensible reasons to explain the stranger's presence. The authors tested the resilience of this belief with clinically inspired challenges. Although visual challenges (e.g., the hypnotist appearing in the mirror alongside the subject) were most likely to breach the delusion, some subjects maintained the delusion across all challenges. Findings are discussed in light of the dominant theory of delusions and highlight the advantages of using hypnosis to explore delusional beliefs.

Entre as interfaces das racionalidades da saúde: por que terapia floral? / Between the interfaces of the rationalities of health: why floral therapy?

A ciência ocidental, hoje, é a ciência instituída que vem em primeiro lugar, com características como a objetividade, mensuração e o cartesianismo. Este trabalho vem trazer à luz, de certa forma, uma discussão antiga sobre o que é ciência. E, por trás desse pano de fundo, desvela-se a questão central: quais motivos levaram alguns médicos, imersos na racionalidade biomédica e, consequentemente, na racionalidade científica ocidental, a olhar outras racionalidades da saúde, chegando a escolher trabalhar com pelo menos uma delas, a medicina floral, tema central deste estudo. Justo esta, uma medicina embasada em outra racionalidade de saúde, em outra racionalidade científica e, com isso, outra compreensão de sujeito, de doenças, de saúde, de tratamento e de cura. Enquanto a ciência médica ocidental foca seu olhar nas doenças, órgãos e lesões e ainda está a passos lentos, começando a olhar para os sujeitos e sua relação consigo mesmo e com o seu entorno para pensar a cura e a doença, a medicina floral que é uma das medicinas complementares olha o sujeito em todas as suas relações para realizar seu diagnóstico e seu tratamento, sem fragmentar o indivíduo e seu corpo. Através da análise de conteúdo de Bardin (2010), realizada com as oito entrevistas feitas com médicos que também atuam com medicina floral no município de Porto Alegre-RS, foram observadas seis categorias, as quais indicam as diferenças das racionalidades e as influências de cada uma em seus trabalhos e, ainda, os motivos pela escolha da medicina floral como mais uma ferramenta de trabalho no tratamento dos sujeitos doentes, ou melhor, com algum desequilíbrio físico, mental ou emocional. As categorias são: 1. O que é doença?; 2. O que é cura?; 3. O que é saúde?; 4. Como é a medicina ocidental; 5. Como é a medicina floral; 6. Caminho da biomedicina ao floral. Estas categorias indicam a forma de pensar dos médicos durante sua história de vida e sua história profissional, o que os influenciou e até os levou a trabalhar com terapia floral. Alguns deles já possuíam em sua vida fatores e concepções que foram os pilares para aguçar sua curiosidade em relação a outras formas de cuidado com os pacientes, que complementassem o que aprenderam com a medicina. Outros médicos, totalmente imersos na racionalidade científica e médica ocidental, foram pegos de surpresa pelos efeitos do floral em suas vidas ou na vida de pessoas próximas, o que os fez repensar sobre seu agir médico. Todos, no entanto, ao entrar em contato com a medicina floral, disseram ter percebido nesta a possibilidade de ajudar seus pacientes e a si mesmos na arte de curar o sofrimento humano, obtendo assim resultados que foram e são interessantes ou mesmo surpreendentes. Talvez essa surpresa não seja apenas pelos resultados, mas pela maior aproximação que o estudo dos florais possibilitou entre esses médicos e seus pacientes, e, assim, entre esses médicos e a arte de curar, tornando-os, ainda mais, agentes de cura de sujeitos, e não apenas de doenças ou lesões.(AU)

Western science, today, is science that has been instituted and comes in the first place, with characteristics such as objectivity, measurement and Cartesianism. This study brings to light, in a way, an old debate about what science is. And, behind that backdrop, reveals itself the central question: what reasons have led some doctors, immersed in the biomedical rationality and, consequently, in the Western scientific rationality, to look at other rationalities of health, getting to choose to work with at least one of them, the floral medicine, main theme of this study. Just this, a medicine based on other rationality of health, on other scientific rationality and, therefore, another understanding of individual, disease, health, treatment and cure. While the Western medical science focuses its gaze on diseases, organs and injuries and it is still slow, floral medicine - which is one of the complementary medicines is starting to look at the individuals and their relation with themselves and their surroundings to think about healing and illness, it looks at the person in all his relations to make his diagnosis and treatment, without fragmenting the individual and his body. Through content analysis of Bardin (2010), held with eight interviews with doctors who also work with floral medicine in the city of Porto Alegre, six categories were observed, which indicate the differences of the rationalities and the influences of each one in their work and also the reasons for the choice of floral medicine as a tool in the treatment of sick individuals, or better, of individuals with some physical, mental or emotional imbalance. The categories are: 1. What is illness? 2. What is healing? 3. What is health? 4. How does Western science work; 5. How does floral medicine work; 6. The path from biomedicine to floral medicine. These categories indicate the way of thinking of doctors during their life history and their professional history, what has influenced them and even led them up to work with floral therapy. Some of them already had in their lives factors and concepts that were the pillars to whet their curiosity about other forms of care with patients that complemented what they learned with medicine. Other doctors, fully immersed in the Western medical and scientific rationality, were caught by surprise by the effects of floral in their lives or in the lives of people nearby, which made them rethink their actions as doctors. All, however, when in contact with floral medicine, claimed to have noticed in this the possibility of helping their patients and themselves in the art of curing human suffering, thereby obtaining results that were and are interesting or even amazing. Maybe this surprise is not only because of the results, but because of the approximation that the study of floral made possible between these doctors and their patients, and thus between these doctors and the art of healing, making them even more curing agents of individuals and not just of illness or injuries.(AU)