Support- and meaning-focused coping as key factors for maintaining adult quality of life during the COVID-19 pandemic in Germany.

Introduction: During the COVID-19 pandemic, questions about both consequences and helpful strategies to maintain quality of life (QoL) have become increasingly important. Thus, the aim of this study was to investigate the distribution of coping factors during the COVID-19 pandemic, their associations with QoL and the moderating role of certain sociodemographic characteristics. Methods: Analyses were based on cross-sectional self-reports from German adult participants (N = 2,137, 18-84 years, 52.1% female) of the CORONA HEALTH APP Study from July 2020 to July 2021. Multivariate regression analyses were used to predict (a) coping factors assessed with the Brief COPE and (b) QoL assessed with the WHOQOL-BREF while taking measurement time, central sociodemographic, and health characteristics into account. Results: During the COVID-19 pandemic, German adults mostly pursued problem- and meaning-focused coping factors and showed a relatively good QoL [Mean values (M) from 57.2 to 73.6, standard deviations (SD) = 16.3-22.6], except for the social domain (M = 57.2, SD = 22.6), and with a decreasing trend over time (ß from -0.06 to -0.11, ps < 0.01). Whereas, escape-avoidance coping was negatively related to all QoL domains (ß = -0.35, p < 0.001 for psychological, ß = -0.22, p < 0.001 for physical, ß = -0.13, p = 0.045 for social, ß = -0.49, p < 0.001 for environmental QoL), support- and meaning-focused coping showed positive associations with various QoL domains (ß from 0.19 to 0.45, ps < 0.01). The results also suggested differences in the pursuit of coping factors as well as in the strength of associations with QoL by sociodemographic characteristics. Escape-avoidance-focused coping was negatively associated with QoL levels in older and less educated adults (simple slopes differed at ps < 0.001), in particular. Conclusions: The results demonstrated what types of coping may be helpful to avoid QoL deterioration (i.e., support- and meaning-focused coping) and provide implications for future universal or targeted health promotion (i.e., older or less educated adults who lack social or instrumental support) and preparedness in the face of unknown challenging societal situations similar to that of the COVID-19 pandemic. Cross-sectional trends of enhanced use of escape-avoidance-focused coping and QoL deterioration point toward a need for increased attention from public health and policy.

Role of the European Pharmacist in the Implementation of the Latest WHO Guidelines for Malaria.

Following the publication a few months ago of the new WHO guidelines for malaria, the European pharmacist, even out of endemic areas, as a health care professional and advisor, has a major role to play in their effective implementation and in the interest of public health. The pharmacist is central in the health care system to ensure the correct application of these recommendations and to perform a decisive role in the prevention of malaria infections, both in the adapted pharmaceutical advice on personal protection against biting vector insects on the one hand, and in the pharmaceutical analysis and recommendations concerning antimalarial chemoprophylaxis prescriptions on the other hand. Physicians and pharmacist biologists, as well as hospital pharmacists, are also important for the analysis and treatment of effective malaria cases, particularly in the management of the diagnostic and therapeutic emergency that a P. falciparum infection represents.

Candida auris as an Emergent Public Health Problem: A Current Update on European Outbreaks and Cases.

Candida auris is considered to be an emerging fungal pathogen and is related to high mortality rates, persistent candidemia, inconsistencies in susceptibility testing results and misidentification by available commercial identification systems. Multidrug-resistant (MDR) and pandrug-resistant (PDR) strains are increasingly detected. In Europe, hospital outbreaks caused by C. auris have been reported in the United Kingdom (UK), Italy and Spain; however, several cases have been sporadically detected in all European countries. C. auris is difficult to control despite enhanced control measures due to its ability to survive for a long time in environments and colonize patients for prolonged periods. An adequate laboratory diagnostic capacity and national surveillance are fundamental to rapidly detect new C. auris cases and to apply the correct measures to circumscribe them and prevent their spread. Our narrative review aims to highlight the primary C. auris outbreaks and case reports that have occurred in Europe.

Collective Prevention of Non-Communicable Diseases in an Ageing Population with Community Care.

The Dutch population is rapidly ageing, and a growing number of people are suffering from age-related health problems such as obesity, cardiovascular diseases and diabetes. These diseases can be prevented or delayed by adapting healthy behaviours. However, making long-lasting lifestyle changes has proven to be challenging and most individual-based lifestyle interventions have not been effective on the long-term. Prevention programs focused on lifestyle should involve the physical and social context of individuals, because the (social) environment plays a large role in both conscious and unconscious lifestyle choices. Collective prevention programmes are promising strategies to mobilize the potential of the (social) environment. However, little is known about how such collective prevention programs could work in practice. Together with community care organization Buurtzorg, we have started a 5 year evaluation project to study how collective prevention can be practised in communities. In this paper, we discuss the potential of collective prevention and explain the methods and goals of our study.

Civic Education's Role in Advancing Health Equity for LGBTQIA2S+ Youth.

A healthy democracy requires civic engagement from citizens. In the current political climate that is hostile toward LGBTQIA2S+ youth, young adults, and individuals of all ages, it is imperative that public health promotion integrate civic education into health education programs to build civic engagement knowledge, skills, and efficacy among young people. In the United States, we are experiencing an alarming increase in state and federal policies designed to censor and erase LGBTQIA2S+ history and visibility, critical race theory, and civic education. Public health practitioners have an opportunity and a responsibility to integrate civic education as a crucial component of health promotion and education not just to advance LGBTQIA2S+ justice but justice and equity in all its forms.

Analysis of the Impact of Communication Campaigns under the Project "Syphilis No": A National Tool for Inducing and Promoting Health.

Syphilis is increasingly prevalent around the world as a result of complex factors. In Brazil, the government declared a syphilis epidemic in 2016 and then set a strategic agenda to respond to this serious public health problem. In a joint effort, Brazil's Federal Court of Accounts (TCU) recommended that novel and diversified health communication strategies should be developed, which the "Syphilis No" project (SNP) later conducted through nationwide mass communication campaigns. We performed exploratory data analysis to identify and understand the results of three health communication campaigns by considering syphilis data trends in Brazil. The SNP, by using traditional and innovative means of communication, focused on multiple target audiences to encourage behavior changes through awareness and syphilis knowledge acquisition via the internet. In addition, the SNP disseminated information on syphilis testing, prevention, and treatment through social media and multiple media outlets. We observed that the period of the health campaigns corresponded to the period when the syphilis testing uptake increased and the number of reported cases dropped. Thus, our findings indicate that public health responses could substantially benefit from the use of health communication campaigns as a tool for health promotion, education, and transformation.

Discourse about human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) on Twitter: Lessons for public health education about OPC and dental care.

Objectives: Public understanding of human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is minimally understood. Therefore uncovering communication gaps between the public and healthcare professionals regarding this disease is vital. Social media provide an unobtrusive way to understand public perception about health issues. Study design: Computer-assisted quantitative content analysis. Methods: Tweets about HPV-associated OPC (N = 3,112) were collected for 40 weeks using the standard real-time streaming Application Programming Interface (API). The collection of tweets was not limited to one specific geographic location but worldwide. All tweets were entered into nVivo 12.0 to conduct computer-assisted quantitative content analysis. We used an inductive method to develop a coding scheme and examined the frequency of specific keywords, terms, and phrases in texts. Results: Findings show that (a) the majority of discourse on Twitter focused on risk factors and prevention with little information on diagnosis, treatment, and prognoses; (b) many tweets promoted HPV vaccination among boys and emphasized the risk of HPV-associated OPC among males; (c) the role of dental care professionals in the prevention and detection of OPC minimally appeared; (d) the public referred to OPC as oral cancer, head and neck cancer, or throat cancer; and (e) health organizations in New Zealand, Australia, and the United Kingdom led the discussion on HPV-associated OPC on Twitter. Conclusions: The current study unravels the utility of social media data and data mining techniques in understanding public perception and understanding of HPC-associated OPC. The outcomes from the current study provide baseline knowledge of where communication gaps exist in terms of HPV-associated OPC, without which the planning of potential interventions and much-needed social media-based campaigns cannot be effectively undertaken.

An online course about cosmetics improves skin care practices and skin health.

Background: The incidence of cosmetics-associated dermatoses is on the rise recently while the awareness and knowledge about proper utilization of cosmetics are insufficient in both the public and specialists due to limited education about cosmetics. Methods: Our aim was to build and enhance the public's ability to select appropriate cosmetics, manage possible dermatoses and improve skin-care practices and skin health by offering access to medical information via free online courses. Consequently, we launched a massive open online course (MOOC), Appreciation and Analysis of Cosmetics. An online questionnaire was also sent to evaluate the effectiveness of the course. Results: Nearly 540,000 learners were enrolled in the course since 2014. In the discussion forum, there were 8,383 posts and 73,014 replies in total, where learners were mostly concerned about topics of sun protection, cleansing and proper utilization of cosmetics in some skin diseases. 645 learners answered the questionnaire with 88.84% of the them changed skin care practices and 50.39% reported improvement in skin health. Moreover, participants who completed the course reported better understanding and utilization of cosmetics-related knowledge (p values < 0.05). 72.09% of respondents were willing to recommend this course to others. Conclusions: Free online public courses are feasible for conducting public health education campaigns related to cosmetics and associated dermatology to lower the incidence of cosmetics-associated dermatoses.

Sociodemographic and Occupational Factors Associated with Low Early Uptake of COVID-19 Vaccine in Hospital-Based Healthcare Workers, Georgia, March-July 2021.

In Georgia, an upper-middle income European country, the COVID-19 vaccine rollout began on 15 March 2021 with health workers (HWs), a priority group for vaccination. We assessed the factors associated with COVID-19 vaccination among HWs at six large hospitals in the early stages of the vaccine rollout (March−July 2021). Among 1533 HWs, 274 (17.9%) had received one dose of the COVID-19 vaccine. Strong independent predictors of early vaccine uptake were age > 40 years, especially 50−59 years old (aOR 2.40, 95% CI 1.50−3.88), considering the vaccine as "somewhat effective" or "very effective" rather than "not effective" (aOR 6.33, 95% CI 2.29−26.3 and aOR 10.9, 95% CI 3.88−45.70, respectively), and previous vaccination against seasonal influenza (aOR 2.98, 95% CI 2.19−4.08). Previous SARS-CoV-2 infection was negatively associated with receiving the vaccine (aOR 0.6, 95% CI 0.40−0.80). Compared to physicians, nurses/midwives (aOR 0.22, 95% CI 0.15−0.32), administrative staff (aOR 0.36, 95% CI 0.22−0.56), and ancillary staff (aOR 0.07, 95% CI 0.04−0.15) were less likely to have received the COVID-19 vaccine. Tailoring the COVID-19 vaccine communications campaign to younger and non-physician HWs, and emphasizing the benefits of the COVID-19 vaccine, could help further increase vaccine coverage among HWs in Georgia.

Hepatitis of Unknown Origin and Etiology (Acute Non HepA-E Hepatitis) among Children in 2021/2022: Review of the Current Findings.

Several clusters and individual cases of acute hepatitis have been reported in the US, Europe and recently in Asia and Central America since October 2021. A laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results prompting the use of the term "acute non HepA-E hepatitis" to describe this condition. The cases were characterized by the manifestations of acute hepatitis (abdominal pain, vomiting, diarrhea, jaundice and very high levels of liver enzymes) affecting children with a median age of 3-4 years. The exact underlying etiology has not been revealed yet; however, a leading hypothesis is that an infectious agent is the culprit, underlying cause or a risk factor for acute non HepA-E hepatitis occurrence. So far, laboratory testing has shown the presence of the group F human adenovirus serotype 41 (HAdV-F41) in about three-fourths of the investigated cases. As of 13 May 2022, more than 450 cases were reported worldwide, the majority of which were in the UK (n = 176), the US (n = 109), 13 European countries (at least 103 cases) and in Argentina, Brazil, Canada, Costa Rica, Indonesia, Israel, Japan, Palestine, Panama, Singapore and South Korea. Vigilant surveillance and epidemiologic investigations to identify further cases are warranted to delineate the features of this emergent public health issue. The possible role of environmental and toxic agents including foodborne toxins should also be considered. Specific guidelines for identification of further cases are necessary, particularly in low-income settings where testing for adenoviruses is not considered routinely. A genetic analysis of HAdV-F41 isolates is recommended to assess the potential changes in the virus genome with subsequent possible altered virus behavior. Immunopathogenesis is another possibility that should be evaluated considering the lack of viral structures in liver biopsies of the affected children in the US.

Factors associated with vaccine intention in adults living in England who either did not want or had not yet decided to be vaccinated against COVID-19.

Early studies showed that 28-36% of UK adults were unsure or unwilling to be vaccinated against COVID-19. We wanted to identify which socio-demographic, socio-economic, personal health and psychological factors were associated with COVID-19 vaccine intentions (CVI) in adults living in England who did not want, yet to consider, or not sure whether to vaccinate. In October/November 2020, prior to vaccine availability, we surveyed adults stratified by gender, region, and deprivation, with additional purposive sampling of those aged 50 and over and those from an ethnic minority. Two hundred and ten did not want; 407 had yet to consider; and 1,043 were not sure whether to be vaccinated. Factors positively associated with CVI were: favorable vaccine views, trust in institutions associated with vaccine approval, vaccine subjective norms, anticipated regret of not having a vaccine, perceived vaccine benefits, perceived safety knowledge sufficiency, and a history of having an influenza vaccine. Factors negatively associated were: anti-lockdown views, and being a health or social care worker. Whilst showing significant relationships with CVI when analyzed in isolation, neighborhood deprivation and ethnicity did show an independent relationship to intention when all study measures were controlled for. Our findings suggest vaccine promotion focusing on the anticipated regret of not having a vaccine, the benefits of a mass COVID-19 immunization program, and the safety of a vaccine whilst ensuring or engendering trust in those bodies that brand a campaign may be most supportive of COVID-19 vaccine uptake.

Digital Citizen Science for Responding to COVID-19 Crisis: Experiences from Iran.

The Coronavirus Disease 2019 (COVID-19) pandemic has so far been the most severe global public health emergency in this century. Generally, citizen science can provide a complement to authoritative scientific practices for responding to this highly complex biological threat and its adverse consequences. Several citizen science projects have been designed and operationalized for responding to COVID-19 in Iran since the infection began. However, these projects have mostly been overlooked in the existing literature on citizen science. This research sheds light on the most significant online citizen science projects to respond to the COVID-19 crisis in Iran. Furthermore, it highlights some of the opportunities and challenges associated with the strengths and weaknesses of these projects. Moreover, this study captures and discusses some considerable insights and lessons learned from the failures and successes of these projects and provides solutions to overcome some recognized challenges and weaknesses of these projects. The outcomes of this synthesis provide potentially helpful directions for current and future citizen science projects-particularly those aiming to respond to biological disasters such as the COVID-19 pandemic.

"Out there it's YOLO": Youth perspectives on a mass media HIV- and gender-based violence campaign in South Africa.

Gender-based violence continues to be a leading determinant of South Africa's HIV/AIDS epidemic. As such, gender socialisation and de-normalisation of gender inequality and violence remain principal objectives for public health organisations. This article discusses youth reception of a mass media HIV/AIDS prevention campaign targeting gender inequality. Applying social cognitive theory to the analysis of focus group data highlights three interrelated challenges to encouraging positive self-efficacy in gender-based violence and HIV prevention: (1) HIV/ AIDS-related media saturation; (2) AIDS messaging fatigue; and (3) challenges reconciling popular youth culture with gender equity messaging. The article recommends public health and social justice organisations consider a flexible approach to the ideological or behavioural congruence of potential celebrity ambassadors and/or media to maximise youth appeal and reduce messaging fatigue.

The Improved Health Outcomes Program (iHOP): A Unique Model to Promote Provider-Driven Research in a Medicaid Population.

We describe an effort to improve the care of Medicaid and uninsured individuals through a three-way partnership between a Medicaid managed care insurer, front-line providers, and an academic university. The project provided annual funding over eleven years, for research, pilot programs, and demonstration projects. Projects were provider-driven in design and methods. The Medicaid-managed care insurer-funded proposals were vetted by a neutral university team experienced in grant writing and community-based research and scored by a community-based review panel. The grant program ran from 2007 to 2018, funding 41 projects, totaling USD 2,097,842. The partnership of an insurer, a university, and frontline providers was not only viable and sustainable for over a decade, but also flexible, free of project selection issues, and well-received by all stakeholders. Funded providers worked in both urban and rural settings and included hospitals, community non-profits, outpatient clinics, academic and community health partnerships, and public health agencies. The projects generally reflected common issues in the Medicaid and uninsured population needs, such as childhood obesity, and they were consistent with the targeted goals of the program. Broad health foci included child and/or maternal health, chronic conditions, mental health, preventive health, screening, system effectiveness, special populations including refugees, Latinos, and rural individuals, and substance use disorders. Details of the awarded grantee goals, the grants management process, and lessons learned from the partnership are presented. The partnership triad model was effective and stable, with each partner adding unique value. The use of the academic institution to administrate the program provided an arms-length relationship between the insurer and the providers in project selection and allowed assistance to less experienced researchers in community settings.

Transforming Screening Uptake in Low-resource and Underinformed Populations: A Preliminary Study of Factors Influencing Women's Decisions to Uptake Screening.

OBJECTIVES: The objective of this study was to assess the factors influencing women's decision to uptake screening mammography in an underinformed population. STUDY DESIGN: The study is a cross-sectional survey of factors influencing screening uptake. METHODS: A modified breast cancer awareness measure was used to assess women's knowledge of breast cancer, mammography, and factors that influence screening uptake. A second questionnaire investigated health professionals' (HPs') attitude to screening and the criteria for screening recommendation. Descriptive statistics were used to assess women's breast cancer awareness, factors that influence screening uptake, and HPs' attitude to breast cancer education and mammography recommendation. We ranked HPs' responses pertaining to criteria for screening recommendation using a Kendall's W test. RESULTS: Sixty-nine percent (n = 180) of women were aware of breast cancer, and half of them had performed breast self-examination (n = 131). About 53% (n = 138) of women were not aware of mammography, and only 15.4% (n = 40) of them have had a screening mammogram. Women's awareness of breast cancer risk factors and symptoms was poor. Many women would consider having a screening mammogram if instructed to do so by their husbands (87.7%; n = 228), HPs (96.2%; n = 250), and if government-funded screening programmes are available (90%; n = 234). Less than 40% (n = 21) of HPs had referred at least one woman for screening mammography within the last 6 months. Family history, age, and reproductive factors ranked as the highest criteria for screening recommendation. CONCLUSIONS: Spouses and HPs may be crucial to changing the current status quo around screening utilisation and government-funded screening programmes may increase screening uptake.

Adverse effect of long work hours on incident diabetes in 7065 Ontario workers followed for 12 years.

OBJECTIVE: According to the International Diabetes Federation, the most important challenge for prevention is now to identify social and environmental modifiable risk factors of diabetes. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. We evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada. RESEARCH DESIGN AND METHODS: Data from Ontario respondents (35-74 years of age) to the 2003 Canadian Community Health Survey were prospectively linked to the Ontario Health Insurance Plan database for physician services and the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions. Our sample consisted of actively employed participants with no previous diagnoses of diabetes. Cox proportional hazard regression models were then performed to evaluate the relationship between long work hours (≥45 hours per week) and the incidence of diabetes. RESULTS: Long work hours did not increase the risk of developing diabetes among men. However, among women, those usually working 45 hours or more per week had a significantly higher risk of diabetes than women working between 35 and 40 hours per week (HR: 1.63 (95% CI 1.04 to 2.57)). The effect was slightly attenuated when adjusted for the potentially mediating factors which are smoking, leisure time physical activity, alcohol consumption and body mass index. CONCLUSION: Working 45 hours or more per week was associated with an increased incidence of diabetes among women, but not men. Identifying modifiable risk factors such as long work hours is of major importance to improve prevention strategies and orient policy making.

Urban air pollution perception through the experience of social practices: Talking about breathing with recreational runners in London.

This paper examines how interviews with outdoor recreational runners can help us understand how urban air pollution insinuates itself into the consciousness of those who may be breathing more polluted air than most. It begins by making the case for why studies of air pollution perception might turn to the subjectivities associated with taking part in relevant social practices. Then, with reference to debate about the extent to which groups of exercisers are thinking about certain aspects of what is physically happening during their exercise, we examine how outdoor recreational runners in London talk about the air that they breathe when running. We might imagine that this group would be particularly alive to urban air pollution in view of a presumed interest in physical performance and a personal history of running through various bodies of city air. However, through close scrutiny of their running talk, this paper documents how and why the suggestion of breathing polluted air is often placed beyond the realm of conscious thought for them during their runs. These findings point to particular strategies for encouraging healthy urban lifestyles and illustrate the potential of further studies on how social practices shape pollution perceptions.

Feasibility of an Outdoor Mindful Walking Program for Reducing Negative Affect in Older Adults.

Mindful walking has emerged as a potential intervention strategy to improve mental health and promote well-being in adult and clinical populations. This strategy has not been implemented specifically with older adults to date. This study evaluated the feasibility, acceptability, sustainability, and preliminary efficacy of a mindful walking program for reducing negative affect in older adults. Community-dwelling older adults (n = 29) completed a 1-month, outdoor mindful walking program distributed across eight 30-min sessions. Responses from postprogram and follow-up questionnaires revealed that mindful walking was well-accepted, highly valued, and maintained after the program ended. Analysis from the pre- and postwalk surveys also suggested the preliminary efficacy of a mindful walking program for reducing negative affect. Positive results identified in the current feasibility study indicate readiness for randomized controlled trials to further examine the efficacy and effectiveness of a mindful walking intervention for promoting health and well-being in older populations.

Exercise and environment: New qualitative work to link popular practice and public health.

The health benefits of physical activity are many and well known. Those hoping to promote public health are therefore understandably keen on encouraging physical exercise. This commentary considers the role of qualitative research in this undertaking, given a context in which medical researchers have more commonly taken a quantitative approach to the motivations that are thought to underpin exercise. Our core argument is that studies concerned with how particular environments are inhabited by particular groups of exercisers could play a more central part in public health promotion. In making this case, and by way of an introduction to this Health and Place special issue, we present a series of statements that we think could usefully guide the further development of this work. Specifically, we argue for further attention to: the ways in which different material settings play into the exercise experience; how many of the exercise practices that we may hope to understand sit rather uneasily with the idea of sport; the subtleties of how sociality features in contemporary exercise practices; the physical pleasures that come from exercise; and how exercise practices are both acquired by individuals and evolve as a whole. In so doing, the aim is to encourage relevant researchers to engage more directly in conversation with health promoters instead of either being indifferent to, or critical of, them.

Challenges of complementary and alternative medicine in the SUS aiming to health promotion / Desafios das práticas integrativas e complementares no SUS visando a promoção da saúde

The complementary and alternative medicines (CAM) besides promoting the reduction of costs, have also proven to be effective as well as they have invested in health promotion and health education, as a means of preventing the disease to take control and possibly result in serious consequences. OBJECTIVE: to investigate the knowledge, opinions and social representations of managers and health professionals about those practices (CAM) in Public Health System (SUS) as well as to identify the difficulties and challenges that are present in their implementation, use and disclosure in the Health Services. METHODS: the survey was carried out in a Basic Health Unit and Specialty Clinic in the northern area of São Paulo/SP, Brazil. We chose the qualitative approach with its instruments, documentary analysis and interviews based upon pre-established guidelines directed to managers and health professionals of these units. The total of 35 interviews took place between the months of July to August 2010. RESULTS: the results support the thesis that managers are not prepared to implement the National Policy on Complementary and Integrative Practices (NPCIP) inSUS: only five out of the twenty six respondents were aware of the National Policy (NPCIP); the biomedical model sessions still prevails; material supply and acquisition of raw materials used in some of the CAM have become a major issue in the unit; the disclosure of the CAM has not been enough so as to be fully known by professionals and users alike. Furthermore, most of the professionals working in the Specialty Clinic where the CAM has been offered have undervalued those activities. The Complementary and Alternative Medicine have not played the role they should and/or could in the SUS for the Promotion of Health yet. CONCLUSIONS: it is pivotally necessary that the City of São Paulo/SP encourages and creates conditions for taking the CAM into all Health Units, so as to improve, disclose and support ...(AU)

As medicinas tradicional e complementar, além de promoverem a redução dos custos, têm se mostrado eficazes e investido na promoção da saúde e na educação em saúde, contribuindo para evitar que a doença se instale e que suas consequências sejam muito graves. OBJETIVOS: investigar os conhecimentos, opiniões e representações sociais dos gestores e profissionais de saúde sobre essas Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS) e identificar as dificuldades e desafios que se apresentaram em sua implantação, utilização e divulgação nos Serviços de Saúde. MÉTODO: a pesquisa foi realizada na zona norte de São Paulo/SP, em uma Unidade Básica de Saúde e em um Ambulatório de Especialidades. Optou-se pela abordagem qualitativa tendo como instrumentos, a análise documental e a entrevista com roteiro pré-estabelecido direcionada aos gestores e aos profissionais de saúde destas unidades. As entrevistas ocorrem entre os meses de julho a agosto de 2010 sendo obtido um total de 35 entrevistas. RESULTADOS: os resultados mostraram que os gestores não estavam preparados para a implantação da Política Nacional de Práticas Integrativas e Complementares (PNPIC) no SUS, que apenas cinco dos 26 entrevistados conheciam a PNPIC, que ainda prevalece o modelo biomédico nos atendimentos, que o fornecimento de material e aquisição de insumos utilizados em algumas das PIC tem se constituído em grande problema na unidade, que a divulgação das PIC não tem sido suficiente para que profissionais e usuários as conheçam. Nem todos os profissionais que atuavam no Ambulatório de Especialidades onde as PIC têm sido oferecidas têm valorizado essas atividades. As Práticas Integrativas e Complementares não têm ocupado o papel que deveriam e/ou poderiam dentro do SUS para a promoção da saúde. DISCUSSÃO: A saúde, ao deixar de ser centrada na biologia, amplia a forma de pensar as possíveis intervenções em seus problemas. Cada vez mais pesquisadores concentram-se ...(AU)