Understanding and explaining the link between anthroposophy and vaccine hesitancy: a systematic review.

BACKGROUND: Due to low vaccination uptake and measles outbreaks across Europe, public health authorities have paid increasing attention to anthroposophic communities. Public media outlets have further described these communities as vaccine refusers or "anti-vaxxers". The aim of this review was to understand the scope of the problem and explore assumptions about vaccination beliefs in anthroposophic communities. For the purpose of this review, we define anthroposophic communities as people following some/certain views more or less loosely connected to the philosophies of anthroposophy. The systematic review addresses three research questions and (1) collates evidence documenting outbreaks linked to anthroposophic communities, (2) literature on vaccination coverage in anthroposophic communities, and (3) lastly describes literature that summarizes theories and factors influencing vaccine decision-making in anthroposophic communities. METHODS: This is a systematic review using the following databases: Medline, Web of Science, Psycinfo, and CINAHL. Double-blinded article screening was conducted by two researchers. Data was summarized to address the research questions. For the qualitative research question the data was analysed using thematic analysis with the assistance of Nvivo12.0. RESULTS: There were 12 articles documenting 18 measles outbreaks linked to anthroposophic communities between the years 2000 and 2012. Seven articles describe lower vaccination uptake in anthroposophic communities than in other communities, although one article describes that vaccination coverage in low-income communities with a migrant background was lower than in the anthroposophic community they studied. We found eight articles examining factors and theories influencing vaccine decision making in anthroposophic communities. The qualitative analysis revealed four common themes. Firstly, there was a very broad spectrum of vaccine beliefs among the anthroposophic communities. Secondly, there was a consistent narrative about problems or concerns with vaccines, including toxicity and lack of trust in the system. Thirdly, there was a strong notion of the importance of making individual and well-informed choices as opposed to simply following the masses. Lastly, making vaccine choices different from public health guidelines was highly stigmatized by those outside of the anthroposophic community but also those within the community. CONCLUSION: Continuing to further knowledge of vaccine beliefs in anthroposophic communities is particularly important in view of increasing measles rates and potential sudden reliance on vaccines for emerging diseases. However, popular assumptions about vaccine beliefs in anthroposophic communities are challenged by the data presented in this systematic review.

Effects of Bryophyllum pinnatum Administration on Wistar Rat Pregnancy: Biochemical and Histological Aspects.

INTRODUCTION: Bryophyllum pinnatum is widely used in folk medicine. It has neuropharmacological, anti-inflammatory, immunomodulatory, antidiabetic, hepatoprotective, and nephroprotective effects, among others. It also acts on uterine contractility. It is prescribed by practitioners of anthroposophic medicine for preterm labor, insomnia, and emotional disorders, and has other potential uses in obstetrics. As all drugs currently used in preterm labor have side effects, new tocolytic agents remain an area of active research. OBJECTIVE: To evaluate the effect of B. pinnatum mother tincture (MT) on albino rats and their offspring throughout pregnancy from a biochemical and histological standpoint. METHODS: Longitudinal, prospective, randomized controlled bioassay. This is the second stage of a trial that investigated 60 animals distributed across six equal groups: controls C1 and C2, which received 1 and 25 times the vehicle dose (30% ethanol), B1 and B2 (1- and 25-fold doses of B. pinnatum MT), and B3 and B4 (which received 50- and 100-fold doses of B. pinnatum concentrate). At this stage, blood chemistry parameters (glucose, alanine aminotransferase [ALT], aspartate aminotransferase [AST], creatinine, and blood urea nitrogen) were measured in dams, as well as histological aspects of dam liver, kidney, placenta, and uterine tissue and fetal liver, kidney, heart, and brain. RESULTS: No differences were found between group B1 (therapeutic dose) and its control C1 in relation to glucose, AST, ALT, and creatinine. Group B2 exhibited lower glucose levels than groups C1, B3, and B4. There was no difference in AST across groups. Groups B3 and B4 exhibited higher ALT levels than groups C1 and B1. Groups B1-B4 exhibited higher urea nitrogen levels than group C1. Creatinine levels were higher in groups B2 and B3 than group C1. On morphological evaluation, fatty infiltration of the liver was observed in the alcoholic vehicle control groups (C1 and C2). CONCLUSIONS: Daily administration of B. pinnatum at therapeutic doses (group B1) to pregnant albino rats appears to be safe, with reduced glucose at dose B2, elevated ALT at doses B3 and B4, and increased urea at doses B1 to B4 and creatinine at B2 and B3, but never exceeding the normal reference range. It was not associated with histological changes in specimens of the maternal or fetal structures of interest.

Thoughts, beliefs and concepts concerning infectious childhood diseases of physicians practicing homeopathic, anthroposophic and conventional medicine - a qualitative study.

BACKGROUND: Physicians who include complementary medicine in their practice are thought to have an understanding of health and disease different from that of colleagues practicing conventional medicine. The aim of this study was to identify and compare the thoughts and concepts concerning infectious childhood diseases (measles, mumps, rubella, chickenpox, pertussis and scarlet fever) of physicians practicing homeopathic, anthroposophic and conventional medicine. METHODS: This qualitative study used semistructured interviews. Participating physicians were either general practitioners or pediatricians. Data collection and analysis were guided by a grounded theory approach. RESULTS: Eighteen physicians were interviewed (6 homeopathic, 6 anthroposophic and 6 conventional). All physicians agreed that while many classic infectious childhood diseases such as measles, mumps and rubella are rarely observed today, other diseases, such as chickenpox and scarlet fever, are still commonly diagnosed. All interviewed physicians vaccinated against childhood diseases. A core concern for physicians practicing conventional medicine was the risk of complications of the diseases. Therefore, it was considered essential for them to advise their patients to strictly follow the vaccination schedule. Homeopathic-oriented physicians viewed acute disease as a biological process necessary to strengthen health, fortify the immune system and increase resistance to chronic disease. They tended to treat infectious childhood diseases with homeopathic remedies and administered available vaccines as part of individual decision-making approaches with parents. For anthroposophic-oriented physicians, infectious childhood diseases were considered a crucial factor in the psychosocial growth of children. They tended to treat these diseases with anthroposophic medicine and underlined the importance of the family's resources. Informing parents about the potential benefits and risks of vaccination was considered important. All physicians agreed that parent-delivered loving care of a sick child could benefit the parent-child relationship. Additionally, all recognized that existing working conditions hindered parents from providing such care for longer durations of time. CONCLUSIONS: The interviewed physicians agreed that vaccines are an important aspect of modern pediatrics. They differed in their approach regarding when and what to vaccinate against. The different conceptual understandings of infectious childhood diseases influenced this decision-making. A survey with a larger sample would be needed to verify these observations.

Death and Dying Between Anthroposophy and Biomedicine / A morte e o morrer entre a antroposofia e a biomedicina

Abstract Death and dying constantly provoke debates regarding boundaries, rules and disputes for the legitimacy of different meanings regarding processes of finalizing life. This article places special emphasis on conflicts between the therapeutic system of anthroposophy and biomedicine in Brazil. The reflections contained in the text are based on ethnographic research, carried out in multiple locations between 2012 and 2015, investigating concepts of cure in anthroposophy in three different communities: two in Brazil, and one in Switzerland. Over the course of this journey, our experience as ethnographers led us to reflect on death and dying among the Widows of Demétria, one of the anthroposophical communities in which we conducted our research. Demétria is a rural neighborhood located in the city of Botucatu, in the interior of São Paulo state. The community was first organized during the 1970s, and it consists mostly of women - both Europeans and Brazilians - who live together, sharing a lifestyle that reimagines the ethos of death as a part of the aesthetic project of Bildung, which differs significantly from the conception of the death process in biomedicine.

Resumo A morte e o morrer suscitam continuamente o debate sobre as fronteiras, as regras e a disputa pela legitimidade dos distintos significados que envolvem os processos de finalização da vida. Este artigo busca abordar, especialmente, os conflitos que ocorrem entre o sistema terapêutico antroposófico e a biomedicina no Brasil. As reflexões se dão com base na etnografia multissituada realizada entre os anos 2012 e 2016 que se debruçou sobre a concepção de cura na antroposofia em três comunidades, duas no Brasil e uma na Suíça. Nesse percurso, fomos levados pela experiência etnográfica às elaborações sobre a morte e o morrer das viúvas da Demétria, uma das comunidades antroposóficas investigadas. Demétria é um bairro rural no interior do estado de São Paulo, na cidade de Botucatu, composto na sua maioria por mulheres, europeias e brasileiras, que convivem e partilham de um estilo de vida que reelabora o ethos da morte como um projeto estético de Bildung que difere da concepção do processo de morte na biomedicina.

Study and Development of an Anthroposophical Formula Based on Phosphorus and Formica rufa for Onychomycosis´s Treatment.

Onychomycosis is a fungal infection of the nail plate or nail bed that leads to the gradual destruction of the nail. The main difficulties in the treatment of onychomycosis refer to the duration of treatments and their side effects. Thus, it becomes relevant to look for new therapeutic alternatives in the treatment of such common diseases that are efficient without causing the undesirable side effects on the patient's body. In this way, the objective of this study was to develop an anthroposophical formula for the treatment of onychomycosis, based on Phosphorus and Formica rufa, from an extensive bibliographic survey on the functions of these components, evaluating within the principles of Anthroposophy. Considering the set of knowledge and practices on the use of these components, it was possible to arrive at a proposal therapy that can be effective for the treatment of onychomycosis. After an extensive review of several existing patents, it was observed that formulations containing Phosphorus and Formica rufa together have not been described in other studies. Subsequently, our research group published a patent of the anthroposophical formula using these two components, with the number BR1020180750755, which will be efficient to help the recovery of nails, and facilitate normal growth.

The usage of over-the-counter products by private insured patients in Germany - a claims data analysis with focus on complementary medicine.

BACKGROUND: An important contribution to well-being of human beings can be observed by the use of self-medication products that is reflected in the constantly growing volume of over-the-counter (OTC) drugs. The aim of the current study was to extend the measurement concept for OTCs by exploring the relevance of the peripheral assortment provided by the widely accepted framework of the Anatomical Therapeutical and Chemical (ATC) classification of the WHO. METHODS: The focus was on the prescriptions and drug-related receipts submitted by privately insured persons to 18 private health insurers (PHIs) in Germany from the year 2016. The age- and gender-specific average claims amount per risks of outpatient drug expenditure were used as weights to scale up the relative distributions of the item amounts. The ATC-classification defines the commodity groups and discriminates between the main and the peripheral assortment. A descriptive analysis assessed the OTC frequencies and sum scores of the product groups within the main and peripheral assortment whereby the study group explored and assessed the relevance of each category independently according to the OTCs and integrative medicines. RESULTS: The analysis included 22.1 Mio. packages from the main assortment and examined 10.1 Mio. packages from the peripheral assortment. The latter was examined thoroughly and the commodity groups "Pharmaceutical food products", "Medicinal products for special therapy options" and particular "Hygiene and body care products" meet the defined requirements for OTCs relevant for integrative medicines. A high proportion of OTC products from the peripheral assortment was associated with the categories "medicinal products for special therapy options". Homeopathy and anthroposophy present two special therapy options, which are relevant for the extended OTC measurement. CONCLUSIONS: The analysis of OTC drugs is feasible when the main and the peripheral assortment is available and enable to integrate about 18% of all OTCs, which are neglected by the common ATC-based approach. The presented extended approach may help to identify potential users of OTCs or people in need of OTC use. In case of the highly disputed homeopathy and anthroposophy products, more research among interactions with prescriptions drugs (Rx), nutrition's and other potentially harmful exposures is recommended.

Acceptance, satisfaction and cost of an integrative anthroposophic program for pediatric respiratory diseases in a Swiss teaching hospital: An implementation report.

BACKGROUND: For the pilot phase of an integrative pediatric program, we defined inpatient treatment algorithms for bronchiolitis, asthma and pneumonia, using medications and nursing techniques from anthroposophic medicine (AM). Parents could choose AM treatment as add-on to conventional care. MATERIAL AND METHODS: To evaluate the 18-month pilot phase, parents of AM users were asked to complete the Client Satisfaction Questionnaire (CSQ-8) and a questionnaire on the AM treatment. Staff feedback was obtained through an open-ended questionnaire. Economic data for project set-up, medications and insurance reimbursements were collected. RESULTS: A total of 351 children with bronchiolitis, asthma and pneumonia were hospitalized. Of these, 137 children (39%) received AM treatment, with use increasing over time. 52 parents completed the questionnaire. Mean CSQ-8 score was 29.77 (95% CI 29.04-30.5) which is high in literature comparison. 96% of parents were mostly or very satisfied with AM; 96% considered AM as somewhat or very helpful for their child; 94% considered they learnt skills to better care for their child. The staff questionnaire revealed positive points about enlarged care offer, closer contact with the child, more relaxed children and greater role for parents; weak points included insufficient knowledge of AM and additional nursing time needed. Cost for staff training and medications were nearly compensated by AM related insurance reimbursements. CONCLUSIONS: Introduction of anthroposophic treatments were well-accepted and led to high parent satisfaction. Additional insurance reimbursements outweighed costs. The program has now been expanded into a center for integrative pediatrics.

Avanços e desafios para a implementação das práticas integrativas e complementares no Brasil / Advances and challenges for the implementation of integrative and complementary practices in Brazil

Analisou-se a conjuntura da produção científica, os avanços e os desafios para a implementação das Práticas Integrativas e Complementares (PIC) no Brasil. O estudo se deu por meio de Revisão Integrativa dos artigos indexados nas bases de dados bibliográficas da Rede Biblioteca Virtual de Saúde (BVS), selecionando-se 68 artigos. Notou-se que a região Sudeste permanece como polo científico e a maior parte dos estudos não possui nível de evidência significativo. No decorrer dos anos, houve pequeno aumento no número de estudos e maior comprovação da eficácia e eficiência das PIC em diversas áreas, porém entraves relacionados a pouca formação profissional, má gestão do Sistema e concepções enraizadas na medicina alopática permanecem e dificultam a ampliação das PIC no país.

We analyzed the scientific production, the advances, and the challenges for the implementation of Integrative and Complementary Practices (ICP) in Brazil. The study was done through an integrative review in the Virtual Health Library, selecting 68 articles. It was noted that the Southeast region continues as a scientific hub, and that most of the studies do not have a significant level of evidence. Over the years, there has been a small increase in the number of studies and greater evidence of the effectiveness and efficiency of ICP in several areas. However, problems related to poor professional training, bad management of the system, and concepts rooted in allopathic medicine remain, and hinder the expansion of ICP in Brazil.

Mães Waldorf: gestação e parto na comunidade antroposófica / Waldorf mothers: pregnancy and birth in an anthroposophical community / Madres Waldorf: gestación y parto en la comunidad antroposófica

As recentes pesquisas em Ciências Sociais e Saúde Coletiva apontam para diferentes contornos sobre o ato de parir na contemporaneidade. Em 2013, por seis meses, realizamos uma etnografia sobre a cura na Antroposofia no bairro rural da Demétria, em Botucatu, São Paulo. Neste artigo, buscamos refletir sobre as orientações da medicina romântica da Antroposofia destinadas à gestação e ao parto em uma comunidade rural antroposófica e as relações estabelecidas com a biomedicina e com serviços de saúde. O contato com as mães e gestantes mostrou a existência de uma gramática emocional na qual a gestante é levada a buscar purificação e controle corporal, além de um silêncio religioso na hora de enfrentar as dores do parto como demonstração de coragem. Quando buscam acessar serviços de saúde, as expectativas sobre o parto se colocam distantes das práticas e concepções da medicina convencional.(AU)

Recent research in the Social Sciences and Colective Health points to different forms in contemporary attitudes toward the act of giving birth. During a six-month period in 2013, we carried out an ethnographic study of anthroposophical healing in Demétria, a neighborhood in the city of Botucatu in Sao Paulo State, Brazil. In this paper we seek to draw reflections about the guidelines set out in Anthroposophy's romantic medicine as it applies to gestation and birth in a rural anthroposophical community and to the relationships established with biomedicine and with health services. Contact with mothers and pregnant women showed there to be an emotional grammar through which these women seek out physical purification and control of their bodies, as well as a religious silence when it comes to facing the pains of giving birth, as a form of showing courage. When they seek to access health services, expectations about the birth are found to be distant from the practices and conceptions of conventional medicine.(AU)

Las recientes investigaciones en Ciencias Sociales y en Salud Colectiva señalan diferentes contornos sobre el acto de parir en la contemporaneidad. En 2013, durante seis meses, realizamos una etnografía sobre la cura en la Antroposofía, en el barrio rural de Demétria, en Botucatu, São Paulo. El objetivo de este artículo fue reflexionar sobre las orientaciones de la medicina romántica de la Antroposofía destinadas a la gestación y al parto en una comunidad rural antroposófica y las relaciones establecidas con la biomedicina y con servicios de salud. El contacto con las madres y gestantes mostró la existencia de una gramática emocional en la cual la gestante es llevada a buscar purificación y control corporal, además de un silencio religioso en el momento de enfrentar los dolores del parto como demostración de coraje. Cuando buscan el acceso a los servicios de salud, las expectativas sobre el parto se plantean distantes de las prácticas y concepciones de la medicina convencional.(AU)

The Role of Complementary and Alternative Medicine in the Healthcare System: A German Paradox.

BACKGROUND: This paper examines a paradox in the German healthcare system: Complementary and alternative medicine (CAM) practices are a major element of medical encounters in Germany. Patients seek them, physicians provide them, and public health insurances pay for them in part. Despite all this, CAM practices are not acknowledged as scientifically valid. MATERIAL AND METHOD: I will examine this situation in detail based on 2 ethnographic studies. The first study refers to an attempt to introduce homeopathic education at a German university. The second one is a study in the context of cancer and CAM. These cases are perfect examples of the current power struggles that are impeding the expansion of CAM practices in Germany. RESULTS: The results should be seen from the theoretical angle of the study of science. The conventional method of proving scientific validity is in contradiction to those frameworks in which the impact of CAM might be demonstrated. There are economic interests invested in preventing the integration of CAM into existing scientific structures. However, the current hybridization of CAM with conventional medicine might be a step towards an institutionalized heterogenization of medical practices in Germany. CONCLUSIONS: A broader understanding of scientific methods within the CAM community could provide a useful frame for future research. I suggest that the CAM community more actively takes part in the discourse with representatives of conventional medicine and come out of the closet.

Plantas, metais e planetas: o caso do Bryophyllum / Plants, metals and planets: the case of Bryophyllum

Neste presente trabalho, os autores realizam um estudo fenomenológico da relação entre ritmos cósmicos e terrestres, e sua influência na organização vital humana. A partir disto, aprofundam-se no conhecimento de um ritmo cósmico arquetípico (o da Lua) e sua relação direta com as qualidades do metal que reflete estas forças na natureza: a prata (Argentum). O conhecimento da ação dinâmica das forças lunares no organismo humano, assim como a observação de uma planta tipicamente lunar, o Bryophyllum calycinum, permite a compreensão efetiva de suas indicações terapêuticas.(AU)

In this paper, the authors perform a phenomenological study on the relationship between cosmic and terrestrial rhythms, and its influence over the human vita lorganization. From this, they deepen in the knowledge of an archetypal cosmic rhythm (of the Moon) and its direct relationship with the qualities of the metal which reflects these forces in the nature: the silver (Argentum). The knowledge about the dynamic action of lunar forces over the human organism, as well as the observation of a typically lunar plant, Bryophyllum calycinum, allows an effective understanding of its therapeutic indications.(AU)

Bryophyllum e a perspectiva antroposófica dos distúrbios histéricos / Bryophyllum and the anthroposophic perspective of hysterical disorders

Na concepção antroposófica, a histeria só pode ser compreendida quando comparada sob o ponto de vista fenomenológico ao seu oposto, a neurastenia. Quando o equilíbrio entre os sistemas orgânicos estiver ausente ou deficitário, irão resultar causas constitucionais para doenças na organização vital. Rudolf Steiner as chama de histeria e neurastenia, num sentido muito mais amplo que a terminologia médica.No caso da histeria, as forças do mundo exterior não podem ser digeridas e suficientemente transformadas. O polo superior está fraco demais para transformar completamente as forças exteriores. Já na neurastenia, o polo superior está excessivamente envolvido com a atividade consciente da organização anímica e do eu. Em ambos os casos, a base da terapia está relacionada ao sistema rítmico. A síndrome pré-menstrual pode ser entendida como um distúrbio histérico, onde processos metabólicos "mal digeridos" repercutem sobre o polo neurossensorial e sobre todo o comportamento do indivíduo. A histeria significa a invasão da consciência e do campo anímico de sensibilidade por conteúdos inconscientes, volitivos, metabólicos. Entre os sintomas da histeria, estão distúrbios menstruais acompanhados de dores, humor instável, perturbações digestivas, sintomas sexuais, emotividade exagerada e avidez desejosa. Bryophyllum calycinum (família Crassulaceae), é uma planta suculenta, com uma relação peculiar com o elemento aquoso. Propaga-se principalmente por brotação foliar, e não por sementes. Regenera-se com facilidade incomum. Steiner propôs uma indicação totalmente nova para esta planta: o tratamento da histeria. Não a histeria no sentido psiquiátrico, mas antroposófico, em contraposição à neurastenia. Coube também a Steiner a indicação do cultivo do Bryophyllum com prata dinamizada, pelo processo denominado vegetabilização. A prata (Argentum) possui a faculdade de ligar a organização vital ao corpo físico. O Bryophyllum Argento cultum possibilita melhor controle das forças vitais no âmbito do sistema metabólico.(AU)

From the anthroposophic conception, hysteria can only be understood if compared under phenomenological point of view to its opposite, neurasthenia. The imbalance of the organic systems generates the constitutional bases to disorders of the vital organization. Rudolf Steiner called them hysteria and neurasthenia, in a much wider sense than defined by medical terminology. In case of hysteria, the forces coming from external world cannot be sufficiently metabolized and transformed. The superior pole is too weak to transform completely external forces. While in neurasthenia, the superior pole is excessively involved with the conscious activity of the soul and I-organization. In both cases, the base of therapy is focused on rhythmic system. Premenstrual syndrome may be understood as a hysterical disorder, where metabolic processes poorly "metabolized" resound over nerve-senses pole and over the whole behavior of the individual. Hysteria means the invasion of the consciousness and the soul field of sensibility by unconscious, volitional, metabolic contents. Among the symptoms of hysteria are menstrual disorders accompanied by pain, instable humor, digestive disorders, sexual symptoms, exaggerated emotiveness and anxious desire. Bryophyllum calycinum (Crassulaceae) is a succulent plant with a peculiar relationship with aqueous element. It propagates itself mainly by leaves sprouting, not by seeds. It regenerates itself in an unusually easy way. Steiner proposed a totally new indication to this plant: treatment for hysteria. Not hysteria in psychiatric meaning, but in anthroposophic one, as opposite of neurasthenia. Steiner had also given the indication for Bryophyllum cultivation with potentized silver, through the process called vegetabilization. Silver (Argentum) is capable of binding the vital organization to the physical body. Bryophyllum Argento cultum enables better control of vital forces in the sphere of metabolic system.(AU)

Caring touch--patients' experiences in an anthroposophic clinical context.

This study describes the phenomenon of caring touch from the patients' perspective in an anthroposophic clinical context where caring touch is often used to promote health and alleviate suffering. The aim of the study was to explore and phenomenologically describe the phenomenon of caring touch from the patients' perspectives. The study has been carried out with a Reflective Lifeworld Research approach in order to understand and describe human existential phenomena. Ten female patients were interviewed in an anthroposophic clinic in Sweden. The findings show how caring touch has multifaceted meanings and makes the patients' feel present and anchored in a meaningful context. The patients' feel that they are seen, accepted and confirmed. Furthermore, touch creates a caring space where the patients become receptive for care and has the power to alleviate the patients' suffering, as well as to frighten and cause or worsen the suffering. In order to take advantage of the caring potential, the patient needs to be invited to a respectful and sensitive form of touch. An interpersonal flexible space is necessary where the touch can be effective, and where a dynamic interplay can develop. In conclusion, caring touch is an opportunity for carers to support well-being and health. The carers need to approach their patients in both a sensitive and reflective way. A caring science perspective can serve as a help to further understand touch as a unique caring act.

Social Cultivation of Vaccine Refusal and Delay among Waldorf (Steiner) School Parents.

U.S. media reports suggest that vastly disproportionate numbers of un- and under-vaccinated children attend Waldorf (private alternative) schools. After confirming this statistically, I analyzed qualitative and quantitative vaccination-related data provided by parents from a well-established U.S. Waldorf school. In Europe, Waldorf-related non-vaccination is associated with anthroposophy (a worldview foundational to Waldorf education)­but that was not the case here. Nor was simple ignorance to blame: Parents were highly educated and dedicated to self-education regarding child health. They saw vaccination as variously unnecessary, toxic, developmentally inappropriate, and profit driven. Some vaccine caution likely predated matriculation, but notable post-enrollment refusal increases provided evidence of the socially cultivated nature of vaccine refusal in the Waldorf school setting. Vaccine caution was nourished and intensified by an institutionalized emphasis on alternative information and by school community norms lauding vaccine refusal and masking uptake. Implications for intervention are explored.

A gestante na visão da antroposofia: contribuições para um acompanhamento psicológico integral / The pregnant woman in the perspective of anthroposophy: contributions to a comprehensive counseling

A partir do conhecimento das alterações fisiológicas e psíquicas, do momento de crise biográfica e das consequências da saúde mental da gestante no desenvolvimento fetal, percebe-se a importância do acompanhamento psicológico neste período da vida da mulher. Este estudo aborda os conceitos sobre a gestação e o que ocorre com a mulher grávida na perspectiva da antroposofia, visando fornecer elementos complementares para a reflexão de uma prática psicológica mais integral no acompanhamento às gestantes. A metodologia utilizada foi o levantamento de bibliografia disponível sobre gestação sob o ponto de vista da antroposofia e das abordagens tradicionais da psicologia, em português e inglês. A bibliografia sobre o processo emocional da gestante durante a gravidez é mais focada em intercorrências do que no processo natural que ocorre neste período. As publicações referentes à gestação fisiológica são raras, em sua maioria encontradas em livros. A bibliografia relacionada à antroposofia é bastante escassa. Não foi encontrado nenhum artigo sobre o tema, em inglês ou português. No entanto, tem-se indicações deste processo por meio de publicações em livros. A antroposofia visa ampliar o conhecimento obtido pelo método científico convencional, buscando o entendimento dos sintomas a partir da observação fenomenológica. A literatura tradicional mostra-se bastante rica no que diz respeito à observação fenomenológica do que ocorre à gestante, quando se exclui a parte interpretativa das modificações. É de suma importância que mais psicólogos se interessem e se envolvam com esta temática, para podermos criar equipes interdisciplinares mais completas e oferecermos um acompanhamento mais integral às gestantes.(AU)

From the knowledge of the physiological and psychological changes, the time of biographical crisis and the consequences that pregnant woman's mental health have in fetal development, we can realize the importance of counseling in this period of woman's life. This study addresses the concepts of pregnancy and what happens to pregnant women from the perspective of anthroposophy, in order to provide additional information for the reflection of a more comprehensive psychological practice in monitoring pregnant women. The methodology used was the bibliography available survey about pregnancy from the point of view of anthroposophy and traditional approaches of psychology, in Portuguese and English. The literature on the emotional process of the mother during pregnancy is more focused on complications than in the natural process that occurs during this period. Publications related to physiological pregnancy are rare, mostly found in books. The literature related to anthroposophy is rather scarce. We found no article on the subject in English or Portuguese. However, it has been given indications in this subject in books. Anthroposophy aims to extend the knowledge obtained by the conventional scientific method, seeking the understanding of the symptoms from the phenomenological observation. The traditional literature is quite rich in phenomenological observation of what happens to pregnant, if we exclude the interpretation of the changes. It is very important that more psychologists get interested and involved with this issue, in order to create more complete interdisciplinary teams and offer a more comprehensive care to pregnant women.(AU)

Quadrimembração: as quatro organizações que constituem o ser humano de acordo com a antroposofia / Fourfoldness: the four organizations that constitute the human being according to anthroposophy

A antroposofia fundamenta sua visão do ser humano em alguns conceitos básicos. Um deles é a quadrimembração, ou constituição quádrupla, composta pela organização física (ou corpo físico), organização vital (ou corpo etérico), organização anímica (ou corpo astral) e finalmente organização do eu (ou espírito). A doutrina dos quatro elementos, de épocas pré-cristãs, correlaciona cada um deles às organizações citadas, respectivamente: terra, água, ar e fogo. A organização física é o que o ser humano tem em comum com o reino mineral. Sua dimensão é o espaço, e o órgão-terra, o pulmão. A organização vital, aquilo que temos em comum com o reino vegetal, determina as forças de crescimento, anabolismo e os sete processos vitais. Sua dimensão é o tempo e o órgão-água, o fígado. A organização anímica, que os animais também possuem, é o que determina a vida de relação, os instintos, as dualidades simpatia/antipatia, prazer/dor, as forças de contenção do crescimento (catabolismo). O órgão-ar é o rim. A organização do eu é exclusiva dos seres humanos e determina aquilo que é essencialmente humano: andar ereto, falar e pensar. Através dessas habilidades as pessoas têm chance de desenvolverem autoconsciência, autorreflexão e a possibilidade de modelar seu próprio destino individual.(AU)

Anthroposophy bases its view of human beings in some basic concepts. One of them is fourfoldness, or quadruple constitution, composed by the physical organization (or physical body), vital organization (or life body, or etheric body), soul organization (or astral body) and finally the ego organization (or spirit). The doctrine of the four elements from pre-Christian times correlates each element with the aforementioned organizations, respectively: earth, water, air and fire. The physical body, as physicalmaterial structure, held in common with the mineral kingdom. Its dimension is the space, and the organ-earth is the lung. The vital organization, what we have in common with the plant kingdom, determines the growth forces, anabolism and the seven life processes. Its dimension is the time and the organ-water is the liver. The soul organization, which animals also have, represents the growth containment forces (catabolism) and determines the relationships, the instincts, the dualities: sympathy-antipathy, pleasure-pain. The organ-air is the kidney. Finally, the ego organization, only found in human beings, determines what is essentially human: the abilities to walk upright, talk and think. Through these skills people have the chance to develop self-awareness, self-reflection and the possibility to change their own individual destiny.(AU)

Plumbum mellitum / Plumbum mellitum

A elaboração do Plumbum mellitum por Rudolf Steiner e Ita Wegman evidencia um princípio terapêutico essencial da medicina ampliada pela ciência espiritual: a busca das forças curativas e restituidoras de vida e saúde nos processos da natureza e do Universo. Este medicamento é composto por chumbo, mel e açúcar, preparados por um complexo processo farmacêutico, realizado pelo Laboratório Weleda AG. Tem indicação principal nos processos de esclerose. Fisiologicamente, a organização do eu provoca desgaste no organismo para o desenvolvimento da consciência. Na esclerose, a atuação da organização do eu torna-se muito fraca, e como ela mesma não consegue promover um desgaste suficiente, o desgaste é realizado pelo corpo astral. O Plumbum mellitum age restaurando esse equilíbrio entre o corpo astral e a organização do eu. O mel transfere o efeito catabólico do corpo astral, induzindo a organização do eu a exercer o necessário domínio do processo. Já o açúcar atua diretamente na organização do eu, fortalecendo-a em si mesma e promovendo o cumprimento de suas tarefas. Consequentemente, esse medicamento propicia que o chumbo exerça um efeito de desgaste a partir da organização do eu, e não do corpo astral. Desta forma, retira do corpo astral a relativa autonomia apresentada na esclerose. (AU)

The elaboration of Plumbum mellitum by Rudolf Steiner and Ita Wegman shows an essential therapeutic principle of medicine extended by the spiritual science: the search of healing and restorative forces in the processes of the nature and the Universe. This medicine is composed of lead, honey and sugar, prepared through a complex pharmaceutical process, which is performed by the Laboratory Weleda AG. Sclerosis is its main indication. Physiologically, the ego-organization consumes vitality for the development of consciousness. In sclerosis, the acting of ego-organization becomes very weak and it cannot promote a sufficient consumption. So, this action is performed by the astral body. Plumbum mellitum acts restoring the balance between the astral body and ego-organization. Honey transfers the catabolic effect of the astral body, inducing the ego-organization to exercise the necessary process control. Sugar acts directly in the ego-organization, strengthening it in itself and promoting the fulfillment of its tasks. Consequently, with this medicine, the lead exerts a consumption effect from the ego-organization, rather than the astral body. In this way, it removes the relative autonomy of the astral body presented in sclerosis.(AU)

Impact of lifestyle on the gut microbiota of healthy infants and their mothers­the ALADDIN birth cohort.

An anthroposophic lifestyle, which has been associated with reduced allergy risk in children, has several characteristics that could influence gut microbiota. This study aimed to investigate the impact of anthroposophic lifestyle as well as specific early life exposures on the gut microbiota. In total, 665 stool samples from 128 mother-infant pairs from the ALADDIN birth cohort study were included. Samples collected from infants at ages 6 days, 3 weeks, 2 months and 6 months, and from their mothers before and after delivery, respectively, were analyzed using 454-pyrosequencing. Information regarding lifestyle exposures was collected prospectively through interviews and questionnaires. Six-month-old infants in anthroposophic families had a significantly higher abundance of Bifidobacterium and lower abundances of Bacteroides and Veillonella. Caesarean section and breastfeeding had a significant impact on the microbiota: caesarean section was primarily associated with delayed colonization of Bifidobacterium and Bacteroides, whereas breastfed children had a higher relative abundance of Bifidobacterium and a lower abundance of Clostridiales. However, despite large differences in lifestyle exposures, we determined no significant differences in the gut microbiota between the anthroposophic and non-anthroposophic mothers or their infants' before 6 months of age.

Contribuições da medicina antroposofica a integralidade na educação medica: uma aproximação hermenêutica / Contribuciones de la medicina antroposofica a la integralidad en la educación medica: una aproximación hermeneuticaaa / Contributions of anthroposophic medicine to integrality in medical education: ma hermeneutic approach

O objetivo deste trabalho é apontar possíveis contribuições da obra do fundador da medicina antroposófica, Rudolf Steiner, à integralidade na educação médica. Trata-se de um estudo hermenêutico, como apontado por Gadamer, dos cursos e das palestras dados por Steiner sobre medicina. São apresentadas quatro proposições, síntese do seu pensamento: (1) uma crítica ao modelo de ciência materialista que pode ser ampliada a partir de uma fenomenologia goetheana; (2) a trimembração e quadrimembração antroposóficas como chaves interpretativas do processo saúde-adoecimento; (3) a integração entre ser humano e natureza como fundamento de pesquisa de novos tratamentos; e (4) o vínculo entre desenvolvimento moral e formação técnica-científica na educação médica. Os limites e as potencialidades destas proposições são analisados na perspectiva da viabilidade de uma pluralidade epistemológica nos conhecimentos e práticas em medicina.

El objetivo de este trabajo es señalar posibles contribuciones de la obra del fundador de la medicina antroposófica, Rudolf Steiner, a la integralidad en la educación médica. Se trata de un estudio hermenéutico, conforme señalado por Gadamer, de los cursos y conferencias dictados por Steiner sobre medicina. Se presentan cuatro propuestas síntesis de su pensamiento: (1) una crítica al modelo de ciencia materialista que se puede ampliar a partir de una fenomenología goetheana; (2) la trimembración y cuadrimembración antroposóficas como claves interpretativas del proceso salud-enfermedad (3) la integración entre ser humano y naturaleza como fundamento de investigación de nuevos tratamientos; y (4) el vínculo entre desarrollo moral y formación técnico-científica en la educación médica. Los límites y potencialidades de estas propuestas se analizan bajo la perspectiva de la viabilidad de una pluralidad epistemológica en los conocimientos y prácticas en medicina.

The aim of this study was to identify possible contributions from the work of the founder of anthroposophic medicine, Rudolf Steiner, to integrality in medical education. This was a hermeneutic study along the lines indicated by Gadamer, on the courses and lectures on medicine given by Steiner. Four main summarized proposals regarding his thinking are presented: (1) a critique of the model of materialistic science that can be expanded through Goethean phenomenology; (2) anthroposophic threefolding and fourfolding as interpretative keys for the health-illness process; (3) integration between human beings and nature as the foundation of research on new treatments; and (4) the link between moral development and scientific and technical training in medical education. The limits and potentials of these proposals were analyzed from the perspective of the viability of epistemological plurality within medical knowledge and practices.

O cuidado ampliado pela antroposofia: um estudo de caso sobre a prática da enfermagem antroposófica / Care extended by Anthroposophy: a case study on the practice of anthroposophical nursing

A presente pesquisa tem como objetivos descrever o exercício da Enfermagem Antroposófica a partir de sua prática e vivência laboral em uma clínica antroposófica; identificar os tratamentos adotados no cuidado em Enfermagem Antroposófica; analisar, à luz da Antroposofia, os fundamentos do cuidado exercido pela enfermagem no ser humano. A Antroposofia significa sabedoria do ser humano com um duplo sentido: além da sabedoria terrena, também aquela que pode ser adquirida investigando-se outro mundo, o espiritual. Engloba o ser atuante, o tempo todo presente, que lida com sua dimensão material e espiritual. Nessa visão, o homem possui três faces da natureza, as quais Steiner (2004), fundador desta concepção, denominou de corpo, alma e espírito. Justifica-se a realização desse trabalho a incipiência de estudos sobre a Enfermagem Antroposófica no Brasil, diferentemente de outros países, há somente duas teses de doutorado publicadas sobre o assunto. Neste estudo foi utilizada uma pesquisa qualitativa, cujo método foi o estudo de caso e a observação participante como técnica de coleta de dados. Os sujeitos do estudo foram os membros da equipe de enfermagem de uma clínica médica antroposófica num município da Zona da Mata Mineira. Os resultados evidenciaram que as terapias utilizadas foram o banho intestinal, as compressas, as massagens (deslizamento e massagem com mel), banhos de imersão de óleo, repouso terapêutico, terapia com viscum album, nos casos de pacientes oncológicos. O cuidado antroposófico foi fundamentado nos doze sentidos, nos sete processos vitais, nos doze gestos do cuidado, na trimembração e na quadrimembração. O enfermeiro ao assistir considera o ser humano em sua singularidade, na sua relação com a natureza e com o cosmo. Constatamos que a cura envolve a existência de forças sutis e a enfermagem deve estimulá-la através de um cuidado individualizado.(AU)

This study aims to describe the practice of Anthroposophic Nursing from their practice and the experience of working in a anthroposophical clinic; to identify treatments used in Anthroposophical nursing care; examine, in the light of anthroposophy, the fundamentals of nursing care exercised by humans. Anthroposophy means wisdom of the human being, with a double meaning: beyond earthly wisdom, also one that can be gained by investigating other world, the spiritual. Includes active being; all time present which handles material and spiritual dimension. In this view, man has three faces of nature, which Steiner (2004), founder of this design, called body, soul and spirit. It is justified to carry out this work the paucity of studies on the Anthroposophical Nursing in Brazil, unlike other countries, there are only two doctoral dissertations published on the subject. This study used a qualitative research method which was the case study and participant observation as a technique for data collection. The study subjects were members of the nursing staff of an anthroposophical medical clinic in a town in Zona da Mata Mineira. The results showed that the therapies used were intestinal bath, compresses, massage (sliding and massage with honey), oil immersion baths, relaxing terapeutic, therapy with Viscum album, in cases of cancer patients. The anthroposophic care was substanciated in the twelve senses, in the seven life processes, in the twelve gestures of care, and in threefolding and fourfolding. The nurse watching considers the human being in its uniqueness, in its relationship with nature and the cosmos. We note that healing involves the existence of subtle forces and nursing must stimulate it through individualized care.(AU)