ABSTRACT
ABSTRACT Objective: to report the use of virtual reality and its effects on clinical parameters, pain and its consequences in the treatment of two burned children in a Burn Treatment Center in southern Brazil. Method: case report on the use of virtual reality in two burned children treated at a reference burn treatment center in southern Brazil. Data were collected from January to February 2017, using the variables: pain, distraction, clinical parameters (heart rate and oxygen saturation) and analgesic medications. The measurements were carried out in five occasions and the intervention was applied for three days. The reports and reactions of children, guardians and the nursing team were also registered. Results: the use of virtual reality during dressings reduced the pain between two to four points on the scale used; oxygen saturation remained between 96 and 98%; heart rate decreased after the intervention. The children reported having fun, less time thinking about pain and were more collaborative during the procedure. Conclusion: this technology is innovative in the treatment of burned children and proved to be effective for the analyzed variables. New clinical studies with a larger sample are needed in the Brazilian context to contribute to these findings.
RESUMEN Objetivo: informar el uso de la realidad virtual y sus efectos bajo parámetros clínicos, dolor y sus consecuencias en el tratamiento de dos niños quemados en un Centro de Tratamiento de Quemaduras en el sur de Brasil. Método: informe de caso sobre el uso de la realidad virtual en dos niños quemados tratados en un centro de tratamiento de quemaduras de referencia en el sur de Brasil. Los datos se recopilaron de enero a febrero de 2017, a partir de las variables: dolor, distracción, parámetros clínicos (frecuencia cardíaca y saturación de oxígeno) y medicamentos analgésicos. Las mediciones se llevaron a cabo en cinco momentos y la intervención se aplicó durante tres días. También se anotaron los informes y las reacciones de los niños, tutores y el equipo de enfermería. Resultados: el uso de la realidad virtual durante el vendaje redujo el dolor entre dos y cuatro puntos en la escala utilizada; la saturación de oxígeno se mantuvo entre 96 y 98%; la frecuencia cardíaca disminuyó después de la intervención. Los niños informaron que se divirtieron, menos tiempo pensando en el dolor y fueron más colaborativos durante el procedimiento. Conclusión: esta tecnología es innovadora en el tratamiento de niños quemados y demostró ser efectiva para las variables analizadas. Se necesitan nuevos estudios clínicos con una muestra más grande en el contexto brasileño para contribuir a estos hallazgos.
RESUMO Objetivo: relatar a utilização da realidade virtual e os seus efeitos sob parâmetros clínicos, dor e suas consequências no tratamento de duas crianças queimadas em um Centro de Tratamento de Queimados do Sul do Brasil. Método: relato de caso sobre a utilização da realidade virtual em duas crianças queimadas atendidas em um centro de tratamento de queimaduras de referência do sul do Brasil. Os dados foram coletados de janeiro a fevereiro de 2017, a partir das variáveis: dor, distração, parâmetros clínicos (frequência cardíaca e saturação de oxigênio) e medicamentos analgésicos. As medidas foram realizadas em cinco momentos e a intervenção foi aplicada durante três dias. Foram anotados, também, os relatos e as reações das crianças, dos responsáveis e da equipe de enfermagem. Resultados: o uso da realidade virtual durante o curativo diminuiu a dor entre dois a quatro pontos da escala utilizada; a saturação de oxigênio manteve-se entre 96 a 98%; a frequência cardíaca obteve redução após a intervenção. As crianças relataram diversão, menor tempo pensando na dor e foram mais colaborativas durante o procedimento. Conclusão: esta tecnologia é inovadora no tratamento de crianças queimadas e mostrou-se eficaz para as variáveis analisadas. Novos estudos clínicos com uma amostragem maior são necessários no contexto brasileiro para contribuir com esses achados.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Pain , Pediatrics , Burns , Virtual Reality Exposure Therapy , Implosive TherapyABSTRACT
In urology technologies and surgical practices are constantly evolving and virtual reality (VR) simulation has become a significant supplement to existing urology methods in the training curricula of urologists. However, new developments in urology also require training and simulation for a wider application. In order to achieve this VR and simulation could play a central role. The purpose of this article is a review of the principal applications for VR and simulation in the field of urology education and to demonstrate the potential for the propagation of new progressive treatments. Two different cases are presented as examples: exposure therapy for paruresis and virtual cystoscopy for diagnosis and surgery of bladder cancer. The article uses research and publications listed in openly accessible directories and is organized into 3 sections: The first section covers features of VR and simulation technologies. The second one presents confirmed applications of current technologies in urology education and showcases example future applications in the domain of bladder treatment and surgery. The final section discusses the potential of the technology to improve health care quality.
Subject(s)
Curriculum , Cystoscopy , Diagnosis , Education , Implosive Therapy , Quality of Health Care , Urinary Bladder , Urinary Bladder Neoplasms , UrologyABSTRACT
Verificar o desenvolvimento manipulativo de bebês de diferentes idades por meio de uma intervenção motora. Participaram do estudo 15 bebês que frequentavam escolas de Educação Infantil da cidade de Porto Alegre. A intervenção foi constituída de atividades de manipulação de uma rica variedade de objetos cotidianos, escolhidos no intuito de oferecer diferentes estímulos ao bebê. As avaliações dos bebês foram realizadas no início e ao final do período interventivo através da Escala do Desenvolvimento do Comportamento da Criança no Primeiro Ano de Vida. Foi utilizado o Teste de Wilcoxon para comparações do período pré para o pós-intervenção e descritivamente foi analisado o desenvolvimento dos bebês conforme o seu trimestre de vida. Os resultados sugerem que os bebês tiveram desempenho superior do período pré-intervenção para o pós-intervenção. Intervenções motoras e sensoriais nos primeiros anos de vida proporcionam mudanças positivas no desenvolvimento global dos bebês...(AU)
To assess the manipulative's development of babies from different ages beyound a motor intervention. Participants were 15 infants who attended early childhood education in Porto Alegre. The intervention consisted of handling activities with rich variety of everyday objects, chosen in order to provide different stimuli to the baby. The Scale of Child Development and Behavior performed the evaluations of the infants at the beginning and intervention's end in his/her First Life's Year. It was used the Wilcoxon test for comparisons in the pre and post-intervention and it was analyzed descriptively the babies development as their three months of life. The results suggest that infants have outperformed the pre-intervention and post-intervention. Sensory and motor interventions in the first ages of life provide positive changes in the overall development of infants...(AU)
Subject(s)
Infant , Child Development , Early Intervention, Educational , Implosive Therapy , Physical Therapy Specialty , Clinical Trial , SchoolsABSTRACT
OBJECTIVES: The aim of this systematic literature review is to analyze the psychosocial interventions for children and adolescents after disasters. METHODS: We conducted a review of the extant research literature from 1991 to 2015 via a comprehensive search of the MEDLINE, EMBASE, Cochrane CENTRAL, PubMed and PsyclNFO databases. The keywords employed in this research included: ‘child’, ‘adolescent’, ‘youth’, ‘disaster’, ‘posttraumatic’, ‘psychosocial’, ‘therapy’ and ‘intervention’. The researchers followed the PRISMA guidelines. A total of 850 articles were screened for their eligibility and fifty-nine were found to meet the study criteria. The final data analysis was performed based on the disaster type, study design, type of intervention, sample size, age, school grade, number of sessions, setting of intervention delivery, providers, approach and parent involvement. RESULTS: Countries worldwide have experienced various kinds of disasters, including earthquakes, hurricanes, vessel accidents, tornados, tsunamis, volcanic eruptions, war, fire, terrorism, and traffic accidents. The types of psychosocial intervention that were conducted after these disasters included: psychological first aid, psychological debriefing, psychoeducation, trauma focused cognitive behavior therapy, eye movement desensitization reprocessing, prolonged exposure therapy, group play therapy and arts therapy, project interventions, school-based interventions and web-based interventions. CONCLUSION: The findings of the systematic literature review suggest that an appropriate psychosocial intervention could be utilized as evidence-based mental health treatment for children and adolescents after disasters.
Subject(s)
Adolescent , Child , Humans , Accidents, Traffic , Cognitive Behavioral Therapy , Cyclonic Storms , Disasters , Earthquakes , Eye Movement Desensitization Reprocessing , Fires , First Aid , Implosive Therapy , Mental Health , Parents , Play Therapy , Sample Size , Statistics as Topic , Terrorism , Tornadoes , Tsunamis , Volcanic EruptionsABSTRACT
A história de Lacan no campo de saber da psicanálise confunde-se com a construção do conceito de sujeito nesse campo, já que não foi Freud quem estabeleceu suas bases formais. Ao longo do ensino lacaniano, contudo, percebe-se o deslocamento do autor, que parte do centramento na linguagem e passa a caminhar em direção à preponderância do real, o que tem efeitos sobre a noção de sujeito. Aos poucos, fica evidente a dificuldade de Lacan de abranger toda a questão do inconsciente pela linguagem, o que faz com que o autor reconheça inequivocamente o lugar preponderante da pulsão na construção disso que se chama de sujeito de linguagem ou sujeito barrado.
Lacan's role in psychoanalytic field is very close to the construction of the concept of the subject in this field, since it was not Freud who established their formal foundations. Along the Lacanian school, however, we can see that the author moves from a position centered in language issues toward the preponderance of the real instance, path that has effects on the notion of subject. Gradually, it becomes clear the impossibility of covering the unconscious with the symbolic field, which makes the author clearly recognize the predominant role of drive in the construction of what we call the subject in psychoanalysis.
La historia de Lacan en el campo del psicoanálisis es entrelazada con la construcción del concepto de sujeto en este campo, ya que no fue Freud quien estableció sus bases formales. A lo largo del ensino lacaniano, podemos, sin embargo, percibir el desplazamiento del autor de la centralidad del lenguaje hacia la preponderancia de lo real, camino que tiene efectos sobre la noción de sujeto. Poco a poco, se pone de manifiesto la dificultad de Lacan de recubrir integralmente lo inconsciente con el lenguaje, lo que lo hacer e conocer el papel predominante de la pulsión en la construcción de lo que llamamos el sujeto en psicoanálisis.
L'histoire de Lacan dans le domaine de la psychanalyse est liée à la construction du concept de sujet dans ce domaine, car il n'était pas Freud qui a établi leurs bases formelles. On peut percevoir le déplacement de Lacan de la centralité de la langue et su marche vers la prépondérance du réel, ce qui a des effets sur la notion de sujet. Peu à peu, il devient clair la difficulté de Lacan de couvrir complètement l'inconscient avec la langage, cet qui rend l'auteur reconnaît le rôle de la pulsión dans la construction de le sujet barré.
Subject(s)
Humans , Male , Female , Psychoanalysis , Symbolism , Implosive Therapy , LanguageABSTRACT
A Psicoterapia Cognitivo-Comportamental (TCC) tem sido considerada a terapia de escolha para o tratamento do Transtorno de Estresse Agudo (TEA), sendo empregada como forma de prevenção ao Transtorno de Estresse Pós-Traumático (TEPT). No entanto, não há um consenso sobre as estratégias mais eficazes dentro desta abordagem. O presente artigo teve por objetivo identificar, por meio de uma revisão sistemática de estudos clínicos controlados, as estratégias que apresentam maior eficácia dentro da abordagem cognitivo-comportamental. Foram consultadas as bases de dados Scielo, LILACS, MedLine/PubMed, Web of Science e PsychInfo em Junho de 2012. Foram inicialmente identificados 1103 estudos. Após a adoção dos critérios de exclusão, cinco estudos foram incluídos no processo de revisão. A partir dos estudos encontrados e da análise destes, conclui-se que a terapia de exposição apresenta resultados promissores para tratamento do TEA. A revisão indicou ainda a necessidade de estudos com melhor qualidade metodológica e amostras mais abrangentes.
Cognitive Behavioral Therapy (CBT) has been considered the gold-standard treatment to Acute Stress Disorder (ASD), with its use in ASD course mainly focusing the prevention of the development of Post Traumatic Stress Disorder (PTSD). However, there is no consensus about effective strategies into CBT approaches for ASD treatment. Thus, this article aims to identify the most efficient strategies in the CBT approach. In order to attend this purpose, a systematic review was conducted, looking for randomized clinical trials addressing ASD treatment, on the following databases: Scielo, LILACS, MedLine / PubMed, Web of Science and PsychInfo in June 2012. Initially, 1103 studies were identified. After the adoption of the exclusion criteria, five studies were included in the review process. The results of the review point that exposure therapy have the most promising outcomes in ASD treatment. Furthermore, the review also indicates the need for studies with better methodological quality, as well as the use of broader samples.
Subject(s)
Humans , Cognitive Behavioral Therapy , Effectiveness , Implosive Therapy , Stress, PsychologicalABSTRACT
Post-traumatic stress disorder [PTSD] is considered as one of the most prevalent disorder during the life time and can negatively influence the individual, family and social relationships of patients; so, prevention and treatment of this disorder is highly important. Eye movement desensitization and reprocessing [EMDR], psychological debriefing [PD], and imaginal exposure [IE] are some treatment but there is controversy about long effects of these treatments, especially among chronic patients. In a semi experimental study, a total of 54 adult male patients, based on Davidson scale and psychiatric diagnostic, were randomly selected, and then were divided into 3 equal therapy groups. All participants were evaluated before, after and 3 months after the treatment. Data were analyzed through the repeated variance and Duncan post-hoc tests. Psychological debriefing and eye movement desensitization and reprocessing were better than imaginal exposure in relief of chronic post-traumatic stress disorder signs and remaining the effectiveness in three months follow-up. It is concluded that all of the above methods are effective on chronic post-traumatic stress disorder and the efficacy of the therapeutic techniques would be still in force even after 3 months. Considering the importance of psychological interventions, it is necessary that such methods be taught to psychologists so that they can use them after traumatic accidents
Subject(s)
Humans , Male , Adult , Stress Disorders, Post-Traumatic/prevention & control , Crisis Intervention , Eye Movement Desensitization Reprocessing , Implosive Therapy , Treatment OutcomeABSTRACT
OBJETIVO: Tem-se observado um aumento da prevalência de dependentes de crack em amostras clínicas, o que torna necessária a realização de pesquisas quanto a estratégias de tratamento direcionadas a essa clientela. O objetivo deste estudo foi descrever o caso de um dependente de crack internado no qual foram utilizados o tratamento de exposição a estímulos (TEE) e o treinamento de habilidades (TH) como coadjuvantes ao tratamento tradicional. DESCRIÇÃO DO CASO: O paciente é do sexo masculino, 29 anos de idade, solteiro, ensino médio completo. Era dependente de crack e de maconha e fazia uso nocivo de álcool. O paciente já estava internado havia 2 semanas e tinha passado por um protocolo de quatro sessões com entrevista motivacional e prevenção à recaída. Foram feitas seis sessões, ao longo de 2 semanas, de TEE e TH, nas quais o paciente foi exposto in vivo e pela imaginação a estímulos evocadores de fissura, como cachimbo de crack, isqueiro, pedras simuladas, lembranças de locais e amigos associados ao uso da droga. Ele também foi treinado para utilizar estratégias de manejo da fissura. Após 3 meses da alta hospitalar, foi realizado screening toxicológico para avaliar a manutenção de abstinência. O paciente avaliou o uso das técnicas como importante para a manutenção da abstinência após 3 meses da alta e para sua baixa média de fissura pelo crack. COMENTÁRIOS: Talvez o TEE e o TH para manejo da fissura possam ser úteis como coadjuvantes no tratamento de dependentes de crack. Tal uso deve ser avaliado em ensaios clínicos para demonstrar seu real benefício (AU)
OBJECTIVE: An increased prevalence of crack cocaine users has been observed in clinical samples over the past years, underscoring the need for conducting research and developing treatment strategies aimed at this population. The objective of this study was to describe the case of a crack cocaine addict (inpatient) submitted to cue exposure treatment (CET) and coping skills training (CS) as adjuvant approaches to the conventional addiction treatment. CASE DESCRIPTION: A male patient, 29 years old, single, with complete high school, was dependent on crack cocaine and marijuana and also had a diagnosis of harmful alcohol use. The patient had been hospitalized for 2 weeks and had undertaken a protocol comprising four motivational interview and relapse prevention sessions. Six sessions of CET and CS were carried out over 2 weeks, including both in vivo and imaginal exposure to stimuli evoking craving for crack cocaine, such as a crack pipe, a lighter, and simulated crack cocaine rocks (in vivo exposure), or remembering places and friends associated with drug use (imaginal exposure). The patient was also trained to use strategies for the management of craving. Three months after hospital discharge, toxicological screening was performed to assess abstinence. CET and CS were considered by the patient to be important techniques for the maintenance of abstinence and of a low level of craving 3 months after discharge. COMMENTS: These findings suggest that the two techniques may be useful as adjuvant therapies in the treatment of crack cocaine dependents. CET and CS should be assessed in clinical trials in order to demonstrate their real benefits (AU)
Subject(s)
Humans , Male , Adult , Crack Cocaine , Cocaine-Related Disorders/therapy , Craving , Implosive Therapy , Adaptation, Psychological , Cocaine-Related Disorders/psychology , CuesABSTRACT
OBJECTIVE: Smoking related cues may elicit smoking urges and psychophysiological responses in subjects with nicotine dependence. This study aimed to investigate the effect of repeated virtual cue exposure therapy using the surround-screen based projection wall system on the psychophysiological responses in nicotine dependence. METHODS: The authors developed 3-dimensional neutral and smoking-related environments using virtual reality (VR) technology. Smoking-related environment was a virtual bar, which comprised both object-related and social situation cues. Ten subjects with nicotine dependence participated in 4-week (one session per week) virtual cue exposure therapy. Psychophysiological responses [electromyography (EMG), skin conductance (SC), and heart rate] and subjective nicotine craving were acquired during each session. RESULTS: VR nicotine cue elicited greater psychophysiological responses and subjective craving for smoking than did neutral cue, and exposure to social situation cues showed greater psychophysiological responses in SC and EMG than did object-related cues. This responsiveness decreased during the course of repeated therapy. CONCLUSION: The present study found that both psychophysiological responses and subjective nicotine craving were greater to nicotine cue exposure via projection wall VR system than to neutral cues and that enhanced cue reactivity decreased gradually over the course of repeated exposure therapy. These results suggest that VR cue exposure therapy combined with psychophysiological response monitoring may be an alternative treatment modality for smoking cessation, although the current findings are preliminary.
Subject(s)
Cues , Heart , Implosive Therapy , Nicotine , Skin , Smoke , Smoking , Smoking Cessation , Tobacco Use DisorderABSTRACT
Este trabalho revisa a literatura acerca do transtorno do estresse pós-traumático, acometendo pacientes vítimas de sequelas de queimaduras. São enfocadas definições, critérios para diagnóstico, epidemiologia, patofisiologia, psicopatologias pré-mórbidas em pacientes adultos queimados, aspectos psicológicos da queimadura, aspectos clínicos e tratamento.
This paper revises the literature about the posttraumatic stress disorder in the burn patients with functional, esthetics and psychological modifications. Its relates the definition, diagnostic judgements, epidemiology, pathophysiology, premorbid psychopathology in the patients with functional, esthetics and psychological modifications, psychological aspects of the burn, clinical aspects and treatment.
Subject(s)
Humans , Stress Disorders, Post-Traumatic , Burns/complications , Burns/psychology , Family Relations/psychology , Implosive Therapy/instrumentationABSTRACT
A number of recent case reports and series indicate that obsessive compulsive disorder (OCD) can develop after traumatic experience as a comorbid conditon to post-traumatic stress disorder (PTSD). These descriptive studies consistently addressed that those patients respond poorly to treatments and had an unfavorable outcome. However, this conclusion was not supported by prospective follow up with objective measurement of symptomatology. This report presents three single trauma-related PTSD patients who developed full-blown OCD concurrently with or after the initiation of PTSD. These patients represent 10% of new PTSD outpatients at a PTSD clinic during one year period and 25% of PTSD patients who had been admitted. In all three cases compulsion seemed to distract or serve as avoidance to intrusive symptoms of PTSD. Despite Eye Movement Desensitization and Reprocessing (EMDR) and/or exposure therapy for PTSD together with at least two antidepressant trials for PTSD and OCD, at six month follow-up PTSD partially improved and OCD remained unchanged. This finding is consistent with previous reports from western literature.
Subject(s)
Humans , Eye Movements , Follow-Up Studies , Implosive Therapy , Obsessive-Compulsive Disorder , Outpatients , Stress Disorders, Post-TraumaticABSTRACT
OBJECTIVE: To identify the etiologic agent responsible for a disease outbreak following an overflow of sewage water in Valle de Chalco, Mexico. MATERIAL AND METHODS: A retrospective cross-sectional study was carried out. Rectal samples were collected from the population of Chalco valley, who suffered from diarrhea and vomiting during a natural disaster that took place on May 31, 2000. The Instituto de Diagnóstico y Referencia Epidemiológicos (Epidemic Reference and Diagnosis Institute, InDRE, Ministry of Health), received 1521 rectal swab samples from diarrhea cases, to test for E. coli strains. Statistical analysis was performed to find a difference of proportions between cases and non-cases (chi-squared test). ETEC, EIEC, EPEC and EHEC pathogenic E. coli groups were hybridized by colony blot. RESULTS: Strains isolated were ETEC (62.2), EIEC (0.84), EPEC (0.84), and EHEC non-O157:H7 (0.08); there was no hybridization in 36.02 of E. coli strains. Other isolated microorganisms were Salmonella spp (0.45) and Shigella spp (0.06). CONCLUSIONS: Enterotoxigenic E. coli was the most likely etiologic agent. Sanitary control strategies should be targeted to preventing outbreaks caused by this pathogenic agent.