Hair cortisol reduction and social integration enhancement after a mindfulness-based intervention in children.

BACKGROUND: Over recent decades, chronic stress at an early age has become a worrying health problem in children. We seek to evaluate an intervention involving mindfulness-based practices and prosocial activities in 7- to 8-year-old children. METHODS: Stress levels were determined using hair cortisol concentration (HCC), and social integration was measured by means of a sociogram. The program had previously proven to be effective in decreasing salivary cortisol levels and in favouring social integration in children. A total of 35 children participated in the study: 18 constituted the intervention group and 17 the wait-list group. In both groups, HCC and social integration were evaluated before and after the intervention conducted throughout an entire school year. RESULTS: The experimental group showed a significant reduction in HCC, as well as significant enhancement of social integration levels, whereas no changes were observed in the wait-list group. CONCLUSIONS: This is the first research to show that HCC, a reliable neuroendocrine indicator, decreased as a result of a mindfulness-based program. This successful outcome adds new evidence to previous findings regarding the reduction of chronic stress in children following participation in this program.

A invenção de um setting on-line para atendimento psicológico remoto / The invention of an online environment for remote psychological care / La invención de un entorno en línea para la atención psicológica remota

Com o advento da covid-19, foi declarado estado de emergência de saúde pública e decretadas medidas de isolamento e distanciamento social para conter a propagação da doença. O Conselho Federal de Psicologia, considerando a importância do acolhimento seguro durante a pandemia, publicou a Resolução CFP nº 4/2020, permitindo que serviços psicológicos aconteçam de maneira remota. O presente estudo visa, através do Método da Cartografia, apresentar a construção de um setting on-line para intervenções grupais e os desafios na oferta de acolhimento e atendimento remoto. Foram ofertados grupos terapêuticos, por meio da plataforma Google Meet, para estudantes da Universidade Federal Rural do Rio de Janeiro. Um diário de bordo foi produzido para acompanhar as forças que atravessavam e constituíam o território e a experiência grupal remota. Compreendemos que o território-espaço-grupal-on-line era composto pelo espaço virtual em que nos reuníamos, pelos espaços individuais de cada integrante e pelas forças que os atravessavam. Observamos que nem sempre os participantes dispunham de um lugar privado, mas estiveram presentes no encontro com câmeras e áudios abertos e/ou fechados e/ou através do chat da videochamada. A participação no grupo funcionou como alternativa no momento de distanciamento social, sendo uma possibilidade para o atendimento psicológico em situações de dificuldade de encontros presenciais; entretanto, se mostrou dificultada em diversos momentos, pela falta de equipamentos adequados e instabilidade na internet, fatores que interferiram nas reuniões e impactaram na possibilidade de falar e escutar o que era desejado.(AU)

With the advent of COVID-19, a state of public health was declared, and measures of isolation and social distance to contain the spread of the disease was decreed. The Federal Council of Psychology, considering the importance of safe reception during the pandemic, published CFP Resolution No. 4/2020, allowing psychological services to happen remotely. This study narrates, via the Cartography Method, the experience of inventing an Online Setting for group reception. Therapeutic groups were offered, via Google Meet Platform, to students at the Federal Rural University of Rio de Janeiro. A logbook was produced to accompany the forces that crossed and constituted the territory and the remote group experience. We understand that the territoryspace-group-online was composed by the virtual-space that we gathered, by the individualspaces of each member and by the forces that crossed them. We observed that the participants did not always have a private place, but they were present at the meeting with open and/or closed cameras and audio and/or through the video call chat. Participation in the group worked as an alternative at the time of social distancing, being a possibility for psychological care in situations of difficulty in face-to-face meetings, however, it proved to be difficult at various times, due to the lack of adequate equipment and instability on the internet, factors that interfered in meetings and impacted the possibility of speaking and listening to what was desired.(AU)

La llegada de la COVID-19 produjo un estado de emergencia de salud pública, en el que se decretaron medidas de confinamiento y distanciamiento físico para contener la propagación de la enfermedad. El Consejo Federal de Psicología, considerando la importancia de la acogida segura durante la pandemia, publicó la Resolución CFP nº 4/2020, por la que se permite la atención psicológica remota. Este estudio tiene por objetivo presentar, mediante el método de la Cartografía, la elaboración de un escenario en línea para la intervención grupal y los desafíos en la oferta de acogida y atención remota. Grupos terapéuticos se ofrecieron, en la plataforma Google Meet, a estudiantes de la Universidad Federal Rural de Río de Janeiro. Se elaboró un diario para acompañar a las fuerzas que atravesaron y constituyeron el territorio y la experiencia remota del grupo. Entendemos que el territorio-espacio-grupo-en línea estaba compuesto por el espacio-virtual que reunimos, por los espacios individuales de cada integrante y por las fuerzas que los atravesaban. Observamos que los participantes no siempre tenían un lugar privado y que estaban presentes en la reunión con cámaras y audio abiertos y/o cerrados y/o por el chat de la videollamada. La participación en el grupo funcionó como una alternativa en el momento del distanciamiento físico y revela ser una posibilidad de atención psicológica en situaciones de dificultad en los encuentros presenciales, sin embargo, se mostró difícil en varios momentos, ya sea por la falta de medios adecuados o por inestabilidad en Internet, factores que interferían en las reuniones e impactaban en la posibilidad de hablar y escuchar lo que se deseaba.(AU)

Social integration: A concept analysis.

BACKGROUND: In recent decades, social isolation has been increasingly linked to serious health conditions. However, social integration (SI) is a complex concept that has not been systematically explored or defined in nursing. It is essential for nurses and healthcare providers to have a clearer concept of SI to better provide holistic care to support optimal health. PURPOSE: This concept analysis aimed to clarify the concept of SI in health research and to identify attributes, antecedents, and consequences of the concept of SI to enhance understanding of the concept and its implications for human health. METHODS: Walker and Avant's framework was used as the methodology for the concept analysis of SI. A literature search using PubMed, CINAHL, and Embase databases on SI was conducted with keywords: "integration," "social integration," "social relationships," "social participation," "community integration," "socialization." Studies included in the search were published from 2001 to 2021. RESULTS: SI is affected by multidimensional individual, societal, and environmental factors. Defining attributes are productive activities, social relationships, community engagement, and leisure activities. SI is effective in promoting multiple aspects of health as well as healthy aging and overall well-being. CONCLUSION: The analysis contributes to a comprehensive and fundamental understanding of SI and contributes to helping nurses better understand patients' circumstances that promote or inhibit SI. This knowledge will support the development of interventions that support optimal health and well-being, in assisting patients to remain integrated or reintegrate into society during and following an illness or injury.

Rehabilitation Response to COVID-19: Optimizing Recovery and Social Reintegration for Military Beneficiaries.

COVID-19 is a novel disease with complex primary and secondary health effects that may significantly impact the functional independence and quality of life of patients and their families. While the term "rehabilitation" is often associated with exercise, the interventions employed by rehabilitation professionals in both the inpatient and outpatient setting are much more complex and very relevant in caring for individuals hospitalized with respiratory infections. Since the start of the pandemic, the Department of Rehabilitation at Walter Reed National Military Medical Center has cared for over 85% of the military beneficiaries admitted to the hospital for COVID-19. In addition to providing acute inpatient occupational, physical, and recreational therapy to help maximize each patient's functional independence, the rehabilitation team has also developed a novel program to help facilitate the safe discharge and successful recovery and social reintegration for all patients with COVID-19. Using a holistic approach, a team led by Occupational Therapy has applied a needs-based assessment of each patient and developed an individualized treatment plan, which employs home monitoring, virtual health interventions, peer support, and augmentation to case management and behavioral health care. The overall acceptance and satisfaction of this program by the patients and staff has been excellent, with early evidence to suggest improved quality of life and possible mitigation of long-term complications. This article describes the development and essential elements of this unique rehabilitation program so that other military treatment facilities may consider implementing.

A School Intervention Helps Decrease Daily Stress While Enhancing Social Integration in Children.

Stress coping is highly relevant during childhood. This study analyses how the participation in a behavioral intervention involving mindfulness-based practices and empathic collaboration activities impact on diurnal cortisol rhythm and social integration in children. In both experimental and waitlist groups, we evaluated before and after the intervention: daily stress, by sampling salivary cortisol at three measurement time-points, and social integration, assessed by a social preference index. Daily average cortisol (DAC) and the area under the curve (AUC) differed when comparing pre-post intervention values in both groups: in the experimental group these measures decreased while in the waitlist group DAC and AUC increased. At the end of the intervention, the experimental group showed an enhancement in the social preference index whereas this parameter diminished in the waitlist group. This kind of behavioral intervention seems to be effective at reducing daily stress and improving social integration in Primary School children.

Práticas integrativas e complementares em uma Organização Não Governamental: em busca de um cuidado integral / Housing-related sanitary conditions of a rural community in the Jiquiriçá Valley, Brazil / Condiciones sanitarias relacionadas a la vivienda en una comunidad rural del Valle del JIQUIRIÇÁ, Bahía, Brasil

As práticas que complementam os tratamentos convencionais estão sendo cada vez mais procuradas, em busca de uma promoção da saúde que atenda tanto as necessidades físicas quanto emocionais e espirituais. Entre as práticas de cuidado buscadas e utilizadas milenarmente destacam-se as Práticas Integrativas e Complementares em Saúde (PICS). O objetivo deste estudo foi discutir as motivações dos usuários para procura das PICS em uma organização não governamental (ONG). O referencial teórico utilizado foi de Arthur Kleinman e Madeleine Leininger. Trata-se de uma pesquisa qualitativa e exploratória, que abordou 12 usuários de práticas integrativas e complementares disponibilizadas na referida organização. Realizaram-se entrevista semiestruturada no domicílio dos participantes no período de maio a agosto de 2014 e observação participante no local de estudo. A análise dos dados foi realizada de acordo com a proposta operativa de Minayo. A maioria dos participantes recorreu à ONG após algum problema de saúde. Além das PICS, outros fatores foram mencionados como importantes no cuidado realizado nesse ambiente, tais como acolhimento, criação de vínculos e espiritualidade, evidenciando o relevante significado sociocultural desse local. Destaca-se que a busca por práticas integrativas e complementares e por esse espaço de cuidados surge a partir da necessidade de um cuidado biopsicossocial, cultural e espiritual.

Practices that complement conventional treatments are being increasingly sought out, in pursuit of a health care that addresses both physical, emotional, and spiritual needs. Among the care practices sought and used millennially, the complementary comprehensive health care practices (PICS) stand out. Hence, this qualitative and exploratory study discusses the motivations of users when seeking complementary comprehensive practices in a non-governmental organization (NGO). The works of Arthur Kleinman and Madeleine Leininger make up the theoretical framework. Data was collected by means of semi-structured interviews conducted with 12 users of the complementary comprehensive practices available in the organization, at the participants' home, from May to August 2014, and participant observation at the study site. Data analysis was performed according to Minayo's operational proposal. Most participants turned to the NGO after some health issue. Besides the complementary comprehensive practices, the respondents mentioned user embracement, bonding, and spirituality as other important factors in the care given, thus highlighting the great socio-cultural meaning of this space. Importantly, the search for complementary comprehensive practices and for this health care space stems from the need for biopsychosocial, cultural, and spiritual care.

Las prácticas que complementan los tratamientos convencionales se están buscando cada vez más para tener una promoción de la salud que atienda tanto las necesidades físicas como emocionales y espirituales. Entre las prácticas de cuidado buscadas y utilizadas milenariamente se destacan las prácticas integradoras y complementarias (Pic). Este artículo pretende discutir las motivaciones de los usuarios en cuanto a la búsqueda de las Pic en una organización no gubernamental (ONG). El referencial teórico utilizado fue de Arthur Kleinman y Madeleine Leininger. Este estudio resulta de una investigación cualitativa, exploratoria que abordó a 12 usuarios que utilizaban las prácticas integradoras y complementarias disponibles en esta organización. Se realizaron una entrevista semiestructurada en el domicilio de los participantes en el período de mayo a agosto de 2014 y una observación participante en el local de estudio. El análisis de los datos fue realizado de acuerdo con la propuesta operativa de Minayo. La mayoría de los participantes recurrieron a la ONG después de algún problema de salud. Y se evidenció que, además de las Pic, otros factores fueron mencionados como importantes en el cuidado realizado en este ambiente, tales como la acogida y la creación de vínculos y espiritualidad, lo que muestra el relevante significado sociocultural de este espacio. Se destaca que la búsqueda por las prácticas integradoras y complementarias y por este espacio de cuidados surge a partir de la necesidad de un cuidado biopsicosocial, cultural y espiritual.

Applications of complementary therapies during rehabilitation for individuals with traumatic Spinal Cord Injury: Findings from the SCIRehab Project.

Objective: Evaluate the use of complementary therapies during rehabilitation for patients with traumatic spinal cord injury (SCI). Design: Secondary analyses were conducted to identify the use and associated outcomes of complementary therapies provided by occupational therapists (OTs) and physical therapists (PTs) during rehabilitation from a public dataset. Setting: Inpatient rehabilitation. Participants: A public dataset composed of 1376 patients with SCI that were enrolled in a five-year, multi-center investigation, the SCIRehab Project. Secondary analyses focused on a subset of 93 patients (47 who received complementary therapy during treatment and 46 case-matched controls who received no complementary therapy). Interventions: OTs and PTs recorded use of complementary therapies during sessions, including yoga, Pilates, tai chi, aromatherapy, relaxation techniques, imagery and other. Outcome Measures: Pain interference, pain severity, mobility, and social integration. Results: Three percent of participants received any complementary therapies. Patients who received complementary therapies showed greater reductions in pain severity from 6 months to 12 months relative to matched controls. Furthermore, the amount of time that patients received complementary therapies during physical therapy sessions was associated with reduced pain interference at 6 months and with reduced pain severity at the 6-month and 12-month follow-ups. Complementary therapy use was not associated with mobility or social integration. Conclusion: The current study provides preliminary evidence documenting the limited use of complementary therapies in rehabilitation settings and highlights the opportunity for further research, particularly regarding pain-related outcomes.

Redes integradas de servicios de salud: ¿Solución o problema? / Integrated Networks of Health Services: Solution or Problem?

Hace ya tiempo que se identifican la inequidad y la eficiencia como problemas centrales que afectan a los sistemas de salud de Latinoamérica y el Caribe. Como respuesta a dichos problemas, en las últimas dos décadas muchos países de la región han llevado a cabo reformas en la financiación y provisión de sus servicios de salud. Estas reformas, fuertemente influidas por el pensamiento neoliberal, con-templan la búsqueda de una asignación más eficiente de los recursos mediante la introducción de mecanismos de mercado, entre otras medidas, a través de diferentes formas de organizar el sector. En relación a las transformaciones de la organización del sector, tanto en países desarrollados como en desarrollo, se han promovido formas diversas de integración delos servicios de salud, entre las que se encuentran las Redes Integradas de Servicios de Salud.

Inequity and efficiency have long been identified as central problems affecting health systems in Latin America and the Caribbean. In response to these problems, in the last two decades many countries in the region have carried out reforms in the financing and provision of their health services. These reforms, strongly influenced by neoliberal thinking, include the search for a more efficient allocation of resources by introducing market mechanisms, among other measures, through different ways of organizing the sector. In relation to the transformations in the organization of the sector, both in developed and developing countries, various forms of integration of health services have been promoted, among which are the Integrated Health Services Networks.

O Trabalho Psicodramatico e o Estigma da Doenca: A Epilepsia

Abordagem de um trabalho de psicoterapia psicodramatica com uma paciente epileptica, do sexo feminino. Apos ter perdido o controle de suas crises, afastou-se de tudo e de todos, isolando-se. Seus papeis ficaram como que estagnados, dificultando assim sua interacao com o ambiente. Na evolucao do tratamento, novos papeis foram se desenvolvendo, ocorrendo tambem mudancas em seu perfil psicologico que possibilitaram uma melhor integracao bio-psico-social.