ABSTRACT
Articular cartilage (AC) injuries often lead to cartilage degeneration and may ultimately result in osteoarthritis (OA) due to the limited self-repair ability. To date, numerous intra-articular delivery systems carrying various therapeutic agents have been developed to improve therapeutic localization and retention, optimize controlled drug release profiles and target different pathological processes. Due to the complex and multifactorial characteristics of cartilage injury pathology and heterogeneity of the cartilage structure deposited within a dense matrix, delivery systems loaded with a single therapeutic agent are hindered from reaching multiple targets in a spatiotemporal matched manner and thus fail to mimic the natural processes of biosynthesis, compromising the goal of full cartilage regeneration. Emerging evidence highlights the importance of sequential delivery strategies targeting multiple pathological processes. In this review, we first summarize the current status and progress achieved in single-drug delivery strategies for the treatment of AC diseases. Subsequently, we focus mainly on advances in multiple drug delivery applications, including sequential release formulations targeting various pathological processes, synergistic targeting of the same pathological process, the spatial distribution in multiple tissues, and heterogeneous regeneration. We hope that this review will inspire the rational design of intra-articular drug delivery systems (DDSs) in the future.
ABSTRACT
RESUMO In online psychodrama, with all its peculiarities and risks, is it possible to a complete therapeutic process take place, moved by the therapeutic factors: action catharsis, action insight, action learning, corrective emotional experience and reintegration of the new experience; the same as in psychodrama in therapeutic room? The focus is on possible effects and challenges of interference of different realities when working with psychodrama in the space of a virtual platform. Invasion ofexternal reality in the individual space and reality of the auxiliary ego could influence the online group reality. The result can be a mixture of different times, spaces and realities, as well as the chance to unlock a deep process, catalyzing a personal work for the protagonist.
RESUMO No psicodrama online, com todas as suas peculiaridades e riscos, é possível realizar um processo terapêutico completo, executado pelos fatores terapêuticos: catarse de ação, insight de ação, aprendizagem de ação, experiência emocional corretiva e reintegração da nova experiência; o mesmo que em psicodrama na sala terapêutica? O foco está nos possíveis efeitos e desafios da interferência de diferentes realidades ao trabalhar com psicodrama no espaço de uma plataforma virtual. A invasão da realidade externa no espaço individual e na realidade do ego auxiliar poderia influenciar a realidade online do grupo. O resultado pode ser uma mistura de diferentes tempos, espaços e realidades, bem como a chance de desbloquear um processo profundo, catalisando um trabalho pessoal para o protagonista.
RESUMEN ¿En el psicodrama online es posible llevar a cabo un proceso terapéutico completo, realizado por los factores terapéuticos: catarsis de acción, insight de acción, aprendizaje de acción, experiencia emocional correctiva y reintegración de la nueva experiencia; el aunque sea en psicodrama en la sala terapéutica? El foco se centra en los posibles efectos y desafíos de la interferencia de diferentes realidades cuando se trabaja con psicodrama en el espacio de una plataforma virtual. La invasión de la realidad externa en el espacio individual y la realidad del ego auxiliar podría influir en la realidad grupal online. El resultado puede ser una mezcla de diferentes tiempos, espacios y realidades, así como la posibilidad de desbloquear un proceso profundo, catalizando un trabajo personal para el protagonista.
ABSTRACT
Os serviços-escola de Psicologia são espaços vinculados à formação de futuros psicólogos. Oferecem à população atendimentos psicológicos a baixos custos e/ou gratuitos e, com isso, filas de espera e abandono do tratamento. Entende-se, assim, ser relevante o desenvolvimento de estratégias de acolhimento imediato dos interessados tais como grupos abertos e plantão psicológico. A partir desse contexto, objetivou-se compreender a visão de usuários em relação a um grupo aberto para adultos realizado em um serviço-escola de Psicologia de uma universidade pública. Trata-se de uma pesquisa qualitativa, empreendida por meio de entrevistas semi dirigidas, com indivíduos que tivessem frequentado o grupo por um período mínimo de dois meses. Os resultados foram analisados e categorizados a partir dos Fatores Terapêuticos propostos por Yalom e Leszcz. Percebeu-se, a despeito de não possuírem uma finalidade psicoterapêutica a priori, a presença de fatores terapêuticos em operação nos grupos abertos investigados, sinalizando a importância quanto ao desenvolvimento de intervenções psicológicas dessa natureza nos serviços-escola de Psicologia.
Psychology school services are spaces linked to the formation of future psychologists. They offer low-cost and/or free psychological care to the population, thereby waiting lines and treatment abandonment. Thus, it is understood to be relevant the development of strategies for immediate reception of stakeholders such as open groups and psychological duty. From this context, the objective was to understand the view of users in relation to an open group for adults held in a psychology school service of a public university. This is a qualitative research, conducted through semi-directed interviews with individuals who had attended the group for a minimum of two months. The results were analyzed and categorized from the Therapeutic Factors proposed by Yalom and Leszcz. Despite the lack of a priori psychotherapeutic purpose, the presence of therapeutic factors at work in the open groups investigated, indicating the importance of the development of psychological interventions of this nature in the Psychology school services.
Los servicios de escuela de psicología son espacios vinculados a la formación de futuros psicólogos. Se ofrece atención psicológica gratuita o de bajo costo a la población, lo que genera colas y abandono del tratamiento. Por lo tanto, se entiende que es relevante el desarrollo de estrategias para la recepción inmediata de las partes interesadas, como los grupos abiertos y la guardia psicológica. Desde este contexto, el objetivo era comprender la opinión de los usuarios de un grupo abierto a adultos en un servicio escolar de psicología de una universidad pública. Esta es una investigación cualitativa, realizada a través de entrevistas semi direccionadas con personas que habían asistido al grupo durante un mínimo de dos meses. Los resultados fueron analizados y categorizados a partir de los factores terapéuticos propuestos por Yalom y Leszcz. A pesar de la falta de un propósito psicoterapéutico a priori, se investigó la presencia de factores terapéuticos en funcionamiento en los grupos abiertos, lo que indica la importancia del desarrollo de intervenciones psicológicas de esta naturaleza en los servicio de escuela de psicología.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psychoanalytic Therapy , Psychology , Schools , Therapeutics , Training Support , Universities , Clinical Clerkship , After-Hours Care , User EmbracementABSTRACT
Os grupos de apoio psicológico se destacam como uma das modalidades assistenciais mais proveitosas diante da necessidade de oferecer suporte emocional a mães de bebês prematuros. O presente estudo teve por objetivo descrever a incidência do aconselhamento enquanto fator terapêutico em um grupo de apoio a mães de bebês prematuros internados na Unidade de Terapia Intensiva Neonatal (UTIN) de um hospital filantrópico. O corpus de pesquisa foi constituído pelos registros de 10 sessões do grupo, os quais foram submetidos a análises descritivo-exploratórias conduzidas independentemente por dois pesquisadores e, posteriormente, cotejadas quanto à identificação da ocorrência do aconselhamento e seus efeitos benéficos. O aconselhamento foi identificado ao menos uma vez em cada sessão, tendo emergido essencialmente em um contexto de oferecimento ativo de informações, sugestões e orientações. Observou-se que o aconselhamento derivou tanto de intervenções verbais do coordenador quanto de relatos das próprias participantes. Os resultados sugerem que as mães que frequentavam o grupo de apoio em questão valorizavam a troca de experiências, o que potencializava processos de mudança.
Psychological support groups stand out as one of the most beneficial care modalities in face of the need to offer emotional support to mothers of preterm infants. The objective of the present study was to describe the incidence of counseling as a therapeutic factor in a support group for mothers of premature infants admitted to the Neonatal Intensive Care Unit (NICU) of a philanthropic hospital. The corpus of the research was consisted by the records of 10 sessions of the group, which were submitted to descriptive-exploratory analyzes conducted independently by two researchers and, later, compared regarding the identification of the occurrence of and its beneficial effects. The counseling was identified at least once in each session, having emerged essentially in a context of actively offering information, suggestions and guidance. It was noted that counseling derived from verbal interventions by the coordinator and from participants reports. The results suggest that the mothers who attended the support group in question valued the exchange of experiences, which potentiated change processes.
Los grupos de apoyo psicológico se destacan como una de las modalidades asistenciales más provechosas ante la necesidad de ofrecer soporte emocional a madres de bebés prematuros. El presente estudio tuvo por objetivo describir la incidencia de la consejería como factor terapéutico en un grupo de apoyo a madres de bebés prematuros internados en la Unidad de Terapia Intensiva Neonatal (UTIN) de un hospital filantrópico. El corpus de investigación fue constituido por los registros de 10 sesiones del grupo, los cuales fueron sometidos a análisis descriptivo-exploratorias conducidas independientemente por dos investigadores y posteriormente cotejadas para la identificación de la ocurrencia de la consejería y sus efectos benéficos. La consejería fue identificada al menos una vez en cada sesión, emergiendo esencialmente en un contexto de ofrecimiento activo de informaciones, sugerencias y orientaciones. Se observó que la consejería derivó de intervenciones verbales del coordinador y de relatos de las participantes. Los resultados sugieren que las madres que frecuentaban el grupo de apoyo en cuestión valoraron el intercambio de experiencias, lo que potenciaba procesos de cambio.
Subject(s)
Infant, Newborn , Self-Help Groups , Infant, PrematureABSTRACT
Este estudo teve como objetivo identificar fatores terapêuticos em um grupo de apoio para pacientes com transtornos alimentares (anorexia e bulimia). O grupo de apoio psicológico é parte da estratégia de assistência oferecida por um serviço especializado em saúde. Duas sessões, com um total de 10 participantes, foram audiogravadas e transcritas na íntegra. A análise de conteúdo temática evidenciou que, ao reconhecerem na experiência alheia aspectos semelhantes aos seus próprios problemas, os participantes puderam se identificar uns com os outros e construir um espaço homogeneizado pela normalização das dificuldades. Além disso, os participantes mencionaram que o grupo promove esperança, conforto e bem-estar a partir do compartilhamento de experiências vitais. Desse modo, universalidade e instilação de esperança foram os principais fatores terapêuticos de apoio ativados nas sessões grupais, contribuindo para potencializar processos de mudança em uma perspectiva ampliada de saúde...
This study aimed to identify therapeutic factors in a support group for patients with eating disorders (anorexia and bulimia). Psychological support groups compose part of the strategy of assistance offered by a specialized health service. Two group sessions with 10 participants were audio recorded and transcribed in full. Thematic content analysis showed that, the participants recognized similar aspects of their own problems in the experience of others, and could identify with each other and construct a space homogenized by standardization of the difficulties. In addition, the participants mentioned that the group promotes hope, comfort and well-being through the sharing of life experiences. Thus, universality and instillation of hope were the main therapeutic factors activated in the group sessions, helping to improve the process of change in a broad perspective of health...
Subject(s)
Humans , Anorexia Nervosa , Bulimia Nervosa , Feeding and Eating Disorders , Psychotherapy, Group , Self-Help GroupsABSTRACT
Se revisa el papel de la hospitalización parcial dentro del marco de la continuidad asistencial de los servicios de salud mental. A partir del análisis de cuatro casos ejemplificadores de las diversas opciones terapéuticas de estos programas, se cuestionan algunos mitos en relación con esta modalidad y se subrayan las evidencias establecidas con respecto a ésta. Asimismo, se identifican sus principales funciones y los aspectos fundamentales e idiosincráticos que caracterizan a este tipo de recursos.
This paper reviews partial hospitalization in the context of the continuum of care of mental health services. This is accomplished through the analysis of four case examples that illustrate different modalities offered by these programs. Myths about this treatment modality are discussed in light of available evidence. The principal functions, in addition to the fundamental and unique features characteristic of partial hospitalization are identified and discussed.
ABSTRACT
OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.
Subject(s)
Humans , Male , Antipsychotic Agents , Follow-Up Studies , Inpatients , Outpatients , Rehabilitation , Retrospective Studies , SchizophreniaABSTRACT
OBJECTIVES: The long-term outpatient group psychotherapy with the chronically ill is an effective, expedient therapeutic modality that makes patients maintain medication and improve their symptoms, helps patients resolve emotional conflict, and corrects their maladaptive interpersonal relationship. Therefore, we performed weekly the semi-opened, heterogeneous, long-term(open-ended), outpatient group psychotherapy to be applicable effectively for the chronically ill. The objectives of this study are as follows; first, we introduce therapeutic principles and management methods of the group psychotherapy to be applicable in the clinical environment with the chronically ill; second, we examine the therapeutic factors in each group development stage which are helped by participants, and analyze the characteristics showed in the process of study; third, we verify the appropriateness and the validity of this group psychotherapy and then establish the base of the effective long-term outpatient therapy for the chronically ill that will be settled down as a applicable treatment modality economically and efficiently in the present medical environment of Korea. METHODS: This study was performed in the subject of the chronically ill who attended at the day care program of Community Mental Health Center in Hanam city from January 1998 to June 1999. The participants were 27 patients, but we dropped 7 patients who attended under 6 months because of long-term group. So the last subjects were 20 patients (12 males and 8 females) who attended for 18 months. The 13 therapeutic factors scale was filled out by participants just after each session and the self-report total assessment questionnaire was performed at the time of study-termination and patient-termiation. RESULTS: The ranks of 13 therapeutic factors scale are as follows: in the forming stage, the upper ranks of therapeutic factors were existential factor, guidance of therapists, instillation of hope, altruism, and catharsis in order. And in the storming stage, the upper ranks of therapeutic factors were existential factor, instillation of hope, guidance of therapists, catharsis, and group cohesiveness in order. Lastly in the norming stage, the upper ranks of therapeutic factors were existential factor, altruism, corrective recapitulation, interpersonal learning, and catharsis in order. According to the total assessment questionnaire about group psychotherapy reported by the participants 90% of them were helped, 80% of them had an idea to recommend this program to other patients actively, and 75% of them had an opinion to attend again this program if given for them. And they evaluated positively about the structure of this program and the therapist. CONCLUSIONS: The long-term outpatient group psychotherapy would be applicable effectively to the chronically ill as a economic, efficient therapeutic modality for rehabilitation. It is much more effective for therapist to perceive in detail the therapeutic factors in each group develop-ment stage when he perfoms the group psychotherapy.
Subject(s)
Humans , Male , Altruism , Catharsis , Chronic Disease , Day Care, Medical , Hope , Korea , Learning , Mental Health , Mentally Ill Persons , Outpatients , Psychotherapy, Group , Surveys and Questionnaires , RehabilitationABSTRACT
OBJECTIVES: This study is designed to develop a large group phychodrama for light delin-quent adolescents (hereinafter called as "Psychodrama") thereby determining therapeutic factors for dealing with them. METHODS: The study was conducted in the program of Seoul Metropolitan Youth Centre called "the class of love" during the period of July through December, 1998. The subjects consisted of a total of 827 young delinquents (759 boys and 68 girls, with the average age of 15.9 years old). To develop "this psychodrama", after we composed of therapeutic team centered by psychiatrists, we prepared from January to June, 1998 by practicing psychodrama with delinquent adolescents and by analyzing the results. "This psychodrama" has three basic steps: (1) warming-up (small group me-eting), (2) action (situation drama and main drama), (3) sharing. A survey of treatments, from a pool of participating adolescents, based on evaluation sheets and 13 therapeutic factors scale followed every session of this psychodrama. RESULTS: "This psychodrama" was helpful for 47.4%, interesting for 49.2%, not helpful for 12.1% and not interesting for 16%. In the whole group of subjects, the important therapeutic factors were existential factor, universality, identification with the therapist and the instillation of hope in the order of rank. When categorized in four different groups (audience, participants in situation drama, auxiliary egos, participants in sharing) the 4 groups displayed different results to one another. First, the therapeutic factors of audience were similar to that of the whole group. Second, participants in situation drama showed a higher catharsis than others. Third, auxiliary egos were leading in the guidance of members and therapists. Fourth, participants in sharing displayed higher group cohesiveness. CONCLUSION: As it is getting harder to find program's suitable for the treatment of increasing number of delinquents due to limited budget and experts, this psychodrama could be more cost-effective than any other measures.