Neurobiology of Psychopathology and Psychotherapy and practical implications of materialistic view in mind definition

A psicologia passa no momento atual por uma importante mudança de paradigma teórico e conceitual. Essa mudança ficou bastante marcada na década de 90, considerada a "década do cérebro", quando aumentaram significativamente o número de estudos em comportamento que baseavam-se no funcionamento do cérebro. O mainstream das ciências do comportamento retornou à noção monista materialista de que cérebro e comportamento estão intrinsecamente interligados. Essa noção saiu dos laboratórios de pesquisa básica e chegou com força nas pesquisas aplicadas à psicopatologia e à psicoterapia. A presente revisão narrativa tem como principal objetivo traçar um panorama atual desse empreendimento científico, com ênfase nos esforços feitos dentro dasáreas da psicopatologia e da psicologia clínica. Ao final, discute-se até que ponto essa mudança de paradigma pode chegar na prática profissional do psicólogo.Psychology faces nowadays for a major change of theoretical and conceptual paradigm. This change was quite marked in the 90s, which was considered the "decade of the brain" when the number of behavioral studies based on brain functioning significantly increased. The mainstream of the behavioral sciences returned to the monistic materialistic notion that the brain and behavior are inextricably intertwined. This idea came out of basic research laboratories and influenced strongly in applied research in psychopathology and psychotherapy. This narrative review aims to draw up a current view of the scientific enterprise, with emphasis on efforts within the areas of clinical psychology and psychopathology. It is also discussed to what extent this paradigm shift can reach the professional practice of psychology.info:eu-repo/semantics/publishedVersio

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Museus e seus arquivos: em busca de fontes para estudar os públicos Museums and their archives: in search of sources for researching audiences

Aborda a relevância dos arquivos históricos dos museus como fontes documentais para o desenvolvimento de estudos sobre os públicos. Analisa o processo de construção do conhecimento sobre a relação dos museus com os seus diversos visitantes e usuários, contextualizando o surgimento dos públicos como categoria de entendimento e objeto de estudo nas ciências sociais. Apresenta, como importante subsídio para as pesquisas nesta temática, o Guia de fontes primárias: o Museu Nacional - seu público no século XIX e no início do XX, elaborado por Luciana Sepúlveda Köptcke e Marcelle Pereira. O guia de fontes consiste em ferramenta de orientação capaz de expandir o significado dos fundos documentais, revelando a natureza e o grau de importância atribuídos aos diferentes públicos pela instituição.<br>The article explores to what extent historical archives at museums may serve as documental sources in developing audience research. It analyzes the process by which we construct our knowledge of the relation between museums and their different visitors and also contextualizes the emergence of 'audience' as a category and object of study by the social sciences. The article presents Luciana Sepúlveda Köptcke and Marcelle Pereira's Guia de fontes primárias: o Museu Nacional - seu público no século XIX e no início do XX (Guide of primary sources: the National Museum - its audience in the nineteenth and early twentieth centuries), a valuable research tool that can enhance the significance of documental fonds and reveal the nature and import assigned to different audiences by these institutions

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt