The use of pacifiers is deeply rooted in our culture, even in a population oriented towards avoiding it. The association between pacifier use and shorter duration of breastfeeding and exclusive breastfeeding was confirmed in this population.

In Brazil, during the XX century, dozens of Spiritist psychiatric hospitals emerged seeking to integrate conventional medical treatment with complementary spiritual therapy. This combined inpatient treatment is largely found in Brazil, where many psychiatric hospitals stem from the Spiritist movement. The present report describes the use of these spiritual practices, their operating structure, health professionals involved, modalities of care, and institutional difficulties in integrating spiritual practices with conventional treatment in six leading Brazilian Spiritist psychiatric hospitals. These hospitals combine conventional psychiatric treatment with voluntary-based spiritual approaches such as laying on of hands ("fluidotherapy"), lectures regarding spiritual and ethical issues, intercessory prayer, spirit release therapy ("disobsession") and "fraternal dialogue". The non-indoctrination and optional nature of these spiritual complementary therapies seem to increase acceptance among patients and their family members. In conclusion, the Spiritist psychiatric hospitals in Brazil have, for more than half a century, provided an integrative approach in the treatment of psychiatric disorders, associating conventional and spiritual treatments, more specifically Spiritist therapy. The lack of standardized treatment protocols and scientific studies remain a barrier to assessing the impact of this integrative approach on patients' mental health, quality of life, adherence, and perceived quality of treatment.

Belief in the healing power of prayer is found in various religious traditions. Spiritually grounded clinical interventions, such as intercessory prayer (IP), need to be understood in a broader sense. This essay features the IP trials, observing the controversial relationship between inconsistent results and allegedly inadequate methods and theoretical hypothesis. A survey of the literature was conducted including publications indexed until September 2013, focusing on the trials developed in the field and on the critics about the methodological design. Recent meta-analyses and multicenter studies found inconclusive results in the investigation of IP. Clinical trials on IP present some methodological difficulties: The intervention is not fully controlled; the primary outcome is not properly defined; and the theoretical models seem inconsistent. The "non-local consciousness" model may be appropriate for studies of IP. Directions for future research: greater emphasis on the evaluation of the effectiveness of this intervention in animal models; selection of subjects and healers who have previous connection; considering the hypothesis of non-local consciousness in the study design.

PALAVRAS-CHAVE-Espiritualidade.-Educação Médica.-Atenção Primária à Saúde. RESUMO Introdução: Muitas universidades ao redor do mundo têm incluído o tema religiosidade/espiritualidade (R/E) no currículo médico no período de graduação, especialmente nos Estados Unidos e Reino Unido. Este artigo objetiva apresentar a opinião de médicos, especializandos em Saúde da Família da KEYWORDS-Spirituality.-Medical Education.-Primary Health Care. ABSTRACT Introduction: Many universities around the world have included religious or spiritual (R/S) issues

Background: There is general agreement between physicians and medical school faculty that health professionals should be aware and know how to deal with patient's spirituality. The spiritual dimension is being included in some University curricula, and a more humanistic health care approach is being advocated. Methods: An integrative review was conducted to gather information about spirituality research in medical undergraduate curricula. The major question to be answered is what we already know about the teaching of religiosity/spirituality (R/S) in medical curricula. Results: The final sample was composed of 21 articles, among which 16 were empirical studies and five were theoretical essays. Most of the publications were from the United States, followed by Brazil, United Kingdom, New Zealand and Australia. Most of the students and teachers believe they must be prepared to address the issue spirituality with patients, despite a lack of consensus about contents, teaching methods and the best moment of teaching during the medical course. Conclusions: Teaching R/S is a developing process which is not yet a global phenomenon, as shown by the fact that publications of only a few countries are available. The subject is relevant and important as a curricular element in medical education, but needs further developments.

INTRODUÇÃO: A ocorrência familiar do transtorno obsessivo-compulsivo permite-nos especular sobre diferenças clínicas entre indivíduos com história familiar de TOC (HF+) e sem história familiar de TOC (HF-). Este estudo investigou a associação entre história familiar de TOC e algumas características clínicas. MATERIAL E MÉTODOS: Foram estudados retrospectivamente 111 pacientes através de revisão de prontuários de atendimento no Hospital Materno-Infantil Presidente Vargas de Porto Alegre, no período de julho de 1994 até julho de 2002. RESULTADOS: A idade média de início dos sintomas foi menor no grupo HF+ (17,8 anos ± 8,69 versus 20,8 anos ± 9,65; p = 0,000963). A intensidade dos sintomas obsessivo-compulsivos medidos pela YBOCS foi mais grave no grupo HF+ (22,5 ± 4,16 versus 17,93 ± 9,95; p < 0,001). Encontrou-se uma incidência maior de colecionismo no grupo HF+: quatro de 15 pacientes (26,6%) versus três de 69 pacientes (4,3%); p = 0,029. Não houve diferença relevante na variedade de fármacos utilizados no tratamento dos grupos estudados, bem como na freqüência da aplicação da terapia cognitivo-comportamental. Oito de 15 pacientes (53,3%) com história familiar e 13 de 69 pacientes (18,8%) sem história familiar necessitaram de terapia complementar à farmacológica (p = 0,022). CONCLUSÃO: Em resumo, os pacientes portadores de TOC com história familiar positiva para o mesmo, em nosso estudo, mostraram início dos sintomas mais precoce, maior gravidade dos sintomas medidos pela YBOCS e maior complexidade terapêutica, além de presença mais freqüente de colecionismo. Estudos prospectivos, com informações colhidas diretamente dos pacientes e dos familiares, além da inclusão de grupos-controle randomizados, poderão evidenciar adequadamente esses resultados.

This study emphasized the importance of using candidate genes in predicting semen quality in bulls that can be used in cow-calf production. The aim of this study was to evaluate some candidate genes related to reproductive traits in Braford and Hereford bulls. All bulls (n=188) were submitted to breeding soundness evaluations at 24, 28, 32, and 36 months of age. The microsatellite markers ILSTS002 and BMS3004 associated with the luteinizing hormone-β (LHβ) gene, IDVGA-51 to leptin (LEP) gene, HEL5 and AFZ1 within the IGF-IR gene, and two SNP markers (LHR and FSHR) associated with the LHR and FSHR genes, respectively, were evaluated by the amplification of DNA products. The variation in the IDVGA-51 allele 177-185 showed polymorphic information content (PIC) associated with sperm motility and vigor traits in Hereford bulls. Hereford animals showed PIC of 0.36 to 0.75% along with expected heterozygosity (H) of 0.49 to 0.78%. Braford bulls that indicated the ILSTS002 allele 137-175 and AFZ1 allele 113-119 showed PIC associated with major and minor defects, respectively. The PIC ranged from 0.28 to 0.78%, with an expected H of 0.35 to 0.81%. AFZ1 allele 121-127 had the highest minor defects and ILSTS002 allele 125-135 showed the highest major defects from ejaculated semen in Braford bulls. In addition, IDVGA-51 allele 175 showed lower motility and vigor in Hereford bulls. The markers AFZ1 (IGF-IR) and ILSTS002 (LHβ) in Braford and IDVGA-51 (LEP) in Hereford bulls were effective in verifying the reproductive traits of the bulls. Key words: Molecular markers. Single nucleotide polymorphisms. Microsatellites. Genetic variability. Braford and Hereford breeds. ResumoEste estudo enfatizou a importância do uso de genes candidatos na predição da qualidade do sêmen em touros que podem ser utilizados na produção de bezerros. O objetivo deste estudo foi avaliar alguns

O objetivo deste experimento foi determinar o intervalo entre o início do estro induzido ou espontâneo e a ovulação em fêmeas bubalinas (Bubalus bubalis) com o auxílio da ultra-sonografia, o que permitirá a determinação de um horário mais apropriado para a I.A. pré-fixada. Nos meses de março a junho, outono no sul do Brasil (época reprodutiva dos bubalinos), 132 fêmeas adultas ciclando foram divididas em 3 grupos experimentais: Grupo A - 53 fêmeas foram tratadas com implante subcutâneo de Norgestomet ou espiral intravaginal contendo progesterona. Na retirada dos dispositivos, foi aplicado 250mg de cloprostenol pela via intra-submucosa vulvar (i.s.m.v.), Grupo B - 48 búfalas foram tratadas com dupla aplicação de 250mg de cloprostenol pela via i.s.m.v. com intervalo de 11 dias e Grupo C - 31 búfalas foram consideradas testemunhas, sem tratamento. Todas as búfalas foram inseminadas no momento da observação do maior diâmetro do folículo pré-ovulatório, detectado por ultra-sonografia, durante o estro. Após o diagnóstico de prenhez, constatou-se, nos três tratamentos, que houve diferença significativa entre as búfalas prenhes e vazias no período compreendido entre o início do estro até o momento da ovulação e no período entre a I.A.e a ovulação. Os índices de prenhez foram de 41,5%, 52,1% e 54,8% nos grupos A, B e C, respectivamente. A variação no intervalo estro-ovulação nas búfalas é uma barreira para a obtenção de taxas de prenhez por I.A. pré-fixada comparáveis à monta natural, tanto no estro induzido através de progesterona e prostaglandina F2 alfa como no estro espontâneo.