Playing With a Purpose: The Impact of Therapeutic Recreation During Hospitalization.

Background: Youth undergoing cancer treatment and hematopoietic stem cell transplant (HSCT) spend significant time in the hospital, which is disruptive to their physical, social, and emotional development. Therapeutic recreation (TR) can help individuals with an illness maintain or improve their health, quality of life, and physical functioning. TR is an understudied intervention, particularly with youth in the hospital setting. Methods: Forty-nine children (median age = 12 years, interquartile range [IQR] 11-15 years) hospitalized for cancer treatment or HSCT were assigned to participate in either the historical control or TR intervention. Participants wore a Fitbit charge HR for three days to measure movement. At the end of the study participation, they completed self-report measures of mood, social connectedness, and health-related quality of life. Results: Compared with historical controls, the TR intervention group had improved positive affect and decreased mood disturbance (p = 0.03); had better sleep quality (p = 0.003); and was more satisfied with the leisure activities offered in the hospital (p = 0.01). There were no differences in the number of steps taken per day, somatic distress, cooperation with cares, or interaction with medical personnel or caregivers. Both groups reported poor availability and support of peer companions. Discussion: TR is one avenue to increase leisure activities and positively impact mood. More thought needs to be given to how TR programs can be leveraged to increase physical activity and social connectedness.

Relação da dança com o cuidado em saúde: nexos com o estilo de vida e a saúde integral / Relationship of dance with health care: links with lifestyle and integral health

Objetiva-se analisar os significados atribuídos à dança pelas mães de crianças acometidas pelo câncer na relação com o estilo de vida e o cuidado em saúde. Estudo explicativo, qualitativo, realizado com mães de crianças com câncer, no momento da internação hospitalar para realização de quimioterapia, na pediatria do Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro. Os dados foram coletados através de formulário de identificação e caracterização do estilo de vida, além de entrevista semiestruturada em profundidade, no período de fevereiro de 2019 até março de 2020. Optou-se pelo Interacionismo Simbólico, como base referencial, juntamente com a Grounded Theory, para a produção e análise dos dados. O estudo justifica-se por ser original e inédito, também, pela transmutação que a dança realizou nas mães de crianças com câncer, refletindo novas possibilidades para cuidar de si e para cuidar do outro. Emergiram dos dados os componentes correspondentes ao modelo paradigmático, a saber: "Percebendo situações diárias desafiantes à sobrevivência: entre o real e o ideal"; "Ressignificando a percepção do agravo estereotipado através de um espaço lúdico de criação"; "Repercutindo, por meio da experiência no espaço da dança, novas possibilidades para cuidar de si e para cuidar do outro". Como categoria central, o estudo revelou: "Transmutando a energia da mãe da criança com agravo oncológico através do simbólico da dança". O estudo aponta, assim, constructos explicativos que versam sobre o fenômeno dos significados atribuídos à dança pelas mães de criança com câncer com nexo ao estilo de vida e a saúde integral, haja vista as condições intervenientes, as estratégias de ação/interação e as consequências/resultados, que implicam no cuidado em enfermagem/ saúde.

The objective is to analyze the meanings attributed by mothers of children affected by cancer to dance, in relation to lifestyle and health care. explanatory, qualitative study, carried out with mothers of children with cancer, at the time of hospitalization for chemotherapy, in the pediatrics department of the José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro.The data were collected through a lifestyle identification and characterization form and in-depth semi-structured interviews, from February 2019 to March 2020. Symbolic Interactionism was chosen as the reference base and Grounded Theory for the production and analysis of Dice. The study is justified for being original and unpublished and for the transmutation that dance performed in the mothers of children with cancer, reflecting new possibilities for taking care of themselves and for taking care of others.The components corresponding to the paradigmatic model emerged from the data, namely: Perceiving daily situations challenging survival: Between the real and the ideal, Re- signifying the perception of stereotyped grievance through a playful space of creation, Echoing through the experience in the dance space, new possibilities to take care of yourself and to take care of others. As a central category, the study highlighted: Transmuting the energy of the child's mother with cancer through the symbolic of dance.The study thus points out explanatory constructs that deal with the phenomenon of meanings attributed to dance by mothers of children with cancer related to lifestyle and comprehensive health, given the intervening conditions, action/interaction strategies, and consequences/ results, which imply for nursing/health care.

El objetivo es analizar los significados que las madres de niños afectados por cáncer atribuyen a la danza, en relación al estilo de vida y la atención a la salud. Estudio explicativo, cualitativo, realizado con madres de niños con cáncer, en el momento de la hospitalización por quimioterapia, en el departamento de pediatría del Instituto Nacional del Cáncer José Alencar Gomes da Silva, Río de Janeiro. Los datos fueron recogidos a través de un formulario de identificación y caracterización de estilos de vida y entrevistas semiestructuradas en profundidad, desde febrero de 2019 hasta marzo de 2020. Se eligió el Interaccionismo Simbólico como base de referencia y la Teoría Fundamentada para la producción y análisis de datos. El estudio se justifica por ser original e inédito y por la transmutación que la danza realiza en las madres de niños con cáncer, reflejando nuevas posibilidades de cuidarse a sí mismas y de cuidar a los demás. Los componentes correspondientes al modelo paradigmático emergieron de los datos, a saber: Percepción de situaciones cotidianas que desafían la supervivencia: Entre el real y el ideal, Re- significando la percepción del agravio estereotipado a través de un espacio lúdico de creación, Haciendo eco a través de la experiencia en el espacio de la danza, nuevas posibilidades para cuidarse y cuidar a los demás. Como categoría central, el estudio destacó: Transmutar la energía de la madre del niño con cáncer a través del simbólico de la danza. Así, el estudio señala constructos explicativos que abordan el fenómeno de los significados atribuidos a la danza por las madres de niños con cáncer relacionados con el estilo de vida y la salud integral, dadas las condiciones que intervienen, las estrategias de acción / interacción y las consecuencias / resultados que implican cuidados de enfermería/salud.

Recreational Physical Activity and Outcomes After Breast Cancer in Women at High Familial Risk.

Background: Recreational physical activity (RPA) is associated with improved survival after breast cancer (BC) in average-risk women, but evidence is limited for women who are at increased familial risk because of a BC family history or BRCA1 and BRCA2 pathogenic variants (BRCA1/2 PVs). Methods: We estimated associations of RPA (self-reported average hours per week within 3 years of BC diagnosis) with all-cause mortality and second BC events (recurrence or new primary) after first invasive BC in women in the Prospective Family Study Cohort (n = 4610, diagnosed 1993-2011, aged 22-79 years at diagnosis). We fitted Cox proportional hazards regression models adjusted for age at diagnosis, demographics, and lifestyle factors. We tested for multiplicative interactions (Wald test statistic for cross-product terms) and additive interactions (relative excess risk due to interaction) by age at diagnosis, body mass index, estrogen receptor status, stage at diagnosis, BRCA1/2 PVs, and familial risk score estimated from multigenerational pedigree data. Statistical tests were 2-sided. Results: We observed 1212 deaths and 473 second BC events over a median follow-up from study enrollment of 11.0 and 10.5 years, respectively. After adjusting for covariates, RPA (any vs none) was associated with lower all-cause mortality of 16.1% (95% confidence interval [CI] = 2.4% to 27.9%) overall, 11.8% (95% CI = -3.6% to 24.9%) in women without BRCA1/2 PVs, and 47.5% (95% CI = 17.4% to 66.6%) in women with BRCA1/2 PVs (RPA*BRCA1/2 multiplicative interaction P = .005; relative excess risk due to interaction = 0.87, 95% CI = 0.01 to 1.74). RPA was not associated with risk of second BC events. Conclusion: Findings support that RPA is associated with lower all-cause mortality in women with BC, particularly in women with BRCA1/2 PVs.

Play and Learn for Surgeons: A Serious Game to Educate Medical Residents in Uterine Artery Ligation Surgery.

Objective: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality. Surgical interventions, such as uterine artery ligation and utero-ovarian arteries ligation (UAL and UOAL), are considered as effective methods to control PPH. Owing to PPH's severe outcomes, various educational tools have been developed to train surgical residents. A potential educational medium for this purpose could be serious digital games. In this pilot study, we assessed the usability and effectiveness of a serious game to promote the surgical skills of UAL/UOAL among obstetrics and gynecology (OB/GYN) residents. Methods: We designed and developed the Play and Learn for Surgeons (PLS) game to train OB/GYN residents. We assessed and compared the usability challenges of PLS before and after revising the game. To assess the effectiveness of PLS, residents were allocated randomly in control and intervention groups. Surgical skills of the residents were assessed pre- and post-test using the Objective Structured Assessment of Technical Skills checklist. Setting: This pilot study took place at the OB/GYN wards of Omolbanin Hospital (Mashhad University of Medical Sciences) and Imam Ali Hospital (Zahedan University of Medical Sciences) in Iran. Participants: Thirteen subject matter experts (nine OB/GYN experts and four senior clinical assistants) participated in the user interface design and usability assessment of PLS. Total of 46 OB/GYN residents participated in the educational effectiveness analysis of PLS. All participants were female with mean ages of 40.6, 29.9 and 28.0 years for OB/GYN experts, assistants, and residents, accordingly. Results: All participants completed the study. PLS significantly improved the skills of residents for UAL (P-value = 0.018) and UOAL (P-value <0.001) procedures. Conclusion: Serious games can be an effective and affordable approach in training OB/GYN residents for UAL and UOAL procedures. Approval number: (# IR.MUMS.fm.REC.1396.345) Trial registration number: (# IRCT2017092436366N1).

"A place to call our own": The impact of camp experiences on the psychosocial wellbeing of children and youth affected by cancer - A narrative review.

BACKGROUND: Although childhood cancer mortality rates are decreasing, intensive treatment modalities and missed school days may leave childhood cancer patients psychologically and socially vulnerable. Children with cancer often have increased anxiety, lower levels of self-esteem, and higher rates of depression, all of which may impair their psychosocial wellbeing. Specialized camps for children with cancer are becoming increasingly popular, as they provide a stress-free, outdoor environment in which children are able to interact with individuals similar to themselves, while experiencing the joys of a "normal childhood." OBJECTIVE: The aim of this review was to explore how camp participation impacts the psychosocial wellbeing of childhood cancer patients and survivors. METHODS: Six databases (MEDLINE, PsychINFO, EMBASE, CINHAL, Sociological Abstracts, Social Sciences Citation Index) were systematically searched for English literature published between 2007 and 2018. The search generated 1707 titles, and after being evaluated for relevance, 18 articles met the inclusion criteria. A thematic analysis was conducted. RESULTS: A variety of camp programs and methodologies were employed among the studies. Camp participation led to improved social health, followed by enhanced constructions of the self, quality of life, sense of normalcy, and attitude. CONCLUSION: This review demonstrates the potential ability of camp to buffer psychosocial losses for children affected by cancer. Addressing limitations, such as the lack of child-centered methodologies employed in camp settings, may not only help to guide future research on therapeutic recreation experiences for children with cancer, but also expand the evidence base for children living with other chronic illnesses and disabilities.

[Effect of forest bathing (shinrin-yoku) on human health: A review of the literature]. / Effets des forêts et des bains de forêt (shinrin-yoku) sur la santé humaine : une revue de la littérature.

Humans have enjoyed forest environments for ages because of the quiet atmosphere, beautiful scenery, mild climate, pleasant aromas, and fresh, clean air. In Japan, since 2004, serial studies have been conducted to investigate the effects of forest environments on human health. We have established a new medical science called Forest Medicine. The Forest Medicine is a new interdisciplinary science, belonging to the categories of alternative medicine, environmental medicine and preventive medicine, which encompasses the effects of forest environments on human health. It has been reported that forest environments have the following beneficial effects on human health:1. Increase human natural killer (NK) activity, the number of NK cells, and the intracellular levels of anti-cancer proteins, suggesting a preventive effect on cancers.2. Reduce blood pressure, heart rate, and stress hormones, such as urinary adrenaline and noradrenaline and salivary cortisol.3. Increase the activity of parasympathetic nerves and reduce the activity of sympathetic nerves.4. Increase the levels of serum adiponectin and dehydroepiandrosterone sulfate.5. In the Profile of Mood States (POMS) test, reduce the scores for anxiety, depression, anger, fatigue, and confusion, and increase the score for vigor, showing psychological effects as well.These findings suggest that forest environments may have preventive effects on lifestyle-related diseases.

The Effect of Clown Intervention on Self-Report and Biomarker Measures of Stress and Fatigue in Pediatric Osteosarcoma Inpatients: A Pilot Study.

BACKGROUND: Pediatric cancer patients experience different psychological processes during hospitalization that may regulate the immune response and affect recovery and response to cancer treatment. In this study, we aimed to examine the feasibility of longitudinal testing of psychophysiological parameters of stress and fatigue in pediatric osteosarcoma patients hospitalized for chemotherapy submitted to clown intervention; and to investigate whether changes in the levels of biomarkers are associated with psychological stress and fatigue levels in these patients after the clown intervention. METHODS: A pretest-posttest quasi-experimental pilot study was conducted at the pediatric oncology inpatient unit in a comprehensive cancer care center in Brazil including children and adolescents with osteosarcoma hospitalized for chemotherapy. Eight saliva samples were collected, comprising 4 at baseline (pre-intervention) and 4 after the clown intervention (+1, +4, +9, and +13 hours post-awakening). Salivary cortisol, α-amylase (sAA), cytokines, and matrix metalloproteinase-9 (MMP-9) levels were determined using high-sensitivity enzyme-linked immunosorbent assay (ELISA) kits. Stress and fatigue were measured by Child Stress Scale-ESI and PedsQL Multidimensional Fatigue Scale respectively. Bivariate association analysis between stress and fatigue scores and biomarker levels were investigated using nonparametric statistics. Effect sizes were calculated for each outcome variable. RESULTS: Six pediatric osteosarcoma patients were enrolled with no missing data. No significant effects sizes were observed for psychophysiological outcomes. Effect sizes ranged from 0.54 (cortisol) to 0 (interleukin-1ß [IL-1ß]). Decreasing overall trends were observed for cortisol levels for all 6 pediatric osteosarcoma patients over time. In addition, a similar pattern of tumor necrosis factor-α (TNF-α) levels over time was found for all 6 patients. Patients with metastatic osteosarcoma showed a linear trend for a decrease in MMP-9 levels between 1 and 9 hours after the clown intervention and restoration to basal levels after 13 hours. CONCLUSIONS: The results of this pilot study suggest that it is feasible longitudinally measure psychophysiological outcomes in the pediatric osteosarcoma inpatients for chemotherapy. Clown intervention merits further study as a way to reduce stress as well as fatigue, since that the stress and cytokines measurements are feasible based on our work.

Psychosocial Care of the Pediatric Oncology Patient Undergoing Surgical Treatment.

OBJECTIVE: To review the psychosocial aspects experienced by children with cancer undergoing surgical and procedural treatments. DATA SOURCES: CINAHL, PubMed, and PsycINFO resources. CONCLUSION: The diagnosis of cancer is a threatening experience for the pediatric patient with cancer leading to anxiety and distress, which is elevated with a surgical or procedural approach to treatment. Assessing the child's developmental level and previous experiences are fundamental in identifying the appropriate interventions to reduce anxiety and distress to support effective coping. IMPLICATIONS FOR NURSING PRACTICE: Nurses are instrumental in assessing the child's level of anxiety related to surgical procedures. Suggested evidence-based interventions for anxiety and distress include therapeutic play, structured educational preparation, and art-based programs (ie, Hope Bead program).

Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months.

BACKGROUND: The number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess. METHODS: Camp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected. DISCUSSION: This is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk. TRIAL REGISTRATION: NCT02908230/09-19-2016.

Effects of an Avatar-Based Anti-Smoking Game on Smoking Cessation Intent.

The purpose of this study was to compare the effects of a computer-based anti-smoking game on the intent and motivation to quit tobacco. Smokers with nicotine dependence were briefly exposed to an anti-smoking game with or without an avatar resembling the smoker's self. The computer-based anti-smoking game improved participants' immediate intent and motivation to quit smoking. Embedding an avatar resembling self into the game did not result in added benefits.

Efficacy of recreational football on bone health, body composition, and physical functioning in men with prostate cancer undergoing androgen deprivation therapy: 32-week follow-up of the FC prostate randomised controlled trial.

UNLABELLED: Androgen deprivation therapy (ADT) for prostate cancer (PCa) impairs musculoskeletal health. We evaluated the efficacy of 32-week football training on bone mineral density (BMD) and physical functioning in men undergoing ADT for PCa. Football training improved the femoral shaft and total hip BMD and physical functioning parameters compared to control. INTRODUCTION: ADT is a mainstay in PCa management. Side effects include decreased bone and muscle strength and increased fracture rates. The purpose of the present study was to evaluate the effects of 32 weeks of football training on BMD, bone turnover markers (BTMs), body composition, and physical functioning in men with PCa undergoing ADT. METHODS: Men receiving ADT >6 months (n = 57) were randomly allocated to a football training group (FTG) (n = 29) practising 2-3 times per week for 45-60 min or to a standard care control group (CON) (n = 28) for 32 weeks. Outcomes were total hip, femoral shaft, femoral neck and lumbar spine (L2-L4) BMD and systemic BTMs (procollagen type 1 amino-terminal propeptide, osteocalcin, C-terminal telopeptide of type 1 collagen). Additionally, physical functioning (postural balance, jump height, repeated chair rise, stair climbing) was evaluated. RESULTS: Thirty-two-week follow-up measures were obtained for FTG (n = 21) and for CON (n = 20), respectively. Analysis of mean changes from baseline to 32 weeks showed significant differences between FTG and CON in right (0.015 g/cm(2)) and left (0.017 g/cm(2)) total hip and in right (0.018 g/cm(2)) and left (0.024 g/cm(2)) femoral shaft BMD, jump height (1.7 cm) and stair climbing (-0.21 s) all in favour of FTG (p < 0.05). No other significant between-group differences were observed. CONCLUSIONS: Compared to standard care, 32 weeks of football training improved BMD at clinically important femoral sites and parameters of physical functioning in men undergoing ADT for PCa.

Tangoterapia / Tangotherapy

Se propone la tangoterapia como una técnica terapéutica catalizadora del desenvolvimiento personal, un método de exploración de los recursos personales y un potenciador de las capacidades de cada persona, a través del uso de la metáfora diagnóstica para arribar a conclusiones y llevar a cabo la acción terapéutica. Un espacio de realización y creatividad, de encuentros humanizados, plenos de significados y satisfacciones. Un lugar de intercambios humanos y de juego. De vínculos con sentido y consecuencia, dentro de un marco de una vivencia atrayente y creativa singular...

The tangoterapia as a technical therapeutic catalyst for personal development, a method of exploration of personal resources and a booster of the abilities of each person, through the use of the metaphor diagnostic to arrive at conclusions and carry out the therapeutic action is proposed. A space of creation and creativity, encounters Humanized, full of meanings and satisfactions. A place of human exchanges and play. Links with meaning and consequence, within a framework of a singular attractive and creative experience...

Contributions of ludic care in nursing to chemical detoxification due to the use of crack cocaine / Contribuciones del cuidado lúdico en enfermería en la desintoxicación química debido al uso de crack / Contribuições do cuidado lúdico em enfermagem na desintoxicação química devido ao uso de crack

OBJECTIVE: to understand the contributions of ludic care in nursing by stimulating the acceptance of chemical detoxification from crack on the perception of people in the detoxification process. METHODS: an exploratory, descriptive study with a qualitative approach, performed with five people hospitalized for chemical detoxification from crack, from March to July 2013 in a chemical detox unit of a midsize hospital in the central region of Rio Grande do Sul. Data was collected using a semi-structured interview and was subjected to content analysis. RESULTS: Two categories emerged: Ludic care in nursing as a stimulus to the acceptance of chemical detoxification; Ludic care in nursing in the promotion for healthy living after chemical detoxification. CONCLUSION: ludic care in nursing proved to enhance the acceptance of chemical detoxification from crack in the reality investigated. .

OBJETIVO: conocer las contribuciones del cuidado lúdico en enfermería en el estímulo a la aceptación de la desintoxicación química por el uso del crack en la percepción de las personas en ese proceso. MÉTODOS: estudio exploratorio, descriptivo de abordaje cualitativo realizado con cinco personas hospitalizadas para desintoxicación química, en el período de marzo a julio de 2013, en una unidad de desintoxicación química de un hospital de mediano porte de la región central de Rio Grande do Sur. Los datos fueron recolectados por una entrevista semiestructurada y sometidos a análisis de contenidos. RESULTADOS: surgieron dos categorías: El cuidado lúdico en enfermería, como un estímulo a la aceptación y como la promoción para el vivir saludable después de la desintoxicación química. CONCLUSIÓN: el cuidado lúdico en enfermería, se mostró potenciador a la aceptación de la desintoxicación del crack en la realidad investigada. .

OBJETIVO: conhecer as contribuições do cuidado lúdico em enfermagem no estímulo à aceitação da desintoxicação química pelo uso do crack na percepção das pessoas em processo de desintoxicação. MÉTODOS: estudo exploratório, descritivo, de abordagem qualitativa, realizado com cinco pessoas internadas para desintoxicação química do crack, no período de março a julho de 2013, em uma unidade de desintoxicação química de um hospital de médio porte da região central do Rio Grande do Sul. Os dados foram coletados por meio de uma entrevista semiestruturada e foram submetidos à análise de conteúdo. RESULTADOS: emergiram duas categorias: O cuidado lúdico em enfermagem como um estímulo à aceitação da desintoxicação química; Cuidado lúdico em enfermagem na promoção para o viver saudável após a desintoxicação química. CONCLUSÃO: o cuidado lúdico em enfermagem mostrou-se potencializador para a aceitação da desintoxicação química do crack na realidade investigada. .

Nature-based experiences and health of cancer survivors.

PURPOSE: Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors. METHODS: This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases. RESULTS: Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health. CONCLUSIONS: This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study.

An outdoor adventure program for young adults with cancer: positive effects on body image and psychosocial functioning.

This study evaluated the psychological effects of an outdoor adventure program on young adult cancer survivors (ages 18-39). The 6-day adventure program included personal instruction and supervision on the basics of kayaking, surfing, or climbing. Compared to a wait-list control group, participants who took part in the program for the first time had improved (relative to pretest) body image, self-compassion and self-esteem, and less depression and alienation. Participants who took part for the second time, though also helped by the program in similar ways, were no better off psychologically than participants who took part for the first time. Possible explanations for the positive effects and their apparent short duration are offered.

Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy: study protocol for the 'FC Prostate' randomized controlled trial.

BACKGROUND: Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The 'Football Club (FC) Prostate' study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer. METHODS/DESIGN: Using a single-center randomized controlled design, 80 men with histologically confirmed locally advanced or disseminated prostate cancer undergoing ADT for 6 months or more at The Copenhagen University Hospital will be enrolled on this trial. After baseline assessments eligible participants will be randomly assigned to a soccer training group or a control group receiving usual care. The soccer intervention will consist of 12 weeks of training 2-3 times/week for 45-60 min after which the assessment protocol will be repeated. Soccer training will then continue bi-weekly for an additional 20 weeks at the end of which all measures will be repeated to allow for additional analyses of long-term effects. The primary endpoint is changes in lean body mass from baseline to 12 weeks assessed by dual X-ray absorptiometry scan. Secondary endpoints include changes of cardiovascular, metabolic, and physical function parameters, as well as markers of bone metabolism and patient-reported outcomes. DISCUSSION: The FC Prostate trial will assess the safety and efficacy of a novel soccer-training approach to cancer rehabilitation on a number of clinically important health outcomes in men with advanced prostate cancer during ADT. The results may pave the way for innovative, community-based interventions in the approach to treating prostate cancer. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01711892.

Efficacy of therapeutic play for pediatric brain tumor patients during external beam radiotherapy.

OBJECTIVE: External beam radiotherapy (EBRT) is frequently used to improve disease control for pediatric brain tumor patients. However, to facilitate the radiotherapy (RT) procedure, "forced" type interventions including conscious sedation or general anesthesia are frequently used to manage patients' fear and anxiety. The aim of this study was to investigate the effects of therapeutic play (TP) in reducing anxiety for pediatric brain tumor patients treated by EBRT. METHODS: Between April 1st and September 30th, 2009, 19 young brain tumor patients, aged 3-15 years and recommended for RT, were recruited: ten to a control group and nine to the study intervention group. The study group was introduced with TP during EBRT. The Beck Youth Anxiety Inventory and the Faces Anxiety Scale were used to evaluate patients' psychological levels of anxiety. The heart rate variability and salivary cortisol concentrations were used to indicate the patients' physical levels of anxiety. Both the psychological and physiological tests were administered to all subjects before and after the RT procedure. RESULTS: The study group had significantly lower anxiety scores and expressed fewer negative emotions than did the control group before EBRT. CONCLUSIONS: TP can not only improve the quality of medical services but can also reduce costs and staffing demands. In addition, it can help lower young patients' anxiety and fear during medical procedures. As a result, it further decreases the potential negative impacts of hospitalization on these young patients.

Projeto brincar e contar: a terapia ocupacional na atenção básica em saúde / Project "play and tell": occupational therapy in primary health care

Este artigo relata uma experiência de um grupo de contação de histórias e brincar ocorrida nas dependências de uma Unidade Saúde da Família do município de São Carlos, SP. Esse grupo foi constituído a partir da avaliação da terapeuta ocupacional no contexto da atenção básica à saúde de forma ampliada que considerou a vida cotidiana dos envolvidos: as crianças, uma usuária do serviço e a equipe de saúde. Através do olhar da terapia ocupacional para as problemáticas do território foram propostas intervenções que articulavam o cuidado individual, o cuidado coletivo e a corresponsabilização da comunidade e da equipe na busca da ressignificação do cotidiano desses atores. Trata-se de um exemplo concreto de mudança de paradigma do modelo de saúde existente para os preceitos da Estratégia Saúde da Família com o envolvimento de usuários e profissionais de várias áreas. A terapeuta ocupacional identificou diferentes demandas do território: a necessidade de transformação do cotidiano e da rotina de uma usuária, a necessidade de espaços de lazer e brincadeiras para as crianças no território e o desejo da equipe de construir esse espaço através de uma brinquedoteca. A possível junção das realidades cotidianas da usuária, das crianças e da equipe constituiu um projeto de intervenção baseado na visão da clínica ampliada. O ?Brincar e Contar? foi capaz de transformar na prática o modelo de atenção à saúde.

This paper reports the experience of a "storytelling and playing" group that took place in a Family Health Unit in Sao Carlos, State of Sao Paulo. The group was formed as from the evaluation of the occupational therapist in the context of Primary Health Care, which broadly considers the daily lives of the actors involved: children, one user of the system, and the health team. From the viewpoint of Occupational Therapy, with focus on the problems of the territory, interventions linking the following matters were proposed: individual care, collective care, and co-responsibility of the community and staff in pursuit of the resignificance of the everydaylives of the actors involved. This is a concrete example of paradigm shift from the existing health model to the precepts of the Family Health Strategy, with the involvement of users and professionals from various areas.The occupational therapist identified different demands of the territory: the need for transformation of daily life and routine of a user; the need for children?s leisure; and the desire of the health team to build this spacethrough a playroom. The possible combination of the user, children and the team?s everyday realities composed an intervention project based on the vision of the clinic expanded. The ?playing and storytelling? was able toactually transform the health care model.

Aproximações do teatro do oprimido com a Psicologia e o Psicodrama / Appoximations among the theatre of the oppressed, Psychology and Psychodrama / Aproximaciones del teatro del oprimido con la Psicología y el Psicodrama

O presente artigo aborda as aproximações do teatro do oprimido na modalidade do arco-íris do desejo, método de terapia e teatro criado por Augusto Boal com a Psicologia, em especial com o psicodrama. O teatro do oprimido é frequentemente comparado e até mesmo confundido com o psicodrama, daí a necessidade de apontarmos algumas semelhanças e diferenças entre os dois métodos, as teorias que inspiraram seus criadores, bem como os objetivos que procuravam alcançar. Procuraremos problematizar o uso das técnicas do arco-íris do desejo considerando a função e a preparação do curinga para aplicá-las, seu manejo, bem como o lugar de autoridade que lhe é conferido. As técnicas boalianas devem ser utilizadas com o devido cuidado, pois é necessário não perder de vista as possíveis consequências que o seu uso indevido pode provocar nos participantes, posto que são técnicas mobilizadoras de fortes conteúdos emocionais...

This article discusses the approaches of the theatre of the oppressed in the form of the rainbow of desire, a method of therapy and theatre created by Augusto Boal with psychology, especially with psychodrama. The theatre of the oppressed is often compared and even confused with psychodrama, hence the need to point out some similarities and differences between the two methods, the theories that inspired its creators, as well as the goals that they want to achieve. We will strive to discuss the use of rainbow of desire’s techniques, considering the preparation of the joker to apply them, their management and the authority conferred on it. Boalians’ techniques should be used carefully, and the applicator must not lose sight of the possible consequences such misuse may cause to their participants, since these techniques can mobilize a strong emotional content...

El presente artículo aborda las aproximaciones del teatro del oprimido en la modalidad del arco iris del deseo, método de terapia y teatro creado por Augusto Boal con la Psicología, en especial con el psicodrama. El teatro del oprimido es frecuentemente comparado e incluso confundido con el psicodrama, de ahí la necesidad de que apuntemos algunas semejanzas y diferencias entre los dos métodos, las teorías que inspiraron a sus creadores, así como los objetivos que procuraban alcanzar. Procuraremos problematizar el uso de las técnicas del arco iris del deseo considerando la función y la preparación del comodín para aplicarlas, su manejo, así como el lugar de autoridad que le es conferida. Las técnicas boalianas deben ser utilizadas con el debido cuidado, pues es necesario no perder de vista las posibles consecuencias que su uso indebido puede provocar en los participantes, puesto que son técnicas movilizadoras de fuertes contenidos emocionales...

Health-related quality of life changes of children and adolescents with chronic disease after participation in therapeutic recreation camping program.

BACKGROUND: The principals of therapeutic recreation underpin a camping program for children and adolescents living with chronic disease. This study aimed to evaluate the campers' health-related quality of life (HRQoL) before and after the program. METHOD: We used the Hungarian version of Kidscreen-52 questionnaire to assess HRQoL. The study sample (n = 115) consisted of children and adolescents aged 10-18 (Mean Age: 13,34; SD: 2,20) collected two months before and two months after camp with the following illnesses: oncology patients (n = 32), diabetes (n = 55) and juvenile immune arthritis (JIA) (n = 28). Repeated measures of multivariate analysis of variance (MANOVA) evaluated pre and post camp changes. We used the Reliable Change Index (RCI) to calculate all the 10 subscales of clinically significant changes. RESULTS: The Self-perception subscale showed significant positive change from pre camp to post camp with small effect size. Autonomy scores showed time related decline as well as significant time and age group interaction: children under 14 years of age showed a significant moderate effect size decrease on the Autonomy subscale. 32 children (27.8%) showed clinically significant improvement (RCI > 1.96) at least on one subscale. All positive changes were independent of the type of disease, age, gender, and previous camp experience. CONCLUSION: The therapeutic recreation camping program had a positive impact on HRQoL of children and adolescents living with cancer, diabetes mellitus and JIA. The experience enhanced their self-perception in all age groups and reduced the autonomy of children under 14 years of age. This study is an innovative use of the KIDSCREEN-52 questionnaire to measure the outcome effectiveness of a psychosocial rehabilitation program and to assess and compare HRQoL of children living with different chronic diseases.