Adherence to online psychotherapy during the COVID-19: a scoping review / Adesão à psicoterapia on-line durante a COVID-19: uma revisão de escopo / Adherencia a la psicoterapia online durante el COVID-19: una revisión del alcance

Evidence suggests that changes in online psychotherapy adherence factors occurred during the COVID-19 pandemic. Thus, this study aimed to review the perception of patients and psychotherapists regarding factors associated with adherence to online psychotherapy during the pandemic. Thus, 18 articles remained for analysis after searches in five databases and 25 factors associated with adherence to online psychotherapy were identified. The main factors for psychotherapists were confidence in professional skills and connection stability. For the patients, basic informatics skills and finding an adequate setting to participate in sessions. Furthermore, the factors fear of contagion, tiredness and the impossibility of face-to-face meetings emerged during the pandemic. Modifications of factors associated with pre-pandemic adherence were identified and strategies to overcome barriers related to online sessions were presented and discussed. The pandemic has increased adherence to online psychotherapy, although not everyone intends to follow this modality in the post-pandemic. (AU)

Evidências sugerem que ocorreram modificações nos fatores de adesão a psicoterapia online durante a pandemia de COVID-19. Assim, este estudo objetivou revisar a percepção dos pacientes e psicoterapeutas sobre fatores associados a adesão à psicoterapia online durante a pandemia. Restaram 18 artigos para análise após as buscas em cinco bases de dados. Foram identificados 25 fatores associados a adesão a psicoterapia on-line. Para os psicoterapeutas, os principais fatores foram a confiança nas habilidades profissionais e estabilidade da conexão. Para os pacientes, foram o conhecimento básico de informática e encontrar setting adequado para participar das sessões. Ademais, os fatores medo do contágio, cansaço e a impossibilidade de reuniões presenciais surgiram durante a pandemia. Modificações em fatores associados a adesão pré-pandemia foram identificadas e estratégias para contornar barreiras relacionadas aos atendimentos on-line foram apresentadas e discutidas. A pandemia aumentou a adesão a psicoterapia on-line, mas nem todos pretendem seguir nessa modalidade no pós-pandemia. (AU)

Evidencias sugieren que se produjeron cambios en los factores de adherencia a la psicoterapia en línea durante la pandemia del COVID-19. Por lo tanto, este estudio busca revisar las percepciones de pacientes y psicoterapeutas sobre los factores asociados a la adherencia a la psicoterapia en línea durante la pandemia. Se analizaron 18 artículos seleccionados tras una búsqueda en cinco bases de datos. Se identificaron 25 factores de la adherencia a la psicoterapia en línea. Para los psicoterapeutas, los principales factores fueron la confianza en las competencias profesionales y la estabilidad de la conexión. Ya para los pacientes, los factores básicos fueron las habilidades informáticas básicas y la búsqueda del entorno adecuado para participar en las sesiones. Además, durante la pandemia surgieron los factores miedo al contagio, cansancio y la imposibilidad de encuentros físicos. Se identificaron modificaciones en los factores asociados a adherencia prepandémica y se presentaron y discutieron estrategias para superar las barreras relacionadas con las sesiones en línea. La pandemia aumentó la adhesión a la psicoterapia en línea, aunque no todos tengan la intención de seguir esta modalidad en la pospandemia. (AU)

Feasibility of speech telerehabilitation for a patient with Parkinson's Disease in a low-resource country during the pandemic: A case report

@#Parkinson’s disease (PD) is a chronic, neurodegenerative condition resulting in various motor impairments, including speech disorders. However, at the height of the coronavirus disease 2019 pandemic, a patient with PD could not access traditional in-person neurorehabilitation care. This case report highlights the feasibility of telerehabilitation to deliver speech therapy over a distance using available resources in a developing country. We describe a Filipino elderly woman, public speaker, and marriage counselor, seeking teleconsultation for her voice problems (slow and soft) attributed to PD. At that time, most center-based outpatient rehabilitation centers in Manila were closed due to the pandemic, and the patient preferred to stay at home for safety reasons. Hence, she was evaluated and managed remotely by an interdisciplinary team (neurologist, physiatrist, speech-language pathologist) through video calls. Since the ideal rehabilitation set up (in-person evaluation and therapy; use of Lee Silverman Voice Therapy) could not be done, the clinicians had to find practical alternatives, such as remotely administering subjective perceptual voice assessments, objective speech analysis using the Praat™ computer application, and speech teletherapy through synchronous (videocalls, phone calls) and asynchronous (e-mails, text messages, pre-recorded exercise videos) techniques. Notable speech improvements were observed by the clinicians, patient, and patient’s frequent communicative partners after at least four teletherapy sessions. However, the carry-over of the improvements was affected by the patient’s lack of compliance with the prescribed home exercise program. Telerehabilitation using synchronous and asynchronous techniques for speech disorders due to PD was found feasible, beneficial, safe, and practical amid social distancing and low resources in a developing country

Speech-language teletherapy practice: perceptions of Brazilian speech-language-hearing therapists / A prática da telefonoaudiologia: percepções de fonoaudiólogos brasileiros

ABSTRACT Purpose: to verify Brazilian speech-language-hearing therapists' perception of speech-language teletherapy. Methods: a qualitative/quantitative cross-sectional study. The 22 participants answered an online questionnaire on sociodemographic information, academic degree, occupation, and teletherapy experience. Absolute and relative frequencies in scale and multiple-choice answers were calculated, whereas the content of qualitative data was analyzed. Results: the mean age of the speech-language-hearing therapists was 28 years; 86.4% were females, and 63.3% graduated from public institutions. All participants (100%) reported knowing the guidelines prescribed by the Federal Speech-Language-Hearing Council. Most of them treated children (77.3%), with oral language procedures (54.5%); 59.1% faced difficulties, while 63.7% felt qualified to practice teletherapy. Conclusion: all participants said they knew speech-language teletherapy. Most of them reported that the topic was not addressed in their undergraduate studies; hence, they sought training from other sources to offer teleconsultation. Moreover, they reported that most patients agreed to continue with that type of care, although the number of new patients seeking treatment during the pandemic decreased.

RESUMO Objetivo: verificar a percepção de fonoaudiólogos sobre a telefonoaudiologia. Métodos: estudo transversal, abordagem quali-quantitativa. Os vinte e dois participantes responderam ao questionário on-line que continha informações sociodemográficas, formação, atuação profissional e experiência com a telefonoaudiologia. Para as respostas escalares e de múltipla escolha, foram calculadas a frequência absoluta e relativa e para os dados qualitativos realizou-se análise de conteúdo. Resultados: a média de idade dos fonoaudiólogos foi 28 anos, 86,4% eram do sexo feminino e 63,3% formaram-se em instituições privadas. Todos os participantes (100%) relataram conhecer as diretrizes prescritas pelo Conselho Federal de Fonoaudiologia. A maioria atendeu crianças (77,3%), realizando procedimentos na área de linguagem oral (54,5%). Dentre estes, 59,1% enfrentaram dificuldades, enquanto 63,7% se sentiam qualificados para exercer a prática da teleconsulta. Conclusão: todos os participantes afirmaram conhecer a telefonoaudiologia. A maioria afirmou não ter tido contato com o conteúdo durante a graduação, optando por buscar formação externa para realizar a teleconsulta. Além disso, relataram que a maioria dos pacientes aceitou continuar com o atendimento, mesmo havendo uma diminuição da procura de novos pacientes durante o período de pandemia.

Systematic and Collaborative Review of E-health Ecological Networks (SCREEN) Model

@#Due to the Covid-19 pandemic, occupational therapy services in the Philippines experienced a shift in service delivery. As face-to-face services were halted, E-health became the key solution for rendering rehabilitation services. Practitioners relied on their clinical judgment in accepting clients for this type of service delivery. The Systematic and Collaborative Review of E-health Ecological Networks or SCREEN is a model that may aid occupational therapists practicing in the pediatric setting and providing services through E-health. The SCREEN model will assist practitioners in deciding what type of service delivery would be beneficial for the client and if the therapist is equipped to provide E-health as a service. SCREEN model includes the framework and a decision tree for its usability and application to OT practice, particularly in E-health.

The Tele-Evaluation Facilitators Model

@#Telehealth has become an alternative service delivery of different healthcare professionals, including occupational therapists, upon the onset of the COVID-19 pandemic. Occupational therapists have adapted to this platform to deliver service in response to the global crisis. This conceptual framework explores the facilitators of occupational therapy evaluation provided via telehealth. It aims to provide insights to clinicians and clients in engaging tele-evaluation. It also aims to establish primary considerations to ensure a thorough evaluation process. The Tele-Evaluation Facilitators Model (TFM) describes the occupational therapy evaluation in the therapy setting. It outlines the OT evaluation process, adapting it to the telehealth setting. The process emphasizes the importance of client-caregiver interaction in creating and achieving occupational therapy goals. Moreover, surrounding the tele-evaluation process, the model highlights the facilitators of tele-evaluation, enabling a comprehensive evaluation process despite the challenges and barriers of this alternative service delivery. Across practice settings, the COVID-19 pandemic necessitated a shift in service delivery to telehealth, and occupational therapists adapted accordingly. Evaluation frameworks exist for telehealth services, but none are unique to occupational therapy evaluation. As a result, an occupational therapy framework that highlights the facilitators of telehealth evaluation will benefit occupational therapy. TFM consists of three domain areas: (1) Family Involvement, (2) Accessibility, (3) Professional Development. This framework promotes telehealth evaluation to clinicians and clients who have hesitations and difficulties in this service delivery model.

Telepráctica de la Terapia Vocal: una ref lexión sobre su aplicación a partir del COVID-19 / Telepractice of voice therapy: a ref lection on its application from the beginning of COVID-19

El manejo de la pandemia por COVID-19 ha generado grandes cambios sociales y mundiales. Uno de ellos, debido al distanciamiento social, ha sido la incorporación de la telepráctica de la terapia vocal en países que tenían poco o nulo conocimiento de ella. Este artículo tiene el propósito de reflexionar sobre la aplicación de la teleprác-tica de la terapia vocal, considerando los beneficios, barreras y oportunidades que surgen de ella. Además, se plantea que la aplicación de la telepráctica requiere de una política, de un marco legislativo y de aspectos éticos para asegurar una terapia vocal exitosa. ¿Es efectiva la telepráctica? ¿es posible aplicarla? ¿qué requiere su aplicación?

The management of the COVID-19 pandemic has generated huge changes socially and worldwide. One of these, due to social distancing, has been the incorporation of telepractice to voice therapy in countries where the knowledge of it was very little or there was none. The purpose of this article is to reflect about the usage of tele-practice in voice therapy by considering the benefits, barriers and opportunities that emerge from it. The paper also poses that the application of telepractice requires po-licies, a legislative framework and ethical aspects to ensure a successful voice therapy. Is the telepractice effective? Can it be implemented? What does its appliance require?

Sistema computacional para dosimetria de nêutrons e fótons baseado em métodos estocásticos aplicado a radioterapia e radiologia / Stochastic method-based computational system for neutron/photon dosimetry applied to radiotherapy and radiology

OBJETIVO: Este artigo mostra um procedimento de conversão de imagens de tomografia computadorizada ou de ressonância magnética em modelo de voxels tridimensional para fim de dosimetria. Este modelo é uma representação personalizada do paciente que pode ser usado na simulação, via código MCNP (Monte Carlo N-Particle), de transporte de partículas nucleares, reproduzindo o processo estocástico de interação de partículas nucleares com os tecidos humanos. MATERIAIS E MÉTODOS: O sistema computacional desenvolvido, denominado SISCODES, é uma ferramenta para planejamento computacional tridimensional de tratamentos radioterápicos ou procedimentos radiológicos. Partindo de imagens tomográficas do paciente, o plano de tratamento é modelado e simulado. São então mostradas as doses absorvidas, por meio de curvas de isodoses superpostas ao modelo. O SISCODES acopla o modelo tridimensional ao código MCNP5, que simula o protocolo de exposição à radiação ionizante. RESULTADOS: O SISCODES vem sendo utilizado no grupo de pesquisa NRI/CNPq na criação de modelos de voxels antropomórficos e antropométricos que são acoplados ao código MCNP para modelar braquiterapias e teleterapias aplicadas a tumores em pulmões, pelve, coluna, cabeça, pescoço, e outros. Os módulos atualmente desenvolvidos no SISCODES são apresentados junto com casos exemplos de planejamento radioterápico. CONCLUSÃO: O SISCODES provê de maneira rápida a criação de modelos de voxels personalizados de qualquer paciente que podem ser usados em simulações por códigos estocásticos tipo MCNP. A combinação da simulação via MCNP com um modelo personalizado do paciente traz grandes melhorias na dosimetria de tratamentos radioterápicos.

OBJECTIVE: The present paper describes a procedure for conversion of computed tomography or magnetic resonance images into a three-dimensional voxel model for dosimetry purposes. Such model is a personalized representation of the patient that can be utilized in nuclear particle transport simulations by means of the MCNP (Monte Carlo N-Particle) code, reproducing the stochastic process of nuclear particles interaction with human tissues. MATERIALS AND METHODS: The developed computational system - SISCODES - is a tool designed for 3D planning of radiotherapy or radiological procedures. Based on tomographic images of the patient, the treatment plan is modeled and simulated. Then, the absorbed doses are shown by means of isodose curves superimposed on the model. The SISCODES couples the threedimensional model with the MCNP5 code, simulating the protocol of exposure to ionizing radiation. RESULTS: The SISCODES has been utilized by the NRI/CNPq in the creation of anthropomorphic and anthropometric voxel models which are coupled with the MCNP code for modeling brachytherapy and teletherapy applied to lung, pelvis, spine, head and neck tumors, among others. The current SISCODES modules are presented together with examples of cases of radiotherapy planning. CONCLUSION: The SISCODES provides a fast method to create personalized voxel models of any patient which can be used in stochastic simulations. The combination of the MCNP simulation with a personalized model of the patient increases the dosimetry accuracy in radiotherapy.

Effects of teletherapy and located hyperthermia on VX_2 rabbits'cytokines / 肿瘤研究与临床

Objective To observe teletherapy and local hyperthermia effects on VX2 carcinoma rabbits'cytokines and curative effect. Methods 60 male white health rabbits were selected, and divided them into three group. The group of teletherapy were 20. The group of local hyperthermia were 20. So were the group of comparison. Their tumors' changes, rates of death and changes of IL-2, IL-6, IL-8, TNF, IGF, CA-50 before and after VX2 carcinoma replanted and those treated after one, three, four weeks were observed. Results The diameters of tumors and rates of death from large to small in turn was comparison's group, hyperthermia's group and teletherapy's group. After VX2 carcinoma replanted IL-2, IL-8 were low but IL-6, TNF, IGF, CA-50 were high. After being treated one, three or four weeks, IL-2, IL-8 were getting lower and lower but there was significant difference between teletherapy's group with other group in IL-2 and IL-8(P