A invenção de um setting on-line para atendimento psicológico remoto / The invention of an online environment for remote psychological care / La invención de un entorno en línea para la atención psicológica remota

Com o advento da covid-19, foi declarado estado de emergência de saúde pública e decretadas medidas de isolamento e distanciamento social para conter a propagação da doença. O Conselho Federal de Psicologia, considerando a importância do acolhimento seguro durante a pandemia, publicou a Resolução CFP nº 4/2020, permitindo que serviços psicológicos aconteçam de maneira remota. O presente estudo visa, através do Método da Cartografia, apresentar a construção de um setting on-line para intervenções grupais e os desafios na oferta de acolhimento e atendimento remoto. Foram ofertados grupos terapêuticos, por meio da plataforma Google Meet, para estudantes da Universidade Federal Rural do Rio de Janeiro. Um diário de bordo foi produzido para acompanhar as forças que atravessavam e constituíam o território e a experiência grupal remota. Compreendemos que o território-espaço-grupal-on-line era composto pelo espaço virtual em que nos reuníamos, pelos espaços individuais de cada integrante e pelas forças que os atravessavam. Observamos que nem sempre os participantes dispunham de um lugar privado, mas estiveram presentes no encontro com câmeras e áudios abertos e/ou fechados e/ou através do chat da videochamada. A participação no grupo funcionou como alternativa no momento de distanciamento social, sendo uma possibilidade para o atendimento psicológico em situações de dificuldade de encontros presenciais; entretanto, se mostrou dificultada em diversos momentos, pela falta de equipamentos adequados e instabilidade na internet, fatores que interferiram nas reuniões e impactaram na possibilidade de falar e escutar o que era desejado.(AU)

With the advent of COVID-19, a state of public health was declared, and measures of isolation and social distance to contain the spread of the disease was decreed. The Federal Council of Psychology, considering the importance of safe reception during the pandemic, published CFP Resolution No. 4/2020, allowing psychological services to happen remotely. This study narrates, via the Cartography Method, the experience of inventing an Online Setting for group reception. Therapeutic groups were offered, via Google Meet Platform, to students at the Federal Rural University of Rio de Janeiro. A logbook was produced to accompany the forces that crossed and constituted the territory and the remote group experience. We understand that the territoryspace-group-online was composed by the virtual-space that we gathered, by the individualspaces of each member and by the forces that crossed them. We observed that the participants did not always have a private place, but they were present at the meeting with open and/or closed cameras and audio and/or through the video call chat. Participation in the group worked as an alternative at the time of social distancing, being a possibility for psychological care in situations of difficulty in face-to-face meetings, however, it proved to be difficult at various times, due to the lack of adequate equipment and instability on the internet, factors that interfered in meetings and impacted the possibility of speaking and listening to what was desired.(AU)

La llegada de la COVID-19 produjo un estado de emergencia de salud pública, en el que se decretaron medidas de confinamiento y distanciamiento físico para contener la propagación de la enfermedad. El Consejo Federal de Psicología, considerando la importancia de la acogida segura durante la pandemia, publicó la Resolución CFP nº 4/2020, por la que se permite la atención psicológica remota. Este estudio tiene por objetivo presentar, mediante el método de la Cartografía, la elaboración de un escenario en línea para la intervención grupal y los desafíos en la oferta de acogida y atención remota. Grupos terapéuticos se ofrecieron, en la plataforma Google Meet, a estudiantes de la Universidad Federal Rural de Río de Janeiro. Se elaboró un diario para acompañar a las fuerzas que atravesaron y constituyeron el territorio y la experiencia remota del grupo. Entendemos que el territorio-espacio-grupo-en línea estaba compuesto por el espacio-virtual que reunimos, por los espacios individuales de cada integrante y por las fuerzas que los atravesaban. Observamos que los participantes no siempre tenían un lugar privado y que estaban presentes en la reunión con cámaras y audio abiertos y/o cerrados y/o por el chat de la videollamada. La participación en el grupo funcionó como una alternativa en el momento del distanciamiento físico y revela ser una posibilidad de atención psicológica en situaciones de dificultad en los encuentros presenciales, sin embargo, se mostró difícil en varios momentos, ya sea por la falta de medios adecuados o por inestabilidad en Internet, factores que interferían en las reuniones e impactaban en la posibilidad de hablar y escuchar lo que se deseaba.(AU)

Psicoterapia com idosos: percepção de profissionais de psicologia em um ambulatório do SUS / Psychotherapy with older adults: perception of psychologists at an outpatient service of the brazilian unified health system / Psicoterapia con ancianos: percepción de profesionales de psicología en un dispensario del SUS

A busca dos idosos por serviços de saúde tem aumentado exponencialmente devido ao crescimento populacional e às mudanças no perfil epidemiológico. Em função das especificidades dessa fase da vida, compõem um público que requer cuidado especializado. Assim como em outras faixas etárias, os idosos estão expostos a problemáticas emocionais com que por vezes não conseguem lidar sozinhos e necessitam de acompanhamento psicológico, que pode ser prestado por meio de ambulatórios em serviços do Sistema Único de Saúde (SUS). No campo da Psicologia, a psicoterapia com idosos ainda é um tema pouco discutido, o que designa ao profissional desafios práticos. Frente a essas questões, neste trabalho investiga-se sua atuação na psicoterapia com idosos. Trata-se de uma pesquisa qualitativa em que foram realizadas entrevistas semiestruturadas com sete profissionais de Psicologia que atuam em um ambulatório público de um hospital-escola em Pernambuco. Utilizou-se a análise de conteúdo de Minayo para empreender a análise das entrevistas. Foram discutidas as principais demandas que chegam aos profissionais no contexto pesquisado, bem como o manejo delas. Verificou-se que os estereótipos envolvendo a pessoa idosa interferem na condução do processo terapêutico, principalmente de forma negativa. Ficou evidente o grande número de idosos com sintomas depressivos que buscam acompanhamento psicológico. A pesquisa abriu a possibilidade de discutir sobre o alcance da atuação profissional, as limitações e as possibilidades de avanço, além de ter evidenciado a necessidade de preparo, na área da Psicologia clínica, para manejar as questões referentes ao envelhecimento.(AU)

As a result of population growth and epidemiological transition, the demand for health services among older adults is exponentially increasing, for this age group requires specialized care due to the specificities of this stage of life. As in other age groups, older adults are often exposed to emotional disorders that cannot be handled by themselves, thus requiring psychological counseling - a service that can be offered by the outpatient care service in the Brazilian Unified Health System (SUS). Yet, discussions addressing psychotherapy with older adults are still rather scarce within the field of Psychology, which imposes practical challenges to the professionals. Thus, this qualitative research sought to understand the predominant demands of older adults in an Outpatient Clinic at a teaching hospital in Pernambuco, as well as the professional management and performance in psychotherapy with geriatric population. Data were collected by means of a semi-structured interview conducted with seven psychologists and analyzed in the light of Minayo's content analysis. The results indicate that some age-related stereotypes can interfere negatively with the therapeutic process, with a considerable number of older individuals presenting depressive symptoms who have searched for psychological counseling. This study advanced knowledge on the extent of professional performance, limitations, and potential progress, besides highlighting the need for training regarding the management of aging issues within the field of Clinical Psychology.(AU)

Los ancianos que buscan servicios de salud se vienen aumentando debido al aumento de la población y los cambios en el perfil epidemiológico. Con las especificaciones de esta fase de la vida, componen un público que requieren cuidado especializado. Así como en individuos de otras edades, los ancianos están sujetos a problemáticas emocionales que muchas veces no consiguen resolver solos y necesitan de acompañamiento psicológico, que es ofrecido por los dispensarios del Sistema Único de Salud (SUS). La psicoterapia en ancianos todavía es un tema poco discutido en el campo de la Psicología, por lo que constituye un reto práctico a estos profesionales. Esta investigación pretende comprender la actuación de estos profesionales en la psicoterapia con ancianos. Esta es una investigación cualitativa realizada con entrevistas semiestructuradas a siete profesionales de Psicología que actúan en el dispensario público de un Hospital-Escuela en Pernambuco (Brasil). Se utilizó el análisis de contenido de Minayo para el análisis de las entrevistas. Se discutieron las principales cuestiones que llegan a los profesionales en el contexto investigado, así como su manejo. Se observó que los estereotipos hacia la persona anciana interfieren, principalmente de forma negativa, en la conducción del proceso terapéutico. Resulta evidente el gran número de ancianos con síntomas depresivos que buscan tratamiento psicológico. La investigación plantea la discusión sobre el alcance de la actuación profesional, las limitaciones, las posibilidades de avanzo y evidencia la necesidad de preparación en el área de la Psicología clínica para manejar las cuestiones referentes al envejecimiento.(AU)

A literature review on the facilitators and barriers to the uptake of interprofessional collaboration in the field of assistive technology within rehabilitation medicine

@#Assistive technology (AT) enables an optimized life for persons with disability through the scaffolding of functional capabilities. However, AT provision faces challenges such as long approval processes, funding inadequacies, and difficulties integrating evidence into practice. A means to address these issues is through interprofessional collaboration (IPC), the process by which health professionals efficiently coordinate and work with each other towards a common goal to maximize limited resources. To promote its effective implementation, there is a need to know the facilitators and barriers that affect its implementation. Thus, this paper aims to review the facilitators and barriers to the uptake of IPC in the field of AT within rehabilitation medicine identified by existing literature. This literature review followed the steps outlined by The Model Systems Knowledge Translation Center. Articles published between January 2000 until September 2019 were retrieved from four electronic databases (Cochrane Library, PubMed, Scopus, Science Direct). Three studies were included in the study. Facilitators identified were: (1) optimal work culture, (2) professional competence, and (3) associating with team members. Barriers to effective IPC in the field of AT were identified as: (1) presence of professional silos, (2) lack of unified language, and (3) gaps in bureaucratic support. The mechanisms and factors in implementing interprofessional collaboration identified by the World Health Organization are vital in the field of AT. However, the barriers identified above need to be addressed to promote the uptake of IPC within this specialized field.

Efficacy and Safety of Secukinumab for the Treatment of Moderate to Severe Psoriasis in Korea / 대한피부과학회지

BACKGROUND: Secukinumab, a fully human monoclonal antibody that targets interleukin (IL)-17A, which is a central cytokine in the pathogenesis of psoriasis, has emerged as a promising treatment for moderate to severe psoriasis. However, to date, there are no real-world data for secukinumab in Korean patients with psoriasis. OBJECTIVE: To assess the clinical efficacy and safety of secukinumab in Korean patients with psoriasis. METHODS: Prospective data were gathered during follow-up from 28 consecutive patients with chronic plaque-type psoriasis treated with secukinumab for minimum of 12 weeks at a single referral center. Patient demographics, Psoriasis Area Severity Index (PASI) score, Physicians' Global Assessment (PGA), Dermatologic Life Quality Index (DLQI), and adverse events were investigated. RESULTS: The mean PASI score was significantly decreased after the induction period of secukinumab treatment (paired t-test, p<0.05). Of the 28 patients, 17 (60.7%) had obtained near complete clearance (PASI 90) at the last follow-up visit. No unexpected adverse events, other than nasopharyngitis, were observed. CONCLUSION: Secukinumab can be of benefit for the treatment of Korean patients with psoriasis, as the treatment was associated with a rapid and satisfactory response and safety profile.

The Risk Factors of Workplace Violence among Healthcare Workers in Public Hospital

@#Introduction: Workplace violence become a global concern and perceived as a very serious safety and health hazard especially in healthcare setting. The aim of this study was to determine the prevalence of workplace violence and its associated risk factors among healthcare workers in public hospital. Methods: This was a cross-sectional study which involved 136 randomly selected respondents among doctors and nurses in a public hospital in Kuala Lumpur. Data was gathered through a self-administered questionnaire consisted of two standardized questionnaire; Workplace Violence (WPV) and Job Content Questionnaire (JCQ-27). Results: The response rate was 91%. The prevalence of reported WPV was 71.3% where nurses (73.2%) had slightly higher prevalence than doctors (69.2%). The most common forms of WPV was verbal abuse (70.6%), followed by bullying/mobbing (29.4%), physical violence (11.0%), and sexual harassment (6.6%). The perpetrators were mostly among relatives of patients and visitors followed by the patients. Multiple logistic regression shows that respondents working in Accident and Emergency (A&E) Department was 17 times more likely to report workplace violence than those working in Pediatric Department. Also, for every 1 year younger, respondents were 5 times more likely to experience workplace violence controlling for other factors. Conclusion: The prevalence of workplace violent among respondents were high and most common among young workers, especially nurses and those working in A&E Department. Hence, further assessment should be carried out to reduce the identified risk factors and to find ways of solving this issue.

Efficacy and Safety of Ustekinumab in the Treatment of Moderate to Severe Psoriasis in Korea / 대한피부과학회지

BACKGROUND: Ustekinumab, a fully human monoclonal immunoglobulin antibody that targets the P40 subunit shared by interleukin (IL)-12 and IL-23 has emerged as a promising treatment for moderate to severe psoriasis. However, to date, there are no 'clinical practice setting' data on ustekinumab in Korean patients with psoriasis. OBJECTIVE: To assess the clinical efficacy and safety of ustekinumab in Korean patients with psoriasis. METHODS: Prospective data were gathered during the follow-ups of 34 consecutive chronic plaque psoriasis patients treated with ustekinumab for a minimum of 16 weeks at a single referral center. Patients' demographics, Psoriasis Area Severity Index (PASI) score, Physicians' Global Assessment (PGA), Dermatologic Life Quality Index (DLQI), and adverse events were investigated. RESULTS: The mean PASI score significantly decreased after the first administration of ustekinumab (paired t-test, p<0.05). Twenty-one of 34 patients (61.8%) had obtained near-complete clearance (PASI 90) upon the last follow-up visit. No unexpected adverse events other than herpes zoster and elevated liver enzymes were observed. CONCLUSION: Ustekinumab can be of benefit in the treatment of Korean psoriasis patients, as it was associated with a rapid and satisfactory response and was well tolerated.

(En)quadros estéticos (artísticos e clínicos) e seus efeitos sensíveis / Aesthetic frames (artistical and clinical) and their sensitive effects / Encuadros estéticos (artísticos y clínicos) y sus efectos sensibles

Com base nas investigações estéticas de Freud, o trabalho tem a intenção de trazer articulações entre possíveis efeitos sensíveis causados pelo contato/recepção com as obras de arte (tendo-as aqui como "quadros artísticos") e o enquadre clínico psicanalítico. O texto também se preocupa em mostrar que a produção desses efeitos impactantes se dá pela condição de tais elementos (artísticos e clínicos) estarem necessariamente sob um enquadre e, por isso, conceituados como estéticos ao longo do argumento deste artigo...

Based on the aesthetic investigations of Freud, the work intends to bring joints between possible sensitive effects caused by contact / reception with works of art (having them here as "framed art") and psychoanalytic clinical setting. The text is also concerned to show that the production of these striking effects, happens by the condition of these items (artistic and clinical) are under a frame and therefore conceptualized as aesthetic in this article arguments...

Con base teórica en las investigaciones estéticas de Freud, el trabajo tiene la intención de establecer articulaciones entre los posibles efectos sensitivos causados por el contacto/recepción con las obras de arte (haciendo referencia a los cuadros artísticos) y al encuadre clínico psicoanalítico. El texto también muestra que la producción de estos se da por la condición de tales elementos (artísticos y clínicos) están sobre un encuadre y, por eso, conceptuados como estéticos en los argumentos del presente artículos...

Agreement between Parent and Teacher Reports in Clinical Setting : Comparing SDQ-Kr with K-CBCL

OBJECTIVES: The aims of this study were to examine agreement between parent and teacher ratings of the Korean version Strengths and Difficulties Questionnaire (SDQ-Kr) for the children's psychopathology and to determine whether it is effective in diagnostics as the Korean version of Childhood Behavior Checklist (K-CBCL). METHODS: SDQ-Kr and K-CBCL were completed by parents and teachers of 165 children aged 6-12 years. The clinical diagnosis was made by a child and adolescent psychiatrist who did not have knowledge of the outcome. Spearman's correlations were computed for associations between parents' and teachers' ratings on a subscale level. The Mann-Whitney U test was performed for the influence of child's age and sex on the results. Finally, AUC values were calculated for the diagnostic capacity and the difference between informants was tested using the z test. RESULTS: High correlations were observed between parents' and teachers' SDQ-Kr on every scale. Parents were more sensitive to emotional symptoms of girls, while teachers appeared to be more responsive to externalized symptoms of boys, inattention-hyperactivity of young children, and emotional symptoms of seniors. Parents' SDQ-Kr demonstrated the highest prediction of attention-deficit hyperactivity disorder. CONCLUSION: Teachers' SDQ-Kr can be used in identification of child psychopathology when parents are absent or when their reliability is considered low.

Mentoring in the clinical setting: Process, issues and challenges

Abstract: Mentoring in academic medicine requires the trained mentor to commit time, purpose and dedication for the personal and professional development of three categories of protégés or mentees i.e. medical students, the clinician-trainee and the clinical-educator. Conventionally, assigned mentors monitor the progress of the first two categories of personnel as their career pathway is clearly defined. On the other hand the clinician–educator in academic medicine could be a scientist or a career clinician expected to contribute to medical education activities and research. The clinicianeducator has grown in complexity as he multitasks in providing clinical care, assists in delivering the medical curriculum and is expected to do research and publish. Although there is dearth of research in mentoring the clinician-educator, it is clear that mentored clinicaleducators are more productive by way of scientific publications. Trained mentors are expected to identify the needs of the mentee with regards to the level of his career development and his aptitude to move up the academic ladder, successfully nurturing the maturation process. Processes of mentoring in the clinical setting, attributes of the successful mentor and facilitating the mentee in overcoming challenges in academic medicine are discussed.

“La letra con sangre entra”: el maltrato en la formación médica / “Spare the rod and spoil the child”: mistreatment in medical education

Aunque es bien conocido que un ambiente de respeto y confianza favorece el aprendizaje, el maltrato sigue siendo un comportamiento frecuente en las facultades de medicina. Esta conducta suele ser aceptada y justificada en todos los niveles de la práctica médica, desde los estudiantes y profesores, hasta los mismos pacientes y se considera como inherente a la cultura hospitalaria. Este artículo revisa el maltrato en la educación médica y pone en evidencia la falta de formación docente en pedagogía y didáctica así como las características propias del entorno hospitalario como dos posibles causas de su perpetuación.

Although it is well known that an atmosphere of respect and confidence favors learning, mistreatment continues being a frequent behavior in the medical schools. This conduct is usually accepted and justified at all the levels of medical practice, and it is considered an inherent behavior in the hospital culture This article reviews mistreatment in medical education and puts in evidence the lack of professor’s education in pedagogy and didactics as well as the characteristics of the clinical setting as two possible causes of its perpetuation.

Iluminando o self: uma experiência clínica psicanalítica não convencional / Shining the self: a non-conventional psychoanalytic experience

O artigo apresenta a narrativa de uma experiência psicanalítica em enquadramento clínico diferenciado com pacientes soropositivos para o HIV. Os portadores do HIV estão potencialmente sujeitos a vivências de estados agônicos em função do diagnóstico, do convívio e da severidade do tratamento de sua condição de soropositividade. As autoras foram levadas a buscar um enquadre clínico que contemplasse com maior pertinência o sofrimento existencial daquelas pessoas. A experiência clínica foi inspirada pela psicanálise winnicottiana. Utilizando a confecção de velas ornamentais como materialidade mediadora, isto é, como forma de contato com os pacientes, as autoras tomam "o brincar" como paradigma para a instalação do campo clínico e o "jogo do rabisco" como modelo. O artigo visa apresentar um empreendimento fielmente ancorado na utilização do método psicanalítico, aqui compreendido como ruptura/transformação do campo das agonias impensáveis.

The paper presents the narrative of a psychoanalytic experience in a special clinical setting with HIV positive patients. HIV positive patients are likely to experience high levels of suffering because of the diagnosis, the involvement, and the harshness of the treatment for their condition. The authors had sank a clinical setting that encompassed those people's existential suffering of. The clinical experience was inspired by the Winnicottian psychoanalysis. Using the ornamental candles crafting as a materiality mediator, i.e., as a patients' consultation method, the authors uses the playing activities as a paradigm of the clinical setting establishment, and the Squiggle game as a model. The aim of the paper is to demonstrate a project faithfully anchored in the psychoanalytic method, here understood as rupture/transformation of the unimaginable suffering field.