Entre zelar e cuidar: sentidos sobre saúde-doença em dirigentes da Umbanda / Entre celar y cuidar: significados sobre salud-enfermedad en los líderes de Umbanda / Between watching over and caring: meanings about health-disease in Umbanda leaders

RESUMO Por meio da antropologia da saúde, podemos compreender o terreiro de umbanda como parte de um sistema popular de cuidado. Este estudo teve por objetivo investigar as concepções de saúde e doença produzidas por zeladores de terreiro de umbanda. Participaram dez zeladores de terreiro da cidade de Uberaba (MG/Brasil), sendo três mulheres e sete homens, com idades entre 40 e 76 anos. O tempo médio de atuação como dirigente foi de 18,4 anos, variando de cinco a 43 anos. Os terreiros chefiados por esses participantes atendem entre 15 e 280 pessoas por dia de funcionamento. Pela análise das entrevistas, destaca-se que o cuidado em saúde oferecido pelos zeladores ultrapassa os limites rituais, nas cerimônias públicas, sendo prestado de modo contínuo nos terreiros. As posturas assumidas pelos entrevistados envolvem ações de escuta, acolhimento e proximidade física no momento da urgência. Pelas narrativas, pode-se concluir que o zelar, no sentido de gerenciar o espaço do terreiro, espiritual e materialmente, não pode ser dissociado do cuidar, significando os zeladores como importantes agentes populares de saúde.

RESUMEN A través de la antropología de la salud podemos entender el terreiro de umbanda como parte de un sistema de atención popular. Este estudio tuvo como objetivo investigar las concepciones de salud y enfermedad producidas por los cuidadores del terreiro de umbanda. Participaron diez cuidadores de terreiro de la ciudad de Uberaba (MG/Brasil), tres mujeres y siete hombres, con edades comprendidas entre 40 y 76 años. El tiempo promedio como gerente fue de 18.4 años, que van de cinco a 43 años. Los terreiros encabezados por estos participantes atienden entre 15 y 280 personas por día de operación. Del análisis de las entrevistas, se destaca que la atención médica ofrecida por los cuidadores va más allá de los límites rituales, en ceremonias públicas, que se brindan continuamente en los terreiros. Las actitudes asumidas por los entrevistados implican escuchar, acoger y proximidad física en el momento de urgencia. A través de las narrativas, se puede concluir que el cuidado, en el sentido de administrar el espacio del terreiro, espiritual y materialmente, no se puede disociar del cuidado, lo que significa que los cuidadores son importantes agentes de salud populares.

ABSTRACT Through health anthropology we can understand the umbanda terreiro (specific place for the religious ritual) as part of a popular system of care. This study aimed to investigate the conceptions of health and illness produced by saint keepers of umbanda terreiro. Ten leaders of the terreiros in the city of Uberaba (MG/Brazil) participated, being three women and seven men, between 40 and 76 years old. The average time of performance as a manager was 18.4 years, ranging from 5 to 43 years. The terreiros led by these participants attend between 15 and 280 people working day. The health care offered by saint keepers exceeds ritual limits in public ceremonies and is provided on a continuous basis in the terreiros. The postures assumed by the interviewees involve actions of listening, welcoming and physical proximity at the moment of urgency. From the narratives, it can be concluded that care, in the sense of managing the space of the terreiro, both spiritually and materially, can not be dissociated from caring, meaning saint keepers as important popular health.

Acceptability of hair harvest as a method of tuberculosis therapeutic drug monitoring among adult pulmonary TB patients: a qualitative study

Background: The current six months regimen for drug-susceptible tuberculosis (TB) is long, complex, and requires adherence monitoring. TB hair drug level assay is one innovative approach to monitor TB treatment adherence however, its acceptability in the context of African multi-cultural settings is not known. Objective: To determine the acceptability of hair harvest and testing as a TB therapeutic drug monitoring method. Methods: The study explored perceptions, and lived experiences among TB patients with regard to using hair harvest and testing as a method of tuberculosis therapeutic drug monitoring in the context of their cultural beliefs, and faith. We used a descriptive phenomenological approach. Results: Four main themes emerged namely: participants' perceptions about the cultural meaning of their body parts; perceptions about hair having any medical value or meaning; perceptions about hospitals starting to use hair harvest and testing for routine hospital TB treatment adherence monitoring; and perceived advantages and disadvantages of using hair for treatment adherence monitoring. Overall, we found that using hair to monitor adherence was acceptable to TB patients provided the hair was harvested and tested by a medical worker. Conclusion: Hair harvest for medical testing is acceptable to TB patients on the condition that it is conducted by a medical worker

Complemento a la teoria del levantamiento del velo corporativo en Colombia desde el principio de la buena fe y el abuso del derecho / Complement to the theory of lifting the corporate veil in Colombia based on the principle of good faith and abuse of law / Complemento à teoria de perfuração do véu corporativo na Colômbia baseado no principio da boa-fé e abuso de direito

RESUMEN Este artículo tiene como objetivo complementar la teoria del levantamiento corporativo definida por los máximos tribunales colombianos con reflexiones doctrinales sobre el principio de la buena fe y del abuso del derecho. El texto presenta los hallazgos de una investigación Qualitativa con un enfoque dogmático de técnica documental especializada, que permitió identificar y seleccionar sentencias hito en el período 1999-2019 que caracterizaran el levantamiento del velo corporativo y además, permitió identificar y seleccionar estudios doctrinales, con preferencia de la misma época, que permiten consolidar la teoria. La estrategia de búsqueda inició con la delimitación de las variables de análisis con base en el proyecto de investigación, que fueron usadas posteriormente en la consulta y selección de artículos de investigación jurídica en las bases de datos especializadas a partir de criterios de elección temáticos, temporales, geográficos, idiomáticos y de tipo de publicación. Con la investigación se concluye que no es suficiente con mencionar la buena fe y el abuso del derecho en los procesos de desestimación de la personalidad jurídica, se hace necesario dotar estos principios de contenido normativo para realizar una tarea de identificación de actos antijurídicos en el contexto societario.

ABSTRACT This article aims to complement the theory of the disregard of the legal entity defined by the highest Colombian courts with doctrinal reflections on the principles of good faith and abuse of law.The text presents the findings of a qualitative research with a dogmatic approach of specialized documentary technique, which allowed to identify and select landmark sentences in the period 1999-2019 that characterized the lifting of the corporate veil and allowed to identify and select doctrinal studies, with preference of the same period, which permit to consolidate the theory The search strategy began with the delimitation of variables for analysis based on the research project, which were subsequently used in the consultation and selection of legal research articles in specialized databases based on thematic, temporal, geographical, idiomatic and publication-type selection criteria. With the investigation it is concluded that it is not enough to mention the good faith and the abuse of the right in the processes of dismissal of the legal personality it is necessary to provide these principles with normative content to carry out a task of identifying unlawful acts in the context corporate law.

RESUMO Este artigo tem como objetivo complementar a teoria do levantamento corporativo definida pelos máximos tribunais colombianos com reflexões doutrinais sobre o princípio da boa-fé e do abuso do direito. O texto apresenta os resultados de uma investigação qualitativa com uma abordagem dogmática de técnica documental especializada, que permitiu identificar e selecionar sentenças marco no período 1999-2019 que caracterizaram o levantamento do véu corporativo e, além disso, permitiu identificar e selecionar estudos doutrinários, com preferência da mesma época, que permitem consolidar a teoria. A estratégia de pesquisa começou com a delimitação das variáveis para a análise com base no projeto de pesquisa, que foram usadas posteriormente na consulta e seleção de artigos de pesquisa jurídica nas bases de dados especializadas a partir de critérios de eleição temáticos, temporais, geográficos, idiomáticos e de tipo de publicação. A investigação concluiu que não basta mencionar a boa fé e o abuso do direito nos processos de rejeição da personalidade jurídica, é necessário dotar estes princípios de conteúdo normativo para realizar uma tarefa de identificação de atos antijundicos no contexto societário.

Psychosocial Perceptions as Significant Impact Modifiers - A Mixed Method Research Among Hospitalized Covid-19 Patients in A Tertiary Care Hospital in Coimbatore District, Tamil Nadu

Context: Covid 19 pandemic which evolved in successive waves had profound pyschosocial impact on affected in-dividuals. Perceptions had impact on both individual and environmental level with potential behavioural conse-quences. The aim of the research is to study the psychosocial perception and psychological impact of COVID- 19 among hospitalized COVID-19 patients. Methodology: The study was a mixed method research (Quan-Qual sequential design) conducted in the Covid wards of a tertiary care hospital in Coimbatore district. The psychological impact was assessed us-ing the General Health Questionnaire, Perceived Stress Scale. The results of quantitative analyses and qualitative analyses were expressed as proportions and done using thematic analysis using grounded theory respectively. Results: About 55% of the hospitalized Covid-19 patients had psychological impact. On multivariate analysis, the factors which emerged as independent risk factors for presence of psychological morbidi-ties due to COVID were presence of high stress level, sleep disturbances and their perception of COVID as high threat. Conclusions: Focussed Counselling with specific reference to attend to spiritual health component in addition, would go a long way in diminishing immediate and long-term psychological impact due to covid-19 illness.

A Perspective On COVID-19 Vaccine Hesitancy in India

India started vaccination drives in January of 2021. One of the biggest challenges faced by the govern-ment was the hesitancy to get vaccinated. Vaccine hesitancy causes the vaccination process to be de-layed, affecting the process of building herd immunity and allowing the virus to evolve. Certain anthropo-logical factors are responsible for vaccine hesitancy in a community. These factors are broadly catego-rised as personal beliefs, the role of media, and religion. An in-depth analysis of available literature, including the grey literature indicated that these factors influence an individual’s decision-making. Vac-cine hesitancy was largely affected by rumours surrounding it. Contradictory information regarding the vaccines created uncertainty about the consequences of getting vaccinated. A holistic approach is neces-sary to tackle vaccine hesitancy. The interventions from the government need to consider these social and cultural factors to address vaccine hesitancy in the future. Due to the diverse sample size, there is a need for various actors and stakeholders to come together and implement demographic-specific measures to address vaccine hesitancy in India.

Faith-based intervention, change of religiosity, and abstinence of substance addicts

Objective: To investigate the effects of developing religiosity on abstinence of substance abuse among recovering addicts in a faith-based and a secular-based treatment program. Methods: Religiosity of recovering addicts was measured using the 38-item Brief Multidimensional Measure of Religiousness/Spirituality at three points in time: at initiation of substance addiction treatment (wave 1), discharge from treatment (wave 2), and 6 months after treatment (wave 3). Latent growth curve modeling was used to assess the dynamic and developing effects of religiosity on after-treatment abstinence. Secular-based treatment emphasized the role of biological, psychological, and environmental determinants of substance abuse and provided detoxification interventions, such as counseling and group therapies, skill training, health care, and social support, however also relying on religious and spiritual growth to help recovery. Faith-based treatment fundamentally emphasized the Christian theory of addiction to consider substance abuse a sin caused by one's spiritual void and separation from God, although it also acknowledged the importance of biological, psychological, and social needs of rehabilitants. Results: Recovering addicts in faith-based treatment had significantly higher levels of religiosity at each wave (intercept factor) and better religious development across the three waves (slope factor). This contributed to after-treatment abstinence and mediated the effect of treatment mode on after-treatment abstinence. Conclusion: Service practitioners and researchers should note the importance of dynamic and developing nature of religiosity in relation to the maintenance of abstinence after treatment is completed.

Utilização do cuidado popular por egressos de unidade de terapia intensiva neonatal / Utilización del cuidado popular en niños salidos de unidades de cuidados intensivos neonatales / Use of popular care by discharged patients of a neonatal intensive care unit

Resumo Objetivo Avaliar a relação entre a busca por cuidados populares e condições socioeconômicas e de saúde relacionadas às crianças egressas de unidade de terapia intensiva neonatal. Métodos Coorte retrospectiva com 165 crianças menores de 48 meses, egressas de unidade de terapia intensiva neonatal de duas das maiores maternidades públicas de uma capital do nordeste brasileiro, nos anos de 2014 e 2015. Dados perinatais foram obtidos de prontuários e sobre cuidados de saúde por meio de questionários. Criou-se um modelo teórico, estabelecendo relações entre condições socioeconômicas, presença de morbidade na alta e o impacto direto ou indireto no uso do setor popular. Para análise, utilizou-se Modelagem de Equações Estruturais (α=5%). Resultados A utilização do setor popular foi a menos prevalente entre os três setores de cuidado. A presença de morbidade na alta registrou efeito total significante (coeficiente padronizado de 0,302; valor de p=0,030), porém, sem efeito direto para a busca por esse setor. Dentre as práticas do setor popular, a procura por benzedeira/curandeiro (55,3%) foi a mais prevalente. Conclusão Apresentar morbidade na alta da unidade de terapia intensiva neonatal, associada a outras variáveis não identificadas, é fator que pode influenciar na busca por cuidados de saúde no setor popular, sem excluir a busca por cuidados com profissionais da saúde.

Resumen Objetivo Evaluar la relación entre la búsqueda de cuidados populares y las condiciones socioeconómicas y de salud relacionadas con niños salidos de unidades de cuidados intensivos neonatales. Métodos Cohorte retrospectiva con 165 niños menores de 48 meses, salidos de unidades de cuidados intensivos neonatales de dos de las mayores maternidades públicas de una capital del nordeste brasileño, durante los años 2014 y 2015. Los datos perinatales se obtuvieron de las historias clínicas y los datos sobre cuidados de salud por medio de cuestionarios. Se creó un modelo teórico, que estableció relaciones entre condiciones socioeconómicas, presencia de morbilidad en el alta e impacto directo o indirecto en el uso del sector popular. Para el análisis, se utilizó el Modelo de Ecuaciones Estructurales (α=5 %). Resultados La utilización del sector popular fue la menos prevalente entre los tres sectores de cuidado. La presencia de morbilidad en el alta registró un efecto total significante (coeficiente estandardizado de 0,302; valor de p=0,030), pero sin efecto directo en la búsqueda de ese sector. Entre las prácticas del sector popular, la búsqueda de acceder a un curandero (55,3 %) fue la más prevalente. Conclusión Presentar morbilidad en el alta de la unidad de cuidados intensivos neonatales, junto con otras variables no identificadas, es un factor que puede influenciar en la búsqueda de cuidados de salud en el sector popular, sin excluir la búsqueda de cuidados con profesionales de salud.

Abstract Objective To evaluate the relationship between the search for popular care and socioeconomic and health conditions related to children discharged from a neonatal intensive care unit. Methods Retrospective cohort with a total of 165 children under 48 months old, discharged from the neonatal intensive care unit of two of the largest public maternity hospitals in a capital city in northeastern Brazil, in 2014 and 2015. Perinatal data were obtained from medical records and on health care through questionnaires. A theoretical model was created, establishing relationships between socioeconomic conditions, the presence of morbidity at discharge and the direct or indirect impact on the use of the popular sector. For analysis, Structural Equation Modeling was used (α=5%). Results The use of the popular sector was the least prevalent among the three care sectors. The presence of morbidity at discharge had a significant total effect (standardized coefficient of 0.302; p-value = 0.030), however, with no direct effect on the search for this sector. Among the practices of the popular sector, the search for a healer (55.3%) was the most prevalent. Conclusion Having morbidity at discharge from the neonatal intensive care unit, associated with other unidentified variables, is a factor that can influence the search for health care in the popular sector, without excluding the search for care with health professionals.

Itinerarios terapéuticos de madres qom en una comunidad periurbana de Formosa / Therapeutic itineraries of Qom mothers in a peri-urban community of Formosa

Introducción. Las poblaciones indígenas están atravesando profundos cambios en su estilo de vida que afectan la salud y la manera en que tratan sus enfermedades. El objetivo del estudio fue determinar los itinerarios terapéuticos que las madres qom siguen cuando perciben que sus hijos están enfermos.Población y métodos. Se trabajó en la comunidad periurbana de Namqom, en la provincia de Formosa, con un grupo de madres con niños pequeños, quienes fueron entrevistadas en sus hogares hasta lograr saturación. El estudio siguió un diseño exploratorio cualitativo, basado en un modelo conceptual de creencias de salud.Resultados. Los itinerarios terapéuticos elegidos por 16 madres qom incluyeron el uso de remedios caseros, la sanación bíblica/religiosa, la sanación por curanderos y la visita al centro de salud provincial. El itinerario para seguir, por lo general, depende de la caracterización que hace la madre de los síntomas como naturales (con origen biológico) o no naturales (relacionados con brujería). Los diferentes métodos no son necesariamente incompatibles y, muchas veces, se usan como complementarios. Tanto la confianza en la efectividad como el temor a las consecuencias juegan un papel importante en la selección del tratamiento. Estos resultados son de extrema utilidad para mejorar el diálogo entre la comunidad y el centro de salud. Resulta prioritario promover una mejor coordinación entre diferentes agentes de salud en comunidades indígenas en transición.Conclusiones. Los resultados de este estudio permitieron describir los itinerarios terapéuticos elegidos y, consecuentemente, se puso en evidencia la marcada presencia del pluralismo médico en esta comunidad

Introduction. Indigenous peoples are undergoing profound lifestyle changes that affect their health and the way they manage their diseases. The objective of this study was to determine the therapeutic itineraries followed by Qom mothers whenever they perceive their children are sick.Population and methods. The study was done in the Namqom peri-urban community, in the province of Formosa, with a group of mothers with young children interviewed at their houses until achieving saturation. The study followed an exploratory, qualitative design based on a conceptual health belief model.Results. The therapeutic itineraries selected by 16 Qom mothers included using home remedies, biblical/faith healing, healers, and visiting the provincial health center. In general, the itinerary depends on how the mother characterizes disease symptoms: natural (biological cause) or unnatural (sorcery-related). The different methods are not necessarily incompatible and, many times, are used as complementary. Both reliability on effectiveness and fear of consequences play an important role on treatment selection. These results are extremely helpful to improve the dialog between the community and the health center. It is necessary to promote an improved coordination among the different health care agents working in transitioning indigenous communities.Conclusions. The results of this study described selected therapeutic itineraries and, as a consequence, evidenced the strong presence of pluralistic medical systems in this community

Spirituality and practice of the euphemism in the workplace: perceptions of a nursing team / Espiritualidad y práctica de la eufemia en el lugar de trabajo: percepciones de un equipo de enfermería / Espiritualidade e prática da eufemia no ambiente de trabalho: percepções de uma equipe de enfermagem

ABSTRACT Objectives: to understand the spirituality and the practice of euphemism experienced by nursing professionals in the hospital scenario. Methods: a descriptive, exploratory research with a qualitative approach, carried out with 18 nursing professionals from a hospital in southern Brazil. Data collection took place from September to October 2018, through recorded audio interviews. The reports were submitted to thematic content analysis and the discussion was based on the theory of transpersonal care. Results: four categories emerged from the speeches: Motivational reflection of spirituality in the work environment; Adherence to the practice of euphemism by nursing professionals; Satisfaction and frustration in the practice of euphemism by nursing professionals and; Spirituality as an increase in human faith. Final Considerations: professionals understand spirituality and the practice of euphemism as a tool that helps in motivating the team to face difficulties at work and increase the faith of hospitalized patients.

RESUMEN Objetivos: comprender la espiritualidad y la práctica de la eufemia que experimentan los profesionales de enfermería en el contexto hospitalario. Métodos: investigación exploratoria, descriptiva, cualitativa, desarrollada con 18 profesionales de enfermería de un hospital en el sur de Brasil. Los datos se recopilaron entre septiembre y octubre de 2018, a través de entrevistas de audio grabadas. Los informes fueron sometidos a análisis de contenido temático y la discusión se basó en la teoría del cuidado transpersonal. Resultados: de las declaraciones surgieron cuatro categorías: Reflexión motivacional de la espiritualidad en el ambiente de trabajo; Adhesión a la práctica de la eufemia por profesionales de enfermería; Satisfacción y frustración en la práctica de la eufemia por profesionales de enfermería; y La espiritualidad como un aumento en la fe humana. Consideraciones Finales: los profesionales perciben la espiritualidad y la práctica de la eufemia como una herramienta que ayuda a motivar al equipo, hacer frente a las dificultades en el trabajo y aumentar la fe de los pacientes hospitalizados.

RESUMO Objetivos: compreender a espiritualidade e a prática da eufemia vivenciada por profissionais de enfermagem no contexto hospitalar. Métodos: pesquisa descritiva, exploratória, de abordagem qualitativa, desenvolvida com 18 profissionais de enfermagem de uma instituição hospitalar no Sul do Brasil. Os dados foram coletados no período de setembro a outubro de 2018, por meio de entrevistas áudio gravadas. Os relatos foram submetidos à análise de conteúdo temática e a discussão se fundamentou na teoria do cuidado transpessoal. Resultados: das falas emergiram quatro categorias: Reflexo motivacional da espiritualidade no ambiente de trabalho; Adesão à prática da eufemia por profissionais de enfermagem; Satisfação e frustração na prática da eufemia por profissionais de enfermagem e; Espiritualidade como incremento da fé humana. Considerações Finais: os profissionais percebem a espiritualidade e a prática da eufemia como ferramenta que auxilia a motivação da equipe para o enfrentamento das dificuldades no trabalho e no incremento da fé de pacientes hospitalizados.

O olhar da Medusa: reflexões sobre crack e internação compulsória / The gaze of Medusa: thoughts on crack and compulsory hospitalization / La mirada de la Medusa: reflexiones sobre crack e internación obligatoria

Este ensaio trata de uma discussão teórico-crítica sobre o dispositivo de internação compulsória, especificamente nos casos relacionados ao uso de crack. A construção teórica partirá de algumas reflexões sobre o olhar do outro como parte integrante desse fenômeno, através de uma analogia com o mito da Medusa. A análise terá como base a perspectiva existencialista de Jean-Paul Sartre, trazendo para a discussão o contexto neoliberalista, liberdade, campo dos possíveis, má-fé, estigma e o ser-para-outro. Dessa discussão, emerge o questionamento da internação compulsória como medida de tratamento para pessoas que fazem uso de crack. Essas pessoas, sob o olhar do outro, já têm suas possibilidades barradas em função do uso da substância, sendo que a imposição desse tratamento culmina em seu assujeitamento e objetificação

This essay is about a theoretical-critical discussion about the compulsory hospitalization device, specifically in cases related to the use of crack. The theoretical development will start from some thoughts about the gaze of the other as an integrating part of this phenomena, through the analogy with the Medusa myth. The analysis will have as a basis the existentialist perspective of Jean-Paul Sartre, bringing to the discussion the neoliberalist context, freedom, possible fields, bad faith, stigma and being-for-others. From this discussion, the debate of compulsory hospitalization as an action of treatment for people who use crack emerges. These people, under the gaze of the other, already have their opportunities restrained as a result of the use of the substance, since the imposition of this treatment culminates in their antipersonification and objectification

Este ensayo trata de una discusión teórico-crítica sobre el dispositivo de internación obligatoria, específicamente en los casos relacionados con el uso de crack. La construcción teórica partirá de algunas reflexiones sobre la mirada del otro como parte integrante de ese fenómeno, a través de una analogía con el mito de la Medusa. El análisis tendrá como base la perspectiva existencialista de Jean-Paul Sartre, trayendo para la discusión el contexto neoliberalista, libertad, campo de los posibles, mala fe, estigma y el ser-para-otro. De esta discusión, emerge el cuestionamiento de la internación obligatoria como medida de tratamiento para personas que hacen uso de crack. Esas personas, bajo la mirada del otro, ya tienen sus posibilidades barradas en función del uso de la sustancia, siendo que la imposición de ese tratamiento culmina en su sometimiento y objetivación.

Snakebite and its management in rural West Bengal: The unspoken truth

Background: Snakebite is a common medical emergency in tropical India where agriculture is a major source of earning livelihood. Snakebite has a significant impact on human health and economy. The situation worsens when the majority of snakebite victims adopt harmful practices such as application of tourniquets due to prevalent myths and misconceptions. Objectives: The objective of the study was to study the socio-demographic profile of the study population, to estimate the prevalence of snakebite in the study area, and to assess the knowledge and treatment seeking behavior of the study population regarding snakebite and its management. Materials and Methods: A total of 135 households of Muchisa village of West Bengal were selected by consecutive sampling and one adult member of the household was interviewed with a pre-designed schedule. Results: Majority of the study population were in the age group of 30–60 years (69.5%), females (52.6%), and Hindu (74.8%). Nearly 59.1% (100) of the population were educated up to primary level. Nearly 15.56% of the study population in our study gave a history of snakebite. Nearly 81.1% of study population correctly differentiated between poisonous and nonpoisonous snakebites based on signs and symptoms of the victim. When asked about why snakebite, the villagers said that snakebite when they were touched (57.04%) or hit (33.33%). About 57.78% of the population believed that snakebite can be managed by traditional faith healers (Ojha). The majority preferred tying a tourniquet/similar material above the bite mark. Conclusion: It is essential to communicate about the appropriate management of a snakebite victim to the communities at risk of snakebite.

A Cross-sectional Study of Cancer Knowledge and Beliefs Among Faith-based Chinese in the USA Versus Taiwan / 예방의학회지

OBJECTIVES: This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs. METHODS: A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan). RESULTS: A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p < 0.001) and CWST (6.80 vs. 5.38; p < 0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p < 0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p=0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p=0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor’s recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams. CONCLUSIONS: Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan’s universal healthcare might play a role on the different healthcare seeking patterns.

Traditional Healing – At What Cost ?: A Case Report from Rural India

In rural parts of India still the “magico-religious beliefs” regarding the occurrence of the psychiatric disordersand “magico-religious treatments” of the psychiatric disorders often seen and prevail. Such beliefs andtreatments many times lead to physical as well as psychological trauma to an individual suffering from anypsychiatric disorder and may lead to delay in seeking an appropriate professional help in time. The presentcase report attempts to depict what kind of physical and psychological trauma a person with psychiatricdisorder suffered at the hands of faith healer in absence of lack of awareness about the psychiatric disordersamong family members and other villagers.

Factors associated with retention in faith-based drug treatment centers in the Mexican-American border / Factores asociados a la retención en centros de tratamiento para el consumo de drogas en la frontera

Abstract: Introduction: Faith-based centers are major providers of residential treatment for substance use problems in Mexico, but relatively few studies have been conducted in this context. Objective: To explore factors associated with treatment retention in two faith-based (with different religious orientation) residential treatment facilities for male drug users in Tijuana, Mexico. Method: We conducted an exploratory follow-up study of 328 clients admitted during 2014-2015 to either an Evangelical Pentecostal center or a faith-based center without a specific religious affiliation. The main outcome was retention, defined as remaining in treatment for at least three months. Results: Among participants, the retention rate was 38.7%. Multivariate logistic regression models showed that age (OR 1.04; 95% CI [1.01, 1.06]; p = .002) and having used heroin or opioids in the past 30 days (OR .50; 95% CI [.25, 1.00]; p = .049) were associated with retention. Having a personal religious affiliation was associated with retention in the Evangelical Pentecostal center, but not in the center without a specific religious affiliation. Discussion and conclusion: The retention rate was low, but within the previously reported range. The interaction of personal religious affiliation and the religious orientation of the center suggests that a match between a person's religious convictions and those of the center could be important for retention. More research is needed to clarify the utility of faith-based centers for religious and non-religious drug users.

Resumen: Introducción: Aunque los centros de rehabilitación religiosos proporcionan tratamiento a un gran número de usuarios de drogas en México, existen relativamente pocos estudios sobre estos centros. Objetivo: Explorar los factores asociados con la retención en el tratamiento en dos centros de rehabilitación para hombres usuarios de drogas con diferentes orientaciones religiosas en Tijuana, México. Método: Estudio longitudinal exploratorio de 328 usuarios admitidos durante 2014-2015 en un centro evangélico pentecostal y en un centro religioso sin denominación específica. El resultado principal fue la retención, definida como la permanencia en tratamiento por al menos tres meses. Resultados: La tasa de retención entre los participantes fue de 38.7%. En el análisis con modelos de regresión logística multivariada la edad (OR 1.04; 95% CI [1.01, 1.06]; p = .002) y haber utilizado heroína u opioides en los últimos 30 días (OR .50; 95% CI [.25, 1.00]; p = .049) se asociaron con la retención. Tener una adscripción religiosa personal se asoció con retención en el centro evangélico pentecostal, pero no en el centro sin afiliación religiosa específica. Discusión y conclusión: La tasa de retención observada fue baja, aunque dentro del rango previamente reportado. La interacción entre adscripción religiosa personal y orientación religiosa del centro sugiere que la concordancia entre estos dos elementos podría facilitar la retención. Se requiere más investigación en este contexto para clarificar la utilidad de los centros de rehabilitación religiosos en el tratamiento de usuarios religiosos y no religiosos.

Oskar Pfister e a crítica à concepção freudiana de religião / Oskar Pfister and criticism of the freudian conception of religion

A crítica que Freud faz à religião permeia toda a sua obra de forma que podemos afirmar que a questão religiosa se mostra uma grande questão para ele. No entanto, percebe-se que a visão que Freud tem da religião é bastante reducionista e isso fica bastante claro em diversos textos desse autor. Oskar Pfister se coloca como um grande debatedor da questão religiosa no início do movimento psicanalítco evidenciando as diversas lacunas na visão freudiana da Religião. Esse artigo se propõe a mostrar a crítica feita por Pfister à concepção freudiana de Religião visando com isso trazer elementos para o debate entre psicanálise e religião.(AU)

The criticism that Freud makes to religion permeates all his work so that we can say that the religious question shown a big issue for him. However, it is clear that the vision that Freud has of religion is rather reductive and it is quite clear in many texts of this author. Oskar Pfister stands as a great debater of the religious question at the beginning of psychoanalytic movement showing the various gaps in Freud's view of religion. This article aims to explain the criticism made by Pfister to Freud's conception of religion in order to bring this element to the debate between psychoanalysis and religion.(AU)

Sentidos del trabajo religioso en contextos marcados por la violencia: estudio en un complejo de favelas en Río de Janeiro / Meanings of religious work in contexts marked by violence: a study in a complex of shantytowns in Rio de Janeiro

RESUMEN Este trabajo se propone comprender los sentidos del trabajo religioso en la prevención de la violencia y la recuperación de personas involucradas con actos ilícitos en un complejo de favelas de la ciudad de Río de Janeiro, Brasil. Se analizan la acción de entidades religiosas en el territorio, las visiones de sus líderes sobre su papel y el de su iglesia y sus representaciones sobre el territorio y sobre las personas que realizan actos violentos. Entre 2010 y 2012, desde un abordaje cualitativo, se realizó observación participante y se efectuaron entrevistas a líderes religiosos y "convertidos", cuyos relatos se abordaron a través de análisis de la enunciación. Los líderes resaltan la importancia de la acción de sus iglesias en una localidad precaria y violenta y los "convertidos" destacan el papel de la evangelización en su conversión religiosa. Sin embargo, las relaciones entre religión y violencia son complejas e incluyen varios tipos de trayectorias y comportamientos: si bien se destaca la fuerza del apoyo religioso, también se la cuestiona. Se concluye que las iglesias actúan de forma puntual e individual, por lo que colaboran poco con la transformación de la realidad, asumiendo con frecuencia un papel de control y de pacificación de la cuestión social.

ABSTRACT The purpose of this study is to understand the meanings of religious work in the prevention of violence and in the recovery of people involved in illicit acts in a complex of shantytowns in Rio de Janeiro, Brazil. The activities of religious entities in the territory, the view of religious leaders regarding their role and that of their church, and the representations of the territory and of the people who commit violent acts were analyzed. Using a qualitative approach, participant observation and interviews of religious leaders and "converts" were conducted between 2010 and 2012. The resulting narratives were treated using enunciation analysis. The leaders emphasize the importance of their churches' actions in violent and precarious areas, while the "converts" highlight the role of evangelization in their religious conversion. However, the relationships between religion and violence are complex, involving various types of trajectories and behaviors; in this way, the strength of religious support in the conversion process is both highlighted and questioned. The text concludes that churches' actions tend to be palliative and focused on the individual and therefore do little to transform reality, with the church potentially taking on roles of social control and pacification.

Entre médicos y sanadores: gestionando sentidos y prácticas sobre el proceso de salud-enfermedad-atención en un movimiento carismático católico argentino / Between doctors and healers: managing meanings and practices of the health-disease-care process in an Argentine Catholic charismatic movement

RESUMEN Este trabajo describe y analiza las trayectorias y las estrategias de búsqueda de sanación entre los miembros de un movimiento católico carismático de sanación en Argentina. A partir de una investigación etnográfica realizada entre julio de 2009 y abril de 2015, se focaliza en las concepciones, prácticas y experiencias en torno a la salud-enfermedad-atención. Se señala que el evento de enfermedad requiere una respuesta cognitiva y otra práctica para su gestión e involucra, principalmente, dos recursos terapéuticos: la biomedicina y las terapias religiosas. Asimismo, se postula que cada recurso es referido en momentos específicos de las trayectorias y el pasaje de uno a otro implica el cambio de una noción restringida por una holística del proceso salud-enfermedad-atención.

ABSTRACT This work describes and analyzes the trajectories and strategies in the search for healing among participants of a charismatic Catholic healing movement in Argentina. Using ethnographic research carried out between July 2009 and April 2015, the article focuses on conceptions, practices and experiences surrounding health-disease-care processes. It is highlighted that disease management requires both a cognitive and a practical response, in this case involving two primary therapeutic resources: biomedicine and religious therapies. It is also postulated that each resource is sought at specific moments in the trajectories and the passage from one to another implies a change from a restricted to a holistic notion of the health-disease-care process.

The reform and faith regained:A study on the changes of medical and health policy under the framework of initiative alliance / 中国卫生政策研究

Based on the advocacy coalition framework,the game between policy alliances with different beliefs is regarded as a key factor contributing to the long-term policy changes. At the same time, the policy changes are seen as the product of the antagonism of the core faith of the alliance, the policy-oriented learning and the internal and external shocks of the coalitions. The change of China's health care policy has always been accompanied by the debate on whether fairness or efficiency should be given priority between"government-led"and"market-oriented"coalitions. Its evolving characteristics are consistent with the explanatory logic of the advocacy coalition framework. Based on the advocacy coalition framework this paper makes a comprehensive of review of the historical literature on Chinese medical and health policy,it founds out that advocacy coalitions with different beliefs are critical to the re-form and return of the health care policy, policy-oriented learning promotes the gradual change of the policy, while internal and external shocks provide opportunities for policy paradigm change. Besides,the more passive and lack of active initiatives of policy change,the government's bias of the public welfare feature of the medical business coupled with the underdevelopment of market economy are the main causes for lagging medical policy and frequent industry chaos. To this end,it is recommended to highlight the forward-looking policy,strengthen the internal drive,create a more liberal debate environment for the coalitions,promote the learning of policy orientation among coalitions to en-hance the scientific and effective medical and health policy change.

Representação-turbulência-experiência emocional: pensando a teoria da técnica / Representation-turbulence-emotional experience: reflecting on the theory of technique / La cuestión es: qué es lo que hace el analista con la "experiencia emocional" que va ocurriendo durante la sesión? / Representación-turbulencia-experiencia emocional: pensando sobre la teoría de la técnica

Considerando os autores Freud, Klein e Bion, a autora propõe que a passagem do trabalho centrado nas representações e interpretações do inconsciente em Freud e Klein para o trabalho centrado no aprender da experiência emocional e na teoria de pensamento de Bion expostas na "Grade" e em "Transformações" implica enorme turbulência na prática psicanalítica. Sugere a necessidade de uma teoria da técnica que se coadune com essa mudança, mas se pergunta se essa é possível. A referência aos conceitos pressupõe um leitor familiarizado com os referenciais, pois privilegia, na exposição, questões suscitadas pelas teorias, e não a clarificação destas. A questão é o que faz o analista da "experiência emocional" que vai ocorrendo na sessão?

The author takes into consideration Freud's, Klein's, and Bion's work. The author identifies a great turbulence in the psychoanalytic practice as a result of the transition (or change) from Freud's and Klein's work, whose core is on the Representations and interpretations of the Unconscious, to Bion's work, which is focused on Learning from emotional Experience and on Theory of Thinking, both exposed in The Grid and in Transformations. The author suggests the need of a new Theory of Technique in accordance with this change, although she wonders if it is possible. When the author refers to concepts, she assumes that the reader is familiar with these references. Rather than clarify these theories, the author favours the issues that are raised by them. The main question is: What does the analyst do with the emotional experience that keeps emerging during the session?

Considerando el pensamiento de Freud, Klein y Bion, la autora propone que el pasaje desde el trabajo centrado en las Representaciones e Interpretaciones del Inconsciente, en Freud y Klein, hasta el trabajo centrado en el Aprender de la experiencia emocional y en la Teoría del pensamiento, de Bion, expuestas en La Tabla y en Transformaciones, implica una enorme turbulencia en la práctica psicoanalítica. Sugiere la necesidad de una Teoría de la Técnica que acompañe esta transformación, pero se pregunta si esto es posible. La referencia a conceptos teóricos presupone un lector familiarizado con ellos, pues en la exposición, la autora privilegia cuestiones suscitadas por las teorías y no la explicación de las mismas.

En considérant les auteurs Freud, Klein et Bion, l'auteur de l'article propose que le passage du travail centré sur les représentations et sur les interprétations de l'inconscient chez Freud et chez Klein au travail centré sur l'apprentissage de l'expérience émotionnelle et sur Théorie de la pensée de Bion, exposé dans "La Grade" et dans les "Transformations", amène à une énorme turbulence dans la pratique psychanalytique. L'auteur suggère le besoin d'une Théorie de la technique qui soit d´accord avec ce changement, mais elle se demande si ce changement est-il possible. La référence aux concepts présuppose un lecteur familiarisé avec les référentiels, une fois qu'elle privilégie, lors de l'exposition, les questions suscitées par les théories, n'ayant pas l'intention de les clarifier. La question est; qu'est-ce que l'analyste fait de l'expérience émotionnelle qui a lieu dans la séance?

As experiências e os significados da fé e religiosidade para adolescentes em conflito com a lei / The experiences and meanings of faith and religiosity for adolescents in conflict with the law

A religiosidade tem sido estudada nas diferentes fases do ciclo vital, em especial na adolescência, como fator protetivo a prática do ato infracional. Para compreender esta dimensão da vida sob a ótica de adolescentes autores de atos infracionais, o estudo visou a investigar os significados de fé e religiosidade para adolescentes em conflito com a lei, norteado pelos conceitos de Mauro Amatuzzi. Trata-se de uma pesquisa qualitativa exploratória, realizada com seis adolescentes, com idades entre 15 e 17 anos, em cumprimento de Medida Socioeducativa, Liberdade Assistida, de uma cidade do interior do estado de São Paulo. O estudo utilizou como instrumentos de coleta de dados a entrevista semiestruturada e a fotografia. Inicialmente foi realizada uma oficina de fotografia, na qual os adolescentes receberam a questão a ser respondida em fotografias: "Como você pode representar a sua fé em fotografias?". Após a oficina, os adolescentes fotografaram, com o seu próprio aparelho celular, imagens do seu cotidiano que representavam a sua fé. Em seguida, foi realizada uma entrevista individual a fim de conhecer a história do participante, explorar suas expressões de fé e conversar sobre as imagens capturadas e seus respectivos significados. Por fim, foi realizado um grupo em que os adolescentes puderam ver todas as fotografias impressas, sem que fossem identificados seus respectivos autores, e manipulá-las de forma a agrupá-las conforme os sentidos, construindo categorias. As categorias foram nomeadas pelos próprios participantes como: Tudo, Fé em Deus, É o plano, Paz e Família. Os dados foram analisados por meio da Análise de Conteúdo das entrevistas individuais, que serviram de apoio para a compreensão do material fotográfico. As categorias formadas foram: Proteção, Motivação, Deus onipresente, Identificação, Sentido de ligação afetiva, Referências e Símbolos, Ações e Rituais. A partir dos resultados obtidos foi possível compreender que este grupo de adolescentes em conflito com a lei apresenta diferentes experiências e significados de fé. No entanto, todos revelam relação com o enfrentamento das adversidades cotidianas e projeto de vida, principalmente relacionado a conquistas de bens materiais. Percebemos que o instrumento fotográfico facilitou a participação dos adolescentes na pesquisa e possibilitou aos mesmos o encontro com a própria experiência, evidenciando-se como um recurso efetivo para a compreensão do significado e mediação da narrativa

Religiosity has been studied in the different phases of the life cycle, especially in adolescence as a protective factor the practice of the infraction. In order to understand this dimension of life from the point of view of adolescent offenders, the study aimed to investigate the meanings of faith and religiosity for youth in conflict with the law, guided by the concepts of Mauro Amatuzzi. This is an exploratory qualitative research carried out with six adolescents, aged between 15 and 17 years old, in compliance with the Socioeducational Measure, Assisted Liberty, of a city in the interior of the state of São Paulo. The study used semistructured interviews and photography as instruments of data collection. Initially a photography workshop was held, where the adolescents received the question to be answered in photographs: How can you represent your faith in photographs? After the workshop, the adolescents photographed, with their own mobile devices, images of their daily lives that represented their Faith. Then an individual interview was conducted to learn the story of the participant, to explore their expressions of faith and to talk about the images and their respective meanings. And finally, a group a meeting was done for the adolescents could see all the printed photographs, without identification of the respective authors, and manipulate them in order to group them into categories. The categories were named by the participants as: All, Faith in God, It is the plan, Peace and Family. The data were analyzed through the content analysis of the individual interviews, which served as support for the understanding of the photographic material. The categories formed were: Protection, Motivation, Omnipresent God, Identification, Sense of affective bonding, References and Symbols, Actions and Rituals. From the results it was possible to understand that this group of adolescents in conflict with the law presents different experiences and meanings of faith, however, all reveal relation with the confrontation of daily adversities and life project, mainly related to achievements of material goods. From the results, it was noticed that the photographic instrument facilitated the participation of the adolescents in the research and enabled them to encounter their own experience, proving themselves as an effective resource for understanding the meaning and mediation of the narrative