Missing Ethnicity and Language Information in Healthcare Records of Patients from the Asian Diaspora.

The electronic health record (EHR) should contain information to support culturally responsive care and research; however, the widely used default "Asian" demographic variable in most US social systems (including EHRs) lacks information to describe the diverse experience within the Asian diaspora (e.g., ethnicities, languages). This has a downstream effect on research, identifying disparities, and addressing health equity. We were particularly interested in EHRs of autistic patients from the Asian diaspora, since the presence of a developmental diagnosis might call for culturally responsive care around understanding causes, treatments, and services to support good outcomes. The aim of this study is to determine the degree to which information about Asian ethnicity, languages, and culture is documented and accessible in the EHR, and whether it is differentially available for patients with or without autism. Using electronic and manual medical chart review, all autistic and "Asian" children (group 1; n = 52) were compared to a randomly selected comparison sample of non-autistic and "Asian" children (group 2; n = 50). Across both groups, manual chart review identified more specific approximations of racial/ethnic backgrounds in 54.5% of patients, 56% for languages spoken, and that interpretation service use was underestimated by 13 percentage points. Our preliminary results highlight that culturally responsive information was inconsistent, missing, or located in progress notes rather than a central location where it could be accessed by providers. Recommendations about the inclusion of Asian ethnicity and language data are provided to potentially enhance cultural responsiveness and support better outcomes for families with an autistic child.

Healthcare professionals educational resources for multiple sclerosis-related health behaviour management: a scoping review.

PURPOSE: Multidisciplinary care is needed to facilitate health behaviour management for multiple sclerosis (MS). This review mapped the educational resources developed for healthcare professionals (HCPs) targeting MS-related health behaviours. METHODS: A scoping review, guided by the Arksey and O'Malley framework, was conducted. Peer-reviewed and grey literature databases, organisational websites, search engines and YouTube were systematically searched to collate the evidence sources. Findings were narratively synthesised, and outcomes were categorised using the Kirkpatrick model for educational interventions. RESULTS: Thirty-nine resources (23 training programs, 13 educational materials and three toolkits) were eligible for inclusion. Physical activity (n = 25) was the predominant health behaviour element, followed by psychological well-being (n = 16) and nutrition/diet (n = 13). Only 51% of the resources were specifically designed to target health behaviours, and 31% mentioned their evidence base. More than three-quarters of resources were technology-based and supported self-directed learning. Theories informed five resources, and two included HCPs and people living with MS perspectives in their development. Six programs were evaluated with HCPs, and most outcomes corresponded to levels 1-3 of the Kirkpatrick model (i.e., satisfaction, knowledge/skills and behavioural changes). CONCLUSION: There is a globally limited availability of evidence-based educational resources for HCPs addressing MS-related health behaviours. Recommendations for HCP education and resource development are outlined herein.

An understanding of health behaviours in relation to multiple sclerosis (MS) management is vital for the professional development of healthcare professionals (HCPs).Co-designed evidence-based educational resources that specifically address MS-related health behaviours, especially for nutrition, diet and metabolic comorbidities, are required and should be informed by the needs of HCPs and existing theories.To support person-centred care in rehabilitation, the living experience of people living with MS should be explored when resources are developed.Online resources may form an efficient learning modality for HCPs to offer flexibility in accessing evidence-based information.

Exploring the Role of Practice Managers in Dutch Oral Healthcare Practices.

INTRODUCTION AND AIMS: The practice manager (PM) is a familiar position in Dutch oral healthcare. However, little is known about in which type of practice they work and what their responsibilities are. The aims of this study were to analyse the characteristics of oral healthcare practices that employ a PM and practices that do not, to determine responsibility for tasks described in the PM function description, and to assess to what extent the role of a PM varies between those with an oral healthcare and another background, and across practices with different characteristics. METHODS: At the end of 2022, a questionnaire with questions about the employment of a PM in the practice was presented to 991 randomly selected general dental practitioners. The questions about the tasks of the PM were based on the job description of the PM drawn up by the Royal Dutch Dental Association. Data were analysed using chi-square test, one-way ANOVA, linear regression, and logistic regression analyses. RESULTS: A PM was employed in the practice of 56% of the general dental practitioners. In many cases, this PM was responsible for a large number of tasks within the sub-areas of care process, human resources, operational policy, and communication. Compared to independent practices, practices affiliated with a corporate dental company often employed a PM and the PMs had a relatively large amount of responsibility. CONCLUSION: PMs are now commonly found in Dutch oral healthcare practices, especially in ones that are affiliated with a corporate dental company. The tasks of PMs vary, suggesting an evolving professional profile.

Mental Healthcare Practices from Entry to Release across Southeastern Jails.

Background: Individuals with mental illnesses are disproportionately incarcerated in jails, which have become de facto mental health institutions across the US. Yet there is limited research describing mental healthcare practices from entry to release among multiple jails and states. Methods: We conducted 34 semi-structured interviews with jail healthcare personnel across five Southeastern states. Results: We report results on challenges and practices related to mental health staffing, screening, additional evaluations and services, and discharge planning in jails. Initial mental health screenings were often restricted to the detection of suicidality and history of treatment and medications as opposed to current mental health symptoms. Use of validated mental health screening forms was uncommon. We found delays in care between the initial health screening and being evaluated by a mental health professional. Most jails reported primary responsibilities for mental health care as preventing suicides and managing psychiatric medications. Jails reported mental health care as challenging to manage, with high volumes of individuals with mental health needs, yet limited resources, especially regarding staffing. Discharge planning was limited despite reports of poor continuity of mental healthcare. Conclusions: Jails have a constitutional duty and opportunity to provide adequate healthcare to individuals with mental illnesses, yet practices are insufficient and resources are limited across jails. Based on our findings, we recommend 1) greater adoption and revisions of jail health standards 2) system improvement that expands identification of mental illnesses and quicker, less variable follow-up mental health evaluations, 3) improved linkages and supports for community resources that prevent incarceration of this population.

The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications.

Aim: This qualitative study investigates the impact of cultural practices on children's health in the United Arab Emirates (UAE) by examining the use of traditional remedies and home treatments by mothers. Methods: Twenty-five participants, all mothers who had employed traditional treatments or home remedies for their children during periods of illness, were included in the study. The participants represented a diverse range of educational backgrounds, from school diploma holders to university degree graduates, with ages spanning from 20 to 50 years. Hailing from different Arabic countries and cultural subgroups, the majority of participating mothers were from the UAE. Results: Through in-depth interviews, three major themes emerged from the participants' experiences. Firstly, a strong connection between culture, religion, and healthcare practices was evident. Many mothers opted for cultural remedies as their first line of defense against illnesses due to the practices' strong foundations in their cultural heritage. Herbal remedies, Quranic healing, and other traditional methods were perceived to be both effective and spiritually comforting, reinforcing participants' sense of cultural identity. Secondly, participants highlighted unintended consequences of relying solely on traditional treatments. Some instances were reported where the use of ineffective remedies resulted in delays in seeking appropriate medical care for their children, potentially compromising their health. Additionally, certain misconceptions regarding the safety and efficacy of traditional remedies were identified, emphasizing the need for evidence-based healthcare education. Conclusion: This qualitative study sheds light on the intricate interplay between culture, traditional remedies, and children's health in the UAE. The incorporation of diverse participants from various Arabic countries and cultural subgroups enriches the study's applicability to broader Arabic cultures. By recognizing the significance of cultural healthcare practices and striking a balance with evidence-based care, healthcare providers can create a more inclusive and effective healthcare environment for children in the UAE. Future research should explore diverse samples and develop targeted interventions to further advance cultural awareness and understanding in healthcare practices.

Authority Brings Responsibility: Feedback from Experts Promotes an Overweighting of Health-Related Pseudoscientific Beliefs.

The popularity and spread of health-related pseudoscientific practices is a worldwide problem. Despite being counteracted by competent agents of our societies, their prevalence and spread continue to grow. Current research has focused on identifying which characteristics make us more likely to hold pseudoscientific beliefs. However, how we hold these beliefs despite all the available information against them is a question that remains unanswered. Here, we aimed to assess if the development of health-related pseudoscientific beliefs could be driven by a positive bias in belief updating. Additionally, we aimed to explore whether this bias could be exacerbated, depending on source credibility. In this study, participants (N = 116) underwent a belief updating task where they offered their agreement with various health-related pseudoscientific statements before and after receiving supporting and discrediting feedback from (a) experts (doctors), (b) peers, or (c) a random number generator. Our results suggest that when receiving feedback from experts (but not from peers or random feedback), the participants preferentially integrated supporting information relative to discrediting information about health-related pseudoscience. We discuss the implications of this biased belief updating pattern on health-related pseudoscientific research and suggest new strategies for intervention focused on increasing awareness, training, and consensus among healthcare practitioners.

Apoio institucional na Atenção Primária em Saúde no Brasil: uma revisão integrativa / Institutional support in Primary Health Care in Brazil: an integrative review

Resumo Um dos grandes desafios do Sistema Único de Saúde é a necessidade de transcender o caráter disciplinador e controlador da gestão e fomentar a função democrática, para possibilitar uma maior participação de trabalhadores e comunidade na gestão em saúde. Com o intuito de identificar e sintetizar definições e práticas de apoio institucional implementadas no âmbito da Atenção Primária à Saúde no Brasil, de acordo com o método Paidéia, que preconiza democratização institucional e a qualificação do atendimento à população através de novos arranjos e dispositivos de gestão e do processo trabalho, foi desenvolvida uma revisão integrativa da literatura referente ao período de 2005 a 2019. O corpus de análise contemplou 24 publicações que explicitaram definições e aspectos operacionais incipientes, fragilidades na integração entre o âmbito da clínica ampliada e da gestão compartilhada que deveria se dar na dialética entre o Apoio Institucional e o Apoio Matricial, a necessidade de fortalecer a função do apoiador institucional, enquanto mediador metodológico e de reformular os tradicionais mecanismos de gestão e as estratégias para educação permanente em saúde no âmbito do Sistema Único de Saúde.

Abstract One of the great challenges of the Unified Health System is the need to transcend the disciplinary and controlling character of management and foster the democratic function, to enable greater participation of workers and the community in health management. In order to identify and synthesize institutional support definitions and practices implemented within the scope of Primary Health Care in Brazil, according to the Paidéia method, which advocates institutional democratization and the qualification of service to the population through new management arrangements and devices and the work process, an integrative literature review was carried out for the period from 2005 to 2019. The corpus of analysis included 24 publications that made incipient definitions and operational aspects explicit, weaknesses in the integration between the scope of the expanded clinic and the shared management that should assist in the dialectic between Institutional Support and Matrix Support, there should be the need to strengthen the role of institutional supporter, as a methodological mediator and to reformulate the management and strategy mechanisms for permanent health education within the scope of the Unified Health System.

COVID-19 and Physical Distancing Measures: Experience of Psychiatric Professionals in Europe.

A The COVID-19 pandemic has had a considerable impact on the organization of psychiatric care. The present study examines how care professionals experienced this period and faced these new constraints weighing on their professional practices. Based on a qualitative research methodology, 13 group interviews with healthcare professionals working in psychiatric wards were conducted in five countries in western Europe. To complement this, 31 individual interviews were carried out in Belgium and France. Public health measures hindered certain therapeutic activities, jeopardized communication, and obliged healthcare professionals to modify and adapt their practices. Confronted with a transformation of their usual roles, healthcare professionals feared a deterioration in the quality of care. Impossible to continue in-person care practices, they resorted to online videoconferencing which went against their idea of care in which the encounter holds an essential place. The lockdown contradicted efforts to co-build care pathways toward readaptation, social reintegration, and recovery, thus reviving the perception of psychiatric hospitalization based on isolation.

The Association between Evidence-Based Healthcare Practices and Outcomes among Preterm Births in China.

INTRODUCTION: Very preterm infants are at high risk of early death or severe brain injury, with potential for impaired long-term neurodevelopmental function and physical health. There are evidence-based healthcare practices that can reduce the incidence. MATERIALS AND METHODS: Infants born at 24-316 weeks gestational age and admitted within 24 h to NICUs participating in the Chinese Neonatal Network in 2019 were included. We examined the association between 4 evidence-based practices: inborn (born in a tertiary hospital in the Chinese Neonatal Network), ACS (any antenatal corticosteroid), MgSO4 (prenatal magnesium sulfate), and NT (normothermic temperature [36.0-37.5°C] at admission) and early death and/or severe brain injury in the study population. RESULTS: Of 6,035 eligible infants, the incidence of early death and/or severe brain injury was 10.6%. Exposure to ACS only was associated with significant lower incidence of death and/or severe brain injury than none (aOR, 0.71; 95% CI: 0.57-0.88), but not MgSO4 only (aOR, 0.97; 95% CI: 0.81-1.17), NT only (aOR, 0.91; 95% CI: 0.76-1.08), or inborn only (aOR, 0.91; 95% CI: 0.72-1.15). The association between number of practices and incidence of early death and/or severe brain injury is as follows: none = 23% (31/138), any 1 = 14% (84/592), any 2 = 12% (185/1,538), any 3 = 9% (202/2,285), and all 4 = 9% (140/1,482). DISCUSSION/CONCLUSION: More comprehensive use of evidence-based practices was associated with improved survival without severe brain injury among very preterm infants born at <32 weeks gestational age.

The community health impasse: What can family physicians learn about integration of social determinants of health from the challenges, diversity, and worldview of primary healthcare practices located in Southern India?

CONTEXT: As social position rises, health improves. Alma Ata set the stage for community-oriented primary care (COPC), and family medicine is perfectly positioned to integrate Social Determinants of Health. India presents a unique environment for innovations in family medicine. AIMS: This study aimed to (1) assess the ability of different primary care practices to address the social determinants of health (SDoH); (2) identify key obstacles and supports; and (3) provide practical insights to family physicians and other primary care providers (PCPs) for the integration of SDoH and clinical primary care. SETTINGS AND DESIGN: A diverse sample of primary healthcare practices were selected in southern India for investigation. Data collection involved observation and informal interviews. METHODS AND MATERIAL: The researchers used general observation and informal interviews to collect data. Investigators used a basic interview guide to structure conversations and formal journal entries were recorded immediately following each visit. STATISTICAL ANALYSIS USED: Thematic analysis was conducted with NVIVO software to categorize major themes. RESULTS: Seventeen primary healthcare practices were observed; eleven were formally enrolled for interviews. Four inputs and three outputs of socially oriented primary care practices were identified. The inputs include leadership style, appropriate staffing, funding structures, and patient panels. Social interventions, community contact, and treasuring community empowerment were the major outputs. CONCLUSIONS: Community health lies at the heart of strengthening primary healthcare. Establishing practices that bridge the gap between clinical primary care and SDoH initiatives need to be prioritized. This study fosters agency for family physicians and PCPs to engage with local communities and lead the path toward this integration.

[Assessment of professional practices in treating cardiac arrest]. / Évaluation des pratiques professionnelles dans la prise en charge de l'arrêt cardiaque.

An assessment of professional practices was carried out in 2013-2014 with the aim of improving the treatment of cardiac arrest in hospitals. Two methods were used: an assessment by questionnaire to evaluate theoretical knowledge and a practical assessment of external cardiac massage. The results highlight the need for greater knowledge. The use of cardiac massage must be included in continuing professional development.

Apoio institucional: estratégia democrática na prática cotidiana do Sistema Único de Saúde (SUS) / Institutional support: democratic strategy in the everyday practices of the Brazilian Health System (SUS) / Apoyo institucional: la estrategia democrática en la práctica cotidiana del Sistema Brasileño de Salud (SUS)

Este artigo tem como objetivo refletir sobre uma trajetória da experimentação do apoio institucional no âmbito do Plano de Qualificação das Maternidades e Redes Perinatais no Nordeste e Amazônia Legal (PQM), considerando o contexto onde foi desenvolvida a experiência, as estratégias e processo de trabalho e as reflexões decorrentes da prática do apoio institucional durante esse processo de experiência/intervenção. Mesmo tendo ocorrido em contextos potencialmente adversos à concretização desse Plano, o exercício do apoio institucional, desenvolvido, ao longo do período de 2010 a 2011, em uma instituição privada de um município brasileiro da Amazônia Legal, permitiu afirmar esse dispositivo como um modo inovador e efetivo ao promover grupalidades e equipes de saúde mais solidárias e corresponsáveis com movimentos de mudança das práticas...

This paper aims to reflect on the path of experimentation of institutional support within the sphere of the Maternity Hospital and Perinatal Network Qualification Plan (PQM) in northeastern Brazil and the Amazon region. The context in which the experience was developed, the strategies, the work process and the reflections resulting from institutional support practices during this process of experience and intervention were taken into consideration. These institutional support practices were developed in a private institution in a Brazilian municipality located in the Amazon region between 2010 and 2011. Even though these practices occurred in contexts that were potentially adverse to fulfillment of this plan, it can be affirmed that this device is an innovative and effective means for promoting groupings and healthcare teams that are more cohesive and co-responsible with movements towards changes in practices...

El objetivo de este artículo es reflexionar sobre una trayectoria de experimentación del apoyo institucional en el ámbito del Plan de Capacitación de los Hospitales-Maternidad y de las Redes Perinatales en el Noreste y en la región denominada Amazonía Legal (PQM) en Brasil, teniendo en cuenta el contexto en donde se desarrolló la experiencia, las estrategias y el proceso de trabajo y las reflexiones derivadas de la práctica de apoyo institucional durante este proceso de experiencia / intervención. A pesar de haber ocurrido en contextos potencialmente adversos a la puesta en práctica de este Plan, el ejercicio del apoyo institucional, desarrollado durante el período 2010 a 2011, en una institución privada de un municipio brasileño perteneciente a la Amazonía Legal, permitió que este dispositivo es innovador y eficaz en la promoción de grupos y de equipos de salud más consistentes y corresponsables con los movimientos de cambio de las prácticas...

Redes sociotécnicas de assistência à saúde em acupuntura: estudo de caso sobre a formação básica de estudantes de medicina / Sociotechnical healthcare networks for acupuncture: a case study on the basic training of medical students

Trata-se de estudo qualitativo sobre as redes sociotécnicas que orientam a estrutura e o funcionamento da Liga de Acupuntura da Faculdade de Medicina da Universidade de São Paulo. Emprega-se metodologia da teoria ator-rede, desenvolvida por Bruno Latour nos estudos sobre produção científica. Constituído de observação de campo, entrevista semiestruturada e análise documental, o estudo oferece achados relevantes, com destaque para o entendimento da acupuntura como estratégia terapêutica efetiva na assistência à saúde, modulando o uso de fármacos, a identificação da necessidade de regulamentação do ensino e prática da acupuntura e o reconhecimento de outros profissionais da área da saúde como colegas na prática dessa terapêutica.

This is a qualitative study on the sociotechnical networks that underlie the University of São Paulo School of Medicine’s Acupuncture League. The actor-network methodology, developed by Bruno Latour in studies on scientific productivity, is used. Consisting of field observations, semistructured interviews and a document analysis, the study presents relevant findings, with emphasis on understanding acupuncture as a therapeutic strategy effective in healthcare, modulating the use of drugs. It also identifies the need for regulation of the teaching and practice of acupuncture and recognition of other healthcare professionals as colleagues in the practice of this therapeutic method.

Por uma educação que se movimente como maré e inunde os cotidianos de serviços de saúde / Towards an education that moves like the tide and floods the everyday routines of healthcare services / Por una educación que se mueva como las mareas e inunde los cotidianos de los servicios de salud

We proposed to reflect on care and management practices within healthcare, by taking these to be well-dated social practices. Through placing ourselves at the intersection between the fields of education and healthcare, and, within these, in the field of studies on the body, we showed that healthcare practices comprise cultural pedagogies from which certain meanings and behaviors are prescribed, but also through which meanings and new practices that shift, bifurcate and question these prescriptions are constructed. In other words, here we take the field of healthcare to be a territory both for teaching (pedagogical-bodily formatting) and for learning (experimentation of singular ways of doing and saying things regarding healthcare); and we take care and management within healthcare to be an assembly (bodily) of conflicting parts between some forms of subjection and experimentation forces, from which healthcare practices are woven.

Propomos refletir sobre práticas de cuidado e de gestão em saúde, entendendo-as como práticas sociais bem datadas. Situando-nos no cruzamento entre as áreas da educação e saúde e, nelas, dos estudos sobre corpo, apontamos práticas de saúde como pedagogias culturais, a partir das quais são prescritos determinados sentidos e condutas, mas, também, por meio das quais são construídos sentidos e fazeres inéditos que deslocam, bifurcam, fazem questionar tais prescrições. Dito de outro modo, entendemos aqui o campo da saúde como um território de ensino (formatações pedagógico-corporais), mas, também, de aprendizagens (experimentação de formas singulares nos fazeres e dizeres em saúde), e o cuidado e a gestão em saúde como uma montagem (corporal) conflituosa entre formas de sujeição e forças de experimentação, a partir das quais as práticas em saúde se tecem.

Proponemos la reflexión sobre prácticas de cuidado y de gestión en salud, entendiéndolas como prácticas sociales ya existentes hace tiempo. Nos situamos en el cruce entre las áreas de la educación y salud y, en ellas, de los estudios sobre el cuerpo, señalamos prácticas de salud como pedagogías culturales a partir de las cuales se prescriben determinados sentidos y conductas, pero también por medio de las cuales se construyen sentidos y acciones inéditos que desplazan, bifurcan y ponen en tela de juicio tales prescripciones. Dicho de otra forma, entendemos aquí el campo de la salud como un territorio de enseñanza (formatos pedagógico-corporales) pero también de aprendizajes (experimentaciones de formas singulares en el hacer y decir de la salud) y el cuidado y la gestión de salud como un montaje (corporal) conflictivo entre formas de sujeción y fuerzas de experimentación a partir de las cuales se tejen las prácticas de salud.

Em busca do feto saudavel: ideias, marcas e coisas na reconstrucao do diagnostico da toxoplasmose / In pursuit of a healthy fetus: ideas, signs, and things in the reconstruction of the diagnosis of toxoplasmosis

Resulta da investigação do atendimento médico à gestante na busca do feto saudável, especificamente da operacionalização do diagnóstico e da tomada de decisão quanto ao objeto infecção-doença toxoplasmose. Seguindo a filosofia empírica e Annemarie Mol, esse objeto seria 'manipulado', pelo menos, por médico e paciente. Tal manipulação corresponde a uma reconstrução ontológica, a partir da articulação dos elementos ideias-marcas-coisas no contexto espaçotemporal, o que propicia a multiplicação do objeto. Pretende-se contribuir para a teorização da política ontológica considerando que a multiplicação do objeto e as várias intervenções decorrentes implicaram diferentes modelagens dos corpos e deslocamentos de vida.

The article examines medical care for pregnant women in pursuit of a healthy fetus. Specifically, it explores operationalization of the diagnosis and decision-making processes associated with the infection/disease object toxoplasmosis. According to empirical philosophy and to Annemarie Mol, this object is 'manipulated,' at least, by both physician and patient. This manipulation corresponds to an ontological reconstruction based on the integration of ideas-signs-things in the time-space context, which foster the multiplicity of the object. The article seeks to contribute to theorization on ontological politics, taking into account that multiplicity of the object and several ensuing interventions imply different body modeling and life shifts.

Terapia comunitária: prática relatada pelos profissionais da rede SUS de Santa Catarina, Brasil / Community therapy: practice reported by professionals within SUS in Santa Catarina, Brazil / Terapia comunitaria: práctica relatada por los profesionales del SUS de Santa Catarina, Brasil

O objetivo deste estudo, de natureza exploratória e descritiva, foi descrever as práticas de Terapia Comunitária relatadas por 27 profissionais de saúde da rede do Sistema Único de Saúde (SUS) de Santa Catarina, sul do Brasil. Os dados foram coletados por meio de entrevistas individuais semidirigidas, empregando-se a Análise de Conteúdo como temática categorial. Os resultados foram agrupados em cinco categorias: práticas de terapia comunitária; estratégias de implantação; dificuldades; elementos facilitadores; e benefícios. Conclui-se que a Terapia Comunitária pode contribuir para a construção de uma clínica ampliada e para a valorização dos recursos do território. No entanto, é necessário que a atuação do terapeuta comunitário seja estendida a uma equipe multidisciplinar, dialogue com outros dispositivos, receba o apoio das gestões dos serviços e se alie a outras políticas públicas, ampliando seu campo de ação da saúde para outros setores.

The aim of this exploratory and descriptive study was to describe the community therapy practices reported by 27 healthcare professionals within the Brazilian National Health System (SUS), in Santa Catarina, Brazil. The data were gathered through individual semi-directed interviews, and content analysis was used for categorical themes. The results were grouped into five categories: community therapy practices; implementation strategies; difficulties; facilitative elements; and benefits. It was concluded that community therapy can contribute towards construction of expanded clinical action and improved value for territory resources. However, community therapists' actions need to be extended to a multidisciplinary team, have dialogue with other entities, receive support from service management and be allied to other public policies, in order to expand their field of action from healthcare to other sectors.

El objetivo de este estudio, de naturaleza exploratoria y descriptiva, es describir las prácticas de la Terapia comunitaria relatadas por 27 profesionales de la red del Sistema Único de Salud (SUS) de Santa Catarina, Brasil. La recolección de datos utilizó la entrevista individual semi-dirigida y empleó el análisis de contenido categorial temático. Los resultados fueron agrupados en cinco categorías: Prácticas de terapia comunitaria; estrategias de implantación; dificultades; elementos facilitadores; y beneficios. Se concluye que la Terapia comunitaria puede contribuir con la construcción de una clínica ampliada y la valorización de los recursos del territorio. Sin embargo, es necesario que la actuación del terapeuta comunitario sea extendida a un equipo multi-disciplinario, dialogue con otros dispositivos, reciba el apoyo de las gestiones de los servicios y haga alianzas con otras políticas públicas, ampliando su campo de acción para otros sectores.

Significados e sentidos das práticas de saúde: a ontologia fundamental e a reconstrução do cuidado em saúde / Meanings and senses of healthcare practices: fundamental ontology and the reconstruction of healthcare / Significados y sentidos de las prácticas de salud: la ontología fundamental y la reconstrucción del cuidado en salud

O cuidado em saúde tem sido um tema abordado atualmente por autores da Saúde Coletiva. Essas práticas e estudos refletem dois modos aparentemente antagônicos de se conceber o cuidado, ora baseado na instrumentalidade, com ênfase nos procedimentos e nas intervenções técnicas, ora com foco na relação de encontro entre profissionais e usuários dos serviços de saúde. A partir de uma leitura crítica desse conjunto de estudos, procura-se não opor os dois grupos identificados, mas articulá-los em sua complementaridade por meio da ontologia fundamental de Martin Heidegger. Em Ser e Tempo, Heidegger desconstrói a ontologia tradicional para reconstruir uma nova ontologia que busque os fundamentos da existência humana. Um retorno aos fundamentos mostra-se essencial para uma reconstrução das práticas de saúde e do cuidado.

Healthcare is a topic currently being dealt with by authors within the field of public health. These practices and studies reflect two ways of conceiving of care that are apparently antagonistic. They are sometimes based on instrumentality, with emphasis on procedures and technical interventions, and sometimes with a focusing on the relationship between healthcare professionals and healthcare service users. Based on critical reading of this collection of studies, the aim of the present study was, rather than contrasting the two groups identified, to link them in their complementarity through using Martin Heidegger's fundamental ontology. In Being and Time, Heidegger deconstructs the traditional ontology, to reconstruct a new ontology that seeks the fundamentals of human existence. Returning to these fundamentals can be seen to be essential for reconstructing healthcare and its practices.

El cuidado em salud ha sido una cuestión tratada actualmente por los autores de La Salud Colectiva. Estas prácticas y estúdios reflejan dos maneras aparentemente antagónicas de concebir la atención, a veces basadas en la instrumentación, com énfasis en los procedimientos y técnicas de intervención, a veces com un enfoque en la relación entre profesionales y usuarios de los servicios de salud. De una lectura crítica de esta serie de estudios, buscase non oponerse a los dos grupos identificados, sino combinarlos em su complementariedad a través de la ontología fundamental de Martin Heidegger. Un retorno a esos fundamentos se revela esencial para la reconstrucción de las prácticas de salud y atención.