Fundamentals Of Complementary And Alternative Medicine Pdf

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Complementary and Alternative Medicine CAM are unconventional care practices that, according to the World Health Organization, should be implemented in the Health System, particularly in poor regions of the country.

Complementary and Alternative Medical Practices and Their Impact on Oral and Nutritional Health

Complementary and Alternative Medicine CAM are unconventional care practices that, according to the World Health Organization, should be implemented in the Health System, particularly in poor regions of the country.

In Brazil, they have been adopted by Care Programs and introduced into undergraduate medical education. In this study we were interested in evaluating the teaching-learning process of Integrative Practices in Brazilian medical schools. A cross-sectional study was carried out at Brazilian medical schools with a self-administered questionnaire for teachers and a secondary data survey was obtained from medical school websites and government database institutions.

For the presentation of the variables, frequency distribution and the Pearson coefficient X2 -Chi-square tests were used. The medical schools are highly concentrated in state capitals, and the Northeast region presents a significant concentration of medical schools with CAM in the capitals.

The number of schools with active and traditional methodologies in CAM is equivalent. The new educational guidelines have not affected the number of schools with CAM. There has been no growth in teaching Complementary and Alternative Medicine in undergraduate medical training in Brazil since the introduction of the new curricular guidelines, even in view of the needs of the health system. The demand for unconventional therapies in treatment of various diseases and health problems has been increasing in recent decades and such treatment have been applied in a complementary or integrated manner in relation to the traditional biomedical model.

These practices have been introduced into the health system through their incorporation into care programs in several Western nations [4; 5]. This also relates to a World Health Organization WHO recommendation, since the declaration of Alma Ata at the International Conference on Primary Health Care in [6; 7; 8], and more recently with the publication of the Strategies for Traditional and Integrative Medicines, which established implementation targets for its Member States for the period from to [ 9 ].

Therefore, there is a demand for training human resources to fill this gap in the public health care network, especially for new medical professionals. In Brazil, CAM teaching is unexplored and not mandatory in most undergraduate medical course syllabi [ 4 ].

The National Curricular Guidelines NCG for Medicine courses proposed by the Ministry of Education in and revised in define the principles, fundamentals, conditions and procedures for the training of physicians, established by the Higher Education Chamber of the National Education Council, for nationwide application in the organization, development and evaluation of the pedagogical projects of the Undergraduate Medicine Courses in Brazil.

The guidelines are related to the whole health-disease process of the citizen, the family and the community, integrated to the epidemiological and professional reality, providing the integrality of the actions of care in medicine [ 13 ]. In order to be able to follow the NPICP in the SUS and effectively introduce these specialties, it is necessary for medical schools to add this curricular content to their pedagogical projects for undergraduate courses, so that future physicians are aware of their existence and purpose and can apply them in practice.

Thus, the objective of this research is to investigate the teaching of CAM at medical schools in Brazil and to identify the potential for training professionals in this area.

An observational and exploratory study was conducted, with a descriptive and analytical cross-sectional design and a quantitative approach.

This study was carried out at every Brazilian medical school from May to March All medical schools in the year were included in the study. This study considered the administrative characteristics of the medical schools, geographical and regional distribution, methodological educational approach and CAM teaching at medical schools. Descriptive and analytical elements were considered to obtain the following variables: total number of schools, number of schools with CAM education, relationship between number of schools and offer in the capital and in the interior, applied methodologies and the offer of the subject and the work regime of teachers in CAM.

Descriptive analysis was performed with the presentation of the variables using frequency distribution and the Pearson correlation coefficient X2 -Chi-square. The study was approved by the Research Ethics Committee of the University of Fortaleza under number 1. Agreement was given through the informed consent form ICF. There was a predominance of medical schools located in the Southeast region, corresponding to 41 percent of the total.

There is an even distribution of medical schools, considering the percentage of population by region, but when considering the ratio of the number of available places per inhabitant per region, the total university courses in the Southeast region is the largest in relation to the rest of the country, while the North and Northeast regions have the lowest ratio of available places per inhabitant Table 1. It was found that only 57 of the existing and active medical schools currently address CAM in their curriculum and are distributed throughout the five regions of the country.

The number of medical schools with CAM education is proportionally higher in the South and Midwest, corresponding to almost a quarter of the existing courses in each of these regions Table 2.

The Northeast displays significant growth in number of medical schools and also in the teaching of CAM, but the Southeast holds more than a third of the medical schools in the country and the same proportion refers to schools that have a CAM approach. Therefore, no significant difference was found in the distribution of schools with CAM teaching in the five regions of the country.

There is a statistically significant difference in the number of schools in the capitals of the Northeast region in relation to smaller cities of this region as regards the teaching of CAM. The increase in the total number of medical schools in relation to the number of schools with CAM teaching, especially in the last ten years, has not been significant. Currently, most medical schools in Brazil have a private administrative regime.

However, in relation to the teaching of CAM, there is predominance in the public sector In the Southeast, the teaching of such practices is found mainly in state or private schools. Of all the regions, the North was the one that had the least growth, both in number of schools and in the teaching of CAM. In the Midwest, Northeast and Southeast regions, the proportion of public schools is higher, and proportion of schools with CAM is higher, while the opposite occurs in the South and North regions.

It is observed that the Southeast states have the highest concentration and number of medical schools and of CAM teaching. The medical schools with CAM adopt mostly active methodologies AM of teaching learning, with a predominance of Problem-Based Learning PBL , while one-third of the schools adopt a traditional methodology. Figure 1. As for the teaching of CAM in its various forms of practice and rationalities, most schools adopt a single model of practice and there is a prevalence of homeopathy and acupuncture teaching, followed by integrative medicine and phytotherapy Figure 2.

There is a predominance of teaching in CAM in non-compulsory modules or curricular subjects. This study showed that medical schools are not homogeneously distributed in the five regions of Brazil. There has been growth in recent years, especially in the Northeast region, where the number of schools has tripled, but this has not been enough to overcome the inequality. This disproportion is even greater when considering the relation between the number of available places in schools with population of each region.

The North and Northeast regions have the lowest number of places per inhabitant. On the other hand, the South and Midwest have fewer inhabitants per medical school and, therefore, a higher percentage of schools in relation to the percentage of the national population.

The number of available places is also disproportionate and poorly distributed throughout the regions of the country. When observing some cities in the Midwest, such as the Federal District, a greater ratio of doctors per inhabitant was found, whereas in innerstate cities in the North and Northeast there is a lack of doctors [ 14 ].

It was also found that there has been a growth of medical schools since , which includes the process of internalization, in keeping with previous research [ 15 ], which may in the future result in a greater balance in the proportion of doctors per capita.

In , there were only medical schools in the country and 36 There is, however, a gap between the increase in medical schools and the teaching of CAM, since the growth was only 2. This means that, although the number of medical schools has tripled, ICP teaching has not kept up with the educational landscape, with reduced content in relation to the number of schools in the s Figure 2.

However, in relation to CAM education, public schools remain prevalent. Since , medical teaching has undergone modifications regarding the teaching-learning methodologies used and has been progressively adapting to the National Curricular Guidelines NCG , implemented in and revised in , which explains the predominance of active methodologies.

In relation to the new approaches and teaching methodologies that have been advocated, there are twice as many schools with PBL teaching in the Northeast than traditional schools or schools with mixed methodologies. This is probably due to the expansion of medical teaching centers since the NCG, prioritizing this region in the country. However, the number of schools with CAM is similar in both models. In the Southeast, the teaching of Homeopathy predominates, followed by Integrative Medicine and then Acupuncture.

It is difficult to find Phytotherapy training in this region, perhaps because of the historical colonial influence that brought over French Medicine in the early nineteenth century, with a focus on Homeopathy [19; 20] and only after the immigration of the Eastern populations [ 21 ] SMBA, Anthroposophic Medicine became part of the group of medical rationalities adopted in , and is increasing offered in the health care system [ 22 ].

We have an index of 2. This profile can be modified if there is a better distribution of available places in the capital and the interior of the states. There was an increase in the medical population between and , and this was probably due to the new schools that already had their first graduate medics.

The growing emergence of medical schools and the lack of growth in CAM teaching demonstrated in this research confirms the fact that, while the number of medical schools has almost tripled in Brazil since , even with the official implementation of CAM in the SUS through the NPICP, growth has become less pronounced. Moreover, the motivation to learn presumes involvement of mental processes that are not directly observable.

It is often necessary to involve interactions between an individual and a social context [ 23 ], so it is not an individual phenomenon.

Introducing CAM into the medical school curriculum requires a dedicated team to cause a significant change [ 24 ]. For the medical student interest in CAM depends on its inclusion in the curriculum learning context.

This context needs to be modified, by encouraging this curricular content in pedagogical projects, contributing to the process of humanization in health [13; 23; 24; 25] and following the principles of the National Curricular Guidelines, with respect to receptive listening; development of therapeutic connection; integration of the human being with the environment and society; an expanded view of the health-disease process; global promotion of human care and self-care; and the necessary opening for new knowledge or there will be no growth or worse, there will be a stagnation of teaching of Integrative Practices in Brazilian Medical Schools [1;11;12;25].

The implementation of National Curricular Guidelines in , should have contributed to the growth of schools and the teaching of CAM, however this failed to materialize. The conclusion can be drawn that the number of medical schools almost tripled after , but there was no increase in CAM teaching in these schools, in fact there was a reduction in their implementation in the national scenario.

In the two decades previous to the National Curricular Guidelines being implemented, there was a greater increase in CAM in medical education than in the following period, which is contrary to what the WHO advocated, recommending the preparation of new professionals qualified to work with CAM mainly in Primary Health Care PHC.

Ten years after the creation of the NPICP and after more than two decades of the formalization of Homeopathy and Acupuncture as medical specialties there is still no teaching systematization of CAM in Brazilian medical schools. There is a need to conform to the new National Guidelines for Medical Education and the WHO recommendations to train new human resources to support an integrated and humanized medical practice.

This should be the role of CAM in education and health, provided that strategies for effective implementation and syllabus standardization are considered and adopted by the administrators of medical schools in Brazil, in partnership with the Ministries of Education and Health. Last Update : jun. Teixeira MZ , Medical education in non-conventional therapeutics in the world homeopathy and acupuncture. Barros , NF de. Rev Bras Educ Med ; 34 1 97 - Scheffer M.

The privatization of medical education in Brazil: trends and challenges Human Resources for Health , ; 95 2 : 13 - Salles , SAC. Cogitare ; 19 4 : - 6. Botucatu-SP ; Novaes , RLO.

O tempo e a ordem: sobre a homeopatia. Motivation to learn: an overview of contemporary theories. Med Educ ; 50 : — Acessed 10 jan Teixeira , MZ. Lessons learned from complementary and integrative medicine curriculum change in a medical school.

Med Educ. All authors contributed to the research design, analysis and expression of ideas. Both read and approved the final manuscript. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Services on Demand Journal.

Complementary and alternative therapies: the nurse's role

Alternative medicine is any practice that aims to achieve the healing effects of medicine , but which lacks biological plausibility and is untested , untestable or proven ineffective. Complementary medicine CM , complementary and alternative medicine CAM , integrated medicine or integrative medicine IM , and holistic medicine are among many rebrandings of the same phenomenon. Alternative therapies share in common that they reside outside medical science , and rely on pseudoscience. Traditional practices become "alternative" when used outside their original settings without proper scientific explanation and evidence. Frequently used derogatory terms for the alternative are new-age or pseudo , with little distinction from quackery.

Fundamentals of Complementary and Alternative Medicine: Edition 4 PDF/EPUb Book by Marc S. Micozzi. iDIrripiTErkOYong - Read and download.

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Whole medical systems. Mind-body techniques. Biologically based practices. Manipulative and body-based therapies.

Fundamentals of Complementary and Alternative Medicine. The unique approach in this book provides the historical background of alternative healing systems, in addition to the most up-to-date information on scientific research, plus basic clinical applications. Rather than attempting to address every conceivable alternative therapy, this text instead explores those that are best supported by clinical trials and hard evidence, making it a particularly valuable reference within traditional medical settings. Intended as an introduction to the topic of alternative medicine, Dr. Micozzi's book has become the standard among medical and health care professionals who wish to learn about incorporating these procedures into an allopathic practice.


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