Orientaciones filosóficas en la intervención fonoaudiológica de voz. El desafío actual de dar el alta / Philosophical orientations in voice therapy. The current challenge of discharge

El presente artículo corresponde a una reflexión sobre las orientaciones filosóficas en la terapia vocal actual. Cuando existe alguna alteración o trastorno vocal, se habla comunmente de un desequilibrio entre los subsistemas involucrados en el proceso fonatorio, es decir, fuelle (sistema respiratorio), fuente (pliegues vocales) y filtro (tracto vocal). Si no hay un correcto balance, entonces el sistema no tiene un correcto funcionamiento y pueden aparecer síntomas como ronquera, sensación de cuerpo extraño, prurito, fatiga vocal o bien disfonía o incluso afonía. Como con-secuencia de estas dificultades, se generan compensaciones que durante el proceso de la intervención fonoaudiológica el profesional debe volver a "equilibrar". Para lograr este objetivo, se desarrollan y analizan las diversas herramientas que entregan las filosofías de pensamiento a lo largo de la historia de la rehabilitación vocal, don-de se encuentran la orientación higiénica, psicológica, sintomatológica, fisiológica y ecléctica. En este mismo sentido, el profesional debe buscar lo que percibe como más idóneo para cada paciente o grupo a intervenir, centrado en mejorar la calidad vocal y las necesidades actuales de estos, basándose en el contexto mundial actual, con el objetivo de lograr un buen proceso de entrenamiento o rehabilitación y final-mente lograr el alta.

The present article corresponds to a reflection about the philosophical orientations in the current vocal therapy. When there are some vocal alterations or disorders, we usually talk about an imbalance between the sub-sysmtems involved in the fonatory process, which are bellows (respiratory system), source (vocal folds) and filter (vocal tract). When there is not a correct balance, the system does not work properly and as a consequence, it is possible to experiment symptoms such as hoarseness, foreign body sensation, pruritus, vocal fatigue, dysphonia or even aphonia. As a result of these difficulties, it is possible to generate compensations through the intervention of speech therapy. By virtue of this therapy the professional must 'balance'. In order to achieve this, it is necessary to develop and analyze the different tools that philoso-phical studies offer through the history of vocal rehabilitation. Some of these tools are hygienic orientation, psychological, symptomatological, physiological and eclec-tic. Thinking on that, the professional must search what it is most suitable for every patient or group of people that he/she will be working with. This must be focus on improving vocal quality and the actual necessities of the patient, based on the current global context. The final purpose of the professional is to achieve a good and healthy process of training and/or rehabilitation to accomplish medical discharge.

Pavilhão Mourisco no contexto do ecletismo carioca / The Moorish Pavilion in the context of eclecticism in Rio de Janeiro

Resumo O artigo conta a história do projeto do Pavilhão Mourisco, edifício-sede da Fundação Oswaldo Cruz, no Rio de Janeiro, suas influências e construção. Terminado em fins de 1918, celebrará, em 2021, 40 anos de sua preservação pelo Instituto do Patrimônio Histórico Nacional, como uma das construções mais representativas do período eclético da arquitetura brasileira. Projetado pelo português Luiz Moraes Jr., sua configuração recebeu influências estéticas, formais, espaciais e funcionais das mais diferentes origens, o que consolidou seu reconhecimento oficial como patrimônio cultural brasileiro. O texto também analisa o contexto urbano em que se deu sua implantação na cidade do Rio de Janeiro e ressalta o momento de revisão historiográfica da arquitetura que contribuiu para o processo de seu reconhecimento enquanto valor cultural e científico.

Abstract The article tells the history of the design of the Moorish Pavilion, headquarters of Fundação Oswaldo Cruz (Fiocruz), completed in 1918. The year 2021 marks the fortieth anniversary since its listing by the Brazilian heritage protection agency, Instituto do Patrimônio Histórico Nacional, as one of the most representative examples of eclectic architecture in Brazil. Designed by the Portuguese architect Luiz Moraes Jr., its aesthetic, formal, spatial, and functional features derive from multiple influences, which consolidated its recognition as Brazilian cultural heritage. The urban setting in which it was built, in Rio de Janeiro, is also analyzed, and the revision of the historiography of Brazilian architecture, instrumental in the recognition of its cultural and scientific value, is appraised.

Eclectic approach to anxiety disorders among rural children / Abordagem eclética a transtornos de ansiedade em crianças de zona rural

Abstract Introduction Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study. Methods 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21). Results Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes. Conclusion Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.

Resumo Introdução Transtornos de ansiedade em escolares afetam sua saúde mental e seu desenvolvimento psicológico. Tratamentos alternativos disponíveis consomem tempo e são dispendiosos. Nesse contexto, a terapia eclética é uma abordagem terapêutica que incorpora algumas técnicas e filosofias terapêuticas para criar o tratamento ideal. Neste estudo, terapia eclética consistiu de terapia artística e terapia cognitivo-comportamental (TCC) planejada para escolares com altos níveis de ansiedade. A terapia também incluiu sessões de orientação em grupo para as mães. A eficácia da intervenção foi examinada. Métodos 61 escolares com idade de 9-12 anos e altos níveis de ansiedade participaram do estudo. A intervenção A (n = 20) consistiu de 9 horas de terapia eclética para crianças com sessões de 3 horas de orientação em grupo para as mães. A intervenção B (n = 20) consistiu de 9 horas de terapia eclética para crianças. Houve também um grupo controle (n = 21). Resultados Escores atribuídos pelos professores às dificuldades de saúde mental das crianças e escores de ansiedade autoaplicados indicaram diferenças significativas entre resultados pré-teste e pós-teste, revelando grande tamanho de efeito entre as duas intervenções. Escores pré-teste maiores foram preditores significativos de escores pós-teste mais altos para todos os domínios de ansiedade e dificuldades de saúde mental. Idade, gênero, mães trabalhando 15 horas/dia, nível educacional da mãe, índice de divórcio, morte de um dos pais e renda familiar mensal foram preditores de desfechos da terapia. Conclusão Os resultados sugerem a eficácia de arte eclética e TCC para melhorar a saúde mental de crianças e reduzir a ansiedade através de mudança em pensamentos, crenças, emoções e comportamentos que possam causar medo e ansiedade.

History of the Schools of Kampo Medicine / 日本東洋医学雑誌

The form of modern Kampo Medicine is made after the influence of the schools at past time. This medicine was at first imitation of TCM in China and slowly had acquired the own Japanese form. At 16 century, Dosan Manase introduced the system of TCM from Ming-China to Japan successfully and made a great school called Goei-School. Late stage of 17 century, the influence of “Shang han Lun” research boom in China came to Japan and the new school called Koho-school which was based on this Classic has established. Especially Todo Yoshimasu researched the prescriptions in this book and invented new system named “Ho sho so tai”. After then, doctors had to compromise the thinking of both school. The form of eclectic school was so various that the doctors made individual medicines. After the Meiji Restoration, Kampo Medicine was out of political system but soon obtained revival. The several great doctors of Kampo Medicine have written “Practice of Kampo Medicine” at 1941 which made the base of the modern Kampo Medicine. Current Kampo Medicine adopted a lot of modern medical researches and there are new schools which are different from the past time.