Sistema de avaliação de práticas psicológicas Aluízio Lopes de Brito (SAPP) sobre políticas de cuidado / Aluízio Lopes de Brito psychological practices assessment system (SAPP) on care policies / Sistema de evaluación de prácticas psicológicas Aluízio Lopes de Brito (SAPP) sobre políticas de cuidado

O objetivo do presente manuscrito é caracterizar e descrever os fluxos do Sistema de Avaliação de Práticas Psicológicas Aluízio Lopes de Brito (SAPP), dispositivo instituído no âmbito do Sistema Conselhos de Psicologia e regulamentado pelo Conselho Federal de Psicologia através da Resolução CFP nº 15, de 18 de agosto de 2023. O SAPP surge da necessidade premente de orientação e qualificação profissionais frente às práticas emergentes que produzem o saber/ fazer da psicologia. Nesse sentido, trata-se de processo que busca orientar, qualificar e fazer conhecer práticas que sejam compatíveis ou não com o exercício profissional em psicologia. Com o trabalho realizado no SAPP serão produzidos pareceres que contribuirão minimamente para o conhecimento das fronteiras que delimitam os campos da psicologia e, por excelência, conheceremos melhor nossas próprias formas de atuação. Através da consideração do trinômio teoria-prática-ética, o CFP espera com o SAPP abrir diálogos com grupos, práticas e saberes fronteiriços e constantemente relegados pela psicologia hegemônica. Para tanto, parte do pressuposto de que os saberes e fazeres destas populações podem refinar as teorias psicológicas e fazer a psicologia avançar como ciência e profissão.(AU)

This manuscript aims to characterize and describe the flows of the Aluízio Lopes de Brito Psychological Practices Assessment System (SAPP), an instrument established within the framework of the Psychology Council System and regulated by the Federal Council of Psychology (CFP) with Resolution CFP No. 15, of August 18, 2023. The SAPP arises from the pressing need for professional guidance and qualification in the face of emerging practices that shape the knowledge/practice of psychology. In this sense, it is a process that seeks to guide, qualify, and make known practices that are compatible or not with the professional practice of psychology. The work carried out in the SAPP will produce opinions that will contribute minimally to the understanding of the boundaries that delimit the fields of psychology and, by excellence, we will better understand our own modes of operation. Considering the trinity of theory-practice-ethics, the CFP hopes with the SAPP to open dialogues with groups, practices, and knowledge that are in the borders and are constantly relegated by hegemonic psychology. To this end, it assumes that the knowledge and practices of these populations can refine psychological theories and advance psychology as a science and profession.(AU)

El objetivo de este manuscrito es caracterizar y describir los flujos del Sistema de Evaluación de Prácticas Psicológicas Aluízio Lopes de Brito (SAPP), un dispositivo establecido en el marco del Sistema de Consejos de Psicología y regulado por el Consejo Federal de Psicología a través de la Resolución CFP n.º 15, con fecha del 18 de agosto de 2023. El SAPP surge de la necesidad apremiante de orientación y calificación profesional frente a las prácticas emergentes que configuran el conocimiento y las habilidades de la psicología. En este sentido, es un proceso que busca orientar, calificar y dar a conocer prácticas que sean compatibles o no con el ejercicio profesional de la psicología. El trabajo realizado en el SAPP generará opiniones que contribuirán mínimamente a la comprensión de los límites que delimitan los campos de la psicología y, por excelencia, comprender mejor nuestras propias formas de actuación. A través de la consideración de la tríada teoría-práctica-ética, el CFP espera que con el SAPP puede llevar a cabo el diálogo con grupos, prácticas y conocimientos fronterizos y constantemente pasados por alto por la psicología hegemónica. Con este fin, se asume que los conocimientos y prácticas de estas poblaciones pueden refinar las teorías psicológicas y hacer avanzar la psicología como ciencia y profesión.(AU)

A experiência intersubjetiva na ludoterapia humanista sob uma perspectiva fenomenológica / The intersubjective experience in humanistic play therapy from the standpoint of phenomenology / La experiencia intersubjetiva en la ludoterapia humanista desde una perspectiva fenomenológica

Esta pesquisa qualitativa objetivou compreender, fenomenologicamente, a experiência vivida por psicoterapeutas e crianças no acontecer clínico da ludoterapia humanista. Foram realizados 26 encontros dialógicos individuais com nove psicoterapeutas e sete crianças, registrados pela pesquisadora na forma de Narrativas Compreensivas que incluíram suas impressões impactadas subjetivamente pelas falas e expressões corporais dos participantes. A análise fenomenológica culminou com a escrita de uma Narrativa Síntese. Os resultados indicam que a relação psicoterapêutica é percebida como: facilitadora do crescimento psicológico da criança; intensificadora do fluxo de mudanças ao dinamizar os processos pessoais infantis; geradora de motivação na criança para a relação interpessoal, a partir do envolvimento subjetivo do terapeuta; potencializadora da tomada de consciência com base na corporeidade; propiciadora da integração de experiências por meio do brincar; reveladora das singularidades individuais, catalisando o desenvolvimento; e, por fim, benéfica à atualização de significados e sentidos da experiência pessoal e relacional. Evidenciou-se, entre os psicoterapeutas, uma concepção da ludoterapia humanista que prioriza a compreensão dirigida ao estilo próprio de cada cliente em relação aos modos de sentir e expressar-se no mundo e à estruturação do processo psicoterapêutico a partir do relacionamento com a criança. Concluiu-se, assim, que a experiência desse tipo de relação interpessoal facilita a constituição na criança de singularidades que imprimem um sentido existencial próprio ao seu mundo de relações e historicidade. A relevância do processo psicoterapêutico para o crescimento psicológico da criança apresentou-se também pelo seu caráter psicoprofilático, reverberado no encadeamento de processos associados à experiência pessoal dela.(AU)

This qualitative research aimed to understand, phenomenologically, the lived experience of psychotherapists and children in the clinical event of humanistic play therapy. A total of 26 individual dialogical encounters were held with nine psychotherapists and seven children, registered in the form of Comprehensive Narratives by the researcher, which included her subjectively impacted impressions about the participants' speeches and body expressions. The phenomenological analysis culminated in a Synthesis Narrative. The results demonstrate that the psychotherapeutic relationship is perceived as: facilitating the child's psychological growth; intensifying the flow of change by streamlining children's personal processes; generating motivation for the child to get involved with interpersonal relationship, based on the subjective involvement of the therapist; potentiating awareness raising based on the corporeality; enabling the integration of experiences by playing; revealing the uniqueness, catalyzing development; and, finally, benefiting the updating of meanings and senses of personal and relational experience. A conception of humanistic play therapy became evident among the psychotherapists, which prioritizes the understanding directed to the own way of each client regarding how to feel and express themselves in the world and the structuring of the psychotherapeutic process based on the relationship with the child. Thus, it was concluded that the experience of this interpersonal relationship facilitates the constitution in the child of singularities that bring their own existential meaning to their world of relationships and historicity. The relevance of the psychotherapeutic process for the child's psychological growth was also shown by the psycho-prophylactic character reverberated in the processes associated with the child's personal experience.(AU)

Esta investigación cualitativa tuvo por objetivo comprender, fenomenológicamente, la experiencia vivida por psicoterapeutas y niños en ludoterapia de orientación humanista. La investigadora desarrolló 26 conversaciones dialógicas individuales con nueve psicoterapeutas y siete niños, registradas como narrativas comprensivas que incluyeron sus impresiones impactadas subjetivamente por los discursos y expresiones corporales de los participantes. El análisis fenomenológico culminó con una síntesis narrativa. Los resultados demuestran que la relación psicoterapéutica se percibe como facilitadora del crecimiento psicológico del niño; intensificadora del flujo de cambio, optimizando su procesos personales; generadora de motivación para que el niño se involucre en la relación interpersonal a partir del envolvimiento subjetivo del terapeuta; potenciadora de la toma de conciencia a partir de la corporeidad; propiciadora de la integración de las experiencias por medio del juego; reveladora de singularidades individuales al catalizar el desarrollo; y beneficiosa para actualizar los significados y sentidos de la experiencia personal e relacional. Entre los psicoterapeutas se hizo evidente una concepción de ludoterapia humanista que prima por comprender la forma propia del cliente de sentirse y expresarse y la estructuración del proceso psicoterapéutico a partir de la relación con el niño. Se concluyó que la vivencia de este tipo de relación facilita la constitución en el niño de singularidades que le aportan un sentido existencial a su mundo de relación e historicidad. La relevancia del proceso psicoterapéutico para el crecimiento psicológico también se mostró por su carácter psicoprofiláctico, que reverberó en la cadena de procesos asociados con la experiencia personal del niño.(AU)

Effects of concert music on cognitive, physiological, and psychological parameters in the elderly with dementia: a quasi-experimental study / Efeitos da música de concerto sobre a cognição, parâmetros fisiológicos e psicológicos em idosos com demência: estudo quase experimental

ABSTRACT. Non-pharmacological interventions, such as the use of music, have been shown to be important potential means of controlling adverse symptoms and signs resulting from chronic diseases already present in elderly patients with dementia. Objectives: The objective of this study was to analyze the effects of concert music on cognitive and physiological parameters, and behavioral and psychological symptoms in institutionalized elderly people with dementia. Methods: A descriptive-exploratory, quantitative, quasi-experimental study was conducted with 14 elderly people. They were allocated in intervention group (IG) (n=7) with eight sessions of music listening, once a week, for 2 months, and control group (CG) (n=7) with the same procedure but without listening to the music. All participants were assessed by Neuropsychiatric Inventory Questionnaire (NPI-Q) and Addenbrooke's Cognitive Examination - Revised (ACE-R) before and after the intervention. Blood pressure (BP) data were obtained; heart rate (HR) and coherence were obtained through Cardioemotion during sessions. The data were analyzed using Fisher's exact test and Student's t-test. Results: There was a predominance of female participants, who were widowed and diagnosed with Alzheimer's disease (AD) in both groups. A statistically significant reduction was found in the mean of apathy reduction (p=0.038) and the total mean of NPI-Q severity (p=0.033) (paired Student's t-test) in IG. No significant differences were found in mean level of the pre- and post-analysis variables in CG. Conclusions: Concert music had a positive effect on the behavior of institutionalized elderly. Stimuli and possibilities of improving the current behavioral conditions are observed.

RESUMO. Intervenções não farmacológicas, como o uso da música, têm-se mostrado importantes meios potenciais de controlar os sintomas e sinais adversos decorrentes das enfermidades crônicas já instaladas em idosos com demência. Objetivos: Analisar o efeito da música de concerto sobre a cognição, parâmetros fisiológicos e sintomas comportamentais e psicológicos em idosos com demência institucionalizados. Métodos: Estudo descritivo-exploratório, quantitativo, quase experimental, realizado com 14 idosos. Eles foram alocados em: Grupo Intervenção (GI) (n=7), com oito sessões de audição musical, uma vez por semana, durante dois meses; e Grupo Controle (GC) (n=7), com o mesmo procedimento, porém sem a audição da música. Todos os participantes foram avaliados pelo Neuropsychiatric Inventory Questionnaire (NPI-Q) e Addenbrooke's Cognitive Examination - Revised (ACE-R) antes e depois do período da intervenção. Foram obtidos dados de pressão arterial, frequência e coerência cardíaca por meio do cardioemotion durante as sessões. Os dados foram analisados pelos testes Exato de Fischer e t de Student. Resultados: Em ambos os grupos houve predominância de participantes do sexo feminino, estado civil de viuvez e com diagnóstico de Alzheimer. Foi encontrada redução estatisticamente significativa na média do desgaste na apatia (p=0,038) e média total do NPI-Q gravidade (p=0,033) (teste t de Student pareado) no GI. Para o GC, não foram encontradas diferenças significativas no nível médio das variáveis na pré e pós-análise. Conclusões: A música de concerto teve efeitos positivos no comportamento dos idosos institucionalizados. Nota-se que, em geral, ela trouxe estímulos e possibilidades de melhoria das condições comportamentais atuais.

Effects of clown visits on stress and mood in children and adolescents in psychiatric care-Protocol for a pilot study.

Scientific evidence has shown that healthcare clowning can decrease the level of stress and anxiety in pediatric patients. However, little attention has been devoted to the potentially beneficial impact of clown visits in the child and adolescent psychiatry setting. Therefore, this pilot study aims at investigating short-term effects of clown visits by RED NOSES Clowndoctors Austria on stress and mood levels of children and adolescents in psychiatric care. The sample will consist of approximately 50 children and adolescents in inpatient psychiatric wards who receive clown visits on a weekly basis over four consecutive weeks. The examined intervention, i.e., the clown visits, is an integral part within the selected psychiatric institutions. Using a non-controlled pre-/post-test design, the level of salivary cortisol and self-reported stress and mood will be measured as primary outcomes before and immediately after each clown visit. Additionally, self-reported effects on care staff at the health care facilities will be assessed based on a questionnaire after each clown visit within the same time period of four weeks. Secondary outcome measures (i.e., health-related quality of life, emotional and conduct problems, perceived chronic stress) will be assessed at baseline and at close-out assessment after the four intervention weeks. Further control variables and potential moderators are included at baseline. Due to the nested data structure, multilevel modeling will be used to analyze the data. To our knowledge, this is the first study to examine the stress-reducing and mood-improving effects of clown visits on inpatients in child and adolescent psychiatry. Results will be relevant for the design of future large-scale RCTs and might provide valuable implications for the use of healthcare clowning to reduce stress and improve mood in children and adolescents in psychiatric care. The study is registered at ClinicalTrials.gov (Identifier: NCT04844398).

Saúde mental, arte e reabilitação psicossocial: problematização da produção acadêmica brasileira (2008-2018) / Mental health, art and psychosocial rehabilitation: problematizing brazilian academic production (2008-2018)

Neste artigo problematizamos ações de reabilitação psicossocial realizadas a partir da interface entre arte e saúde mental entre 2008 a 2018 e publicadas em Teses, Dissertações e Artigos publicados no Brasil. A partir da metodologia construtivo-interpretativa, analisamos 78 materiais adquiridos mediante consulta à Biblioteca Virtual em Saúde, ao Portal de Periódicos Capes e à Biblioteca Digital Brasileira de Teses e Dissertações. Identificamos uma pluralidade de ações envolvendo diversas linguagens artísticas, compostas por diferentes atores sociais e em parceria com instituições e movimentos sociais. As potencialidades destas experiências revelam benefícios que extrapolam os limites terapêuticos e vislumbram o fortalecimento do protagonismo dos sujeitos, promovendo tecnologias transformadoras relacionadas ao cuidado, ao trabalho e à organização social. Estes benefícios também afetam os serviços de saúde mental e seus trabalhadores, bem como geram transformações no imaginário social referente à loucura. Entretanto, observamos algumas fragilidades relacionadas, especialmente, à lógica terapêutica e institucionalizada de algumas ações analisadas. Este processo compreende o fato de que por um lado, a reabilitação psicossocial geralmente é confundida como uma aplicação periférica dentro dos serviços de saúde mental e, por outro lado, a arte é limitada a uma mera aplicação ocupacional nesses mesmos serviços. Essas fragilidades acabam por dificultar o protagonismo dos usuários dos serviços de saúde mental.(AU)

In this papper, we discuss psychosocial rehabilitation actions carried out from the interface between art and mental health between 2008 and 2018 and published in Theses, Dissertations and Articles published in Brazil. Based on the constructive-interpretative methodology, we analyzed 78 materials acquired by consulting the Virtual Health Library, the Capes Journal Portal and the Brazilian Digital Library of Theses and Dissertations. We identified a plurality of actions involving different artistic languages, composed by different social actors and in partnership with institutions and social movements. The potential of these experiences reveal benefits that go beyond therapeutic limits and envision the strengthening of the subjects' protagonism, promoting transforming technologies related to care, work and social organization. These benefits also affect mental health services and their workers, as well as generate transformations in the social imagination regarding madness. However, we observed some weaknesses related, especially, to the therapeutic and institutionalized logic of some analyzed actions. This process comprises the fact that, on the one hand, psychosocial rehabilitation is often confused as a peripheral application within mental health services and, on the other hand, art is limited to a mere occupational application in these same services. These weaknesses end up hindering the role of users of mental health services.(AU)

National clinical guideline for assessment and treatment of ADHD in children and young people: quick guide

Professional observers are independent persons who have in-depth knowledge of both children's normal behaviour and development and of ADHD, and who take a multidisciplinary approach to ADHD in their daily work. The observation must be geared to the specific problem with the child in question

Environmental Enrichment in Postoperative Pain and Surgical Care: Potential Synergism With the Enhanced Recovery After Surgery Pathway.

BACKGROUND: Holistic biopsychosocial care has been underemphasized in perioperative pathway designs. The importance and a cost-effective way of implementing biopsychosocial care to improve postoperative pain and facilitate surgical convalescence are not well established, despite the recent popularization of Enhanced Recovery After Surgery (ERAS) programs. OBJECTIVE: We have explored the evidence and rationale of environmental enrichment (EE) as a complementary multimodal psychosocial care pathway to reduce postoperative pain, optimize patient recovery and improve existing weaknesses in surgical care. METHODS: We conducted a database search to identify and grade potential EE techniques for their evidence quality and consistency in the management of acute postoperative pain, perioperative anxiety and the etiologically comparable acute procedural or experimental pain. FINDINGS AND CONCLUSIONS: The introduction of music, virtual reality, educational information, mobile apps, or elements of nature into the healthcare environment can likely improve patients' experience of surgery. Compared with traditional psychological interventions, EE modalities are voluntary, therapist-sparing and more economically sustainable. We have also discussed practical strategies to integrate EE within the perioperative workflow. Through a combination of sensory, motor, social and cognitive modalities, EE is an easily implementable patient-centered approach to alleviate pain and anxiety in surgical patients, create a more homelike recovery environment and improve quality of life.

Brief Report: Parent Perspectives on Sensory-Based Interventions for Children with Autism Spectrum Disorder.

Sensory-Based Interventions (SBIs) are often recommended to enable function/participation in children with ASD. Still, there are limited studies to evaluate their effectiveness. Acceptability studies are an important step towards establishing effective interventions. We examined parents' perceptions of the uptake and acceptability of such interventions. An online survey was sent to 399 families; response rate was 39%. The most frequently therapist-recommended interventions were trampoline (54.6%), massage (47.8%), and oral-motor tools (43.8%). Highest use was reported for massage (96.3%), trampoline (89.2%) and joint compressions and brushing (89.2%). The majority of parents viewed these interventions to be very important /important, (74.8%) but barriers to their use were identified. High acceptability of SBIs was reported by parents of children with ASD.

An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions.

OBJECTIVE: We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. METHODS: A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. RESULTS: Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. CONCLUSIONS: The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.

A systematic review of active group-based dance, singing, music therapy and theatrical interventions for quality of life, functional communication, speech, motor function and cognitive status in people with Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative condition associated with a wide range of motor and non-motor symptoms. There has been increasing interest in the potential benefit of performing arts as a therapeutic medium in PD. While there have been previous reviews, none have considered all performing arts modalities and most have focused on dance. This systematic review examined the potential benefit of all active group-based performing arts interventions for quality of life, functional communication, speech, motor function and cognitive status. METHODS: Searches were conducted in February 2020 on five scholarly databases. Supplementary searches were conducted. Included studies were quantitative in design, and assessed the potential benefit of any active group-based performing arts intervention for quality of life, functional communication, speech, motor function or cognitive status in people with PD. Full text papers were eligible for inclusion, as were conference abstracts since January 2018. Screening, data extraction, narrative synthesis and quality assessment were conducted independently by two reviewers. Quality assessment used the SURE checklists. RESULTS: Fifty-six studies were eligible for inclusion in this systematic review, reported in 67 publications. Published from 1989 to 2020, these studies included a total of 1531 people with PD from 12 countries, and covered four broad performing arts modalities: dance, singing, music therapy and theatre. Dance remains the most commonly studied performing arts modality for PD (38 studies), while there were 12 studies on singing interventions, four on music therapy, and only two on theatrical interventions. There was evidence for a beneficial effect of all four performing arts modalities on at least some outcome domains. CONCLUSIONS: This is the first systematic review to assess the potential benefit of all active group-based performing arts interventions in PD. The evidence suggests that performing arts may be a useful therapeutic medium in PD. However, a substantial limitation of the evidence base is that no studies compared interventions from different performing arts modalities. Moreover, not all performing arts modalities were assessed for all outcome domains. Therefore it is not currently possible to determine which performing arts modalities are most beneficial for which specific outcomes.

A elaboração imaginativa na origem da vida psíquica e suas implicações clínicas / The imaginative elaboration at the origin of psychic life and its clinical implications / La elaboración imaginativa en el origen de la vida psíquica y sus implicaciones clínicas

Este artigo pretende identificar o surgimento e o desenvolvimento da noção de elaboração imaginativa na obra de Winnicott, analisando o seu significado e suas possíveis implicações clínicas. Complexa e pouco explorada, a noção de elaboração imaginativa é uma das contribuições específicas à psicanálise, feitas por D.W. Winnicott, que permite a formulação de uma hipótese teórica sobre a inclusão do corpo como um elemento fundamental na origem da vida psíquica. Considerando o campo sensorial como ponto de partida para a atribuição de sentido às sensações corporais nos primórdios da existência, a capacidade de elaborar imaginativamente inaugura o processo de apreensão da integração psicossomática, assim como a possibilidade de manter viva e presente na vida adulta a conexão entre o campo da sensorialidade, o campo afetivo e a vida de representação. Nesta perspectiva, a elaboração imaginativa está na origem da possibilidade de criar, sonhar, fantasiar, devanear, brincar e simbolizar, constituindo um elemento importante no tratamento psicanalítico (AU)

This paper aims to identify the emergence and development of the imaginative elaboration concept in Winnicott's work, by analyzing its significance and potential clinical implications. Complex and little explored, the notion of imaginative elaboration is one of the specific contributions to psychoanalysis, made by D.W. Winnicott, which allows for the formulation of a theoretical hypothesis about the inclusion of the body as a key element in the origin of psychic life. Considering the sensory field as a starting point for assigning meaning to bodily sensations in the early days of existence, the ability to imaginatively elaborate unveils the process of apprehension related to psychosomatic integration, as well as the possibility of keeping the connection between field of sensoriality, field of affection, and life representation alive and present in the adult life. In this perspective, the imaginative elaboration is at the origin of the power to create, dream, fantasize, daydream, play, and symbolize, setting it up as an important element in psychoanalytic treatment (AU)

Este artículo pretende identificar la aparición y el desarrollo de la noción de elaboración imaginativa en la obra de Winnicott, analizando su significado y sus posibles implicaciones clínicas. Compleja y poco explorada, la noción de elaboración imaginativa es una de las contribuciones específicas al psicoanálisis, echa por D.W. Winnicott, que permite la formulación de una hipótesis teórica sobre la inclusión del cuerpo como un elemento clave en el origen de la vida psíquica. Teniendo en cuenta el campo sensorial como punto de partida para la asignación de sentido a las sensaciones corporales en los primordios de la existencia, la capacidad de elaborar imaginativamente inaugura el proceso de aprehensión de la integración psicosomática, así como la posibilidad de mantener viva y presente en la vida adulta la conexión entre el campo de la sensorialidad, el campo afectivo y la vida de representación. En esta perspectiva, la elaboración imaginativa está en el origen de la posibilidad de crear, soñar, fantasear, devanear, jugar y simbolizar, constituyendo un elemento importante en el tratamiento psicoanalítico (AU)

Heitor Péres e a Praxiterapia Integral na Colônia Juliano Moreira / Heitor Péres and the Integral Praxitherapy at the Colônia Juliano Moreira / Heitor Péres y la Praxiterapia Integral en la Colonia Juliano Moreira

Neste artigo, realiza-se um estudo historiográfico sobre o psiquiatra Heitor Péres, quem, dentre outras funções assumidas no serviço público, dirigiu a Colônia Juliano Moreira entre 1946 e 1956. A pesquisa teve como interesse principal investigar suas contribuições na área da praxiterapia, isto é, o uso de ocupações terapêuticas no âmbito da assistência psiquiátrica. Heitor Péres foi um grande entusiasta do que denominou praxiterapia integral. Sua trajetória profissional auxilia a compreender o lugar desta prática no campo da medicina psiquiátrica no Rio de Janeiro. As conclusões deste estudo sugerem o emprego paralelo de teorias organicistas e métodos de tratamentos com base nas ocupações terapêuticas em sua prática profissional. A trajetória de Heitor Péres ajuda a problematizar a leitura histórica que se tem feito da psiquiatria brasileira das décadas de 1940 e 1950, assim como a desmistificar a ideia de que a praxiterapia era percebida neste contexto como um método de tratamento inferior àqueles de base organicista. (AU)

In this article, a historiographical study is performed about the psychiatrist Heitor Péres, who, among other functions assumed in the public service, directed the Colonia Juliano Moreira between 1946 and 1956. The research had as main interest to investigate the contributions of this character to praxitherapy, or the use of therapeutic occupations within psychiatric care. Heitor Péres was a great promoter and disseminator of what he called integral praxitherapy, in addition to art therapy. His professional career helps to understand the place of these practices in the psychiatric medicine field in Rio de Janeiro. The conclusions of this study suggest the parallel use of organicist theories and treatment methods based on therapeutic occupations in his professional practice. The trajectory of Heitor Péres helps to problematize the history of Brazilian psychiatry of the 1940s and 1950s, as well as to demystify the idea that praxitherapy was perceived in this context as a method of treatment inferior to those based on organicism. (AU)

En este artículo se realiza un estudio historiográfico sobre el psiquiatra Heitor Péres, quien, entre otras funciones asumidas en el servicio público, dirigió la Colonia Juliano Moreira entre 1946 y 1956. El estudio tuvo como principal interés investigar las contribuciones de este personaje a la praxiterapia, el uso de ocupaciones terapéuticas dentro de la atención psiquiátrica. Heitor Péres fue un gran promotor y difusor de lo que llamó praxiterapia integral, además de la terapia de arte. Su carrera profesional ayuda a comprender el lugar de esta práctica en el campo de la medicina psiquiátrica en Río de Janeiro. Las conclusiones de este estudio sugieren el uso paralelo de teorías organicistas y métodos de tratamiento basados en ocupaciones terapéuticas en su práctica profesional. La trayectoria de Heitor Péres ayuda a problematizar la lectura histórica que se ha hecho de la psiquiatría brasileña de los años 1940 y 1950, así como a desmitificar la idea de que a la praxiterapia se la percibía en este contexto como un método de tratamiento inferior a los basados en el organicismo. (AU)

Effects of audio and visual distraction on patients' vital signs and tolerance during esophagogastroduodenoscopy: a randomized controlled trial.

BACKGROUND: Esophagogastroduodenoscopy (EGD) provides an indispensable and unambiguous inspection allowing the discovery upper gastrointestinal lesions. However, many patients are anxious about undergoing EGD. Few studies have investigated the influence on patients' vital signs and tolerance during EGD using subjective and objective assessments. This study was a prospective randomized controlled study that investigated the influence of audio and visual distraction on EGD. METHODS: We randomly divided 289 subjects who underwent EGD into 4 groups (control group, audio group, visual group, combination group) and examined their vital signs, heart rate variability (HRV), psychological items, and acceptance of distraction. RESULTS: Pulse rate (PR) at post-distraction and post-EGD in the 3 distraction groups were significantly lower than those of control group (p <  0.001 and p <  0.01, respectively). Blood pressure (BP) during and post-EGD was significantly higher than that at pre-EGD in control group (p <  0.05), but no significant elevation of BP was observed during the latter half of EGD and post-EGD in the 3 distraction groups. BP at post-distraction improved significantly compared to pre-distraction in the 3 distraction groups (p <  0.05). There was a significant difference in the low-frequency (LF) power/ high-frequency (HF) power at post-distraction and post-EGD among the 4 groups (p <  0.001 and p <  0.001, respectively). The LF power/HF power at post-distraction and post-EGD in the 3 distraction groups was significantly lower than that in control group (p <  0.05). Several items of profile of mood states (POMS) and the impression of EGD at post-distraction improved significantly compared to those at pre-distraction among the 3 distraction groups (p <  0.05). Visual analog scale (VAS) of willingness for the next use of distraction in the 3 distraction groups was excellent because VAS was more than 70. CONCLUSIONS: Distractions effectively improved psychological factors, vital signs and some of HRV at pre and post-EGD. Distractions may suppress BP elevation during the latter half of EGD and lead to stability of HRV on EGD. TRIAL REGISTRATION: This prospective trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000029637. Registered on 20 October 2017.

A Taxonomy of Arts Interventions for People With Dementia.

BACKGROUND AND OBJECTIVES: The current evidence base for the arts and dementia has several limitations relating to the description, explanation, communication, and simplification of arts interventions. Research addressing these challenges must be multidisciplinary, taking account of humanities and science perspectives. Consequently, this research aimed to produce a taxonomy, or classification, of arts interventions for people with dementia as a contribution to this growing field. RESEARCH DESIGN AND METHODS: This research was underpinned by taxonomy and realist methodology. Taxonomy, the science of classification, produces a common language to name, define, and describe the world around us. Realist theory explains how interventions "work" and produce their effects. The main findings in this paper were generated from a case study and a Delphi study. RESULTS: An arts and dementia taxonomy of 12 dimensions was developed: Art Form, Artistic elements, Artistic focus, Artistic materials, Arts activity, Arts approaches, Arts facilitators, Arts location, Competencies, Complementary arts, Intervention context, Principles. DISCUSSION AND IMPLICATIONS: Arts interventions can be classified according to their contexts, mechanisms, and outcomes. A range of stakeholders could benefit from the taxonomy, including people with dementia, artists, practitioners, carers, care staff, funders, commissioners, researchers, and academics. Language relating to the arts and dementia can be adapted depending on the audience. This is a foundational model requiring further development within the arts and dementia community.

"Now I Write Songs": Growth and Reciprocity After Long-Term Nursing Home Placement.

BACKGROUND AND OBJECTIVES: Nursing home residents have a need for activities that are meaningful, yet mandated scheduled activities remain poorly characterized. In order to understand how scheduled activities provide meaning for nursing home residents, we conducted a study of daily life in a nursing home with a robust activities program. RESEARCH DESIGN AND METHODS: This 2-year, longitudinal ethnographic study embedded an ethnographer into the activities department of a 430-bed, not-for-profit, faith-based nursing home. Forty-three interviews and more than 250 hr of participant-observation were conducted, with a focus on creative arts and religious activities. Thirty-two residents and 15 activities staff were followed more than 12-23 months. Data were coded concurrently, and emerging themes challenged through purposive recruitment until thematic saturation was reached. RESULTS: Scheduled activities in the nursing home offered opportunities for learning and personal growth regardless of functional or cognitive disability. Three major themes emerged. Artistic development included new self-identification as a musician, painter, or sculptor through arts programming. Intellectual and spiritual growth involved the use of activities to support ongoing practice and study. Reciprocity occurred as residents used the arts to remain contributing members of their institutional society, reciprocating with the institution that housed them. DISCUSSION AND IMPLICATIONS: Nursing home scheduled activities can facilitate the transformation of identity from resident or patient to the normalized social roles of artist, Torah scholar, and productive member of society.

Serviço social e arte educação: cuidado na prevenção da asma / Social work and art education: attention on prevention of asthma / Trabajo social y arte educación: atención a la prevención del asma

Objetivo: Descrever sobre a experiência em arte educação do Serviço Social em equipe multiprofissional, no cuidado preventivo à asma, e as mudanças sentidas pelos participantes do "Coral Voices em Superação", mediante as (inter)experiências e vivências de cantar e conviver com a asma. Método: Pesquisa qualitativa, empírica, bibliográfica e fenomenológica. Com uso de diário de campo, entrevista semiestruturada e análise de conteúdo. Participaram 14 mulheres e um homem entre 23 e 75 anos, acompanhados no Centro de Referência em Asma. Resultado: Arte educação, por meio da música, é um recurso para o assistente social potencializar a autoestima de pessoas em tratamento de asma. Conclusão: O convívio de pessoas com asma, em uma atividade de arte educação, influencia na sua qualidade de vida

Objective: The purpose of this article is to describe the experience in art education of Social Work in a multiprofessional team, in the preventive care for asthma, and the changes felt by the participants of the "Choir Voices in Overcoming", through the (inter) experiences and experiences of singing and living with to asthma. Methods: Qualitative, empirical, bibliographical and phenomenological research. Using field diary, semi-structured interview and content analysis. A total of 14 women and a man between the ages of 23 and 75 participated in the Asthma Reference Center. Results: Art education, through music, is a resource for the social worker to enhance the self-esteem of people in asthma treatment. Conclusion: The conviviality of people with asthma, in an activity of art education, influences their quality of life

Objetivo: Describir sobre la experiencia en arte educación del Trabajo Social en equipo multiprofesional, en el cuidado preventivo del asma, y los cambios sentidos por los participantes del "Coral Voices en Superación", mediante las (inter) experiencias y vivencias de cantar y convivir con el asma. Métodos: Investigación cualitativa, empírica, bibliográfica y fenomenológica. Con uso de diario de campo, entrevista semiestructurada y análisis de contenido. Participaron 14 mujeres y un hombre entre 23 y 75 años, acompañados en el Centro de Referencia en Asma. Resultado: El arte de la educación, a través de la música, es un recurso para que el asistente social potencializar la autoestima de las personas en el tratamiento del asma. Conclusión: La convivencia de personas con asma, en una actividad de arte educación, influye en su calidad de vida

Feasibility of Three Novel Forms of Passive Exercise in a Multisensory Environment in Vulnerable Institutionalized Older Adults with Dementia.

BACKGROUND: Increasing physical activity levels in patients with dementia can reduce pathology severity and progression of the disease. However, physical activity programs can be challenging to adhere to for this vulnerable population. Three novel forms of passive exercise in a multisensory environment may be feasible alternatives for patients who can no longer be involved in physical activity. OBJECTIVE: To determine the feasibility of three different forms of passive exercise in a multisensory environment in inactive institutionalized older adults with dementia. METHODS: 120 patients with dementia participated in this single blind randomized controlled trial (64.5% female, age 85.3±6.8 years Mini-Mental State Examination range 0-29). Ninety participants were randomly assigned to one of the three intervention groups: Therapeutic Motion Simulation (TMSim), Whole Body Vibration (WBV), and TMSim + WBV. Participants received 6 weeks of passive exercise, 4 sessions a week, 4 (WBV) to 12 (TMSim and TMSim + WBV) minutes per session. Feasibility of the novel forms of passive exercise was evaluated based on attendance, compliance, (proxy) experience scores, adverse events and drop-out rates. RESULTS: On average 87.9% of the offered intervention sessions were attended. All three forms of passive exercise were well appreciated by the participants (7.3 on a scale from 0 to 10). Intervention related drop-out rates were reasonable (12.2%) and no serious adverse events occurred. CONCLUSION: The novel passive exercise interventions TMSim, WBV, and TMSim + WBV are feasible to apply in patients at all stages of dementia. More research is needed to establish effectiveness of passive exercise to limit adverse effects of dementia.

'Waking up' to the symbolic: a psychoanalytic investigation into the effects of a music workshop for children with Pervasive Developmental Disorders (PDDs) / "acordar" para o simbólico: uma investigação psicanalítica sobre os efeitos de um ateliê musical para crianças com transtornos globais do desenvolvimento (tgd)

RESUMO: A pesquisa Os efeitos do ritmo como função de estruturação psíquica em crianças com TGD se propôs a acompanhar os efeitos de um ateliê musical sobre um grupo de crianças com Transtornos Globais do Desenvolvimento (TGD). Trabalhamos com a hipótese de que a atenção a propriedades musicais pode favorecer o desenvolvimento da linguagem e enlaçamento social nesses casos. A partir de recortes clínicos construídos à luz do método psicanalítico, o artigo discute de que maneira a música atrelada à psicanálise pode favorecer o surgimento do sujeito desejante.

Abstract: The research Rhythm effects as psychic structuring function in children with PDD aimed to follow the effects of a musical atelier on a group of children with Pervasive Developmental Disorders - PPD. We worked with the hypotheses that the attention to musical proprieties can favor language development and social binding in these cases. Starting from clinical clippings built through the psychoanalytic method, this article discusses in which way the music associated to psychoanalysis can favor the emergence of the desiring subject.