Oficinas terapêuticas como instrumento de reabilitação psicossocial: percepção de familiares Talleres terapéuticos como herramienta para la rehabilitación psicosocial: percepción de la familia Therapeutic workshops as means of psychosocial rehabilitation: perception of family

As oficinas terapêuticas permitem a possibilidade de projeção de conflitos internos/externos por meio de atividades artísticas, com a valorização do potencial criativo, imaginativo e expressivo do usuário. Objetivou-se identificar a percepção dos familiares sobre as oficinas terapêuticas desenvolvidas. Pesquisa descritiva, com delineamento qualitativo, desenvolvida nos Centros de Atenção Psicossocial (CAPS) de Natal-RN, entre agosto e setembro de 2007. Foram entrevistados 28 familiares que participavam regularmente dos serviços. Os familiares destacaram o impacto positivo dos CAPS em suas trajetórias de tratamento e de vida, na melhoria da harmonia familiar. Sobre as oficinas terapêuticas, identificaram falhas e contradições, denunciando e apontando caminhos de superação. Percebem os espaços de participação nos CAPS como formas importantes de acompanhamento do seu familiar usuário, além do crescimento mútuo. As oficinas terapêuticas representam um instrumento importante de ressocialização e inserção individual em grupos, na medida em que propõem o trabalho, o agir e o pensar coletivos, conferidos por uma lógica inerente ao paradigma psicossocial.<br>Los talleres terapéuticos permiten la posibilidad de la proyección de los conflictos internos / externos a través de actividades artísticas, con la valorización del potencial creativo, imaginativo y expresivo del usuario. El objetivo fue identificar la percepción de las familias acerca de los talleres terapéuticos realizados. Investigación descriptiva, con delineación cualitativa, desarrollada en los Centros de Atención Psicosocial (CAPS) en Natal-RN, Brasil, entre agosto y septiembre de 2007. Entrevistamos a 28 familiares que asistieron regularmente a los servicios. Los miembros de la familia destacaron el efecto positivo de CAPS en sus trayectos de terapéutica y de vida, en mejorar la armonía familiar. En los talleres terapéuticos, detectaron las deficiencias y las contradicciones, revelando y apuntando maneras para superarlos. Ellos perciben los espacios para la participación en CAPS como instrumentos esenciales para la observación de su usuario familiar, además de un crecimiento mutuo. Los talleres terapéuticos representan un importante instrumento de socialización e integración individual en grupos, al paso que se propone trabajar, pensar y actuar colectivamente, conferido por la lógica inherente al paradigma psicosocial.<br>The therapeutic workshops allow the possibility of projection of internal / external conflicts through artistic activities, highlighting the creative, imaginative and expressive potential of the user. We aimed to identify the families' perception of the therapeutic workshops undertaken. The research descriptive, with qualitative design, developed in the Psychosocial Care Centers (CAPS) from Natal/RN between August and September 2007. We interviewed 28 families who regularly attended services. Family members emphasized the positive impact of CAPS in the course of their treatment and life, in improving family harmony. On the therapeutic workshops, were identified failures and contradictions, exposing and pointing ways to overcome them. They realize the opportunities for participation in CAPS as important ways of monitoring their family user, in addition to mutual growth. The therapeutic workshops represent an important instrument of socialization and integration in individual groups, while it proposes working, acting and collective thinking, conferred by an inherent logic of the psychosocial paradigm

Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial

BackgroundTocilizumab blocks pro-inflammatory activity of interleukin-6 (IL-6), involved in pathogenesis of pneumonia the most frequent cause of death in COVID-19 patients.MethodsA multicenter, single-arm, hypothesis-driven trial was planned, according to a phase 2 design, to study the effect of tocilizumab on lethality rates at 14 and 30 days (co-primary endpoints, a priori expected rates being 20 and 35%, respectively). A further prospective cohort of patients, consecutively enrolled after the first cohort was accomplished, was used as a secondary validation dataset. The two cohorts were evaluated jointly in an exploratory multivariable logistic regression model to assess prognostic variables on survival.ResultsIn the primary intention-to-treat (ITT) phase 2 population, 180/301 (59.8%) subjects received tocilizumab, and 67 deaths were observed overall. Lethality rates were equal to 18.4% (97.5% CI: 13.6-24.0, P=0.52) and 22.4% (97.5% CI: 17.2-28.3, P&lt;0.001) at 14 and 30 days, respectively. Lethality rates were lower in the validation dataset, that included 920 patients. No signal of specific drug toxicity was reported. In the exploratory multivariable logistic regression analysis, older age and lower PaO2/FiO2 ratio negatively affected survival, while the concurrent use of steroids was associated with greater survival. A statistically significant interaction was found between tocilizumab and respiratory support, suggesting that tocilizumab might be more effective in patients not requiring mechanical respiratory support at baseline.ConclusionsTocilizumab reduced lethality rate at 30 days compared with null hypothesis, without significant toxicity. Possibly, this effect could be limited to patients not requiring mechanical respiratory support at baseline.Registration EudraCT (2020-001110-38); clinicaltrials.gov (NCT04317092)