Educação permanente no sistema único de saúde: concepções de profissionais da gestão e dos serviços / Continuing permanent education in the brazilian national health system: conceptions from management and care professionals / Educación continua en el sistema único de salud brasileño: concepciones de los profesionales de gestión y servicios

Este artigo pretende compreender as concepções de profissionais da gestão e dos serviços do Sistema Único de Saúde (SUS) sobre Educação Permanente em Saúde (EPS), bem como seus desafios e potencialidades. Utilizou-se de grupo focal para coleta, seguido de análise lexical do tipo classificação hierárquica descendente com auxílio do software Iramuteq. Os resultados delinearam quatro classes: a) EPS - entendimentos e expectativas; b) entraves à EPS; c) ETSUS e EPS por meio de cursos e capacitações; e d) dispositivos de EPS: potencialidades e desafios. Os participantes apontaram equívocos de entendimentos acerca da EPS ao equipará-la à Educação Continuada (EC) voltada à transferência de conteúdo, com repercussões negativas na prática de EPS. Discute-se o risco em centralizar o responsável pela concretização dessa proposta, que deveria ser coletiva e compartilhada entre diferentes atores. Reivindica-se, portanto, uma produção colaborativa, que possa circular entre os envolvidos, de modo que cada um experimente esse lugar e se aproprie da complexidade de interações propiciadas pela Educação Permanente em Saúde.(AU)

This article aims to understand the conceptions of professionals from the management and services of the Unified Health System (SUS) on Permanent Education in Health (EPS), as well as its challenges and potential. A focus group was used for data collection, followed by a lexical analysis of the descending hierarchical classification type using the Iramuteq software. The results delineated four classes: a) EPS - understandings and expectations; b) obstacles to EPS; c) ETSUS and EPS by courses and training; and d) EPS devices: potentialities and challenges. Participants pointed out misunderstandings about EPS, when equating it with Continuing Education (CE) focused on content transfer, with negative repercussions on EPS practice. The risk of centralizing the person responsible for implementing this proposal, which should be collective and shared among different actors, is discussed. Therefore, a collaborative production is claimed for, which can circulate among those involved, so that each one experiences this place and appropriates the complexity of interactions provided by Permanent Education in Health.(AU)

Este artículo tiene por objetivo comprender las concepciones de los profesionales de la gestión y servicios del Sistema Único de Salud (SUS) sobre Educación Continua en Salud (EPS), así como sus desafíos y potencialidades. Se utilizó un grupo focal para la recolección de datos, seguido por un análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Iramuteq. Los resultados delinearon cuatro clases: a) EPS: entendimientos y expectativas, b) Barreras para EPS, c) ETSUS y EPS a través de cursos y capacitación, y d) Dispositivos EPS: potencialidades y desafíos. Los participantes informaron que existen malentendidos sobre EPS al equipararla a Educación Continua, con repercusiones negativas en la práctica de EPS, orientada a la transferencia de contenidos. Se discute el riesgo de elegir a un solo organismo como responsable de implementar esta propuesta colectiva, que debería ser colectiva y compartida entre los diferentes actores. Se aboga por un liderazgo colaborativo, que pueda circular entre los involucrados, para que cada uno experimente este lugar y se apropie de la complejidad de interacciones que brinda la Educación Continua en Salud.(AU)

PsicoQuilombologia: escrevivência de uma psicologia das encruzilhadas em tempos pandêmicos / PsychoQuilombology: writexperience of a psychology of crossroads in pandemic times / PsicoQuilombología: escrivivencia de una psicología de la encrucijada en tiempos pandémicos

O texto é um relato de experiência da participação no Grupo de Estudos psicoQuilombologia ocorrida nos meses de setembro de 2020 a março de 2021, período atravessado pela segunda onda da pandemia de COVID-19 no Brasil. O objetivo do relato é apresentar o conceito-movimento de psicoQuilombologia como uma proposta epistemológica quilombola de agenciamento de cuidado e saúde, com base em uma escuta que se faça descolonial e inspirada no fecundo e ancestral acervo de cuidado dos povos africanos, quilombolas e pretos, preservado e atualizado em nossos quilombos contemporâneos. A metodologia utilizada é a escrevivência, método desenvolvido por Conceição Evaristo que propõe uma escrita em que as vivência e memórias estão totalmente entrelaçadas, imersas e imbricadas com a pesquisa. O resultado das escrevivências dessa pesquisa descortinam que os povos pretos desenvolveram práticas de cuidado e acolhimento às vulnerabilidades do outro, enraizadas no fortalecimento de laços e conexões coletivas de afetos e cuidado mútuos. Práticas de cuidado que articulam memória, ancestralidade, tradição, comunidade, transformação, luta, resistência e emancipação, engendrando modos coletivos de ser e viver. Nas quais cuidar do outro implica tratar suas relações e situar o cuidado como extensão de uma cura que se agencia no coletivo. O trabalho conclui apontando que o cenário pandêmico vigente acentua a pungência de se desenvolver estratégias de cuidado baseadas em epistemologias pretas e quilombolas, valorizando os sentidos de ancestralidade, comunidade, pertencimento e emancipação.(AU)

The text is an experience report of the participation in the psicoQuilombology Study Group that carried out from September 2020 to March 2021, during the second wave of the COVID-19 pandemic in Brazil. The purpose of the report is to introduce the concept-movement of psicoQuilombology as a quilombola epistemological proposal for the development of care and health, based on a decolonial listening and inspired by the rich care collection of African peoples, quilombolas and Blacks, preserved and updated in our contemporary quilombos. The methodology used is writexperience [escrevivências], a method developed by Conceição Evaristo who proposes a writing in that the experiences and memories are totally involved with the research. The result of the writability of this research show that Black people have developed practices of care and acceptance of the other's vulnerabilities, based on the strengthening of ties and collective connections of mutual affection and care. Care practices that mix memory, ancestry, tradition, community, transformation, struggle, resistance and emancipation, outlining collective ways of being and living. The core idea is that taking care of the other means treating your relationships and maintaining care as an extension of a cure that takes place in the collective. The paper concludes by pointing out that the current pandemic scenario demonstrates the urgent need to develop care strategies based on black and quilombola epistemologies, valuing the senses of ancestry, community, belonging and emancipation.(AU)

Este es un reporte de experiencia de la participación en el Grupo de Estudio psicoQuilombología que ocurrió en los meses de septiembre de 2020 a marzo de 2021, periodo en que Brasil afrontaba la segunda ola de la pandemia de la COVID-19. Su propósito es presentar el concepto-movimiento de psicoQuilombología como una propuesta epistemológica quilombola para el desarrollo del cuidado y la salud, basada en una escucha decolonial e inspirada en el rico acervo asistencial de los pueblos africanos, quilombolas y negros, conservado y actualizado en nuestros quilombos contemporáneos. La metodología utilizada es la escrivivencia, un método desarrollado por Conceição Evaristo quien propone una escrita en que las vivencias y los recuerdos están totalmente involucrados con la investigación. El resultado de la escrivivencia muestra que las personas negras han desarrollado prácticas de cuidado y aceptación de las vulnerabilidades del otro, basadas en el fortalecimiento de lazos y conexiones colectivas de afecto y cuidado mutuos. Prácticas de cuidado que mezclan memoria, ascendencia, tradición, comunidad, transformación, lucha, resistencia y emancipación, perfilando formas colectivas de ser y vivir. El cuidar al otro significa tratar sus relaciones y mantener el cuidado como una extensión de una cura que tiene lugar en lo colectivo. El trabajo concluye que el actual escenario pandémico demuestra la urgente necesidad de desarrollar estrategias de atención basadas en epistemologías negras y quilombolas, y que valoren los sentidos de ascendencia, comunidad, pertenencia y emancipación.(AU)

Sistema de avaliação de testes psicológicos: histórias contadas e não contadas / Psychological test evaluation system: stories told and untold / Sistema de evaluación de tests psicológicos: historias contadas y no contadas

O Sistema de Avaliação de Testes Psicológicos (SATEPSI) recebeu notoriedade entre brasileiros e estrangeiros por oferecer um complexo sistema de qualificação dos testes psicológicos, pouco visto em âmbito mundial. Sua elaboração dependeu de uma autarquia, que o financiou, normatizou e o mantém, mas também de pesquisadores docentes de avaliação psicológica, que trouxeram a expertise da área para que houvesse o pleno estabelecimento de seus parâmetros. Passadas duas décadas de seu lançamento, o SATEPSI foi tema de artigos, capítulos, lives e diálogos digitais, nos quais foram destaque, de modo geral, as Resoluções do Conselho Federal de Psicologia, que o normatiza, e seus impactos para a área de avaliação psicológica - como, por exemplo, o aumento do número de pesquisas e de testes brasileiros qualificados. O que se pretende neste artigo é mencionar sua construção, à luz dos autores que vivenciaram o SATEPSI em funções e tempos distintos. Atenção especial será dada aos Métodos Projetivos, cuja história ainda é pouco revelada.(AU)

The system to evaluate psychological tests (Satepsi) received notoriety among Brazilians and foreigners for offering a complex system of qualification of psychological tests, which is rarely seen worldwide. Its development depended on an autarchy (which financed, standardized, and maintains it) and on researchers teaching psychological assessment, who brought their expertise to the area so its parameters could be fully established. After two decades of its launch, Satepsi was the subject of articles, chapters, lives, and digital dialogues, which usually highlighted the Resolutions of the Federal Council of Psychology that normatize psychological evaluation and their impacts, such as the increase in the number of qualified Brazilian tests. This study aims to mention its construction in the light of the authors who experienced Satepsi in different functions and times, giving special attention to Projective Methods, whose history remains to be shown.(AU)

El Sistema de Evaluación de Tests Psicológicos (SATEPSI) ganó notoriedad entre los brasileños y los extranjeros por ofrecer un complejo sistema de calificación de los tests psicológicos, poco frecuente a nivel mundial. Su elaboración dependió de una autarquía, que lo financió, lo estandarizó y lo mantiene, pero también de investigadores docentes de evaluación psicológica, que trajeron la experiencia del área para que hubiera el pleno establecimiento de sus parámetros. Tras dos décadas de su lanzamiento, SATEPSI fue tema de artículos, capítulos, en directo y diálogos digitales, en los cuales destacaron, de modo general, las Resoluciones del Consejo Federal de Psicología que lo normatiza y sus impactos para el área de evaluación psicológica, como el aumento del número de investigaciones y de pruebas brasileñas calificadas. Lo que se pretende en este artículo es mencionar su construcción, a la luz de los autores que vivieron el SATEPSI en funciones y tiempos distintos. Se prestará especial atención a los métodos proyectivos cuya historia aún no se ha revelado.(AU)

Promoção da saúde mental de universitários por meio de vídeo educativo: relato de experiência / Promoting the mental health of university students through educational video: experience report

Objetivo: relatar a experiência de graduandos em Enfermagem e Medicina na elaboração e divulgação de um vídeo motivacional como estratégia de promoção da saúde mental de estudantes universitários.Métodos: relato de experiência acerca da construção e divulgação de um vídeo produzido por discentes da Universidade Federal do Piauí, em setembro de 2019, voltado à promoção dobem-estar psicológico e emocional do público-alvo universitário. A temática escolhida englobou a valorização da vida, abordada na campanha "Setembro Amarelo". Realizou-se uma pesquisa na literatura científica sobre as principais demandas psicológicas de universitários, em seguida, foram selecionados seis discentes com histórias de vida inspiradoras e seguiu-se para as etapasde criação do conteúdo, filmagens e divulgação do produto audiovisual.Resultados: os depoimentos trataram sobre as vivências pregressas à entrada na universidade, desafios na graduação, dificuldades financeiras, conquistas e superações. A experiência na construção do vídeo motivacional permitiu contemplar o quão particulares e diversos são os obstáculos e as superações para a formação no ensino superior. Conclusão: a elaboração do vídeo pelos universitários demonstrou-se uma experiência exitosa, pois transmitiu na película exemplos de apoio mútuo entre discentes que compartilham de demandas psicológicas semelhantes, com relatos de desafios e conquistas em prol da formação universitária

Objective: to report the experience of undergraduate students in Nursing and Medicine in the elaboration and dissemination of a motivational video as a strategy to promote the mental health of university students.Methods:this is anexperience report about the construction and dissemination of a video produced by students of the Federal University of Piauí, in September 2019, that aimed at promoting the psychological and emotional well-being of the university target audience. The theme chosen encompassed the valorization of life, addressed in the campaign "Yellow September". The research was carried out in the scientific literature on the main psychological demands of university students, then six students with inspiring life stories were selected and followed by the stages of content creation, filming and dissemination of the audiovisual product. Results: the statements dealt with the experiences before entering the university, challenges in graduation, financial difficulties, achievements and overcoming. The experience in the construction of motivational video allowed us to contemplate how particular and diverse are the obstacles and overcoming for training in higher education. Conclusion: the preparation of the video by the university students proved to bea successful experience because it transmitted in the film examples of mutual support among students who share similar psychological demands, with reports of challenges and achievements in favor of university education.

Metáforas da lama: multimodalidade e argumentação em discursos sobre sustentabilidade e rompimento de barragens de rejeitos de minério de ferro / Metaphors of the mud: multimodality and argumentation in discourses about sustainability and the rupture of tailings dams of iron ore

As barragens de rejeito de minério de ferro fazem parte do processo de mineração no Brasil. Trata-se de uma técnica antiga envolvendo diversas tecnologias para torná-la mais segura. A constante vigília e cuidado sobre essas estruturas tornaram-se uma rotina frequente das mineradoras para evitar possíveis rupturas dessas barragens. Após o rompimento da barragem de rejeitos de minério em Brumadinho-MG e Mariana-MG muitos discursos com elementos metafóricos acerca da sustentabilidade e a prática de uso de barragens de rejeitos foram sustentados por uma intencionalidade discursiva voltada para a crítica social. O objetivo deste estudo é identificar e analisar o uso de metáforas conceptuais presentes como elementos multimodais na argumentação textual, numa perspectiva sociocognitiva e interacional da linguagem. Para isso, adota-se uma pesquisa expo-facto. O viés teórico da intencionalidade discursiva na linha de Searle; o caráter de modelos mentais, representações sociais e conhecimento sociocultural tal com prevê Van Dijk, a visão sociosemiótica de Geeraerts para compreender como argumentação por meio do campo imagético das charges é construída e sustentada socialmente e o dialogismo na perspectiva de Meyer a partir da argumentação. Nessa perspectiva sociocognitiva e interacional, o texto é pensado como uma construção linguístico-discursiva na qual a intencionalidade está relacionada com os modelos mentais resultantes de representações construídas a partir da experiencia do sujeito em sociedade e das práticas interacionais. Nesse contexto, o texto contempla uma gama de operações cognitivas interligadas como direciona Marscuschi. Constitui-se um corpus de charges publicadas na mídia brasileira, orientadas para a temática do rompimento de barragens de rejeitos de minério de ferro para a análise do aparecimento de metáforas conceptuais. Conclui-se que as metáforas se constituem recursos multimodais na orientação argumentativa e revelam metáforas do medo e da lama envolvendo um discurso do horror sobre a tragédia das cidades de Brumadinho e Mariana.

Iron ore tailings dams are part of the mining process in Brazil. It is an old technique involving several technologies to make it more secure. Constant vigilance and care about these structures have become a frequent routine for mining companies to avoid possible failures of these dams. After the collapse of the ore tailings dam in Brumadinho (MG) and Mariana (MG) cities, many discourses with metaphorical elements about sustainability and the practice of using tailings dams were supported by a discursive intentionality focused on social criticism. The aim of this study is to identify and analyze the use of conceptual metaphors present as multimodal elements in textual argumentation, in a sociocognitive and interactional perspective of language. For this, it is adopted from expo-facto research. The theoretical bias of discursive intentionality along the lines of Searle; the character of mental models, social representations,and sociocultural knowledge as predicted by Van Dijk, the sociosemiotic vision of Geeraerts (2016) to understand how argumentation through the imagery field of cartoons is constructed and socially supported and dialogism in perspective of Meyer from the argumentation. In this sociocognitive and interactional perspective, the text is thought of as a linguistic-discursive construction in which intentionality is related to mental models resulting from representations built from the subject's experience in society and interactional practices. In this context, the text contemplates a range of interconnected cognitive operations as directed by Marscuschi. A corpus of cartoons published in the Brazilian media is constituted, oriented to the theme of breaking up iron ore tailings dams for the analysis of the appearance of conceptual metaphors. It is concluded that metaphors are multimodal resources in the argumentative orientation and reveal metaphors offear and mud involving a horror speech about the tragedy of the cities of Brumadinho and Mariana.

Oficinas terapêuticas para meninos e meninas com Transtorno do Espectro do Autismo: estratégias e possibilidades durante a pandemia de COVID-19 / Talleres terapéuticos para niños y niñas con Trastorno del Espectro Autista: estrategias y posibilidades durante la pandemia de COVID-19 / Therapeutic groups for boys and girls with Autism Spectrum Disorder: strategies and possibilities during the COVID-19 pandemic / Ateliers thérapeutiques pour les enfants atteints de trouble du spectre autiste: stratégies et possibilités pendant la pandémie COVID-19

A chegada dos primeiros casos de COVID-19 ao Uruguai vem acompanhada do decreto de emergência sanitária. Isso interrompe o funcionamento de um dispositivo institucional para meninos e meninas com autismo, que atualmente é composto por oficinas terapêuticas coordenadas por estudantes da Faculdade de Psicologia da Universidade da República. Relatos de dois grupos de expressão plástica e um de música são apresentados e as ações implementadas para dar continuidade ao processo terapêutico na virtualidade são brevemente descritas. A seguir, são discutidas as estratégias utilizadas a partir dos eixos continuidade do tratamento, aliança terapêutica, transferência e técnica. Por fim, são tiradas conclusões sobre a realização das oficinas na modalidade virtual como forma de promover a continuidade do atendimento clínico

La llegada de los primeros casos de COVID-19 en Uruguay es acompañada del decreto de emergencia sanitaria. Esto interrumpe el funcionamiento de um dispositivo institucional para niños y niñas con autismo, que se compone en este momento por talleres terapéuticos coordinados por estudiantes de Facultad de Psicología de la Universidad de la República. Se presentan relatos de dos grupos de expresión plástica y uno de música y se describen brevemente las acciones implementadas para continuar el proceso terapéutico en el mundo virtual. En seguida, se discuten las estrategias utilizadas a partir de los ejes continuidad del tratamiento, alianza terapéutica, transferencia y técnica. Por último, se extraen conclusiones sobre la realización de los talleres en modalidad virtual como forma de propiciar la continuidad de la atención clínica

The arrival of the first cases of COVID-19 in Uruguay is accompanied by the decree of sanitary emergency. This interrupts the operation of an institutional device for boys and girls with autism, which is currently made up of therapeutic groups coordinated by students from the Faculty of Psychology of the University of the Republic. Reports of two groups of plastic expression and one of music are presented and the actions implemented to continue the therapeutic process virtually are briefly described. Next, the strategies used are discussed based on the continuity of treatment, therapeutic alliance, transference and technique. Finally, conclusions are drawn about the virtual groups as a way to promote the continuity of clinical care

L'arrivée des premiers cas de COVID-19 en Uruguay s'accompagne du décret d'urgence sanitaire. Cela interrompt le fonctionnement d'un dispositif institutionnel pour garçons et filles autistes,qui est actuellement composé d'ateliers thérapeutiques coordonnés par des étudiants de la Faculté de psychologie de l'Université de la République. Des rapports de deux groupes d'expression plastique et un de musique sont présentés et les actions mises en œuvre pour poursuivre le processus thérapeutique de manière virtuelle sont brièvement décrites. Ensuite, les stratégies utilisées sont discutées en fonction de la continuité du traitement, de l'alliance thérapeutique, du transfert et de la technique. Enfin, des conclusions sont tirées sur la tenue des ateliers en mode virtuel comme moyen de favoriser la continuité des soins cliniques

Técnicas alternativas del manejo de la conducta en odontopediatría / Técnicas alternativas para a gestão comportamental em odontologia pediátrica / Alternative behavioral management techniques in pediatric dentistry

Diversas técnicas convencionales han sido utilizadas con gran eficacia; sin embargo, la no aceptación de algunas de ellas por los padres, ciertos condicionamientos éticos y legales así como cambios en la educación actual y el avance en nuevas tecnologías, obligan al odontólogo a un replanteamiento de actitudes. Objetivo: El objetivo del presente trabajo es identificar qué técnicas alternativas son empleadas en la clínica dental por los profesionales para el manejo de la conducta de pacientes infantiles. Material y métodos: Se realizó un cuestionario en la plataforma de Google, remitido vía email a 190 odonto/estomatólogos que tratasen pacientes infantiles, obteniendo una participación de 132 encuestas adecuadas para el análisis de 6 técnicas alternativas de manejo de la conducta. El estudio estadístico se realizó en el programa SPSS aplicando el test de ANOVA para una significación de p= 0,05. Resultados: Un 35,1% de los encuestados utilizaban medios audiovisuales para el tratamiento dental, siendo la televisión el más frecuentemente empleado. La musicoterapia fue la técnica más utilizada (70,5% de los participantes) con mayor frecuencia del sexo femenino, aunque sin diferencias significativas, siendo la música moderna la de mayor aceptación. Un 32,8% utilizaron la ludoterapia como técnica de manejo seguida del empleo de técnicas de relajación con un 25%, ambas con mayor porcentaje femenino. Las dos técnicas menos utilizadas fueron la aromaterapia (6,8%) y la hipnosis (2,3%). Conclusiones: A pesar del incremento en la utilización de técnicas alternativas en el manejo de la conducta, todavía su empleo es escaso por los odonto/estomatólogos.

Várias técnicas convencionais têm sido usadas com grande eficácia; contudo, a não aceitação de algumas delas pelos pais, certas condições éticas e legais, assim como as mudanças na educação atual e o avanço das novas tecnologias, forçam o dentista a repensar as atitudes. Objetivo: O objetivo do presente estudo é identificar quais técnicas alternativas são utilizadas na clínica odontológica por profissionais para gerenciar o comportamento de pacientes infantis. Material e métodos: Foi realizado um questionário na plataforma Google, enviado por e-mail a 190 dentistas/stomatologistas que trataram crianças, obtendo 132 pesquisas adequadas para a análise de 6 técnicas alternativas de gestão comportamental. O estudo estatístico foi realizado no programa SPSS aplicando o teste ANOVA para uma significância de p= 0,05. Resultados: 35,1% dos inquiridos utilizaram meios audiovisuais para tratamento dentário, sendo a televisão a mais frequentemente utilizada. A musicoterapia foi a técnica mais utilizada (70,5% dos participantes) pelo sexo feminino, embora sem diferenças significativas, sendo a música moderna a mais amplamente aceita. 32,8% utilizaram a terapia lúdica como técnica de gestão seguida do uso de técnicas de relaxamento com 25%, ambas com uma percentagem maior de mulheres. As duas técnicas menos utilizadas foram a aromaterapia (6,8%) e a hipnose (2,3%). Conclusões: Apesar do aumento do uso de técnicas alternativas na gestão do comportamento, o seu uso ainda é escasso pelos odontologistas/estomatologistas.

Various conventional techniques have been used with great efficiency; nevertheless, the non-acceptance of some of them by the parents, certain ethical and legal conditions as well as changes in the current education and the advance in new technologies, force the dentist to a rethinking of attitudes. Aim: The aim of this paper is to identify what alternative techniques are used by professionals for the behavior's management of pediatric patients in the dental clinic. Material and methods: A questionnaire was carried out on the Google platform, sent via email to 190 odonto / stomatologists who treated pediatric patients, obtaining a participation of 132 appropriate surveys for the analysis of 6 alternative behavior management techniques. The statistical study was carried out in the SPSS program, applying the ANOVA test for a significance of p = 0.05. Results: 35.1% of respondents used audiovisual media for dental treatment, being television the most frequently used. Music therapy was the most applied technique (70.5% of the participants) with the highest frequency of female sex, without significant differences though, being modern music the most widely accepted. 32.8% used play therapy as a management technique followed by the use of relaxation techniques with 25%, both with a higher female percentage. The two least used techniques were aromatherapy (6.8%) and hypnosis (2.3%). Conclusions: Despite the increase in the use of alternative techniques in behavior management, their use is still scarce by dentists / stomatologists.

Effectiveness of nurse-led intervention on self-management, self-efficacy and blood glucose level among patients with Type 2 diabetes mellitus.

Background This study assesses the effectiveness of nurse-led intervention on self-management, self-efficacy, and blood glucose level among patients with Type 2 diabetes mellitus (DM) attending diabetic Out patient department (OPD) in Sri Ramachandra Hospital, Chennai. Methods In this study, the experimental group received nurse-led intervention on video-assisted teaching regarding nature of the disease condition including, diet, medication, hand and leg exercises, home care management, for 30 mins. Then a demonstration of hand and leg exercise was done followed by return demonstration done by the participants. The participants in the control group did not receive nurse-led intervention; they received only routine care. On the 15th day, when the patients came for the first follow-up, posttest was conducted for both the experimental and control groups. Results There was a statistically considerable difference noted in self-management (t=29.639; p<0.001), self-efficacy (t=28.293; p<0.001), FBS (t=2.415; p<0.05), and PPBS (t=2.102; p<0.05) in the posttest among patients with Type 2 DM in the experimental group. Conclusions The study concluded that the nurse-led intervention through video-assisted teaching is an effective method to recover self-management and self-efficacy as well as reduce the fasting blood sugar and postprandial blood sugar among patients with Type 2 DM.

Role of Complementary Medicine (Music, Acupuncture, Acupressure, TENS and Audio-Visual Distraction) in Shockwave Lithotripsy (SWL): A Systematic Review From EAU Sections of Urolithiasis (EULIS) and Uro-Technology (ESUT).

We performed a systematic review to look at the role of alternative or complementary medicine such as music, acupressure, acupuncture, transcutaneous electrical nerve stimulation (TENS) and audiovisual distractions to decrease analgesia requirement and alleviate anxiety during SWL. Twenty-three papers(2439 participants) were included: Music (n = 1056.6%), Acupuncture (n = 517.7%), Acupressure (n = 13.8%), TENS (n = 617.2%), and audiovisual distraction (n = 14.6%). Most of the studies showed that complementary therapy, lowered pain, and anxiety with higher patient satisfaction and willingness to undergo the procedure. With its feasibility and convenience, urological guidelines need to endorse it, and more should be done to promote its use in outpatient urological procedures.

Guided Imagery for Total Knee Replacement: Responses to an Audiobook Placebo Treatment.

The use of a placebo is the gold standard for establishing the efficacy of new treatments in randomized controlled trials (RCTs). Placebo treatments are inert; this allows specific effects of the experimental treatment to be separated from nonspecific physiological, psychological, and social effects. The aim of this study was to scrutinize the workings of an audiobook (AB) placebo treatment, which was used in a placebo-controlled, investigator-blinded, RCT of the effect of guided imagery (GI) to improve pain and function in persons undergoing total knee replacement. A secondary analysis of quantitative and narrative data collected during the RCT was performed. The AB treatment provided attention control. Participants in the AB group identified benefits-pleasant get-away, new knowledge, quiet time-out, and inspiration; however, there was also evidence of resentful demoralization, especially in the postoperative period. The use of ABs as a placebo treatment in GI RCTs should be executed with caution.

A Study Using Visual Art Methods to Explore the Perceptions and Barriers of Self-Management in Children and Adolescents with Lymphedema.

Background: The aims of this study were to explore, using visual art methodology, how children and adolescents perceive their lymphedema and conceptualize the barriers and enablers in self-management and to explore the role of an educational camp in promoting self-efficacy. Methods: Participants (speaking English, French, and Italian) were recruited during an educational camp for children with lymphedema. Children and adolescents used different methodologies to depict living and self-managing their condition. Younger children (aged 5-12 years) drew pictures, and all children and adolescents (aged 5-18 years) were given cameras and asked to take photographs that depicted their experience of learning self-management of their condition during the camp. Rose's critical visual methodology framework was used for analysis. Results: Analysis of the data produced five categories: Normal versus altered childhood, living with lymphedema; perceptions of lymphedema and self-care in younger children; adolescents' perception of living and managing lymphedema; learning self-efficacy; and insights into cultural differences in self-care. Conclusions: The study has shown that self-management is complex. Children and adolescents face many daily challenges and frustrations in managing their condition in addition to the normal challenges of development and growth that impact on: home life, time with friends, school activities, and relationships. Children expressed a deep longing for cure and a recognition that their lives were altered by having the condition that led to limitations in sport and wearing fashionable clothes and shoes. The importance of relationships with professionals was critical as was the experience of meeting and learning with other children through the camp experience. Attempts to simplify self-management techniques would appear to be a key priority as would a greater understanding of the self-beliefs young people have of their ability to influence and control their condition and its impact on their life.

Independent or synergistic? Effects of varying size and using pictorial images in tobacco health warning labels.

INTRODUCTION: Legal challenges have blocked the implementation of large, pictorial health warning labels (HWLs) in the U.S. In light of future legal questions the U.S. Food and Drug Administration may face in proposing alternative HWLs, we examined whether less restrictive HWL versions on the front of packs-smaller HWLs and/or text-only HWLs that do not include pictorial imagery-may be sufficient to promote cognitive and affective outcomes associated with smoking cessation. METHODS: We recruited low-income smokers in two separate experiments through field-based recruitment methods (Study 1, N = 497) or Amazon Mechanical Turk (MTurk) (Study 2, N = 495). In both studies, we randomly assigned participants to a no-HWL control condition or one of four HWL conditions in a 2 (pictorial vs. text-only) × 2 (50% vs. 30% size) between-subjects design. RESULTS: Relative to text-only HWLs, pictorial HWLs increased negative affect but not risk belief acceptance, cognitive elaboration about smoking harms, or quit intentions. The 50% HWLs increased quit intentions relative to the control condition in both studies. The 50% HWLs also outperformed the 30% HWLs in promoting quit intentions in Study 2. Subsequent analyses revealed that this effect in Study 2 may have been driven by the 50% HWLs strengthening the relationship between risk-related thoughts and intentions, although there was no evidence for this pattern in Study 1. We found no evidence for interaction effects between the pictorial and size manipulations. CONCLUSIONS: Our findings suggest that 50% HWLs, whether pictorial or text-only, can encourage low-income smokers to consider quitting under some conditions.

The Impact of Equine Therapy and an Audio-Visual Approach Emphasizing Rhythm and Beat Perception in Children with Developmental Coordination Disorder.

Objectives: This study aims to investigate the impact of a therapeutic horse riding (HR) intervention and an audiovisual (AV) intervention comprising exposure to equine rhythm and motion on developmental parameters of children with Developmental Coordination Disorder (DCD). Design: The study design was a pretest/post-test. Settings/Location: The study took place in three locations across Ireland-St. Michael's Boys School in Mervue, Co Galway, The Hunt Museum in Limerick City, Co. Limerick, and Fettercairn Youth Horse Project in Tallaght, Co. Dublin. Subjects: Eighty-three children (6-14 years) with a primary diagnosis of DCD. Interventions: Children meeting the inclusion criteria were divided into three groups: HR, AV, and a control (C) group. Those in the intervention groups participated in eight 30 min HR lessons or AV screening sessions. Outcome measures: A Childhood Depression Inventory (CDI) measured signs of depression. A Childhood Behavior CheckList (CBCL) determined any behavioral and emotional problems, while a Social Responsiveness Scale (SRS) assessed the presence and extent of any social impairment. A GAITRite system provided an overall Functional Ambulation Performance (FAP) score (an automatic accumulated score of gait parameters, including gait speed, symmetry, distance, cadence, tension, support, and velocity), which was used to evaluate gait improvements. Results: Repeated measures analysis of variance revealed a main effect of time on all variables. Bonferroni post hoc tests revealed that these effects were due to significant improvements in both HR and AV groups for CDI, CBCL, and SRS, and significant improvements in the HR group only for FAP. Conclusions: This study provides initial evidence to support the value of an equine AV perception intervention at improving developmental parameters in children with DCD and provides additional support for the benefits of therapeutic HR on social, emotional, behavioral, and gait variables in these children.

Effects of Guided Reflection on Diabetes Self-Care: A Randomized Controlled Trial.

The purpose of this study was to evaluate the effects of guided reflection on self-care behaviors, confidence scores, and diabetes knowledge among adults with diabetes. A randomized controlled trial with a pre/posttest design was used to generate data from a convenience sample of 62 adults with diabetes recruited from a single site. After viewing a 30-minute video on how to manage diabetes, participants were randomized to a control group (CG) (usual care) or an intervention group (IG). The IG further engaged in a reflection educational session. For 8 weeks, the IG isolated diabetes-related events weekly, critically analyzed them using Gibbs's reflective questions, and recorded their analysis in a journal. They also shared their perspective relative to using the journal in an audiotaped interview. Main measures included baseline and 8-week clinical outcomes (self-care maintenance, monitoring, management, and confidence scores and diabetes knowledge scores) and intervention acceptability. Compared to the CG, the IG had no statistically significant difference in self-care measures over time, although scores trended in the anticipated direction. Importantly, both groups had statistically significant improvement in self-care scores. Furthermore, there was statistically significant improvement in diabetes knowledge among IG participants. Informatively, IG critically analyzed 147 diabetes-related events concentrating on blood glucose, diet, exercise, monitoring, medication, sleep pattern, and health care visits. Participants found the guided reflection activity highly acceptable. Combined educational and reflection interventions are effective approaches for improving self-care outcomes and diabetes knowledge among adults with diabetes. Research concentrating on purposeful patient reflection is warranted in a larger sample paying careful attention to study limitations.

Técnica quirúrgica de la implantación de dispositivo ajustable transobsturador anti-incontinencia urinaria masculina tipo Atoms en una clínica de III nivel en Bogotá / Surgical Technique of the Implantation of Adjustable Masculine Transobsturador Anti-Incontinence Urinary Device Type Atoms in a Clinic of III Level in Bogotá

La prevalencia de incontinencia urinaria de esfuerzo (IUE) post-prostatectomía varía entre el 4% y el 50%, siendo más frecuente en pacientes que son llevados a prostatectomía radical. Es una condición que afecta la calidad de vida de los pacientes y presenta un impacto de grado variable de severidad. Existen diferentes opciones para el tratamiento de esa entidad, dentro de los cuales se encuentran: terapia de piso pélvico con biofeedback, fisioterapia, sistemas recolectores de orina, clamps peneanos, inyecciones periuretrales de materiales abultantes, esfínter urinario artificial (EUA) y cintas pubouretrales.[1] [2] El gold standard para la IUE es el EUA con tasa de éxito entre 50%­80%, no obstante, con una tasa de explante de hasta el 33%. Se han desarrollado otras alternativas con cintas pubouretrales las cuales han reportado una tasa de éxito hasta del 83%.[2] La principal limitante de esas alternativas en el manejo de la IUE, ha sido la necesidad de reajustar esos dispositivos con procedimientos quirúrgicos, exponiendo en repetidas ocasiones a los pacientes a los riesgos de anestesia y del procedimiento quirúrgico, situación que se ha tratado de mejorar con el dispositivo ATOMS®, introducido en Europa desde marzo del 2009, el cual ofrece la oportunidad de realizar tales ajustes en el consultorio.[3] La indicación para la colocación del ATOMS® es la IUE, sin tener claridad en su severidad, hasta en un 92,9% de las ocasiones, y usualmente son pacientes con antecedente de cirugías previas anti-incontinencia fallidas (34,3%). El tiempo quirúrgico promedio es de 47 minutos, entre 29 minutos a 112 minutos.[1]

Relato de utilização de material audiovisual VHS no estudo de homeopatia / Report on the use of VHS audiovisual material in the study of homeopathy

Esse trabalho relata a utilização de fitas audiovisual VHS no estudo de homeopatia. Faz-se uma listagem com os Descritores em Homeopatia das fitas originais existentes no acervo da Biblioteca Artur Rezende de Almeida Filho da Associação Paulista de Homeopatia. Sugere-se que as fitas VHS de maior interesse técnico e ou histórico sejam vertidas para outras mídias de mais fácil acesso de reprodução. (AU)

Impact of electronic and blended learning programs for manual perineal support on incidence of obstetric anal sphincter injuries: a prospective interventional study.

BACKGROUND: Obstetric anal sphincter injuries (OASIS) are associated with anal incontinence, dyspareunia and perineal pain. Bimanual perineal support technique (bPST) prevents OASIS. The aim of this study was to assess the effect of two different bPST training-methods on OASIS incidence. METHODS: This is a prospective-interventional quality improvement study conducted in two Palestinian maternity units between June 1 2015 and December 31 2016. Women having spontaneous or operative vaginal-delivery at ≥24 gestational-weeks or a birthweight of ≥1000 g (n = 1694) were recruited and examined vaginally and rectally immediately after vaginal birth by a trained assessor. Data on baseline OASIS incidence were collected during Phase-1 of the study. Subsequently, birth attendants in both maternity units were trained in bPST using two training modalities. A self-directed electronic-learning (e-learning) using an animated video was launched in phase-2 followed by a blended learning method (the animated e-learning video+ structured face-to-face training) in phase-3. OASIS incidence was monitored during phases-2 and 3. Variations in OASIS incidence between the three phases were assessed using Pearson-χ2-test (or Fisher's-Exact-test). The impact of each training-method on OASIS incidence was assessed using logistic-regression analysis. RESULTS: A total of 1694 women were included; 376 in phase-1, 626 in phase-2 and 692 in phase-3. Compared to Phase-1, OASIS incidence was reduced by 45% (12.2 to 6.7%, aOR: 0.56, CI; 0.35-0.91, p = 0.018) and 74% (12.2 to 3.2%, aOR, 0.29, CI; 0.17-0.50, p < 0.001) in phases-2 and 3, respectively. There was also a significant reduction in OASIS incidence by 52% from phase-2 to phase-3 (6.7% (42/626) to 3.2% (22/692), p = 0.003). These reductions reached statistical significance among parous-women only (aOR: 0.18, CI; 0.07-0.49, p = 0.001) after the first training method tested in phase-2. However, the reduction was significant among both primiparous (aOR: 0.39, CI; 0.21-0.74, p = 0.004) and parous-women (aOR: 0.11, CI; 0.04-0.32, p < 0.001) after implementing the blended learning method in phase-3. CONCLUSION: The animated e-learning video had a positive impact on reducing OASIS incidence. However, this reduction was enhanced by the use of a blended learning program combining both e- learning and face-to-face training modalities. STUDY REGISTRATION NUMBER: ClinicalTrialo.gov identifier: NCT02427854 , date: 28 April 2015.

Effect of the use of a video tutorial in addition to simulation in learning the maneuvers for shoulder dystocia.

The development of video tutorials is flourishing and may make it possible to maintain knowledge learned during instruction with simulation. The aim of this study was to assess the effect of adding a video tutorial to a lecture and simulation for learning the maneuvers and protocol for the management of shoulder dystocia. Student midwives and medical students attended a lecture class including instruction about maneuvers and a presentation of an algorithm for the management of shoulder dystocia. They were randomized into two groups. The video group was reminded every two weeks to watch a short tutorial. The control group was reminded to consult the slide show. At the end of two months, they were evaluated by graders. The practice, theory, and global scores of the students in the video group were significantly higher than those of the students in the control group (14.8 vs. 10.4; 5.6 vs. 3.4; and 9.3 vs. 7.0, P<0.001). The scores for the video group improved at the second simulation session, compared with the first (14.8 vs. 9.9; 5.6 vs. 2.9; and 9.3 vs. 7, P<0.001). The addition of a video tutorial improved learning compared to a standard lecture and simulation session alone.