As funções terapêuticas da atividade: um estudo comparativo em terapia ocupacional

O propósito deste estudo foi verificar as alterações ocorridas em relação a assistência em terapia ocupacional na Unidade Psiquiátrica do Hospital São Paulo, vinculada ao Departamento de Psiquiatria e Psicologia Médica da Universidade Federal de São Paulo, através da análise da aplicação de um instrumento terapêutico da terapia ocupacional, a atividade. Este estudo baseou-se em pesquisa retrospectiva nos prontuários de pacientes internadas na Unidade Psiquiátrica. A pesquisa se propôs sistematizar o registro de procedimentos de terapeutas ocupacionais e de outros profissionais em relação a atividade, no sentido de dar uma contribuição universalização de alguns aspectos do discurso da Terapia Ocupacional, sistematizando-os em categorias. Pretendeu-se verificar a aplicabilidade do instrumento terapêutico pesquisado, através da comparação dos procedimentos encontrados em dois períodos. Os procedimentos metodológicos constaram de: a.- definição dos períodos a serem pesquisados: de 1/1/1988 a 31/12/1988 e de 1/1/1994 a 31/12/1994; b- coleta de dados: foram levantados em 257 prontuários de pacientes internadas na Unidade Psiquiátrica nos períodos acima definidos, os dados sócio demográficos e todos os registros encontrados nos prontuários, sobre uso de atividade e sobre terapia Ocupacional: c- categorização dos dados sobre atividade e terapia ocupacional segundo referências empíricas e funções da atividade e posteriormente em categorias empíricas em terapia ocupacional; d- análise dos dados: através do cotejamento do material encontrados nos dois períodos em relação As categorias criadas e A literatura. A análise dos dados demonstrou que não houve alterações no perfil sócio demográfico da clientela, não se alterando também a pouca atenção da equipe frente a dados relativos a origem, ocupação e perfil econômico. Em relação a idade média das pacientes e tempo de internação a distribuição dos mesmos difere, os indices mais altos encontrados relacionam-se ao segundo período. Quanto ao instrumento terapêutico, a atividade, o estudo comparativo, permitiu identificar modificações em relação a compreensão e uso do mesmo. No primeiro período, o recurso terapêutico, atividade, relaciona-se com a proposta de ambientoterapia, isto 6, toda a utilização da atividade insere-se num movimento mais amplo, grupal, com a participação efetiva de toda a equipe, voltado à experiências sociabilizantes, com raras abordagens especificas de terapeutas ocupacionais. No segundo período a utilização da atividade enquanto instrumento terapêutico, aproxima-se dos recursos teóricos e práticos da terapia ocupacional psicodinâmica, o que permitiu enfoques mais individualizados, introduziu a questão do processo terapêutico, a utilização deste recurso como uma aborgagem eletiva, ampliou o contato das terapeutas ocupacionais com a clientela em grupos específicos de terapia ocupacional e no ambulatório de egressos. Perdeu-se neste segundo período alguns procedimentos relativos a proposta da ambientoterapia e a uniformidade da equipe frente a esta questão. Percebeu-se que, a aplicabilidade deste recurso terapêutico, nos dois períodos, baseia-se nas possíveis funções da atividade, tomadas sempre como recursos estratégicos. Nos dois períodos foi possível verificar que a aplicabilidade deste instrumento terapêutico não se relacionou a categorias diagnósticas, podendo num sentido mais amplo, ter indicação a todos as pacientes.The purpose of this study was to verify the changes occurred within the Occupational Therapy assistance in the Psychiatric Unit of Hospital São Paulo, linked to the Psychiatry and Medical Psychology Department of Universidade Federal de Sao Paulo through the analysis of the use a therapeutic means of Occupational Therapy named the activity. The study was based on retrospective research of inpatients'clinical charts. The research purpose was to sistematyze the procedures of occupational therapists and of other professionals concerning the activity in order to contribute to the generalization of certains aspects of occupational therapy practices by arranging them into categories.Our intention was to verify the applicability of the therapeutic means under analysis through the comparison of procedures found in two distinct periods. The experimental methods consisted of: a. Definition of periods to be researched: from 01/01/1988 to 31/12/1988 and from 01/01/1994 to 31/12/1994. b.Data collection: Data were collected from 257 inpatineclinical charts during the above defined periods, specifically social demographics data and all the information found in charts concerning use of the activity and occupational therapy. c. data categorization about the activity and occupational therapy according to empirical references and functions of the activity and subsequently to empirical categories in occupational therapy d.data analyses: through comparison of the material found in both periods, through created categories and in reference to the existing literature. Data analyses showed that were no changes in patients social demographics profile, as well as in team members'poor charting of data relative to the source, occupation and economical profile of impatient. Concerning the age of the patients and hospitalization period, their distribution differed with higher levels found in the second period. As for the use of the therapeutic instrument, the activity, the comparison allowed the identification of due to its application.changes. In the first period, the activity relates to the millieu therapy proposal, that is, all the activity application inserts itself in a broader movement, with the effective participation of all the members focused on socialization with rare specif interventions of occupational therapists. In the secon period, the use of the activity as a therapeutic instrument follows the theoretical and practical resource of the psychodinamic occupational therapy; that allowed more specific approaches and introduced the subject of the therapeutic process in occupational therapy. The use of this resource as a choice approach enlarged the contact of occupational therapists with patients in Occupational Therapy groups and in the out patient follow-up treatment. During this second period some procedures relating to the millieu therapy project and the unity of the team concerning this subject were lost. We have noticed that the applicability of this therapeutic resource, the activity, during both periods is based on the possible functions of the activity, always taken as strategis resources. It was possible to verify, in both periods, that the applicability of this therapeutic instrument is not related to diagnostic categories, and it that can be beneficial to all the patients.BV UNIFESP: Teses e dissertaçõe

Raman spectroscopy and advanced mathematical modelling in the discrimination of human thyroid cell lines

Raman spectroscopy could offer non-invasive, rapid and an objective nature to cancer diagnostics. However, much work in this field has focused on resolving differences between cancerous and non-cancerous tissues, and lacks the reproducibility and interpretation to be put into clinical practice. Much work is needed on basic cellular differences between malignancy and normal. This would allow the establishment of a clinically relevant cellular based model to translate to tissue classification. Raman spectroscopy provides a very detailed biochemical analysis of the target material and to 'unlock' this potential requires sophisticated mathematical modelling such as neural networks as an adjunct to data interpretation. Commercially obtained cancerous and non-cancerous cells, cultured in the laboratory were used in Raman spectral measurements. Data trends were visualised through PCA and then subjected to neural network analysis based on self-organising maps; consisting of m maps, where m is the number of classes to be recognised. Each map approximates the statistical distribution of a given class. The neural network analysis provided a 95% accuracy for identification of the cancerous cell line and 92% accuracy for normal cell line. In this preliminay study we have demonstrated th ability to distinguish between "normal" and cancerous commercial cell lines. This encourages future work to establish the reasons underpinning these spectral differences and to move forward to more complex systems involving tissues. We have also shown that the use of sophisticated mathematical modelling allows a high degree of discrimination of 'raw' spectral data

Weak Glycolipid Binding of a Microdomain-Tracer Peptide Correlates with Aggregation and Slow Diffusion on Cell Membranes

10.1371/journal.pone.0051222PLoS ONE712

Raman spectroscopy in head and neck cancer

In recent years there has been much interest in the use of optical diagnostics in cancer detection. Early diagnosis of cancer affords early intervention and greatest chance of cure. Raman spectroscopy is based on the interaction of photons with the target material producing a highly detailed biochemical 'fingerprint' of the sample. It can be appreciated that such a sensitive biochemical detection system could confer diagnostic benefit in a clinical setting. Raman has been used successfully in key health areas such as cardiovascular diseases, and dental care but there is a paucity of literature on Raman spectroscopy in Head and Neck cancer. Following the introduction of health care targets for cancer, and with an ever-aging population the need for rapid cancer detection has never been greater. Raman spectroscopy could confer great patient benefit with early, rapid and accurate diagnosis. This technique is almost labour free without the need for sample preparation. It could reduce the need for whole pathological specimen examination, in theatre it could help to determine margin status, and finally peripheral blood diagnosis may be an achievable target

Cancer Treatment and Bone Health

Considerable advances in oncology over recent decades have led to improved survival, while raising concerns about long-term consequences of anticancer treatments. In patients with breast or prostate malignancies, bone health is a major issue due to the high risk of bone metastases and the frequent prolonged use of hormone therapies that alter physiological bone turnover, leading to increased fracture risk. Thus, the onset of cancer treatment-induced bone loss (CTIBL) should be considered by clinicians and recent guidelines should be routinely applied to these patients. In particular, baseline and periodic follow-up evaluations of bone health parameters enable the identification of patients at high risk of osteoporosis and fractures, which can be prevented by the use of bone-targeting agents (BTAs), calcium and vitamin D supplementation and modifications of lifestyle. This review will focus upon the pathophysiology of breast and prostate cancer treatment-induced bone loss and the most recent evidence about effective preventive and therapeutic strategies

A Fluorescent Glycolipid-Binding Peptide Probe Traces Cholesterol Dependent Microdomain-Derived Trafficking Pathways

10.1371/journal.pone.0002933PLoS ONE38

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe