Teologia-política e pandemia Sars-Cov-2/Covid-19: questões à Saúde Coletiva / Political theology and Sars-Cov-2 pandemic: issues to Collective Health

Resumo Este ensaio teórico apresenta, em linhas gerais, o campo da teologia-política enquanto importante área da filosofia política, demonstra sua relevância no atual cenário sociopolítico brasileiro e problematiza suas possíveis intersecções com o campo da Saúde Coletiva. Na primeira parte, busca-se explorar o pensamento teológico-político de autores centrais dessa área, como Santo Agostinho, Giorgio Agamben, Karl Marx, Enrique Dussel e Boaventura de Souza Santos. À luz desses autores, na segunda parte do artigo, descreve-se a emergência de teologias-políticas no cenário político e na dinâmica sociocultural brasileira, manifestas entre grupos evangélicos durante a pandemia de covid-19. Esse cenário da pandemia revelou muitas contradições da sociedade brasileira e evidenciou controvérsias entre duas linhagens de teologias-políticas evangélicas divergentes: as conservadoras/antidemocráticas e as progressistas. A reemergência dessas teologias políticas tem efeitos relevantes no que tange às respostas de grupos sociais e ações do poder frente aos problemas de saúde pública, que merecem maior atenção do campo da Saúde Coletiva. Elas influenciam as esferas do poder e a dinâmica sociocultural no que se relaciona à saúde-doença-cuidado, contribuindo com medidas de proteção coletiva e/ou estimulando posturas de risco, negligências e negacionismos. Conclui-se problematizando contribuições epistemológicas para uma renovada produção do conhecimento-ação na interface da teologia política com a Saúde Coletiva.

Abstract This theoretical essay presents an overview of the field of political theology as an important part of political philosophy, demonstrates its relevance in the current Brazilian social and political scenario, and problematizes its intersections to the Collective Health field. In the first part, we explore the theological-political thoughts from key thinkers of this area, such as Saint Augustine, Giorgio Agamben, Karl Marx, Enrique Dussel, and Boaventura de Souza Santos. In the light of these authors, in the second part of this article, we describe the emergence of political-theologies in the Brazilian political scenario and sociocultural dynamics, manifested among evangelical groups during the COVID-19 pandemic. This pandemic situation shed light on many contradictions of Brazilian society and evidenced controversies between two lines of divergent evangelical political theologies: the conservative/antidemocratic and the progressive ones. The re-emergence of these political theologies holds relevant effects regarding the responses of social groups and actions of power in the face of public health problems, which deserve greater attention of the Collective Health field. They influence the spheres of power and sociocultural dynamics in terms of health-disease-care, contributing with collective protection measures and/or encouraging risky, negligent and denialist postures. We conclude by problematizing epistemological contributions to a renewed production of knowledge-action regarding the interface between political theology and Collective Health.

Escola sem partido e conservadorismo moral: instrumentalização da religião, sexualidade e gênero / School without party and moral conservatism: the instrumentalization of religion, sexuality and gender / Escuela sin partido y conservadurismo moral: la instrumentalización de la religión, sexualidad y género

Este artigo tem por objetivo identificar e discutir alguns estratagemas psicológicos utilizados por movimentos conservadores e autoritários recentemente difundidos no Brasil - em especial, pelo Movimento Escola sem Partido -, em relação a temas como sexualidade e gênero, que atualmente foram incluídos como essenciais à formação escolar. Com esse propósito, empenhamo-nos em compreender a perspectiva cultural em que se apoiam e o modo como a articulam, ideologicamente, para inviabilizar o debate sobre eles. A partir da análise dos Projetos de Lei 246/2019 e 1859/2015, identificamos estratégias conservadoras que, autoritariamente, deslegitimam sua inclusão na formação escolar. Dentre elas, pareceu-nos urgente investigar a instrumentalização da religião, pois favorece a subordinação da crença religiosa, sobretudo associada ao conservadorismo moral imbricado na tradição cristã brasileira, ao discurso político autoritário. Assim como os movimentos fascistas que, nos Estados Unidos da década de 1930, reivindicavam um ordenamento autoritário e opressor da sociedade por meio do apelo a conteúdos religiosos instrumentalizados para esse fim, atualmente, o discurso religioso também é utilizado como forma de suscitar adesão ao conservadorismo social e político e de justificar preconceitos arraigados. Constatamos que a instrumentalização da religião é uma forma de justificar a permanência de valores conservadores na escola e na sociedade, bem como de reiterar o modelo de família heterossexual monogâmica e a ordem patriarcal. Por meio de estratagemas como esses, os movimentos conservadores e autoritários, articulados em função da negação da diversidade sexual e de gênero, impedem que a escola se constitua como espaço democrático e diverso.(AU)

This paper identifies and discusses the psychological ploys employed by recent conservative and authoritarian movements in Brazil, particularly the School without Party movement, against topics like sexuality and gender, which are currently included as essential to school education. To do so, we sought to understand their cultural basis and how they are ideologically articulated to prevent school debate around these topics. By analyzing Bills 246/2019 and 1859/2015, we identified some conservative strategies that authoritatively delegitimize their inclusion in school education. Chief among them is the instrumentalization of religion, since it favors subordinating religious belief, mainly associated with traditional Christian moral conservatism, to authoritarian political discourse. Similar to the fascist movements in the 1930s United States that claimed an authoritarian and oppressive ordering of society by appealing to religious content, religious speech is currently instrumentalized to encourage social and political conservatism adherence and to justify deep-seated prejudices. Religion instrumentalization is used to justify upholding conservative values at school and in society, as well as to reiterate the monogamous heterosexual family model and patriarchy. Through such ploys, authoritarian and conservative movements, articulated around denying sexual and gender diversity, prevent the school from becoming a democratic and diverse environment.(AU)

Este artículo tiene por objetivo identificar y discutir algunas de las estratagemas psicológicas que utilizan los movimientos conservadores y autoritarios, difundidas recientemente en Brasil, en particular por el Movimiento Escuela sin Partido, con relación a temas como sexualidad y género, que actualmente se incluyeron en la formación escolar. Con este propósito, se pretende comprender la base cultural en la que se han apoyado y cómo la articulan ideológicamente para hacer inviable el debate sobre ellas. A partir de análisis de los Proyectos de Ley 246/2019 y 1859/2015, se identificaron estrategias conservadoras que, autoritariamente, deslegitiman la inclusión de estos temas en la formación escolar. Entre ellas, parece urgente analizar la instrumentalización de la religión, porque favorece la subordinación de la creencia religiosa al discurso político autoritario, sobre todo asociada al conservadurismo moral presente en las vertientes del cristianismo brasileño. Al igual que los movimientos fascistas en los Estados Unidos en los años 1930 que reivindicaban una planificación autoritaria de la sociedad mediante un llamado a contenidos religiosos instrumentalizados, actualmente se utiliza el discurso religioso como forma de promover la adhesión al conservadurismo social y político y de justificar los prejuicios. Se constata que la instrumentalización de la religión es un modo de justificar la permanencia de valores conservadores en la escuela, así como de confirmar el modelo de familia heterosexual monógama y el orden patriarcal. Estos estratagemas que son utilizados por los movimientos conservadores y autoritarios, articulados en función de la negación de la diversidad sexual y de género, impiden que la escuela sea democrática y diversa.(AU)

Protestantism and psychoactive drugs: implications for nursing and health / Protestantismo y drogas psicoactivas: implicaciones para la salud y la enfermería / Protestantismo e drogas psicoativas: implicações para a saúde e enfermagem

Objectives: To identify and analyze the social representations of psychoactive drugs to the protestant religious group and their implications for nursing care. Method: The data collection was carried out in the state and city of Rio de Janeiro, through the Free Evocation of Words technique. Results: The participants were 300 subjects divided into three subgroups with 100 Protestant evangelical subjects. Of them, 74.67% were female (224 participants) and 25.33%, males (76). Final thoughts: The assistance, taking into account the factors beyond spiritual, is beneficial not only for the patient, but also for the Nursing team, because it improves the spiritual awareness and understanding of the individual as a being beyond the disease.

Objetivos: Identificar y analizar las representaciones sociales de las drogas psicoactivas para el grupo religioso protestante y sus implicaciones para el cuidado de enfermería. Método: La recolección de datos se realizó en el estado y ciudad de Río de Janeiro, mediante la técnica de Evocación Libre de Palabras. Resultados: Los participantes fueron 300 sujetos divididos entres subgrupos con 100 sujetos evangélicos protestantes. De ellos, el 74,67% eran mujeres (224 participantes) y el 25,33%, hombres (76). Reflexiones finales: La asistencia, teniendo en cuenta los factores más allá de lo espiritual, es beneficiosa no solo para el paciente, sino también para el equipo de Enfermería, porque mejora la conciencia espiritual y la comprensión del individuo como un ser más allá de la enfermedad.

Objetivos: Identificar e analisar as representações sociais das drogas psicoativas para o grupo religioso protestante e suas implicações para o cuidado de enfermagem. Método: A coleta de dados foi realizada no estado e município do Rio de Janeiro, por meio da técnica de Evocação Livre de Palavras. Resultados: Participaram do estudo, 300 sujeitos divididos em grupos de 100 sujeitos para cada subgrupo de evangélicos protestantes. Dos quais 74,67% eram do gênero feminino (224 participantes) e 25,33 do gênero masculino (25,33%). Considerações Finais: A assistência levando-se em conta os fatores para além do espiritual é benéfica não apenas para o paciente, mas também para a equipe de Enfermagem, pois melhora a consciência espiritual e a compreensão do indivíduo como um ser para além da doença.

Análisis de los recursos defensivos y manejo de la muerte en grupos religiosos protestantes / Analysis of defensive resources and of coping with death in protestant religious groups / Análise dos recursos defensivos e manejo da morte emgrupos religiosos protestantes

Este trabajo buscó comprender y analizar las percepciones sobre la muerte y la finitud en grupos religiosos protestantes. Participaron 10 voluntarios autodenominados cristianos protestantes, con edades de los 18 a los 55 años. Se realizó entrevistas semiestructuradas con preguntas sobre el tema "muerte" y se aplicó el Cuestionario Desiderativo (CD), todo eso en línea, por medio de llamadas de video. Se analizó los datos según la teoría propuesta por Nijamkim y Braude. Los resultados indicaron que los mecanismos de defesa instrumentales de todos los participantes tenían fallas, y que la religión influjo en su elección de símbolos y racionalizaciones. Además, el CD mostró matices y conflictos, pues los discursos conscientes (entrevista semiestructurada), que no indicaron medo de la muerte y de la finitud, mientras los resultados del CD (respuestas inconscientes) indicaron el opuesto, mostrando inseguridad, ambivalencia y miedo de la muerteAU.

This work aimed to understand and analyze the perceptions about death and finitude in protestant religious groups. The participants were 10 volunteers, self-described as protestant Christians, from 18 to 55 years old. Semistructuredinterviews were carried out with questions about the topic "death", and the Desiderative Questionnaire (DQ) was also applied, both completely online, through videocalls. The results were analyzed according with the theoretical recommendations by Nijamkim and Braude and suggest that the instrumental defense mechanisms of all participants have shortcomings. They showed that their anxiety strongly interferes when it comes to the proximity of death and that their religion influences their choices of symbols and rationalizations. Furthermore, the DQ showed the nuances and conflicts in the conscious discourses (semistructured interview), as it indicated no fear of death and finitude, while the DQ results (unconscious responses) indicated the opposite, showing insecurities, ambivalence, and fear of deathAU.

O presente trabalho objetivou compreender e analisar as percepções sobre a morte e finitude em grupos religiosos protestantes.Participaram 10 voluntários autodenominados cristãos protestantes, com idades entre 18 e 55 anos. Foram realizadas entrevistas semiestruturadas com perguntas envolvendo a temática "morte" e aplicado o Questionário Desiderativo (QD),de forma totalmente on-line, por videochamada. A análise dos resultados seguiu a proposta teórica de Nijamkim e Braude.Os resultadosapontam que todos os participantes apresentaram falhas nos mecanismos de defesa instrumentais; eles demonstram possuir interferência intensa da ansiedade mediante a iminência da morte e demonstram influência da religião em suas escolhas de símbolos e nas racionalizações trazidas. Além disso, o QD revelou as nuances e conflitos presentes entre os discursos conscientes (entrevista semiestruturada), por trazerem a ausência do medo da morte e finitude, sendo que os resultados do QD (respostas inconscientes) apontam o oposto, uma vez que é percebido inseguranças, ambivalência e temor diante da morteAU.

O Grace Memorial Hospital e a Missão Presbiteriana norte-americana no Brasil: fontes para a história da assistência à saúde, 1955-1971 / Grace Memorial Hospital and the American Presbyterian Mission in Brazil: sources for the history of healthcare, 1955-1971

Resumo Apresenta aspectos da história e do acervo documental do Grace Memorial Hospital, instituição criada em 1926 na antiga cidade de Ponte Nova, atual Wagner, na Chapada Diamantina (BA), pelo médico e missionário presbiteriano norte-americano Walter Welcome Wood. O corpus documental está sob guarda da Universidade do Estado da Bahia, campus II, Alagoinhas, desde o encerramento definitivo das atividades do hospital, e constitui-se em fonte de pesquisa para diferentes áreas de estudo, especialmente para a história da assistência à saúde no Brasil. Os documentos auxiliam as análises sobre a incidência de doenças, tratamentos médicos e outros cuidados com a saúde em uma população que não tinha acesso a outras instituições que atuassem nesse âmbito.

Abstract The paper presents aspects of the history and archives of Grace Memorial Hospital, founded in 1926 in the former town of Ponte Nova, now Wagner, in the Chapada Diamantina region of Bahia state, Brazil, by the American Presbyterian missionary and doctor Walter Welcome Wood. The documents in question have been kept at the Universidade do Estado da Bahia, campus II, Alagoinhas, since the hospital closed down definitively. They constitute a source of research for different areas of scholarship, especially the history of healthcare in Brazil. The documents are used in analyses of the incidence of diseases, medical treatments, and other care given to a population that had no access to other institutions working in this area.

Early Phase of Achalasia Manifested as an Esophageal Subepithelial Tumor / 대한소화기병학회잡지

The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. The patient underwent a high resolution manometry (HRM) examination and was diagnosed with EGJOO. Chest CT was performed to exclude a mechanical obstruction as a cause, and CT revealed a subepithelial tumor (SET) at the upper part of the esophagogastric junction. Therefore, laparoscopic surgery was performed and eccentric muscular hypertrophy of the distal esophagus was observed. Longitudinal myotomy and Dor fundoplication were also performed. The histology findings of the surgical specimens were consistent with achalasia. This paper reports a case of early achalasia that was finally diagnosed by the histology findings, but was initially diagnosed as EGJOO using HRM and misdiagnosed as SET in the image study.

Early Phase of Achalasia Manifested as an Esophageal Subepithelial Tumor / 대한소화기학회지

The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. The patient underwent a high resolution manometry (HRM) examination and was diagnosed with EGJOO. Chest CT was performed to exclude a mechanical obstruction as a cause, and CT revealed a subepithelial tumor (SET) at the upper part of the esophagogastric junction. Therefore, laparoscopic surgery was performed and eccentric muscular hypertrophy of the distal esophagus was observed. Longitudinal myotomy and Dor fundoplication were also performed. The histology findings of the surgical specimens were consistent with achalasia. This paper reports a case of early achalasia that was finally diagnosed by the histology findings, but was initially diagnosed as EGJOO using HRM and misdiagnosed as SET in the image study.

Reconsideration of Dr. Allen's Report about Hemoptysis Patients from High Prevalence of Archaeoparasitological Paragonimiasis in Korea

Horace N. Allen, an American physician, was a Presbyterian missionary to Korea. In 1886, he wrote the annual report of the Korean government hospital, summarizing patient statistics according to outpatient and inpatient classification for the first ever in Korean history. In the report, he speculated that hemoptysis cases of outpatient might have been mainly caused by distoma. Allen’s conjecture was noteworthy because only a few years lapsed since the first scientific report of paragonimiasis. However, he was not sure of his assumption either because it was not evidently supported by proper microscopic or post-mortem examinations. In this letter, we thus revisit his assumption with our parasitological data recently obtained from Joseon period mummies.

Suicídio, cultura e trabalho em município de colonização alemã no sul do Brasil / Suicide, culture and work in a German-colonized municipality in the South of Brazil / Suicidio, cultura y trabajo en un municipio de colonización alemana en el sur del Brasil

O suicídio é um problema de saúde pública de magnitude elevada e ascendente. No Brasil, o Rio Grande do Sul tem apresentado, historicamente, altas taxas de mortalidade, sobretudo em regiões colonizadas por alemães. Este é um estudo de caso social, cujas informações foram produzidas com base em narrativas de 14 informantes-chave, pertencentes aos campos da saúde, agricultura, justiça, segurança pública, comunicação social e educação. Os determinantes atribuídos pelos informantes ao suicídio incluíram: a cultura germânica, a ética protestante e o sofrimento no trabalho que afeta agricultores que trabalham com o fumo em regime de pequena propriedade familiar. As reflexões dos entrevistados apontam para o suicídio como um recurso usado na cultura desses descendentes de alemães para enfrentar as dificuldades, cuja frequência se manteve com a introdução do capitalismo no campo e com a subordinação dos agricultores à indústria fumageira.(AU)

Suicide is a serious public health issue with increasing rates. The state of Rio Grande do Sul, Brazil, has a history of high mortality rates, mainly in regions colonized by German populations. The present investigation is a social case study, whose information was obtained through narratives of 14 informers from the health, agriculture, justice, public safety, social communication and education fields. The decisive factors for suicide reported by the informers were the German culture, protestant ethics and suffering at work, which affects family farmers who grow tobacco. The reflections of the interviewees point to suicide as a resource used in the culture of people who descend from German populations to cope with difficulties, which persists as a consequence of the introduction of capitalism in the countryside and the subordination of producers to the tobacco industry.(AU)

El suicidio es un problema de salud pública de magnitud elevada y ascendiente. En Brasil, el Estado de Rio Grande do Sul ha presentado históricamente grandes tasas de mortalidad, principalmente en regiones colonizadas por alemanes. Este es un estudio de caso social, cuyas informaciones se produjeron con base en narrativas de 14 informantes clave, pertenecientes a los campos de: salud, agricultura, justicia, seguridad pública, comunicación social y educación. Los factores determinantes atribuidos por los informantes al suicidio incluyeron: la cultura germánica, la ética protestante y el sufrimiento en el trabajo que afecta a los agricultores que trabajan con el tabaco en régimen de pequeña propiedad familiar. Las reflexiones de los entrevistados señalan el suicidio como un recurso utilizado en la cultura de esos descendientes de alemanes para enfrentar las dificultades, cuya frecuencia se mantuvo con la introducción del capitalismo en el campo y con la subordinación de los agricultores a la industria del tabaco.(AU)

Quinhentos anos da Reforma Protestante: a cosmovisão cristã calvinista e a bioética / Five hundred years of Protestant Reformation: A Calvinist worldview interfacing with bioethics / Quinientos años de la Reforma Protestante: la cosmovisión cristiana calvinista y la bioética

Resumo Passados quinhentos anos da chamada Reforma Protestante, é possível perceber ideias oriundas desse movimento fundamentando visões de mundo na atualidade. Especificamente, nota-se a aplicabilidade de cosmovisão derivada da Bíblia, centrada em sistema cristão de crença, em especial a vivenciada pelo reformador João Calvino. O objetivo deste trabalho é apontar o reflexo de seu pensamento, a partir de elementos históricos e teológicos, na ampliação da capacidade de interpretar o atual contexto da bioética. Por se caracterizar como construção intelectual ainda pouco conhecida, a cosmovisão cristã calviniana, aqui estudada, necessita ser mais bem compreendida e trabalhada. Mesmo com as evidentes diferenças culturais, históricas, econômicas, políticas e sociais entre o contexto do século XVI e o atual, essa cosmovisão pode contribuir para o avanço de estudos e debates da atualidade no campo da bioética.

Abstract After five hundred years of the Protestant Reformation, it is possible to perceive ideas originating from this movement supporting today's worldviews. Specifically, it is possible to perceive the applicability of a Bible derived worldview, centered on a Christian belief system, especially that experienced by the reformer John Calvin. The goal of this work is to point out the influence of the reformer's thought, based on historical, theological elements, on the expansion of the capacity to interpret the current context of bioethics. Because it is characterised as a little-known intellectual construction, the Calvinist worldview, presented here, needs to be better understood and studied. Even with the obvious cultural, historical, economic, political and social differences between the context of the 16th century and the present-time, Calvin's worldview could contribute to the advancement of studies and debates for the 21th century in the field of bioethics.

Resumen Después de quinientos años de la llamada Reforma Protestante, es posible percibir ideas oriundas de ese movimiento fundamentando visiones de mundo en la actualidad. Específicamente, se puede percibir la aplicabilidad de una cosmovisión derivada de la Biblia, centrada en un sistema cristiano de creencias, en especial la vivenciada por el reformador João Calvino. El objetivo de este trabajo es señalar el reflejo de su pensamiento, a partir de elementos históricos, teológicos, en la ampliación de la capacidad de interpretar el actual contexto de la bioética. Por caracterizarse como una construcción intelectual todavía poco conocida, la cosmovisión cristiana calviniana, aquí estudiada, necesita ser mejor comprendida y trabajada. Incluso con las evidentes diferencias culturales, históricas, económicas, políticas y sociales entre el contexto del siglo XVI y el actual, dicha cosmovisión puede contribuir con el avance de los estudios y debates de la actualidad en el campo de la bioética.

A ética protestante e a formação de um ethos esportivo / The protestant ethic and the formation of a sporting ethos / La ética protestante y la formación de un ethos deportivo

A presente resenha retrata a obra de Steven Overman, denominada "The Protestant Ethic and the Spirit of Sport: How Calvinism and Capitalism Shaped America's Games". Sob linhagem teórica weberiana e com influência direta de Allen Guttmann, o autor resgata as doutrinas puritanas do período reformista, como consequência e causa do espírito capitalista americano. Ao propor as sete virtudes calvinistas como características essenciais da ética protestante, Overman demonstra como as mesmas culminaram no establishment das instituições americanas, inclusive as relacionadas à esfera esportiva. Ao relacionar as virtudes e doutrinas oriundas da reforma no ethos americano, o autor identifica suas correspondências no espírito do esporte, demonstrando como competições escolares e universitárias, o olimpismo moderno e a profissionalização de clubes e atletas, comungam com o capitalismo e protestantismo nos EUA.

The present review depicts Steven Overman's book "Protestant Ethic and the Spirit of Sport: How Calvinism and Capitalism Shaped America's Games." Under Weberian theoretical lineage and with direct influence of Allen Guttmann, the author sees puritan doctrines of the reformist period as both consequence and cause of the American spirit of capitalism. By proposing seven Calvinistic virtues as essential features of Protestant ethic, Overman demonstrates how they culminated in the establishment of American institutions, including those related to the sphere of sport. By relating virtues and doctrines coming from the reform in the American ethos, the author identifies his correspondences in the spirit of sport, demonstrating how school and college competitions, the Olympic movement and the professionalization of clubs and athletes commune with the USA's capitalism and Protestantism.

La presente reseña retrata la obra de Steven Overman, denominada "The Protestant Ethic and the spirit of sport: How calvinism and capitalism shaped America's Games". En linaje teórica weberiana y con influencia directa de Allen Guttmann, el autor rescata las doctrinas puritanas del período reformista como consecuencia y causa del espíritu capitalista americano. Al proponer las siete virtudes calvinistas como características esenciales de la ética protestante, Overman demuestra cómo las mismas culminaron en el establishment de las instituciones americanas incluso las relacionadas a la esfera deportiva. Al relacionar las virtudes y doctrinas oriundas de la reforma en el ethos americano el autor identifica sus correspondencias en el espíritu del deporte, demostrando como competiciones escolares y universitarias, el olimpismo moderno y la profesionalización de clubes y atletas, comulgan con el capitalismo y protestantismo de Estados Unidos.

Hermann Hesse's Depression, Pietism, and Psychoanalysis / 신경정신의학

Hermann Hesse's personal life (1877–1962) is characterized by traumatization caused by suppressive pietistic discipline of his parents during his youth, and depression in his middle age accompanied by psychoanalysis treatment. At the age of 15, he was admitted to mental institutions due to defiant behavior. With this traumatic experience, his psychosexual development seemed inhibited during his adolescence. At age 39, depression developed precipitated by the death of his father. Hesse had received Jungian psychoanalysis from Dr. Lang and Dr. Jung over a 10-year period. However, psychoanalysis could not prevent the recurrence of depression. His appreciation of psychoanalysis became critical. Meanwhile, Hesse announced that he had been a Protestant Christian. In his 50s, he began to create new novels which, beyond polarity based on Jungian psychoanalysis, described the journey toward a greater harmonious and spiritual oneness. Pietism was at one time the reason of his pain, but became life-long support for Hesse's spiritual maturity. He was diagnosed with type II bipolar disorder. The main dynamic factors are thought to be ambivalence, feelings of guilt regarding his aggression toward his parents, and sexual conflict. His coping mechanisms seemed to include pietistic self-control, avoidance, scholarship and creation of literature. By writing the autobiographical Bildungsromans, Hesse tried not only to master his own personal problems but to enlighten readers. However, it seemed that he could not overcome the feelings of guilt associated with leaving his father.

Perfil de saúde de idosos adventistas que ultrapassaram a expectativa de vida / Health profile of adventist elders who exceeded life expectancy / Perfil de salud de ancianos adventistas que superaron la expectativa de vida

O objetivo deste estudo foi verificar aspectos do perfil de saúde de idosos adventistas do sétimo dia que ultrapassaram a expectativa média de vida. O estudo realizado foi analítico observacional transversal. Participaram da pesquisa 90 idosos com média de idade de 82,9 anos. A coleta de dados consistiu na aplicação dos seguintes instrumentos de avaliação: o mini-exame do estado mental (MEEM), questionário sócio-demográfico para conhecer o perfil social; mini-avaliação nutricional (MAN), e a Escala Internacional de Eficácia de Quedas (FES). As atividades básicas da vida diária (AVDB) foram avaliadas pela escala funcional de Katz e a Escala de Lawton e Brody de atividades instrumentais de vida diária (AIVD). A maioria dos idosos entrevistados era de brancos, casados, com 7,3 anos de estudos, aposentados, filhos de pais longevos e do sexo masculino. A doença mais prevalente foi a hipertensão arterial. A carga de doenças foi de 3,2 doenças. A pontuação na Escala de Katz foi de 6,3±0,8 pontos, na Escala de Lawton e Brody de 25,1±3,8, na Escala FES foi de 24,7±10,4 e na MAN de 11,7±1,3 pontos. Não houve diferença ao serem comparados homens em relação a mulheres. Ao serem feitas as correlações entre as variáveis estudadas, houve muitas correlações significantes, porém fracas. Apenas 4 correlações foram consideradas moderadas. Correlação positiva entre AIVD e MEEM, entre AIVD e MAN, Correlação inversa entre AIVD e FES e AIVD e ABVD.

The objective of this study was to study the health profile of Seventh-day Adventist elderly who exceeded the average life expectancy. The study was transversal observational analytical. A total of 90 elderly people with an average age of 82.9 years participated in the study. The data collection consisted of the application of the following evaluation instruments: The mini mental state examination (MEEM), socio-demographic questionnaire to know the social profile; mini nutritional assessment (MAN), International Falls Efficiency Scale (FES). The basic activities of daily living (BADL) were assessed by the Katz functional scale and the Lawton and Brody Scale of instrumental activities of daily living (IADL). The majority of the elderly interviewed were white, married, with 7.3 years of education, retired, children of long-lived and male parents. The most prevalent disease was hypertension. The burden of disease was 3.2 diseases. The Katz Scale score was 6.3 ± 0.8 points, in the Lawton and Brody Scale of 25.1 ± 3.8, in the FES Scale was 24.7 ± 10.4 and in the MAN score of 11, 7 ± 1.3 points. There was no difference when men from women were compared. When the correlations between the studied variables were made, there were many significant but weak correlations. Only 4 correlations were considered moderate. Positive correlation between IADL and MEEM, between IADL and MAN, inverse correlation between IADL and FES and IADL and BADL.

El objetivo de este estudio fue aspectos del perfil de salud de los ancianos adventistas del séptimo día que sobrepasaron la expectativa media de vida. El estudio realizado fue analítico observacional transversal. Participaron de la encuesta 90 ancianos con promedio de edad de 82,9 años. La recolección de datos consistió en la aplicación de los siguientes instrumentos de evaluación: El mini examen del estado mental (MEEM), cuestionario socio demográfico para conocer el perfil social; minima evaluación nutricional (MAN), Escala Internacional de Eficacia de Caídas (FES). Las actividades básicas de la vida diaria (AVDB) fueron evaluadas por la escala funcional de Katz y la Escala de Lawton y Brody de actividades instrumentales de vida diaria (AIVD). La mayoría de los ancianos entrevistados eran blancos, casados, con 7,3 años de estudios, jubilados, hijos de padres longevos y del sexo masculino. La enfermedad más prevalente fue la hipertensión arterial. La carga de las enfermedades fue de 3,2 enfermedades. La puntuación en la escala de Katz fue de 6,3 ± 0,8 puntos, en la escala de Lawton y Brody de 25,1 ± 3,8, en la escala FES fue de 24,7 ± 10,4 y en la MAN de 11, 7 ± 1,3 puntos. No hubo diferencia al ser comparados hombres de mujeres. Al hacer las correlaciones entre las variables estudiadas, hubo muchas correlaciones significantes, pero débiles. Sólo 4 correlaciones se consideraron moderadas. Correlación positiva entre AIVD y MEEM, entre AIVD y MAN, Correlación inversa entre AIVD y FES y AIVD y ABVD.

Perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e a população geral / Profile of mortality from external causes among Seventh-day Adventists and the general populations

Resumo Este estudo teve por objetivo comparar o perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e população geral do Espírito Santo no período de 2003 a 2009. Realizou-se busca dos Adventistas no banco nominal do Sistema de Informação sobre Mortalidade de posse das informações dos Adventistas fornecidas pelas sedes administrativas da instituição. Os óbitos por causas externas ocorridos no período estudado foram então separados em dois grupos: Adventistas e população geral. Os Adventistas apresentaram menor mortalidade proporcional por causas externas (10%) que a população geral (19%), sendo o sexo masculino o principal responsável por essa diferença. Em ambos os grupos os óbitos predominaram na faixa de 20 a 29 anos. As mortes por causas acidentais foram mais expressivas entre os Adventistas (68,08%) enquanto as mortes por causas intencionais relacionadas às agressões e lesões autoprovocadas foram mais significativas na população geral (53,67% de todas as mortes). A razão de mortalidade padronizada para as causas externas foi 41,3, sendo assim ser Adventista reduziu a mortalidade em 58,7%. Acredita-se que o benefício dos Adventistas verificado em relação à mortalidade por causas externas possa estar relacionado à recomendação de abstinência do consumo de álcool por esse grupo.

Abstract This paper aimed to compare the profile of mortality from external causes among Seventh-day Adventists and the general population of Espírito Santo from 2003 to 2009. A search of Adventists was performed in the nominal database of the Mortality Information System containing data on Adventists provided by the administrative offices of the institution. Deaths from external causes occurred during the study period were then divided into two groups: Adventists and the general population. Adventists had lower proportional mortality from external causes (10%) than the general population (19%), and males were the main reason for this difference. In both groups, deaths prevailed in the 20-29 years age group. Deaths from accidental causes were most significant among Adventists (68.08%), while deaths from intentional causes related to assault and self-inflicted injuries were more significant in the general population (53.67% of all deaths). The standardized mortality ratio for external causes was 41.3, thus, being Adventist reduced mortality by 58.7%. It is believed that the benefit of Adventists observed for mortality from external causes is related to this group's abstinence from alcohol consumption.

Results of Absorbable Mesh Insertion and Patient Satisfaction in Breast-Conserving Surgery

PURPOSE: Breast-conserving surgery (BCS) is a standard treatment for breast cancer. Occasionally, patients may be dissatisfied with the breast shape due to deformity after BCS. To ensure satisfactory cosmetic results, a procedure with absorbable mesh after BCS was introduced in 2005. The purpose of this study was to identify the safety and effectiveness of this procedure. METHODS: From November 2013 to December 2015, patients who underwent BCS for a malignant breast mass at Jeonju Presbyterian Medical Center were reviewed, and 63 patients were included in this study. Based on data collected from medical records and telephone interviews, the subjects were divided into two groups as follows and retrospectively compared and analyzed: BCS with absorbable mesh (n=31) and BCS without absorbable mesh (n=32). Patient data included age, body mass index, underlying disease, tumor location and size, specimen size, operative time, axillary dissection based on frozen biopsy results, postoperative wound infection, postoperative radiotherapy, adjuvant chemotherapy, and follow-up period. To compare patient satisfaction between the two groups, a brief questionnaire consisting of four items was administered. RESULTS: Infection occurred in six patients (19.4%) in the absorbable mesh group and one (3.1%) in the BCS only group; however, the difference was not significant (p=0.053). Overall satisfaction, postoperative pain and postoperative motion limitation between the two groups were also not statistically significantly different. However, patients who underwent BCS with absorbable mesh insertion were better satisfied with the breast shape than those who underwent BCS without mesh from 1 year after operation (p=0.011). CONCLUSION: BCS with absorbable mesh is a simple and easy method to improve patient satisfaction for breast shape.

Revisión histórica de la prohibición de las drogas en Estados Unidos: desde los pilgrims hasta el Partido Prohibicionista / Historical review of the prohibition of drugs in the United States: from the pilgrims to the prohibitionist party

En este artículo se identifican las bases históricas del prohibicionismo hacia las drogas en Estados Unidos. Se propone que la negativa del empleo recreativo de las drogas no es exclusiva del siglo XX; en el caso de Estados Unidos es un proceso que se origina desde la llegada de los primeros colonos y tiene fundamento en la esfera religiosa protestante, en el desarrollo del capitalismo y más tarde en la oleada migratoria procedente de otras latitudes

This article describes the historical bases of the prohibition of drugs in the United States of America. It is proposed that the refusal to the recreational use of drugs is not unique to the twentieth century; in the American case is a process that originates from the arrival of the first settlers and in the protestant religious dogma, in the development of capitalism, and later in the migration wave

Risk Factors of Readmission to Hospital for Pneumonia in Children

PURPOSE: We analyzed the risk factors affecting readmission of children with pneumonia. METHODS: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. RESULTS: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. CONCLUSIONS: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

Risk Factors of Readmission to Hospital for Pneumonia in Children

PURPOSE: We analyzed the risk factors affecting readmission of children with pneumonia. METHODS: We retrospectively analyzed the medical records of pediatric patients admitted to the Department of Pediatrics at the Jeonju Presbyterian Medical Center from January 2007 to August 2016. We classified patients who were readmitted with pneumonia within 30 days of discharge as the readmission group and patients who were admitted with pneumonia for the first time as the first admission group. RESULTS: Among 158 patients, the study (readmission) group included 82 patients and the control (first admission) group included 76 patients. Age, the percentage of segmented neutrophils and lymphocytes, the number of admissions in the last 12 months, the associated diseases (respiratory diseases such as asthma), and the affection of the right upper lung were analyzed as risk factors for readmission. However, based on a regression analysis, only age and associated diseases were found to be significant risk factors. The rate of readmission increased with younger age. When there were associated diseases, the rate of readmission also increased. CONCLUSIONS: Young age and associated diseases were significant risk factors for readmission for patients with pediatric pneumonia. When pediatric patients are admitted with pneumonia, if they are young and/or have associated diseases, a comprehensive approach is needed to reduce the rate of readmission with careful consideration of precise examination, treatment, timing of discharge, and follow-up.

Hazardous Alcohol Use in 2 Countries: A Comparison Between Alberta, Canada and Queensland, Australia / 예방의학회지

OBJECTIVES: This article aimed to compare alcohol consumption between the populations of Queensland in Australia and Alberta in Canada. Furthermore, the associations between greater alcohol consumption and socio-demographic characteristics were explored in each population. METHODS: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey were analyzed. Regression analyses were used to explore the associations between alcohol risk and socio-demographic characteristics. RESULTS: A higher rate of hazardous alcohol use was found in Queenslanders than in Albertans. In both Albertans and Queenslanders, hazardous alcohol use was associated with being between 18 and 24 years of age. Higher income, having no religion, living alone, and being born in Canada were also associated with alcohol risk in Albertans; while in Queenslanders, hazardous alcohol use was also associated with common-law marital status. In addition, hazardous alcohol use was lower among respondents with a non-Catholic or Protestant religious affiliation. CONCLUSIONS: Younger age was associated with greater hazardous alcohol use in both populations. In addition, different socio-demographic factors were associated with hazardous alcohol use in each of the populations studied. Our results allowed us to identify the socio-demographic profiles associated with hazardous alcohol use in Alberta and Queensland. These profiles constitute valuable sources of information for local health authorities and policymakers when designing suitable preventive strategies targeting hazardous alcohol use. Overall, the present study highlights the importance of analyzing the socio-demographic factors associated with alcohol consumption in population-specific contexts.

Não apenas em nome de deus: discursos religiosos sobre homossexualidade / No solo en el nombre de dios: discursos religiosos sobre la homosexualidad / Not just in the name of god: religious discourses on homosexuality

A homossexualidade tem sido pauta de diversos discursos religiosos nos últimos anos, sobretudo cristãos, transpondo as arenas religiosas e penetrando em espaços políticos e do direito. O presente artigo pretende, por meio da análise de vídeos de indivíduos que ocupam posições de porta-vozes das religiões católica e evangélica pentecostal e neopentecostal, analisar e problematizar as concepções de homossexualidade dos/as cristãos/ãs, utilizando para tal a Análise do Discurso Foucaultiana como referencial metodológico. Foi verificado um difuso arsenal de discursos acerca da homossexualidade, englobando saberes religiosos, "científicos", entre outros.

La homosexualidad ha sido la agenda de varios discursos religiosos en los últimos años, especialmente en los discursos cristianos, a través de espacios religiosos y ingresando en los espacios políticos y de la ley. Este artículo pretende, mediante el análisis de videos de personas que se presentan como portavoces de las religiones católica y evangélica pentecostal y neo pentecostal, analizar y discutir los conceptos de homosexualidad presentes en estos discursos, mediante el análisis del discurso desde la perspectiva de Michel Foucault.

Homosexuality has been the agenda of several religious discourses in recent years, especially Christians, crossing beyond religious arenas and penetrating political and law field. This article aims, through the analysis of videos of individuals in positions of spokesmen of religions Catholic and Evangelical pentecostal and neo-pentecostal, to analyse and discuss the concepts of homosexuality made by Christians, using Foucault Discourse Analysis as a methodological framework. A diffuse arsenal of discourses about homosexuality was verified, covering "scientific" and religious knowledge, among others.