Complementary and Integrative Medicine (CIM)

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Cad. Saúde Pública  vol.22 número10

Cad. Saúde Pública vol.22 número10

The health field in Brazil entered the 1980s with a confusion of meanings in Complemen- tary Medicine. At times it had an epistemologi- cal dimension, and was therefore a group of categories and concepts, and at other times it had the dimension of a concept referring to a group of practices. When this imprecision was submitted to sociological observation, it was possible to perceive two perspectives: (1) Com- plementary Medicine, viewed as a modern syn- onym of Alternative Medicine in which the re- nomination of previously excluded practices would be fundamental for its incorporation in- to the official health services and (2) the main- tenance of the original meaning of complemen- tary logic that is being replaced by the concept of Integrative Medicine 47,48 . In Brazil, the CAM concept shows yet another confounding ele- ment. In Portuguese, in medical practice, or- dering an ancillary diagnostic test is referred to as a “complementary tests order”. Thus, when one speaks of “complementary medicine”, many health professionals interpret the term as part of the biomedical model. This may explain why some professionals working with CAM practices now refer to themselves as Integrative Medi- cine professionals.
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Use of Complementary and Alternative Medicine in primary healthcare in Florianópolis, Santa Catarina, Brazil: user perception

Use of Complementary and Alternative Medicine in primary healthcare in Florianópolis, Santa Catarina, Brazil: user perception

Abstract This is a partial analysis of the outcome of a survey looking at user perception of the in- stitutional use of Complementary and Alternative Medicine (CAM) in Florianópolis healthcare cen- ters. Structured interviews were applied to users treated with CAM in the locations offering this option most often, using data-based theory as a theoretical-methodological reference. For the most part, the use of CAM was proposed by basic health professionals (the operators of biomedical care), initially as a preferred alternative to biomedicine. Interviewees preferred CAM, associating it to few- er side-effects. Users mentioned enhanced dialog with professionals to negotiate treatment forms. The hypothesis emerged that CAM could be the initial treatment option in a large number of cas- es, saving conventional treatment for subsequent use if necessary, or in some cases as the single or complementary treatment. This enables drafting an expanded flow using CAMs in primary health- care. New studies and institutional experience are required to investigate this hypothesis, expanding the use of CAM in an ecology of institutional care. Key words Integrative medicine, Complementa- ry therapies, Primary healthcare
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Stellenwert von Präventiv- und Alimentärmedizin in der Urologie - Schwerpunkt: Das Prostatakarzinom

Stellenwert von Präventiv- und Alimentärmedizin in der Urologie - Schwerpunkt: Das Prostatakarzinom

Die Alternativ- und Komplementär- medizin wird im englischen Sprachge- brauch mit CAM (Complementary and Alternative Medicine) abgekürzt und folgendermaßen definiert: „Complemen- tary therapies are used as adjuncts to mainstream cancer care while alternati- ve therapies are promoted for use instead of mainstream treatment.“ Eine Kombi- nation aus CAM und Schulmedizin ist die sogenannte Integrative oder Inte- grated Medicine, für die es bereits eine hohe Evidenz in den Bereichen Arznei- mittelsicherheit und Effektivität gibt. Nach einer Erhebung aus dem Jahr 1996, die im Lancet publiziert wurde, nützen eher ältere Personen, Frauen und Sport- ler den Benefit der CAM. Was die Pro- statakarzinompatienten betrifft, verwen- deten laut Datamonitor aus dem Jahr 2002 mindestens 80 % aller Krebspa- tienten mindestens einmal eine kom- plementärmedizinische Methode. Nach einer Studie von Madersbacher et al. nützt in Österreich etwa die Hälfte der Prostatakarzinompatienten das CAM- Angebot, wobei unter anderem fettarme Diät, Misteltherapie, Vitamin E, Multi- vitaminpräparate, Homöopathie oder der Konsum von Tomaten genannt wur- den. Da immer mehr Menschen auf die CAM zurückgreifen oder sich bezüglich einer CAM einen medizinischen Rat ho- len, ist es notwendig, dass auch diese Therapieformen den strengen Maßstä- ben der Evidenzbasierten Medizin (EBM) gerecht werden.
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Rev. Saúde Pública  vol.45 número2

Rev. Saúde Pública vol.45 número2

RESULTS: A total of 17 health centers provided complementary and integrative therapies; 12.4% of professionals had a specialization in homeopathy or acupuncture; 43.5% of doctors were specialists in family and community medicine/family health. Of all participants, 88.7% did not know the national directives for this area, although 81.4% agreed with their inclusion in the Sistema Único de Saúde (Unifi ed Health System). The majority (59.9%) showed an interest in qualifi cations and all agreed that these therapies should be approached during the graduate course. Agreement with the inclusion of such therapies was signifi cantly associated with the fact of being a nurse (p = 0.027) and using homeopathy for oneself (p = 0.019). Interest in complementary therapies was associated with the use of homeopathy for oneself (p = 0.02) and acupuncture by family members (p = 0.013).
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Organizational determinants of interprofessional collaboration in integrative health care: systematic review of qualitative studies.

Organizational determinants of interprofessional collaboration in integrative health care: systematic review of qualitative studies.

We searched four international electronic databases (MED- LINE, EMBASE, AMED, and CINAHL) from their inception until March 2011 for qualitative studies on IPC between BMD and TCAMP. The search keywords of each database are shown in Appendix S1. In addition, we performed a purposive electronic search for TCAM qualitative studies in 16 health services journals and 15 TCAM journals. For TCAM journals, we have chosen those which ranked in the top 20 within the ‘‘Integrative & Complementary Medicine’’ category of the 2009 and 2010 Journal Citation Reports. To ensure comprehensiveness, we also purpose- fully sampled TCAM and health services journals not indexed in that category, but are likely to contain related qualitative studies. The search strategies are listed in Appendix S2. To be eligible for inclusion in this review, the studies must satisfy all of the following criteria: (i) that they employed either a qualitative methodology including case study, focus group, interviews or ethnographic observation techniques, or a mixed methodology with a clear qualitative component; (ii) that they explicitly aimed at investigating how BMD and TCAMP collaborate; and (iii) that they performed original data collection from BMD, TCAMP or managers who were directly involved in providing or managing IHC services. Meanwhile, studies with one or more of the following features are excluded: (i) they were review articles; and (ii) they studied BMD, TCAMP or managers’ general views on TCAM outside the context of IHC service provision. Two reviewers (VC and PM) independently screened the titles and abstracts to assess their eligibility. Articles that were clearly incompatible with the three inclusion criteria; or found to satisfy the two exclusion criteria, were excluded at this stage. For the remaining citations, we confirmed their eligibility by examining their full texts, and judgments were made after detailed examination of the whole article. The final decision on inclusion was made by consensus adjudication between all authors.
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U-stage and EBSD technique as complementary methods

U-stage and EBSD technique as complementary methods

AN eXAmPl e O F gR AIN B O UND AR y PAT- TeR N chAR AcTeR IZATIO N Quartz aggregates, which came from banded iron formation of Quadri- látero Ferrífero region, were analyzed, considering the metamorphic gradient from west to eastern areas of the region that has been characterized for researchers (Pires 1995, Rosière 2001). The data relative to microstruc- tural features are presented through mosaics, frequency histograms and rosettes (Fig. 15). Taking into account the quartz aggregates from different metamorphic and deformational contexts, the aim is to compare the grain size distribution (Fig. 15 b, I-II), the axial ratio of the grains (Fig. 15 c, I-II), as well as their shape-preferred orientation (Fig. 15 d, I-II) and associate these data with the grain boundary geometry and its orientation pattern (Castro 2007, Castro & Lagoeiro 2008). Through the presented data, it is clear that the grains become larger and the axial ratio decreases from lowest temperature condition to higher temperature levels. As for the anal- ysis of grain boundary microstructures it is necessary to combine the U-stage and EBSD data these data will be treated separately.
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Rev. Soc. Bras. Med. Trop.  vol.44 número6

Rev. Soc. Bras. Med. Trop. vol.44 número6

hese articles were published in 1,386 scientiic journals. Eight journals contained 25% of the journal literature on American trypanosomiasis. About half of the literature was concentrated in 35 journals, while the remaining half was scatered over 1,241 journals. Moreover, in 641 journals there was only one paper on Chagas disease published. Table 1 shows a list of the 61 journals with the highest number of papers published during the years 1940-2009, as well as their impact factors for the year 2009, with the journal categories according to JCR classiication and language. Twelve of these journals were not included in the JCR because they did not have an impact factor. he other 49 journals were included in at least one of 22 subject categories. hese source journals mainly include the ields of Parasitology (n = 11), Immunology (n = 9), Tropical Medicine (n = 7), Microbiology (n = 6), General and Internal Medicine (n = 5), Public Health (n = 5), and so on.
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Coherence and correspondence in medicine

Coherence and correspondence in medicine

Traditional medical research tends to be coherence- oriented and driven by theory. The ultimate test of a theory, however, is confirmation with correspondence- based observations. When observations contradict coher- ence theory, investigators may be tempted to either dis- card the theory or question the validity of the observa- tional data. However, paying attention to the coherence- correspondence conflict and searching for the underlying causes of unexpected findings has led to some important therapeutic advances. A particularly striking example is the drug sildenafil (Viagra™). Scientists at the Pfizer pharmaceutical company initially applied a coherence ap- proach to develop a new drug for hypertension and angina based on its theoretical relaxation of smooth muscle in blood vessels. The drug development process was called “rational drug design” (Kling, 1998). The investigators then proceeded with correspondence-based clinical trials. The drug failed to lower blood pressure, but investigators had noted that subjects reported erections as a side effect. By doing further coherence-based research, the company was able to demonstrate how the drug could plausibly treat erectile dysfunction. A change in our understand- ing of the disease from being a psychological problem to a blood vessel problem was also needed for the coherence approach to succeed.
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Honey as a complementary medicine

Honey as a complementary medicine

The observed synergistic actions between honey and some antibiotics highlight the need for the adjustment of antibiotic dosage for those patients who are using honey as a natural sup- plement. Exploring the synergistic effects of honey with other bee products, or vegetable products, seems also to be another promising venue of investigation. In addition, pinpointing the honey’s chemical constituents responsible for its reported anti- viral properties is also a remarkable feature that requires further research. In addition, there is a pressing need to chemically characterize the different types of honey, particularly regarding their geographical and floral origin, to create a catalogue of beneficial compounds that are present in each honey type, allowing the end users to choose the type of honey that best fits their needs.
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BHASMA AND NANO MEDICINE

BHASMA AND NANO MEDICINE

The development of Rasashastra (7 th century AD) has revaioutionised Ayurvedic system of medicine. Many new pharmaceutical techniques are developed like Shodana, jarana & marana by which metals& minerals are converted in to very very fine, absorbable, therapeutically most effective& least or non toxic form of medicines Known as Bhasmas. Bhasma are defined as powder form of a substance obtained by Calcination 5 .

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Conceptions and practices of an integrative treatment for substance use disorders involving Amazonian medicine: traditional healers’ perspectives

Conceptions and practices of an integrative treatment for substance use disorders involving Amazonian medicine: traditional healers’ perspectives

Sample characteristics are shown in Table 2. The age of the expert practitioners ranged between 35 and 86 years, with 15% (n=2) being female. The majority of experts were born (77%, n=10) and lived (93%, n=12) in South America, but there was diversity with respect to the sample’s cultural background. All participants had recei- ved extensive training in one or several traditional systems of Amazonian medicine (e.g., Asha´ninca, Quechua-Lamas, Chazuta traditions), reporting an average of 28 years of traditional medical experience. It was not generally possible for respondents to separate the learning period from pra- ctice, since, as they explained, in Amazonian medicine the learning process occurs concurrently with and through practice. An extreme case was presented by one partici- pant who had started his career in traditional medicine at age 14, and, during the interview, at age 86, insisted he was still learning. With regard to how they had acquired their expertise in SUDs, participants mentioned as their most important source of knowledge instruction by teacher plants (n=8; see below for the concept of teacher plants), years working at Takiwasi (n=6), instruction by senior pra- ctitioners of traditional Amazonian medicine (n=2), years of clinical work in other contexts (n=1), or their personal life experience (n=1). Most participants (69%, n=9) considered themselves to be a curandero/a (general practitioner) with one or more areas of specialization within traditional medi- cine, including the self-given labels of ayahuasquero (spe- cializing in the use of medicines based on the ayahuasca plant, Banisteriopsis caapi; main alkaloids harmine, harma- line, and tetrahydroharmine), perfumero/a (specializing in the use of water-based therapies such as plant baths), huachumero/a (specializing in the use of medicines based on the huachuma plant, Echinopsis pachanoi; main alka- loid mescaline), preparador de plantas (specializing in the preparation of plant remedies), or curioso/a (general prac- titioner considered hierarchically below curandero/a). Besides their training in traditional Amazonian medicine, participants reported additional training and/or work experience in fields Table 1 Interview guidelines (condensed form)
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Nanotechnology and medicine improvement

Nanotechnology and medicine improvement

Nanotechnology has becom e an extraordinarily hopeful area in several human domains. Many scientific disciplines are developing their works in this area since the emergence of nanoscale, giving their contribution to the development of nanosciences. Many recent researches in areas as physical sciences, molecular engineering, biology, biotechnology and medicine for example are contributing for the investigation of biosystems at a nanoscale. Nanotechnology and nanobiosystems are becoming a privileged domain to reach an advanced level in the human development in many fields, as the examples of the biotechnology processes, the synthesis of new drugs and their delivery on a live body, the regenerative medicine and the new technologies in medicine (biotechnology and nanotechnology), body area networks for telem edicine (nanomedicine, nanoimaging, nanotechnological implants, in-body diagnostic systems, nanobiomedical wired devices, etc), or the application on the sustainability of the environment. Nanoscale may provide the tools to get improved conditions to investigate biosystems and to get advances with nanomaterials. These nanoscales, used in biosystems, contribute to enhance very innovative and promising results in medical area. Improvements in the telemedicine and on health are expectable with new systems operations and new nanotechniques. Many ethical problems and also legal and social implications are posed and the need for discussing this theme shows the importance of nanotechnology to the society and the consequences, both positive and negative, that the development of nanotechnology will have to mankind in the future.
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Burnout in general medicine and in intensive care medicine

Burnout in general medicine and in intensive care medicine

In recent years, there has been a great interest in the specialized literature of the phenomenon known as “burnout,” which affects professionals who work in intensive care medicine. In our article, we review the available literature on the prevalence of the burnout syndrome between intensive care physicians, but we do it so based on the study of the German-Korean philosopher, who lives in Berlin, Byung-Chul Han (2015, 2017). Some of Han’s ideas had already been considered by Foucault (2008) in his critique of Gary Becker’s human capital theory and the debate between the author and two Foucault’s pupils in 2012. We argue that there is no independent phenomenon of burnout among workers in critical areas, especially intensive care physicians. The explanation proposed for the presence of this pattern is related to broader issues of our society. In Portuguese, there is no word capable of properly grasping the meaning of such syndrome, in such a way that we chose to use the English word “burnout” even in the original version of the study. Accordingly, we also criticize measures adopted to prevent and to manage this syndrome, identifying them as a manifestation of psychopolitics.
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Predictors for adolescent visits to practitioners of complementary and alternative medicine in a total population (the Young-HUNT Studies).

Predictors for adolescent visits to practitioners of complementary and alternative medicine in a total population (the Young-HUNT Studies).

HUNT is one of the largest health studies ever performed involving the personal and family medical histories of 120,000 people from Nord-Trøndelag county in Central Norway. Nord- Trøndelag is one of 19 counties in Norway and has a stable and homogenous population of nearly 130,000 people with approxi- mately 10% being in the age group 13 to 19 years. It is very similar to Norway as a whole in most demographic variables including sex and gender distribution, economy, and source of income and employment [13]. There are no large cities and the average income and education level is somewhat lower than in the rest of Norway.
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Cad. Saúde Pública  vol.22 número10

Cad. Saúde Pública vol.22 número10

We also highlight medical education as gen- erating anxiety in healthcare professionals in search of more appropriate answers to ques- tions such as the purpose or target of treatment, insofar as there is a progressive loss of capacity by schools of health to train professionals ca- pable of solving health/disease problems for the majority of the population. The rising costs of diagnostic and therapeutic technology fur- ther aggravate this issue. Would complemen- tary or traditional practices be a possible alter- native for improving care?

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Ago-2-mediated slicer activity is essential for anti-flaviviral efficacy of RNAi.

Ago-2-mediated slicer activity is essential for anti-flaviviral efficacy of RNAi.

One reason why the miRNA resembling siRNA failed to suppress virus replication in the above experiment is that both the si and miRNAs were designed to target the coding region in the virus (encoding the viral envelop gene), whereas endogenous miRNAs generally target the 39UTR sequences. To test if this is indeed the case, we also tested si/miRNA resembling oligos that target the viral 3 9 UTR. Initially we tested several potential siRNAs targeting West Nile virus 39 UTR and identified one that potently suppressed viral replication in HeLa cells (not shown). We used this siRNA and its counterpart miRNA structure (Table 1) for virus inhibition in individual Ago expressing cells by FACS analysis as well as testing the culture supernatants for released virus particles by qPCR. Even in this case, the completely complementary siRNA effectively suppressed virus replication in all 4 Ago expressing parental cell line and Ago-2 only expressing cells, but failed to significantly inhibit the virus in Ago 1, Ago 3 and Ago 4 expressing cells (Fig 2B and 2C). Moreover, the miRNA resembling siRNA failed to suppress virus replication in all cell lines. These results are not due to variability in the transfection efficiency in different cell lines, because all the individual Ago expressing cells were equally amenable for transfection with FITC labeled siRNA (Fig. 2D). Taken together, our results suggest that siRNAs designed to mimic miRNA structure fail to inhibit flavivirus replication whether the target is in the coding region or 39 UTR.
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Cad. Saúde Pública  vol.22 número10

Cad. Saúde Pública vol.22 número10

tribute to overcoming (either in diagnosis or therapy) a form of medicine in permanent scien- tific evolution. Through denial we will never un- derstand the Complementary and Alternative Medicine phenomenon, and avoiding the debate will not cause our clients to refrain from turning to such practices. Complementary and Alter- native Medicine exists and is part of our reality.

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Einstein (São Paulo)  vol.15 número1

Einstein (São Paulo) vol.15 número1

This type of progress for treatment and diagnosis has already begun and should advance in the next few years. The changes in the area of Sciences have occurred very rapidly, as well as the transfer of many of these developments to medical areas. The constant progress in information technology enables a large quantity of data to be integrated as never done before, which allows better knowledge of the individual, disease, population group, environment, eating habits, and life conditions. (19)

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Integrative and complementary practices: use by community health agents in self-care Prácticas integradoras y complementarias: utilización por agentes comunitarios de salud en el autocuidado

Integrative and complementary practices: use by community health agents in self-care Prácticas integradoras y complementarias: utilización por agentes comunitarios de salud en el autocuidado

Objective: To verify the use of integrative and complementary practices (ICPs) by community health agents working in family health teams. Methods: Cross-sectional, quantitative research, conducted in the city of Montes Claros, Minas Gerais. An structured form was used for the characterization of participants and use of ICPs. Descriptive and bivariate analyses were conducted. Results: Use of ICPs was referenced by 94 (40.7%) agents. The use of medicinal plants was predominant (32.5%). There were associations between: ICPs in general and negative self-perception of health (p=0.032), homeopathy and higher education (p=0.015), massage and living with partner(p=0.024), chiropractic care and income equal to or greater than four minimum wages (p=0.031), relaxation/meditation and religion (p=0.028). Conclusion: The use of ICPs was verifi ed in the healthcare of community agents. It is necessary to strengthen these practices for the promotion of health and prevention of diseases.
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Medicine and the Task of Healing

Medicine and the Task of Healing

In any particular nation or community, when we come to consider what are the wounds that need healing we need to examine the speciic and local contextual conditions. In developed Western societies ageing and social breakdown, dementia, cancer, non-communicable diseases, obesity, drug addiction and violence have assumed special importance. In developing countries, concerns about infectious diseases, especially HIV and its profound social consequences, and the atrophy of traditional caring relationships with the transition to “modernity” may predominate. he tasks of the doctor and other health professionals have to be fashioned according to need, but have now also to be extended to include the full expanse of human sufering. Sometimes, this will mean that the doctor’s life will be quiet and comfortable; sometimes it will require a degree of social activism; on rare occasions the circumstances will be such that the true practice of the crat will require courage and exposure to risk.
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