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1.
Rev. bras. med. fam. comunidade ; 14(41): e1781, 02/2019. ilus
Artigo em Português | LILACS, Coleciona SUS | ID: biblio-981954

RESUMO

A Medicina tem convocado as pessoas a realizarem cada vez mais ações preventivas, desde medidas de pressão arterial até a aplicação de novas vacinas; entretanto, médicas e médicos de família e comunidade têm identificado riscos e limitações das ações preventivas, mostrando que nem todas elas são ética ou cientificamente justificáveis. Esse é o escopo da prevenção quaternária, que visa poupar as pessoas de sobremedicalização e procedimentos desnecessários. Vivendo em uma sociedade que prima pela alta tecnologia, onde o terror virou negócio e o autocuidado, uma obsessão, pode ser muito difícil desaconselhar a realização de algum exame ou desprescrever alguma medicação; porém, é exatamente nesse contexto que a prevenção quaternária é profundamente necessária, e a dificuldade de sua prática exige articular outros saberes e recursos além do nível de evidência ou do grau de recomendação de uma ou outra ação. As crenças em saúde são objeto de um cuidado centrado na pessoa, e muitas delas são inspiradas ou traduzidas por ditados populares. Nesse ensaio, discuto o excesso de intervenções e a prevenção quaternária a partir de alguns deles. Analisando frases como "é melhor prevenir do que remediar", apresento os aforismos como ferramentas de compreensão da prevenção quaternária, podendo ser usados por profissionais e docentes para discutir essa prática contra-hegemônica com pacientes e estudantes. Ao articular os saberes popular e profissional, o texto contribui à competência cultural da Atenção Primária à Saúde e ajuda a produzir encontros clínicos mais harmoniosos e a promover um cuidado menos invasivo, medicalizador e danoso.


Medicine has been calling on people to carry out more and more preventive actions, from blood pressure measurements to the application of new vaccines; however, family physicians have been identifying risks and limitations of preventive actions, showing that not all of them are ethically or scientifically justifiable. This is the scope of quaternary prevention, which aims to protect people from over-medicalization and unnecessary procedures. Living in a society that excels in high technology, where terror has turned into business and self-care, an obsession, it can be very difficult to discourage some exam or to unprescribe some medication; but it is precisely in this context that quaternary prevention is deeply necessary, and the difficulty of its practice requires articulating other knowledge and resources beyond the level of evidence or the degree of recommendation of one or another action. Health beliefs are object of person-centered care, and many of them are inspired or translated by popular sayings. In this essay, I discuss the excess of interventions and quaternary prevention from some of them. Analyzing phrases such as "better safe than sorry", I present aphorisms as tools for understanding quaternary prevention, which can be used by professionals and teachers to discuss this counter-hegemonic practice with patients and students. By articulating popular and professional knowledge, the text contributes to the cultural competence of Primary Health Care and helps to produce more harmonious clinical encounters and to promote less invasive, medicalizing and harmful care.


La Medicina ha convocado a las personas a realizar cada vez más acciones preventivas, desde medidas de presión arterial hasta la aplicación de nuevas vacunas; sin embargo, médicas y médicos de familia y comunidad han identificado riesgos y limitaciones de las acciones preventivas, mostrando que no todas ellas son ética o científicamente justificables. Este es el alcance de la prevención cuaternaria, que intenta ahorrar a las personas de sobremedicalización y procedimientos innecesarios. En una sociedad que prima por la alta tecnología, donde el terror se volvió negocio y el autocuidado, una obsesión, puede ser muy difícil desaconsejarse la realización de algún examen o desprescribir alguna medicación, pero es precisamente en ese contexto que la prevención cuaternaria es profundamente necesaria, y la dificultad de su práctica exige articular otros saberes y recursos más allá del nivel de evidencia o del grado de recomendación de cada acción. Muchas creencias en salud son inspiradas o traducidas por dichos populares; en este ensayo, discuto el exceso de intervenciones y la prevención cuaternaria a partir de algunos de ellos. Analizando frases como "más vale prevenir que curar", presento los aforismos como herramientas de comprensión de la prevención cuaternaria, pudiendo ser usados por profesionales y docentes para discutir esa práctica contra-hegemónica con pacientes y estudiantes. Al articular los saberes popular y profesional, el texto contribuye a la competencia cultural de la Atención Primaria a la Salud y ayuda a producir encuentros clínicos más armoniosos y a promover un cuidado menos invasivo, medicalizador y dañino.


Assuntos
Aforismos e Provérbios como Assunto , Competência Cultural , Medicina de Família e Comunidade , Medicalização , Prevenção Quaternária
2.
Brain Behav ; 7(10): e00829, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29075575

RESUMO

INTRODUCTION: The Korean language is based on a syntactic system that is different from other languages. This study investigated the processing area of the Korean proverb in comparison with the literal sentence using functional magnetic resonance imaging. In addition, the effect of opacity and transparency of proverbs on the activation pattern, when familiarity is set to the same condition, was also examined. METHODS: The experimental stimuli included 36 proverbs and 18 literal sentences. A cohort of 15 healthy participants silently read each sentence for 6 s. A total of 18 opaque proverbs, 18 transparent proverbs, and 18 literal sentences were presented pseudo-randomly in one of three predesigned sequences. RESULTS: Compared with the literal sentences, a significant activation pattern was observed in the left hemisphere, including the left inferior frontal gyrus, in association with the proverbs. Compared with the transparent proverbs, opaque proverbs elicited more activation in the right supramarginal gyrus and precuneus. CONCLUSIONS: Our study confirmed that the left inferior frontal gyrus mediates the retrieval and/or selection of semantic knowledge in the Korean language. The present findings indicated that the right precuneus and the right supramarginal gyrus may be involved in abstract language processing.


Assuntos
Imagem por Ressonância Magnética/métodos , Córtex Pré-Frontal/diagnóstico por imagem , Semântica , Adulto , Aforismos e Provérbios como Assunto , Mapeamento Encefálico/métodos , Feminino , Humanos , Linguagem , Testes de Linguagem , Masculino , Córtex Pré-Frontal/fisiologia , Leitura , República da Coreia
3.
Am J Speech Lang Pathol ; 26(3): 908-920, 2017 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-28715847

RESUMO

Purpose: The goal of the study was to create a language sampling task appropriate for adolescents and to contribute normative data from speakers with typical language development. Method: Thirty adolescents (mean age = 14 years, 1 month) participated in an interview that involved the retelling and interpretation of 4 Greek fables. Each speaker's performance on the task was audio-recorded, transcribed verbatim, and entered into the Systematic Analysis of Language Transcripts computer program (Miller & Iglesias, 2015). Samples were analyzed statistically for language productivity and syntactic complexity. In addition, each participant's perspective on the moral messages of the fables was examined informally. Results: The Fables task was effective in prompting adolescents to use complex language and in encouraging them to express their opinions about the moral messages. Although boys and girls did not differ in their performance on the task, some fables were more effective than others at eliciting spoken language and complex syntax. Moreover, the adolescents tended to agree with the moral messages of the fables and appeared to find them relevant to their lives. Conclusion: The Fables task has potential for clinical use with adolescents. Research is necessary to expand the normative database to include larger and more diverse groups of adolescents.


Assuntos
Desenvolvimento do Adolescente , Aforismos e Provérbios como Assunto , Bases de Dados Factuais , Desenvolvimento da Linguagem , Testes de Linguagem , Patologia da Fala e Linguagem/métodos , Adolescente , Fatores Etários , Compreensão , Feminino , Humanos , Masculino , Princípios Morais , Valor Preditivo dos Testes , Dados Preliminares , Valores de Referência , Semântica , Fatores Sexuais , Medida da Produção da Fala , Comportamento Verbal
4.
São Paulo; Grupo de Estudos Homeopáticos de São Paulo "Benoit Mure"; 2 ed; 2017. 104 p.
Monografia em Português | HomeoIndex - Homeopatia | ID: hom-12077
5.
São Paulo; Grupo de Estudos Homeopáticos de São Paulo "Benoit Mure"; 2 ed; 2017. 104 p.
Monografia em Português | LILACS, HomeoIndex - Homeopatia | ID: biblio-908915

RESUMO

Desde os primórdios da Homeopatia há uma vontade, ora explícita ora velada, de aproximar, ou até traduzir a linguagem e o conhecimento do vitalismo do século XVIII / XIX e da Homeopatia concebida em sua integridade por Samuel Hahnemann, para uma linguagem mais atual. Quando o médico paulistano George Washington Galvão Nogueira conheceu a Homeopatia pelas mãos enérgicas e incansáveis do Dr. David Castro, o grande médico homeopata de projeção internacional , sentiu essa mesma necessidade à medida em que penetrava com vigor e rigor no conhecimento da Arte de Curar. Não lhe foi difícil nem estranho aproximar e traduzir grande parte da linguagem vitalista de Hahnemann numa linguagem contemporânea, pois fora aluno pródigo, do grande patologista paulista Walter E. Maffei quando freqüentou os bancos de Faculdade de Medicina da PUC-Sorocaba. Os anos foram se passando e à medida que os estudos de Homeopatia se aprofundaram e o retorno ao convívio estimulante com o Prof. Maffei, em encontros cada vez mais freqüentes, o Dr. Galvão passou a compreender na intimidade a Patologia como era ensinada por Maffei, e este por sua vez, contaminado, passou a citar e defender a Homeopatia em aulas e palestras, e até mesmo em situações de confronto com as autoridades instituídas, homeopáticas e alopáticas. Em suas palestras sobre os mecanismos de defesa, o Prof. Maffei referia-se à Homeopatia como forma terapêutica correta a estimular adequadamente a mudança de órgão de choque no processo de cura. Aqui o conceito de moléstia passa a ser o elemento central na ligação dos dois pensamentos. Moléstia, o conjunto de modificações orgânico-funcionais-mentais, de caráter evolutivo, resultante da reação do organismo a uma agressão e representa a sua tentativa de cura. Com essa definição, Maffei expressa sua visão vitalista do Homem, mostrando que os indivíduos adoecem no seu todo, visão esta alcançada através de mais de 120.000 necrópsias feitas ao longo de sua profícua carreira de patologista. Em suas aulas a figura histórica mais citada e reverenciada por Maffei era Hipócrates. A ele se referia dizendo que não fora o maior médico de todos os tempos, mas o "único médico!" E humildemente lamentava-se de não saber de memória todos os Aforismos do Médico de Cós, uma vez que ali estava toda a medicina. Assim, já na maturidade, o Dr. Galvão se debruçando sobre a obra de Maffei e os escritos de Hipócrates, começa a correlacionar os ensinamentos do primeiro com os do segundo, fazendo ainda uma ligação dessas idéias com a doutrina médica homeopática herdada de Hahnemann. (AU)


Assuntos
Aforismos e Provérbios como Assunto
6.
Medizinhist J ; 52(1): 56-81, 2017.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-30549772

RESUMO

How was medicine-taught and studied in the early modern period? How did teachers and students relate to the tradition of medical texts? Historians have addressed these questions mainly through research on printed sources. This article uses student notes as a window on medical training in action in Montpellier. The student was Franqois Boissier de Sauvages; the teacher, Jacques Lazerme. The notes record Lazerme lecturing in the form of commentary on the first 14 Hippocratic Aphorisms and setting quite different emphases from those of earlier commentators: professional ethics and how to handle a case (on aphorism 1), moderation in. bloodletting (on 2), disease classification (on 4-6), similarity of symptoms among different diseases (on 7), treating fever (on 8-io), periodicity of disease (on ii), weather and disease (on iz), "calor innatus" and oscillations in the circulation of the blood, with reference to Isaac Newton (on 14). These commentaries allow a fresh look at medical training between theory and practice.


Assuntos
Aforismos e Provérbios como Assunto/história , Educação Médica/história , Avaliação de Sintomas/história , França , Grécia , História do Século XVIII , História Antiga
8.
Gerontologist ; 56(6): 1007-1022, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-26273027

RESUMO

PURPOSE OF THE STUDY: Although much research has established the nature of attitudes and stereotypes toward older adults, there are conflicting explanations for the root cause of ageism, including the sociocultural view and interpersonal views, that age bias against older adults is uniquely a product of modernity and occurs through social interactions, and the evolutionary view and intraindividual views, that age bias against older adults is rooted in our naturally occurring and individually held fear of death. We make initial investigations into resolving this conflict, by analyzing literature from a society predating the Industrial Revolution, the society of Ottoman Turks. DESIGN AND METHODS: Using Grounded Theory, we analyzed 1,555 Turkish fairy tales of the most well-known older adult in Turkish folklore, Nasreddin Hoca, for stereotype themes of older adults. Using the same method, we then analyzed 22,000+ Turkish sayings and proverbs for the same themes. RESULTS: Results indicated older adults to be viewed both positively and negatively. Positive stereotypes included wisdom, warmth, deserving of respect, and retirement. Negative stereotypes included incompetence, inadaptability, and frailty/nearing of death. Older females were viewed more negatively relative to older males. IMPLICATIONS: Results indicated views of older adults to parallel those found in contemporary research. Results have implications for the design of interventions to reduce ageism and on the cross-cultural generalizability of age-based stereotypes.


Assuntos
Ageismo , Folclore , Estereotipagem , Aforismos e Provérbios como Assunto , Teoria Fundamentada , Humanos , Turquia
11.
Soins Gerontol ; (113): 1, 2015 May-Jun.
Artigo em Francês | MEDLINE | ID: mdl-26144947
12.
Artigo em Inglês | MEDLINE | ID: mdl-25313441

RESUMO

The purpose of this study was to examine proverb interpretation performance and functional independence in older adults. From the limited literature on proverb interpretation in aging and its conceptualization as an executive function, it was hypothesized that proverb interpretation would be related to functional independence similar to other executive functions. Tests of proverb interpretation, additional executive functions, and functional ability were administered to nondemented older adults. Results showed that proverb interpretation accounted for a significant amount of unique variance of functional ability scores. This supports including a measure of proverb interpretation to the assessment of older adults.


Assuntos
Envelhecimento/psicologia , Aforismos e Provérbios como Assunto , Função Executiva , Vida Independente/psicologia , Idoso , Idoso de 80 Anos ou mais , Formação de Conceito , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Semântica
13.
J Psycholinguist Res ; 44(4): 469-83, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24756919

RESUMO

Schizophrenia has been suggested to involve linguistic pragmatic deficits. In this study, two aspects of pragmatic ability were assessed; comprehension and production. Drawing on relevance theory and Gricean implicatures to assess shared attention and interpretation in a linguistic context, discourse samples and proverb interpretation were transcribed from recorded interviews with patients with schizophrenia and control subjects. The productive aspect of implicatures was assessed by quantifying the use of 'connectors' in discourse. Receptive aspects were assessed by scoring interpretations of four common proverbs. Statistically significant effects were found: patients with schizophrenia used connectors less than controls as well as performing worse in proverb comprehension. Positive correlations between connectors and proverb interpretation in all subjects suggested an underlying pragmatic root for both productive and receptive aspects. The relative number of connectors (as a percentage of words used) provided a better index of pragmatic ability than total number because total output appeared to be influenced by additional factors such as IQ. Deficits were found in the use of connectors and in proverb interpretation even when controlling for verbal IQ, suggesting that pragmatic aspects of language are particularly vulnerable in schizophrenia compared with other verbal abilities.


Assuntos
Aforismos e Provérbios como Assunto , Compreensão/fisiologia , Esquizofrenia/fisiopatologia , Distúrbios da Fala/fisiopatologia , Fala/fisiologia , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Esquizofrenia/complicações , Transtorno de Comunicação Social/etiologia , Transtorno de Comunicação Social/fisiopatologia , Distúrbios da Fala/etiologia , Adulto Jovem
14.
Dan Medicinhist Arbog ; Suppl: 7-122, 2015.
Artigo em Dinamarquês | MEDLINE | ID: mdl-27078984

RESUMO

The two Hippocratic texts, Aphorisms and Epidemics III, have not been translated into Danish previously. The Aphorisms are 412 short, pithy statements, mostly on the prognosis in relation to certain symptoms in the course of the diseases, very often febrile. The Aphorisms begin with the famous words: "Life is short, the Art long, opportunity fleeting, experiment treacherous, judgment difficult." (Transl. W H S Jones [22]). Epidemics III consists of 28 case histories, again mostly of febrile patients, but also of observations on the connection of the seasons with general morbidity and mortality. The author describes an epidemic, which in some respects resembles Thucydides' report on the plague in Athens in 430 BC. It is suggested, that observations as have been recorded in the seven Hippocratic texts on epidemic diseases are the material on which prognostic statements as those collected in the Aphorisms are founded.


Assuntos
Aforismos e Provérbios como Assunto , Epidemias/história , Manuscritos Médicos como Assunto , Traduções , Dinamarca , Mundo Grego , História Antiga
15.
Northwest Dent ; 94(6): 11, 2015 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26775534
16.
BMJ ; 349: g7390, 2014 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-25512328

RESUMO

OBJECTIVE: To determine if one of Hippocrates' aphorisms, identifying good cognition and good appetite as two prognostic factors, predicts death in community living older adults in the modern era. DESIGN: Secondary analysis of an existing population based cohort study. SETTING: Manitoba Study of Health and Aging. PARTICIPANTS: 1751 community living adults aged more than 65 enrolled in the Manitoba Study of Health and Aging in 1991 and followed over five years. MAIN OUTCOME MEASURE: Time to death. METHODS: We recreated the hippocratic prognosticator using an item that measures appetite drawn from the Center for Epidemiologic Studies-depression subscale, and the mini-mental state examination, with a score of >25 being considered as normal. People with normal cognition and appetite were compared with those with either poor cognition or poor appetite. We constructed Cox regression models, adjusted for age, sex, education, and functional status. RESULTS: The prognostic aphorism predicted death, with an unadjusted hazard ratio of 2.37 (95% confidence interval 1.93 to 2.88) and a hazard ratio of 1.71 (1.37 to 2.12) adjusted for age, sex, and education. Both poor appetite and poor cognition predicted death. The sensitivity and specificity were not, however, sufficient for the measure to be used alone. CONCLUSION: An aphorism devised by Hippocrates millennia ago can predict death in the modern era.


Assuntos
Transtornos Cognitivos/mortalidade , Transtornos da Alimentação e da Ingestão de Alimentos/mortalidade , Avaliação Geriátrica/métodos , Idoso , Aforismos e Provérbios como Assunto , Apetite/fisiologia , Cognição/fisiologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Manitoba/epidemiologia , Prognóstico , Medição de Risco
18.
Obes Rev ; 15(10): 851-2, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25213703
19.
J Pediatr Nurs ; 29(6): 547-54, 2014 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25150619

RESUMO

The study investigated the effectiveness of a child's fable on the cognition of preschoolers when used to address childhood obesity. A single group, pretest/posttest design was used with 57 preschool children. Analysis of variance compared pre-existing differences between the four classes with respect to pre-test scores. A repeated measures t-test analyzed changes in scores as a result of the intervention. Following the fable intervention, students showed a significant difference (0.5) between their pre- and post-test scores, indicating this method to an effective learning strategy in this setting and age population.


Assuntos
Aforismos e Provérbios como Assunto , Cognição , Educação em Saúde/métodos , Obesidade Pediátrica/prevenção & controle , Pré-Escolar , Avaliação Educacional , Feminino , Humanos , Masculino , Inquéritos e Questionários
20.
Neurophysiol Clin ; 44(2): 189-201, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24930941

RESUMO

CONTEXT: Using natural connected speech, the aim of the present study was to examine the semantic congruity effect (i.e. the difference between semantically incongruous and congruous words) in sentence contexts that generate high or moderate final word expectancies. METHODS: We used sentences with two levels of word expectancy in the auditory modality: familiar proverbs (that generate high final word expectancy), and unfamiliar sentences (that generate only moderate final word expectancy). RESULTS: Results revealed an early congruity effect (0-200 ms) that developed across all scalp sites for familiar proverbs but not for unfamiliar sentences. By contrast, typical centro-parietal N400 and Late Positivity Component congruity effects developed later (200-500 ms and 600-900 ms ranges) for both familiar proverbs and unfamiliar sentences. DISCUSSION: We argue that the early congruity effect for proverbs comprises both a Phonological Mismatch Negativity, reflecting the processing of the acoustic/phonological mismatch between the expected (congruous) and unexpected (incongruous) sentence completions and a typical N400 semantic congruity effect with an unusual short latency because final words can be predicted from the unusually high contextual constraints of familiar proverbs. These results are considered in the light of current views of anticipation and prediction processes in sentence contexts.


Assuntos
Encéfalo/fisiologia , Potenciais Evocados Auditivos , Semântica , Percepção da Fala/fisiologia , Adulto , Aforismos e Provérbios como Assunto , Feminino , Humanos , Masculino , Adulto Jovem
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