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.