Além da relação terapêutica: um percurso histórico e teórico

A relação entre o terapeuta e o consulente tem sido de grande interesse em várias escolas de terapia. Começando com os estudos de Freud sobre transferência e contratransferência, continua com terapias modernas e com o que neste texto foi definido como terapias pós-modernas. Cada uma dessas abordagens destaca alguns aspectos da relação, de acordo com sua postura epistemológica. O objetivo deste trabalho é esclarecer os conceitos que têm abordagens diferentes sobre a relação entre o terapeuta e o consulente: o que alguns chamam relação terapêutica e outros, relação em um contexto terapêutico. Neste artigo, se começará por descrever a abordagem das terapias modernas sobre essa relação; depois se considerará o entendimento da terapia de família e de algumas terapias pós-modernas sobre essa relação e, finalmente, apresentam-se algumas diferenças e semelhanças entre diferentes abordagens para a concepção do construto. Nós concluímos que a relação terapêutica é uma construção social que está em constante transformação no trabalho do terapeuta, que está localizado em um contexto histórico e social e responde às necessidades e condições do momento.La relación entre terapeuta y consultante ha sido de gran interés en diversas escuelas de terapia. Comienza con los estudios de Freud sobre trasferencia y contratransferencia, continúa con las terapias modernas y con lo que en este texto se ha definido como terapias posmodernas. Cada uno de estos enfoques enfatiza algunos aspectos de la relación, de acuerdo con su postura epistemológica. El propósito de este artículo es clarificar las concepciones que distintos enfoques tienen acerca de la relación entre terapeuta y consultante; aquello que algunos llamarán relación terapéutica y otros, relación en un contexto terapéutico. Para lograr este propósito comenzará por describir el abordaje que las terapias modernas hacen acerca de dicha relación; luego se considerará la comprensión que, tanto la terapia familiar como algunas terapias posmodernas tienen acerca de la relación entre terapeuta y consultante; finalmente se presentan algunas diferencias y similitudes entre los distintos enfoques en cuanto a la concepción de dicho constructo. Se concluye que la relación terapéutica es una construcción social que se transforma constantemente en el quehacer del terapeuta, que está ubicada en un contexto histórico y social y que responde a las necesidades y condiciones del momento.The purpose of this paper is to discuss the relationship between therapist and client from different therapeutic approaches. The study of the therapeutic relationship begins with Freud's studies about transference and counter transference. It continues with modern therapies and finishes with what has been called postmodern therapies. This paper aims at clarifying each orientation's conception of the therapeutic relationship. In order to achieve this purpose, it starts by describing such therapies' approach of the therapeutic relationship. It goes then to examine the family therapies' and the postmodern therapies' understanding about the relationship between therapist and client. Finally, some differences and similarities between the various approaches are discussed in terms of their conception of that construct. The study concludes that the therapeutic relationship is a social construction in constant transformation throughout the therapeutic experience, which is also determined by other disciplines and located in a social and historical context. Each therapeutic approach emphasizes different aspects of the relationship between therapist and client depending on their epistemological background

Una escuela abierta. Una investigación sobre nuevos modelos escolares.

Escuela abierta. Una oportunidad, no solo para adaptarnos a la situación actual pandémica, sino para que arquitectos y pedagogos seamos capaces de ofrecer una escuela que genere arquitecturas para nuevos modelos docentes. El objetivo no es cumplimentar una escuela al uso, ni simplemente desarrollarla, sino detectar cuál es esa escuela, cuál es esa arquitectura que aúna naturaleza y nuevo modelo docente, que hace de la arquitectura el marco que relaciona el espacio habitado con la naturaleza como lugar y que de ella surge ese necesario nuevo modelo docente.<br /

Diseño de un aplicativo orientado desde la praxeología como mecanismo de comunicación entre docentes de GBI y estudiantes con discapacidad auditiva

Si la educación tiene como objeto conseguir que el individuo pueda ejercer sus derechos (individuales y colectivos) se hace necesario tener en cuenta las excepcionalidades que presentan algunos sujetos. En este caso particular, más que realizar un cambio dentro del programa o currículo para incluir a los estudiantes con discapacidad auditiva en el aula, se pretende brindar una herramienta tecnológica (aplicativo libre) generando un proceso meta cognitivo que desde la mediación y articulación sea un apoyo al docente de Gestión Básica de la Información. Además esta investigación busca responder a la necesidad de reconocer que hay diversidad y multiculturalidad en el ámbito educativo, y que todos tenemos el derecho a una educación con calidad, la cual debe ser adaptada a dichas particularidades promoviendo nuevas dinámicas de enseñanza, donde se generen estrategias tanto pedagógicas como tecnológicas que desde un enfoque, social, económico, cultural, político permita la aceptación y valoración de las diferencias en el aula

Diseño de un aplicativo orientado desde la praxeología como mecanismo de comunicación entre docentes de GBI y estudiantes con discapacidad auditiva

Si la educación tiene como objeto conseguir que el individuo pueda ejercer sus derechos (individuales y colectivos) se hace necesario tener en cuenta las excepcionalidades que presentan algunos sujetos. En este caso particular, más que realizar un cambio dentro del programa o currículo para incluir a los estudiantes con discapacidad auditiva en el aula, se pretende brindar una herramienta tecnológica (aplicativo libre) generando un proceso meta cognitivo que desde la mediación y articulación sea un apoyo al docente de Gestión Básica de la Información. Además esta investigación busca responder a la necesidad de reconocer que hay diversidad y multiculturalidad en el ámbito educativo, y que todos tenemos el derecho a una educación con calidad, la cual debe ser adaptada a dichas particularidades promoviendo nuevas dinámicas de enseñanza, donde se generen estrategias tanto pedagógicas como tecnológicas que desde un enfoque, social, económico, cultural, político permita la aceptación y valoración de las diferencias en el aula

Effects of Folinic Acid Administration on Lower Limb Ischemia/Reperfusion Injury in Rats

Surgery under ischemic conditions, lasting up to 3 h, is routinely performed in orthopedic surgery, causing undesirable injury due to ischemia-reperfusion syndrome, with short and medium-term functional repercussions. To date, there is no established prophylactic treatment. In this work we evaluated folinic acid (FA) in a rodent model of lower limb ischemia-reperfusion (IRI-LL). 36 male WAG rats underwent 3 h of lower limb ischemia. In the saline group, rats received intraperitoneal administration of saline (used as vehicle for treatment). In the experimental group, rats were pretreated with FA (2.5 mg/kg) before the end of ischemia. After ischemia, animals were sacrificed at 3 h, 24 h or 14 days (for biochemical determination (Na+, K+, Cl-, urea, creatinine, CK, LDH, ALP, ALT, and AST), pathological assessment, or functional study using the rotarod test; respectively). Another six animals were used to establish the reference values. The prophylactic administration of FA significantly reduced the elevation of biochemical markers, especially those that most directly indicate muscle damage (CK and LDH). In addition, it also improved direct tissue damage, both in terms of edema, weight, PMN infiltrate and percentage of damaged fibers. Finally, the administration of FA allowed the animals to equal baseline values in the rotarod test; what did not occur in the saline group, where pre-ischemia levels were not recovered. Following 3 h of lower limb ischemia, FA minimizes the increase of CK and LDH, as well as local edema and leukocyte infiltration, allowing a faster recovery of limb functionality. Therefore, it could be considered as a prophylactic treatment when tourniquet is used in clinics.This research received funding from the University of The Basque Country UPV/EHU (grant reference GIU19/088)

Evaluation of the bioavailability and intestinal effects of milk fermented by folate producing lactic acid bacteria in a depletion/repletion mice model

This study aimed to evaluate the bioavailability and effects on the intestinal mucosa of a bioenriched fermented milk (BFM) prepared with folate-producing lactic acid bacteria, using a depletion/repletion BALB/c mice model. Five Streptococcus thermophilus strains were combined with Lactobacillus plantarum 16cv and the combination that resulted in the best folate production was used for preparation of BFM. The folate content in BFM, prepared under controlled conditions (pH 6.0, 42 °C, 70 rpm, 24 h), was 321.1 ± 14.1 ng/mL. Results for mice fed with BFM were compared to those fed with other diets. The BFM group presented an increase in hemoglobin, hematocrit and red blood cells, and the villi height/crypt depth ratio was similar to that of animals receiving milk supplemented with commercial folic acid. The strains were sensitive to most tested antibiotics and lacked virulence genes, indicating that consumption of BFM may be a promising alternative to increase intake of folate.Fil: Cucick, Ana Clara C.. Universidade de Sao Paulo; BrasilFil: Gianni de Carvalho, Katia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Planta Piloto de Procesos Industriales Microbiológicos; ArgentinaFil: Todorov, Svetoslav D.. Universidade de Sao Paulo; BrasilFil: de Moreno, Maria Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; ArgentinaFil: Leblanc, Jean Guy Joseph. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Centro de Referencia para Lactobacilos; ArgentinaFil: Franco, Bernadette D. G. M.. Universidade de Sao Paulo; Brasi

Neuropathic post-COVID pain symptomatology is not associated with serological biomarkers at hospital admission and hospitalization treatment in COVID-19 survivors

OBJECTIVE: Evidence suggests that individuals who had survived to coronavirus disease, 2019 (COVID-19) could develop neuropathic post-COVID pain. This study investigated the association of serological biomarkers and treatments received during hospitalization with development of neuropathic-associated symptoms.METHODS: One hundred and eighty-three (n = 183) previously hospitalized COVID-19 survivors during the first wave of the pandemic were assessed in a face-to-face interview 9.4 months after hospitalization. Nineteen serological biomarkers, hospitalization data, and treatment during hospitalization were obtained from medical records. Neuropathic pain symptoms (Self-Report Leeds Assessment of Neuropathic Scale), sleep quality (Pittsburgh Sleep Quality Index), pain catastrophizing (Pain Catastrophizing Scale) and anxiety/depressive levels (Hospital Anxiety and Depression Scale) were assessed.RESULTS: The prevalence of post-COVID pain was 40.9% (n = 75). Fifteen (20%) patients reported neuropathic symptoms. Overall, no differences in hospitalization data and serological biomarkers were identified according to the presence or not of neuropathic-associated symptoms. Patients with post-COVID pain had the highest neutrophil count, and post hoc analysis revealed that patients with neuropathic post-COVID associated symptoms had lower neutrophil count (p = 0.04) compared with those without neuropathic pain, but differences were small and possible not clinically relevant. No differences in fatigue, dyspnea, brain fog, anxiety or depressive levels, poor sleep, or pain catastrophism between patients with and without neuropathic symptoms were found.CONCLUSION: It seems that neuropathic-like post-COVID pain symptoms are not associated with neither of assessed serological biomarkers at hospital admission nor hospitalization treatments received in this cohort of hospitalized COVID-19 survivors.</p

Prediction Accuracy of Serial Lung Ultrasound in COVID-19 Hospitalized Patients (Pred-Echovid Study)

The value of serial lung ultrasound (LUS) in patients with COVID-19 is not well defined. In this multicenter prospective observational study, we aimed to assess the prognostic accuracy of serial LUS in patients admitted to hospital due to COVID-19. The serial LUS protocol included two examinations (0–48 h and 72–96 h after admission) using a 10-zones sequence, and a 0 to 5 severity score. Primary combined endpoint was death or the need for invasive mechanical ventilation. Calibration (Hosmer–Lemeshow test and calibration curves), and discrimination power (area under the ROC curve) of both ultrasound exams (SCORE1 and 2), and their difference (DIFFERENTIAL-SCORE) were performed. A total of 469 patients (54.2% women, median age 60 years) were included. The primary endpoint occurred in 51 patients (10.9%). Probability risk tertiles of SCORE1 and SCORE2 (0–11 points, 12–24 points, and ≥25 points) obtained a high calibration. SCORE-2 showed a higher discrimination power than SCORE-1 (AUC 0.72 (0.58–0.85) vs. 0.61 (0.52–0.7)). The DIFFERENTIAL-SCORE showed a higher discrimination power than SCORE-1 and SCORE-2 (AUC 0.78 (0.66–0.9)). An algorithm for clinical decision-making is proposed. Serial lung ultrasound performing two examinations during the first days of hospitalization is an accurate strategy for predicting clinical deterioration of patients with COVID-19

Influenzanet: Citizens Among 10 Countries Collaborating to Monitor Influenza in Europe.

BACKGROUND: The wide availability of the Internet and the growth of digital communication technologies have become an important tool for epidemiological studies and health surveillance. Influenzanet is a participatory surveillance system monitoring the incidence of influenza-like illness (ILI) in Europe since 2003. It is based on data provided by volunteers who self-report their symptoms via the Internet throughout the influenza season and currently involves 10 countries. OBJECTIVE: In this paper, we describe the Influenzanet system and provide an overview of results from several analyses that have been performed with the collected data, which include participant representativeness analyses, data validation (comparing ILI incidence rates between Influenzanet and sentinel medical practice networks), identification of ILI risk factors, and influenza vaccine effectiveness (VE) studies previously published. Additionally, we present new VE analyses for the Netherlands, stratified by age and chronic illness and offer suggestions for further work and considerations on the continuity and sustainability of the participatory system. METHODS: Influenzanet comprises country-specific websites where residents can register to become volunteers to support influenza surveillance and have access to influenza-related information. Participants are recruited through different communication channels. Following registration, volunteers submit an intake questionnaire with their postal code and sociodemographic and medical characteristics, after which they are invited to report their symptoms via a weekly electronic newsletter reminder. Several thousands of participants have been engaged yearly in Influenzanet, with over 36,000 volunteers in the 2015-16 season alone. RESULTS: In summary, for some traits and in some countries (eg, influenza vaccination rates in the Netherlands), Influenzanet participants were representative of the general population. However, for other traits, they were not (eg, participants underrepresent the youngest and oldest age groups in 7 countries). The incidence of ILI in Influenzanet was found to be closely correlated although quantitatively higher than that obtained by the sentinel medical practice networks. Various risk factors for acquiring an ILI infection were identified. The VE studies performed with Influenzanet data suggest that this surveillance system could develop into a complementary tool to measure the effectiveness of the influenza vaccine, eventually in real time. CONCLUSIONS: Results from these analyses illustrate that Influenzanet has developed into a fast and flexible monitoring system that can complement the traditional influenza surveillance performed by sentinel medical practices. The uniformity of Influenzanet allows for direct comparison of ILI rates between countries. It also has the important advantage of yielding individual data, which can be used to identify risk factors. The way in which the Influenzanet system is constructed allows the collection of data that could be extended beyond those of ILI cases to monitor pandemic influenza and other common or emerging diseases