Intervenções para comportamentos suicidas e autolesivos em adolescentes: revisão integrativa de literatura / Interventions for adolescents suicidal and self-injurious behaviors: integrative literature review

Os comportamentos suicidas e autolesivos representam uma preocupação crescente com a saúde dos adolescentes, dado o crescimento significativo do suicídio nessa faixa etária nas últimas décadas. Diante disso, realizou-se uma revisão integrativa de literatura, com o objetivo de investigar a estrutura de intervenções voltadas para comportamentos suicidas e autolesivos na adolescência. A busca rastreou artigos publicados entre 2015 e 2020, nas bases de dados PsycInfo, Cochrane Library e PubMed. Foram selecionados 30 artigos. Os resultados indicam que as estratégias de intervenção voltadas a comportamentos suicidas e autolesivos em adolescentes demandam o uso de uma diversidade de componentes, com a importância da inclusão de pais e/ ou familiares no tratamento. A Terapia Comportamental Dialética (DBT) e a Terapia Cognitivo-Comportamental (TCC) destacam-se como modelos de tratamento com eficácia potencial no tratamento de adolescentes. Identifica-se ampla área de pesquisa a ser desenvolvida, e o campo se beneficiaria do avanço na identificação de mediadores e moderadores de mudança.(AU)

Suicidal and self-injurious behaviors represent a growing concern for the health of adolescents, given the significant increase in suicide in this age group in recent decades. Therefore, an integrative literature review was carried out, with the objective of investigating the structure of interventions aimed at suicidal and self-injurious behaviors in adolescence. The search tracked articles published between 2015 and 2020, in the PsycInfo, Cochrane Library and PubMed databases. 30 articles were selected. The results indicate that intervention strategies aimed at suicidal and self-injurious behaviors in adolescents require the use of a variety of componentes, with the importance of including parents and/or family members in the treatment. Dialectical Behavioral Therapy (DBT) and Cognitive-Behavioral Therapy (CBT) stand out as treatment models with potential efficacy in the treatment of adolescents. A broad area of research to be developed is identified, and the field would benefit from advances in the identification of mediators and moderators of change.(AU)

Las conductas suicidas y autolesivas representan una preocupación creciente para la salud de los adolescentes, dado el aumento significativo de suicidios en este grupo de edad en las últimas décadas. Por lo tanto, se realizó una revisión integrativa de la literatura, con el objetivo de investigar la estructura de las intervenciones dirigidas a las conductas suicidas y autolesivas en la adolescencia. La búsqueda rastreó artículos publicados entre 2015 y 2020 en las bases de datos PsycInfo, Cochrane Library y PubMed. Se seleccionaron 30 artículos. Los resultados indican que las estrategias de intervención dirigidas a las conductas suicidas y autolesivas en adolescentes exigen el uso de una variedad de componentes, siendo importante la inclusión de los padres y/o familiares en el tratamiento. La Terapia Conductual Dialéctica (DBT) y la Terapia Cognitivo-Conductual (TCC) se destacan como modelos de tratamiento con potencial eficacia en el tratamiento de adolescentes. Se identifica un área amplia de investigación a desarrollar, y el campo se beneficiaría de los avances en la identificación de mediadores y moderadores del cambio.(AU)

Types of randomized clinical trials published in PubMed over 40 years / Tipos de ensayos clínicos con asignación aleatoria publicados en PubMed durante 40 años

Abstract Introduction: there are several variations of randomized clinical trials. Trials can be classi fied by design as parallel, cross-over, factorial, assignment by group, n-of-1, paired, withdrawal, adaptive and pragmatic; and by purpose as superiority, non-inferiority and equivalence. Given this heterogeneity, the Consolidated Standards of Reporting Trials (CONSORT) were introduced in 1996 to provide a guideline for reporting randomized clinical trials. Objective: to describe the publication tendency of the various types of randomized clinical trials over 40 years, with reference to the publication of CONSORT and its extensions. Methods: the PubMed tool was used to search for randomized clinical trials published between 1979 and 2018, classifying them according to the varieties described. Results: a total of 472,114 published articles were found; 90.2% did not report the type of design and 98.2% did not report the purpose. Among the articles that reported the variety of randomized clinical trial, the predominant design was cross-over (5.9%), followed by parallel groups (2.34%); while the most common purpose was superiority (0.84%). After the launch of CONSORT, there was an increased proportion of articles published with the following designs: parallel groups; difference in proportions 1.89 95% CI (1.1-2.7); paired 1.07 95% CI (0.2-1.9); and pragmatic 4.73 95% CI (4.4-5.1); and for the purpose of non-inferiority 5.97 95% CI (5.6-6.3). Discussion: most articles on randomized clinical trials do not mention their type in the title and abstract. The proportion of articles that did, increased slightly after CONSORT was published. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1884).

Resumen Introducción: existen múltiples variantes del ensayo clínico aleatorizado; según diseño: grupos paralelos, cruzado, factorial, asignación por grupos, N de 1, pareado, retiro, adaptativo y pragmático; y por propósito: superioridad, no inferioridad y equivalencia. Debido a esta heterogeneidad, en 1996 se introdujo el CONSORT (Consolidated Standards of Reporting Trials) para suministrar una guía para el reporte de los ensayos clínicos aleatorizados. Objetivo: describir la tendencia de publicación de los tipos de ensayos clínicos aleatorizados durante 40 años, en relación con la publicación del CONSORT y sus extensiones. Métodos: se utilizó la herramienta PubMed para realizar una búsqueda de ensayos clínicos aleatorizados publicados entre 1979 y 2018, discriminándolos según las variantes descritas. Resultados: se encontraron 472 114 artículos publicados, el 90.2% no reportó tipo de diseño y 98.2% no reportó propósito. Entre los artículos que reportaron la variante de ensayos clínicos aleatorizados, el diseño predominante fue el cruzado (5.9%), seguido por grupos paralelos (2.34%); mientras que el propósito más frecuente fue el de superioridad (0.84%). Hubo un aumento en la proporción de artículos por variante publicados después del lanzamiento del CONSORT para los diseños de: grupos paralelos; diferencia de proporciones 1.89 IC 95% (1.1-2.7); pareado 1.07 IC 95% (0.2-1.9); pragmático 4.73 IC 95% (4.4-5.1); y para el propósito de no inferioridad 5.97 IC 95% (5.6-6.3). Discusión: la mayoría de los artículos sobre ensayos clínicos aleatorizados no mencionan en su título y resumen la variante de estos. La proporción de artículos que sí lo hicieron, aumentó discre tamente después de la publicación del CONSORT. (Acta Med Colomb 2021; 46. DOI:https://doi.org/10.36104/amc.2021.1884).

Circular RNA CDR1as: A Novel Regulator of Malignant Tumors / 中国生物化学与分子生物学报

Circular RNA (circRNA) is a new type of non-coding RNA with closed circular structures that are widely distributed in various tissues Compared with traditional linear RNA, circRNA does not have 5′ and 3′ ends and will not be easily degraded by exonuclease It can stably exist in a variety of body fluids and is evolutionarily conserved It has become a key research object of clinical non-coding RNA Malignant tumors have the characteristics of late detection, rapid progression, and easy recurrence Currently, effective treatment methods are lacking, and their morbidity and mortality have been high Therefore, how to carry out early diagnosis, treatment intervention and prognosis evaluation is one of the research frontier of contemporary medical research CDR1as is the most widely studied circRNA It can regulate the expression of downstream genes through sponge microRNA (miRNA) or directly bind to RNA-binding proteins (RBPs) to activate related signaling pathways, thereby promoting or inhibiting tumor progression, and even affecting tumor chemotherapy sensitivity CDR1as mainly exists in the cytoplasm and can be released into the blood at the early stage of the disease Therefore, CDR1as may become a bi-omarker for early diagnosis of malignant tumors or an ideal target for therapeutic intervention Focusing on the characteristics and biological functions of circRNA, this article reviews the expression level, mechanism of action and related signaling pathways of CDR1as in the occurrence and development of malignant tumors At the same time, this article analyzes the current research status of CDR1as, preliminarily summarizes the problems it may face in clinical applications in the future, and puts forward ideas and suggestions on the future research direction of CDR1as

Proceso de tratamiento a víctimas del crimen organizado: Un estudio cualitativo centrado en la experiencia de psicólogos clínicos / Process of treatment to victims of organized crime: A qualitative study focused on the experience of clinical psychologists

Resumen El crimen organizado representa una de las más graves problemáticas a nivel mundial. No solo por el gran número de muertes violentas y lesiones entre los grupos rivales y en la población general, sino por las afectaciones en la salud mental de las personas que viven en ciudades con alta incidencia delictiva. Las víctimas directas o indirectas del crimen organizado suelen desarrollar diversos síntomas, dependiendo del tipo de delito y el grado de violencia (intensidad y duración) a la que fueron sometidas, así como del tipo de atención recibida después del ataque. Se presentan los hallazgos de un estudio cualitativo sobre el proceso de atención a víctimas del crimen organizado, desde la perspectiva de los psicólogos clínicos. El estudio fue realizado en el estado de Tamaulipas, al norte de México. Su propósito fue conocer las fases del proceso de atención y las estrategias clínicas utilizadas, las reacciones cognitivas, emocionales y sociales generadas en los terapeutas, las estrategias de autocuidado y las limitaciones contextuales. Participaron ocho psicólogos clínicos de diferentes enfoques terapéuticos. Se realizaron entrevistas individuales semiestructuradas y fueron analizadas con el software Atlas.ti 7, en base a la Teoría Fundamentada. Los resultados indican un proceso de atención con cuatro fases: previa, inicial, tratamiento y cierre. El terapeuta emplea estrategias clínicas específicas para cada fase del tratamiento y además desarrolla estrategias para su autocuidado emocional y protección, debido a las condiciones de violencia en el contexto local.

Abstract Organized crime represents one of the most serious problems worldwide. Not only because of the large number of violent deaths and injuries among rival groups and in the general population, but also because of the mental health effects of people living in cities with a high incidence of crime. The direct or indirect victims of crimes such as homicide, kidnapping, extortion, human trafficking, robbery with violence, rape, among others, often develop various symptoms depending on the type of offense, the degree (intensity and duration) of violence to which they were subjected, and the care (medical, psychological, legal) received after the attack. This paper presents the findings of a qualitative study on the process of care for victims of organized crime from the perspective of clinical psychologists. It was conducted in the state of Tamaulipas, in northern Mexico. The purpose of the study was to know the phases of the psychological care process and the clinical strategies used; the cognitive, emotional and social reactions generated in the therapists; the self-care strategies used by psychologists, and the contextual limitations for care. Eight clinical psychologists from different therapeutic approaches participated. Semi-structured interviews were conducted and analyzed with the Atlas.ti 7 software, based on Grounded Theory. The results indicate a process of attention with four phases: previous, initial, treatment and closure. In the previous phase, participants identify adult men and women as the main victims of organized crime who attend therapy. Direct victims come for crimes such as kidnapping and extortion. Indirect victims are usually close relatives of the direct victims and come for crimes such as homicide, forced disappearance and kidnapping. In the initial phase, psychologists use the therapeutic alliance, rapport, empathy and the promotion of attachment to treatment. Psychologists with private practice can perform specific actions such as attending the patient's home when the patient is afraid to leave. The most frequent diagnoses found in this phase are post-traumatic stress disorder, depressive disorders, and anxiety disorders. The treatment phase is characterized by the diversity of techniques used according to the therapeutic model adopted by each psychologist. The closing phase occurs when the patient has emotionally stabilized and therapists seek relapse prevention, so they follow up on cases. During the process of care for victims, therapists have different cognitive, emotional and social reactions; and develop strategies for their personal care, due to the conditions of violence that are experienced in the local context. The most used self-care strategies are to attend a personal therapeutic process, supervise the cases, exercise, eat well, express their emotions, go to natural environments to distract themselves and reduce the number of cases they attend. Among the limitations identified in the process of care for victims of organized crime, therapists mention the need for specialized training, including not only their professional training, but have a procedure or a specific protocol to deal with such cases.

O acompanhamento terapêutico como multiplicador de egos auxiliares / Therapeutic attendance as a multiplier of auxiliary ego / Acompañamiento terapéutico como multiplicador de egos auxiliares

O acompanhamento terapêutico (AT) é uma intervenção terapêutica que trabalha com o sujeito acompanhado em lócus variados - casa, trabalho etc. O ego auxiliar (EA) é um instrumento psicodramático de tratamento que ajuda a vincular, revelar situações e superar conflitos, por meio da interação entre as partes, buscando desenvolver relações mais saudáveis. Pretende-se aqui explanar sobre o AT com ênfase em sua função de EA e de multiplicador de EAs na comunidade. Para tal, será apresentada a descrição de dois casos de AT cujo processo facilitou o desenvolvimento de EAs na comunidade para que os acompanhados transitassem nesta de forma mais satisfatória. A presença de EAs na comunidade catalisou o processo de inclusão social dos acompanhados.

The therapeutic attendance (TA) is a therapeutic intervention that works with the patient in varied locations - home, work etc. The auxiliary ego (AE) is a psychodrama treatment instrument that helps to bond, reveal circumstances and overcome conflicts through the interaction between the parties, looking for developing healthier relationships. Our goal is to explain the TA focusing on its function of AE and multiplier of AEs in the community. To this end, a description of two cases of TA will be presented, which helped the development of AEs in the community so that those who were accompanied could pass through in a more satisfactory way. The presence of AEs in the community catalyzed the process of social inclusion of the accompanied ones.

El acompañamiento terapéutico (AT) es una intervención terapéutica que trabaja con el sujeto acompañado en locus variados - casa, trabajo etc. El ego auxiliar (EA) es un instrumento de tratamiento del psicodrama que ayuda a vincular, revelar circunstancias e superar conflictos, a través de la interacción entre las partes en la búsqueda del desarrollo de relaciones más saludables. Se pretende aquí explicar el AT con énfasis en la función de EA y de multiplicador de EAs en la comunidad. Para ello se presentará la descripción de dos casos de AT cuyo proceso facilitó el desarrollo de EAs en la comunidad para que los acompañados transitasen de forma más satisfactoria. La presencia de EAs en la comunidad catalizó una inclusión social de los acompañados.

Application of therapeutic intervention scoring system-28 to improve the scheduling model of emergency intensive care unit / 中国中西医结合急救杂志

Objective To investigate whether the nursing staff scheduling pattern of different shifts in Emergency Intensive Care Unit (EICU) of a third-grade first-class hospital in Guizhou Province could be rationally arranged by using the therapeutic intervention scoring system-28 (TISS-28). Methods The nursing workload of 129 patients in EICU was evaluated by TISS-28 from March to June 2017 in the Affiliated Hospital of Guizhou Medical University to look for the best nursing staff scheduling pattern. Results The TISS-28 was used to predict the workload of nurses on night shift and day shift. The TISS-28 scores of day shift and night shift were similar, and they were respectively 38.75±5.01 and 38.66±5.04 scores. There was no statistical significant difference in predicting the nurse-patient ratio between day shift and night shift by using TISS-28 (1 :0.83±0.22 vs. 1 :0.83±0.24, P > 0.05). The number of nursing staff was adjusted from originally 9 nurses during day shift and 5 nurses during night shift to 7 nurses during day shift and 7 nurses during night shift. Conclusions According to TISS-28 score to arrange the numbers of nurses on night shift and day shift is reasonable, the nurse workload of night shift can be reduced and their working enthusiasm improved, thus the degrees of satisfaction of nurses and patients are getting higher.

Efectividad de la reflexología podal en pacientes con artrosis cervical / Effectiveness of podal reflexology in patients with cervical osteoarthritis

Se realizó una intervención terapéutica en 118 pacientes con artrosis cervical, atendidos en el Servicio de Rehabilitación Integral del Hospital Clinicoquirúrgico Docente Dr Joaquín Castillo Duany de Santiago de Cuba, desde julio de 2013 hasta diciembre de 2014, para evaluar la efectividad de la reflexología podal como modalidad de tratamiento. La muestra fue dividida en 2 grupos (de estudio y control), de 54 integrantes cada uno, pareados por edad y sexo. En ambos grupos, el mayor número de afectados superó los 50 años de edad; asimismo, poco más de dos tercios de los individuos seleccionados mejoraron a los 7 días de evolución y en tan solo 3 sesiones de tratamiento, hasta la resolución definitiva a los 21 días (9 sesiones). Se registró una reacción adversa y se concluyó que esta terapia garantiza una mejoría significativa de los síntomas, de ahí su elevada efectividad, sin consumo excesivo de tiempo

A therapeutic intervention in 118 patients with cervical osteoarthritis was carried out. They were assisted in the Comprehensive Rehabilitation Service of Dr Joaquín Castillo Duany Teaching Clinical Surgical Hospital in Santiago de Cuba, from July, 2013 to December, 2014, to evaluate the effectiveness of podal reflexology as a treatment modality. The sample was divided in 2 groups (study group and control group), of 54 members each, paired by age and sex. In both groups, the highest number of affected patients were over 50 years; also, a little more than two thirds of the selected individuals improved at 7 days of the clinical course and with only 3 treatment sessions, until the definitive resolution at 21 days (9 sessions). An adverse effect was registered and it was concluded that this therapy guarantees a significant improvement of symptoms, so its high effectiveness, without excessive consumption of time

Application of TISS-28 in the management for ICU nursing / 中国医学装备

Objective:To explore the application value of therapeutic intervention scoring system-28(TISS-28) in the management for intensive care unit (ICU) nursing.Methods: 120 elderly patients who received cure in ICU were divided into observation group (60 cases) and control group (60 cases) according to treatment time. Patients of observation group received the nursing method of TISS-28, and patients of control group received traditional nursing method. The average work time of nursing, the satisfactory degree of patients for nursing work and the satisfactory degree of paramedics for the manpower management of nursing of the two groups were compared.Results: The average work time of nursing of observation group was significantly less than that of control group (t=16.886, P<0.05). The satisfactory degrees for nursing work included life care, health education, communication with family member and humanistic care of observation group were significantly higher than that of control group, respectively (x2=5.175,x2=4.183,x2=4.227,x2=5.175;P<0.05). The general satisfactory degree for nursing work of observation group was significantly higher than that of control group (x2=4.227,P<0.05). The satisfactory degrees of doctor and paramedic for the nursing manpower management of observation group were significantly higher than that of control group (x2=4.571,P<0.05).Conclusion: It is benefit for scientific management of nursing that TISS-28 is adopted to manage the nursing of ICU, and it can enhance work efficiency of nursing and quality of nursing, and improve the satisfactory degrees of patients for nursing work and paramedics for the personnel management.

Application of TISS-28 in the management for ICU nursing / 中国医学装备

Objective:To explore the application value of therapeutic intervention scoring system-28(TISS-28) in the management for intensive care unit (ICU) nursing.Methods: 120 elderly patients who received cure in ICU were divided into observation group (60 cases) and control group (60 cases) according to treatment time. Patients of observation group received the nursing method of TISS-28, and patients of control group received traditional nursing method. The average work time of nursing, the satisfactory degree of patients for nursing work and the satisfactory degree of paramedics for the manpower management of nursing of the two groups were compared.Results: The average work time of nursing of observation group was significantly less than that of control group (t=16.886, P<0.05). The satisfactory degrees for nursing work included life care, health education, communication with family member and humanistic care of observation group were significantly higher than that of control group, respectively (x2=5.175,x2=4.183,x2=4.227,x2=5.175;P<0.05). The general satisfactory degree for nursing work of observation group was significantly higher than that of control group (x2=4.227,P<0.05). The satisfactory degrees of doctor and paramedic for the nursing manpower management of observation group were significantly higher than that of control group (x2=4.571,P<0.05).Conclusion: It is benefit for scientific management of nursing that TISS-28 is adopted to manage the nursing of ICU, and it can enhance work efficiency of nursing and quality of nursing, and improve the satisfactory degrees of patients for nursing work and paramedics for the personnel management.

Value of APACHEⅡfor predicting the nursing workload in EICU / 中华危重病急救医学

Objective To investigate the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) for nursing workload in emergency intensive care unit (EICU).Methods A retrospective cohort study was conducted. Critical patients except for trauma admitted to EICU of West China Hospital of Sichuan University from June 2012 to July 2016 were enrolled. APACHE Ⅱ score and therapeutic intervention scoring system (TISS-28) score were calculated in each case. The relationship between APACHE Ⅱ score and TISS-28 score was analyzed by correlation analysis and curve estimation.Results A total of 1148 patients were enrolled, including 689 male (60.0%), and age of (56±19) years old, APACHE Ⅱ score was 19 (13, 25), and TISS score was 19 (13, 25). The Spearman correlation coefficient between APACHE Ⅱ score and TISS-28 score was 0.849 (P < 0.001), and that among the linear model quadratic model, composite model, growth model, logarithm model, cubic model and exponential modelR2 were 0.669, 0.710, 0.792, 0.764, 0.765, 0.765, respectively (allP < 0.01), and the most suitable description for relationship between APACHE Ⅱ score and TISS-28 score curve was cubic model. The nursing workload was significantly increased when APACHE Ⅱ score ≥30, and it was decreased when APACHE Ⅱ score < 30.Conclusion APACHE Ⅱ was a useful score for predicting the nursing workload in EICU.

Recent Updates of Therapeutic Intervention Programs for Caregivers of Patient with Dementia: Proposal of Hospital-Based Individual Therapy

Caring for people with dementia is associated with multiple devastating social, financial, physical, and psychological challenges. There is strong evidence that multicomponent tailored caregiver intervention is effective in improving caregiver well-being and delaying institutionalization. In US, the government is actively funding for developing caregiver program and to prove its efficacy through randomized controlled trials (RCTs) to translate into practice. Even with the introduction of Korean Long-term Care Plan, still, the most of the patients with dementia are being cared by the family members. The distress of caregiving is enormous, but structured therapeutic intervention program which efficacy is proven through RCT is very insufficient in Korea. The purpose of this article is to review the caregiver intervention programs of ongoing clinical trials comparing US and Korea, and to propose a tailored, therapeutic intervention program (I-CARE; A multicenter, randomized trial to assess efficacy of therapeutic intervention programs for decreasing caregiver burden in dementia caregiver) for hospital-care in Korea.

Trastornos del Espectro Autista en la Población Infanto Juvenil: diagnóstico, intervenciones y avances / Autism Spectrum Disorders in Children and Adolescents: diagnosis, interventions and advances

Dentro de la psiquiatría infantil, una de las patologías que genera más interrogantes y desafíos son los trastornos del espectro autista. El mundo de los niños y adolescentes con Trastorno del Espectro Autista (TEA) es todavía un enigma, distinto de los demás y con problemas en su comunicación y relaciones interpersonales de variada severidad. A través de los años, no solamente se ha podido avanzar en los factores etiológicos, patologías asociadas y definir el trastorno como espectro, más que un solo síndrome; sino que además han existido muchísimos avances sobre las intervenciones terapéuticas y sus niveles de evidencia en cuanto a su eficacia. En el presente trabajo se revisan brevemente factores etiológicos del trastorno del espectro autista, su definición y las intervenciones más utilizadas hoy en día, describiéndose las principales características y su nivel de evidencia.

In child and adolescent psychiatry, one of the most intriguing and challenging disorders is the autism spectrum disorder (ASD). The world of children and adolescents with autism spectrum disorder (ASD) is still an enigma, very different from the others and with hard problems in communicating and social interacting. Through the years, not only has there been more understanding of the etiology factors, diseases associated with the syndrome and the definition of a spectrum more than just one syndrome. There also have been many advances regarding therapeutic interventions and their level of evidence. In the current paper we briefly review the etiology factors of autism spectrum disorder, its current definition and the most utilized interventions, describing their characteristics and their level of evidence.

Intervenciones terapéuticas para la conducta suicida en adolescentes / Therapeutic interventions in suicidal behavior teens

La conducta suicida presenta un amplio espectro de comportamientos que constituyen un continuo. En la población adolescente en Chile, las ideas de muerte llegan a presentarse hasta en el 62% y se ha observado que los trastornos del ánimo, esquizofrenia, consumo de sustancias, están fuertemente asociados a la conducta suicida tanto en la evidencia internacional como nacional. La conducta suicida tiene una naturaleza compleja y multifactorial, influyendo sobre ella aspectos biológicos, psicológicos, psiquiátricos, familiares y socio-culturales, lo cual complejiza el diseño de una intervención terapéutica eficiente. Este artículo presenta una revisión actualizada de las intervenciones terapéuticas para adolescentes con conducta suicida. Se expone la principal evidencia y el nivel de efectividad de las estrategias de intervención.

Suicidal behavior has a wide spectrum of behaviors that constitute a continuum. In the adolescent population in Chile, the ideas of death occur in up to 62% of adolescents, and it has been observed that mood disorders, schizophrenia, and substance abuse are strongly associated with suicidal behavior in both international and national evidence. Suicidal behavior is of a complex and multifactorial nature, influenced by biological, psychological, psychiatric, familiar and socio-cultural aspects, which complicate the design of efficient therapeutic intervention. This article presents a current review of therapeutic interventions for adolescents with suicidal behavior. The main evidence and the level of effectiveness of intervention strategies are presented.

Intervenciones terapéuticas en depresión de niños y adolescentes / Therapeutic intervention in child and adolescent depression

La depresión en niños y adolescentes tiene en Chile una prevalencia de 5,1%(7). Su manejo debe considerar una perspectiva contextual, incorporando a los diferentes actores en el proceso terapéutico. Independiente del nivel de gravedad, es fundamental realizar psicoeducación y acompañamiento, frecuentemente se deben agregar psicoterapia, farmacoterapia o ambas. En prescolares, no están avalados los antidepresivos, siendo de primera línea de tratamiento la psicoterapia, debiendo incluir a los cuidadores principales. En escolares destaca la terapia cognitivo conductual (TCC) como efectiva, donde las intervenciones van dirigidas al niño y sus cuidadores. El uso de psicofármacos se evalúa individualmente, reservándose para casos graves o comórbidos, privilegiándose los ISRS que poseen mayor evidencia de eficacia y seguridad. En adolescentes aumenta la prevalencia de Depresión, para su manejo destacan la TCC individual y grupal, la Terapia psicoanalítica y la interpersonal. Los inhibidores selectivos de recaptación de la serotonina (ISRS) son de primera línea, considerando que su combinación con psicoterapia es más efectiva y segura que la farmacoterapia sola.

Child and adolescent depression in Chile has a prevalence of 5.1%. Its treatment must consider an environmental perspective, and it must include all the participants in the therapeutic process. It is always fundamental to psychoeducate and to give support, and it can be necessary to add psychotherapy, pharmacological therapy, or both. There is no evidence for the use of antidepressants in preschool age children, where the standard treatment is psychotherapy, which must include the main caregivers. Cognitive Behavioral Therapy is used in school age children, with its interventions directed to the child and his/her caregivers. The need for using drugs is assessed individually, and is preferred in severe cases or ones with comorbid diagnoses. The preferred group of drugs are the most effective and safe SSRIs. The prevalence of depression increases in adolescence, and in this age group there are several types of psychotherapy which can be used: individual or group Cognitive Behavioral Therapy, psychoanalytic therapy and interpersonal therapy. SSRIs are the standard treatment, and are considered most effective and safest when in combination with psychotherapy.

Current Perspective Of Therapies To Gliomas Expressing Hepatocyte Growth Factor

This paper present about Glioblastma multiforme (GBM) is the most common malignant brain tumor of the central nervous system (CNS), the purpose is to investigate the scatter factor/hepatocyte growth factor (SF/HGF) and other current perspective therapies involved in the therapeutic interventions of CNS tumours which would provide excellent tumor control and regression, and may improve the prognosis and quality of life of patients with neurological tumours.

Research on the nursing dynamic management according to TISS-28 in the elderly ICU / 中国实用护理杂志

Objective To measure the daily nursing workload by simplified therapeutic intervention scoring system and provide information for reasonable dynamic management of nursing manpower and improving nursing service satisfaction of patients in elderly ICU.Methods 113 patients in elderly ICU were selected from July 2012 to June 2013.The Therapeutic Intervention Scoring System 28(TISS-28) was used to measure the nursing workload,reasonably arranged the nursing staff according to the daily total nursing workload.The average daily working time and service satisfaction were compared before and after the application of dynamic management of nursing manpower.Results After the application of dynamic management of nursing manpower,the average daily working time of nurses decreased,satisfactory degree of patients with nursing service increased,and satisfactory degree of medical workers with nursing manpower management also increased.Conclusions Measurement of nursing workload by TISS-28 can provide the basis for the dynamic management of nursing manpower in elderly ICU and improve satisfaction degree of medical workers.

Reflexiones sobre la utilidad de la realidad virtual en la práctica fonoaudiológica / Considerations about the usefulness of virtual reality at the language -speech therapy practice

El presente artículo de reflexión refiere la importancia de adherir, de forma frecuente y suficiente, las nuevas Tecnologías de la Información y la Comunicación (TIC) a las prácticas fonoaudiológicas. Enfatiza en la conceptualización y uso de la Realidad Virtual (RV) en tanto se convierte en una herramienta tecnológica que, con seguridad, posibilitará avances importantes en la evaluación y la intervención fonoaudiológica con diferentes poblaciones. Se ubica el concepto de Tecnología de Rehabilitación y, como parte de este, el de Realidad Virtual; la cual se define como un sistema tecnológico, basado en el empleo de computadores y otros dispositivos, cuyo fin es producir una apariencia de realidad que permita al usuario tener la sensación de estar presente en ella. Tiene dos características importantes: la interacción y la inmersión. Se soporta la utilidad de la RV en los procesos de intervención terapéutica desde otras áreas del conocimiento como la Fisioterapia, la Terapia Ocupacional y la Psicología puesto que no existen evidencias de su utilidad en la práctica fonoaudiológica.

This document is a consideration about the importance of connecting, frequently and sufficiently, the new Information and Communication Technologies (ICT) with the language-speech therapy practices. It emphasizes in the conceptualization and useful of Virtual Reality (VR) since it is a technological tool that it will make significant advances in the language-speech therapy evaluation and intervention with several populations. It sets the concept of Rehabilitation Technology and, inside this, the concept of VR. The VR is a technological system that is supported by the use of computers and other devices. Its main target is to create produce a visual image of real with the similarities of the real world to the user and it lets his/her has a sensation that is on it. The VR has two principal features: the interaction and the immersion. The useful of VR at the therapeutic intervention in others knowledge areas such as Physical Therapy, Occupational Therapy and Psychology because it does not exist evidences about its practicality in the language-speech therapy practices.

Intervenções terapêuticas em pessoas com Síndrome de Asperger: revisão da literatura / Therapeutic interventions in people with Asperger’s Syndrome: a literature review

Este estudo teve por objetivo apresentar uma revisão da literatura científica nacional acerca daSíndrome de Asperger (SA), com ênfase nas intervenções terapêuticas desenvolvidas no contexto brasileiro. Foram recuperados dez artigos nas bases LILACS, SciELO e PePSIC, noperíodo de 2001 a 2011. A maior parte dos estudos é de caráter empírico. As intervenções são predominantemente apresentadas pela Fonoaudiologia, devido às características que a pessoaapresenta referentes aos prejuízos na interação e nas habilidades de comunicação. Desse modo geral, constatou-se que as intervenções terapêuticas aplicadas em pessoas com SA têm efeitos positivos e acarretam mudanças de comportamento e melhor qualidade de vida, além de serobservado que o trabalho terapêutico associado à intervenção com a família tende a garantir maiores benefícios a ambos.

This study aimed at reviewing of a Brazilian scientific literature about the Asperger's Syndrome (AS), with emphasis on therapeutic interventions developed in the Brazilian context. Ten articles published between 2001 and 2011 were recovered at LILACS, SciELO and PePSIC. Most of these studies are empirical. Interventions are predominantly made bySpeech-Language Therapy, due to the characteristics that the bearer has related to losses in interaction and communication skills. Overall, it was found that the therapeutic interventionsapplied to patients with AS have positive effects and cause changes in behavior and improved the quality life, and can be observed that the therapeutic work associated with the intervention in the family tends to ensure greater benefits to both.

Aspectos clínicos y rehabilitadores en pacientes con síndrome del túnel carpiano tratados con láser / Clinical and rehabilitation aspects in patients with carpal tunnel syndrome treated with laser

Se realizó una intervención terapéutica en 21 pacientes con síndrome del túnel carpiano, atendidos en los servicios de rehabilitación integral de los policlínicos 30 de Noviembre y Josué País García de Santiago de Cuba, desde junio de 2009 hasta igual mes de 2010, con vistas a describir aspectos clínicos de interés y la respuesta al tratamiento con láser blando semiconductor a 6 J/cm2. Las principales variables analizadas fueron: edad, sexo, demanda funcional, mano afectada, síntomas y signos e intensidad del dolor. Se aplicó la prueba de Ji al cuadrado (p<0,05) y se utilizó el porcentaje como medida de resumen. En la serie predominaron el sexo femenino y el grupo etario de 50-59 años. Luego de la terapia aplicada disminuyó el dolor y se logró la analgesia en 66,7 por ciento de los afectados; asimismo, la mejoría se obtuvo principalmente entre las 16 y 20 sesiones. Se concluyó que la fisioterapia es capaz de modificar evolutivamente parámetros clínicos en quienes presentan esta afección

A therapeutical intervention in 21 patients with carpal tunnel syndrome, assisted in the services of comprehensive rehabilitation of the polyclinics 30 de Noviembre and José País García in Santiago de Cuba was carried out from June, 2009 to the same month of 2010, aimed at describing clinical aspects of interest and the response to the treatment with semiconductor soft laser at 6 J/cm2. The main variables were analyzed: age, sex, functional demands, affected hand, symptoms and signs and intensity of pain. The chi-square test was applied (p <0.05) and the percentage was used as summary measure. In the series the female sex and the age group 50-59 years prevailed. After the applied therapy, the pain decreased and the analgesia was achieved in 66.7 percent of those affected; likewise, the improvement was mainly obtained between the 16 and 20 sessions. It was concluded that the physiotherapy can progressively modify clinical parameters in those who present this disorder

Research in measurement of nursing workload in ICU in municipal hospitals by using different / 中国实用护理杂志

Objective To measure the nursing workload in ICU,and provide the basis for the scientific distribution of human resources and reasonable scheduling in ICU.Methods ICU patients of the First and Third People's Hospital of Zigong from July to September,2011 were selected.The TISS-28 and NAS were applied to measure the nursing workload in the ICU.The number of staff nurses on each day and on each shift was recorded.Results The total nursing workload and the per capita nursing workload for each day in a week showed no significant difference,and the per capita nursing workload of different shifts and the needs of nurse-patient ratio of different patients in ICU were significantly different.Conclusions The allocation of nursing staff should be balance for each day in a week and different shifts for each day.The configuration of the nursing human resources should be based on actual nursing workload,no only considering the species of the diseases,the disease condition,self-care ability and cooperation of the patients,but also the proficiency of nurse skills.