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No full textO câncer de mama tem motivado pesquisas de avaliação e intervenção psicológica pelos altos índices de mulheres acometidas pela doença, por ser o segundo tipo de câncer mais comum entre as mulheres no mundo e também responsável pelo maior número de mortes. As pacientes com câncer de mama enfrentam o sofrimento psíquico com o diagnóstico e as vicissitudes do tratamento oncológico, necessitando de ajuda psicológica urgente. Definiu-se como objetivo geral desta pesquisa investigar os efeitos terapêuticos da Psicoterapia Breve Operacionalizada (PBO) no atendimento de mulheres diagnosticadas com câncer de mama e em tratamento oncológico. Como objetivos específicos este estudo pretende averiguar os efeitos da técnica da PBO nas situações-problema localizadas nos setores adaptativos e verificar a eficiência da PBO nas situações de crise adaptativa. A pesquisa foi delineada pelo método misto e as participantes foram 17 mulheres, com idade entre 30 e 65 anos, que estavam em tratamento num ambulatório de oncologia do Grande ABC Paulista. Os instrumentos utilizados foram: entrevista clínica preventiva; Escala Diagnóstica Adaptativa Operacionalizada (EDAO) para avaliação da adaptação, antes e após a intervenção psicológica breve e no follow-up; e a PBO. Os resultados mostraram na avaliação inicial que 17,5% das participantes estavam com adaptação ineficaz grave (grupo 5), 53% estavam com adaptação ineficaz severa (grupo 4), 17,5% com adaptação ineficaz moderada (grupo 3) e 13% com adaptação ineficaz leve (grupo 2), sendo que 41,2% estavam em crise adaptativa por perda; o setor Orgânico foi o mais comprometido, seguido do Afetivo-Relacional com soluções pouquíssimo adequadas. A situação-problema da maior parte das participantes estava relacionada ao câncer de mama, o que na compreensão psicodinâmica mostrou-se associada ao intenso desamparo egóico diante do adoecimento e tratamento oncológico. Na avaliação adaptativa final e follow-up, 82,4% das participantes apresentaram evolução de grupo adaptativo. Concluímos que a PBO se mostrou eficiente em todas as idades, estado civil, escolaridade, tempo de diagnóstico, fase de tratamento oncológico e tipo de cirurgia (mastectomia radical ou parcial) e a técnica da interpretação teorizada mostrou-se eficiente para a solução das situações-problema e da crise adaptativa por perda. A motivação, a aliança terapêutica e a transferência positiva foram fundamentais para as participantes no aproveitamento das sessõesBreast cancer has motivated research of evaluation and psychological intervention by the high rates of women affected by the disease, because it is the second most common cancer among women worldwide and also responsible for more deaths. Patients with breast cancer face the psychological suffering with diagnosis and the events of cancer treatment, requiring urgent psychological help. Thus this research had as a general objective investigate the therapeutic effects of Brief Psychotherapy Operationalized (PBO) in the care of women diagnosed with breast cancer and cancer treatment. And the specific objectives were to investigate the effects of PBOs technique in problem-situations located in adaptive sectors and verify the efficiency of the PBO in situations of adaptive crisis. The research was outlined by the mixed method and the participants were 17 women aged 30 to 65, who were being treated in an oncology outpatients clinic in São Paulo. The instruments used were: preventive clinical interview, Adaptative Operational Diagnostic Scale (EDAO) for evaluation of adaptation before and after the brief psychological intervention and follow-up; and the PBO. The results showed in the initial evaluation that 17,5% of participants were in ineffective adaptation serious (group 5), 53% were in ineffective adaptation severe, 17,5% ineffective adaptation moderate and 13% ineffective adaptation light, whereas 41,2% were in the adaptative crisis by loss; the Organic sector was the most committed, followed by the Affective-Relational with solutions very little adequate. The problem-situation of most participants was related to breast cancer, which in psychodynamic understanding was associated to the intense helplessness ego in the face of illness and cancer treatment. In the final adaptive evaluation and follow-up, 82,4% of participants presented evolution of adaptive group. We concluded that the PBO was efficient at all ages, marital status, scholarity, time of diagnosis, cancer treatment stage and type of surgery (radical and partial mastectomy) and the technique of interpretation theorized proved efficient for the solution of problem- situations and adaptive crisis by loss. The motivation, the therapeutic alliance and positive transference were crucial for the participants in harnessing of the session
<Invited Articles>Cultivating a View on Life and Death during Early Childhood: A Case of Parent-Child Dialogue
No full text今日、「死生観の空洞化」という事態において、死生観を育むための「生と死の教育」の必要性が指摘されている。学校での「生と死の教育」が期待される一方で限界も指摘されており、地域や家庭での取り組みも改めて期待される。では、死やいのちの理解の発達段階に応じて、「この世ならぬ世界」「この世ならぬ存在」への理解を含む死生観はどのように形成され、そうした死生観を育むためにどのような働きかけが有効なのだろうか。筆者がFacebookに残してきた筆者と息子（6歳）の対話の事例を基に、幼児期の死生観の生成・涵養について検討した。事例からは、家庭という限られた共同体において、実生活と絵本やアニメの世界を通して、それらが互いに関連し合う形で死生の営みに繰り返し触れ、そこに含まれる価値体系が親という他者と共有されることで、死やいのちの理解の発達に応じた死生観が形成される可能性が見て取れた。その際には家庭内で共通した死生観を持っていること、それらが地域に残されている伝統的な価値体系と合致していること、子どもの死生にまつわる問いに親がごまかさずに向き合い応えられることが求められることも示唆された。 Today, views on life and death are lacking. Therefore, life and death education is needed to cultivate these views. Life and death education in schools is expected as difficulties can be easily pointed out during that stage. However, life and death education among a community and at home is also required. A major issue hindering this is that ways to cultivate a view on life and death, which includes a view of the transcendental world, according to children’s developmental stages, are unclear. In this study, dialogues between me and my 6-year-old son, which I have shared on my Facebook account as well, are examined to obtain suggestions regarding how a parent can cultivate a view on life and death during early childhood. Thus, I propose that when everyday life experiences related to life and death and those in the world depicted in picture books are connected, sometimes intentionally by one’s parents, one frequently experiences life and death issues. When one shares such experiences with one’s family, one’s view regarding life and death is cultivated as per one’s developmental stage. Considering this, I recommend that both parents share a similar view on life and death and that the view should also be similar to the traditional view of their community. Moreover, I also suggest that it is necessary for parents to respond to their children’s questions about life and death sincerely
On the battlefield: a study of emotional reactions of parents of preterm infants and its relationship to parenthood
No full textO nascimento prematuro é um problema de saúde pública, cujas consequências incidem tanto sobre as condições de sobrevivência do neonato, quanto sobre as reações emocionais dos pais. A separação precoce entre a mãe o bebê, as limitações impostas pelo ambiente tecnológico de uma Unidade de Terapia Intensiva Neonatal para interação dos pais com o recém-nascido e o sofrimento psicológico vivido pelo casal parental podem repercutir na relação da tríade pai-mãe-bebê. O objetivo desse trabalho foi investigar o conjunto das reações emocionais apresentadas pelos pais de bebês pré-termo de muito baixo peso e as relações entre essas reações e o processo de transição para a parentalidade. Nesta pesquisa de abordagem qualitativa, os participantes foram 4 mães e 4 pais de bebês prematuros internados no Hospital Universitário da USP. Os dados foram coletados através de entrevista semi-estruturada e analisados através da análise de conteúdo. As coordenadas teóricas que sustentaram a análise foram as da teoria psicanalítica de Winnicott, junto a contribuições de outros autores, cuja elaboração teórica foi considerada relevante para a discussão do tema. Foram identificadas reações emocionais ligadas à interrupção precoce da gravidez, ao relacionamento com a criança, à relação do casal parental e à relação com a equipe de saúde. Sensações de medo, apreensão, estranhamento, sentimentos de incompletude, irrealidade e impotência, necessidade de apoio, percepção de transformação pessoal e dos vínculos conjugais compuseram as singulares reações emocionais de cada casal parental. Algumas dessas reações mostraram-se favorecedoras e outras dificultadoras do processo de transição à parentalidade. Nesse estudo, as dificuldades vividas pelos pais não se apresentaram, a priori, como um impedimento para a construção de um vínculo seguro e saudável com os seus filhos. Mas tais dificuldades evidenciam a necessidade, apontada em outros trabalhos, de que os pais recebam atenção especializada do profissional da saúde mental, assim como, assistência integral da equipe de saúde tanto na internação, quanto no período da gravidez e após a alta hospitalarThe birth of a premature infant is a public health problem, whose consequences affect the living conditions of the newborn and parents emotional reactions. The early separation between mother and baby, the limitations established by technological environment of a neonatal intensive care unit for parents-child relation and parental couples psychological distress may affect the relationship of triad father-mother-infant. The goal of this study was investigate the emotional reactions set presented by very low birthweight infants parents and relationship between these reactions and transition to parenthood. This study used qualitative research and the subjects were 4 mothers and 4 fathers of very low birthweight infants admitted at University Hospital of USP. Data were collected through semi-structured interviews and were analyzed through content analysis. The theoretical coordinates that supported analysis were the Winnicotts theories add contributions from other authors, whose theoretical elaborations were considered relevant for discussion. Were identified emotional reactions linked to early interruption of pregnancy, to relationships with child, with health team and parental couples relationship. Fear, apprehension, estrangement, feelings of incompleteness, unreality and helplessness, need support, personal transformation and marital bonds composed the singular emotional reactions of each parental couple. Some of these reactions proved to be favoring and other cause difficulties of transition to parenthood. In This study, the difficulties experienced by parents were not a obstacle to building a secure and healthy bond with their children. But, these difficulties highlight the need for parents to receive specialized care of mental health professionals, as well as, comprehensive care of the health team during hospitalization, pregnancy and after discharg
Operationalized Brief Psychotherapy in diabetic 1 pregnant women with deficient glycemic control
No full textO Ministério da Saúde adverte que o Diabetes Mellitus é um problema de saúde pública devido sua alta taxa de prevalência. Estudos demonstram a correlação entre o funcionamento psicodinâmico de pacientes com diabetes mellitus tipo 1 e o controle glicêmico. Considerando que o controle glicêmico adequado minimiza os riscos para a mãe, o feto e o futuro bebê, salienta-se a importância de um atendimento psicoterápico na fase gestacional. Contudo, não existem pesquisas sobre Psicoterapia Breve Operacionalizada (PBO) enquanto técnica terapêutica para este tipo de população. O objetivo da pesquisa foi investigar possibilidades e limites da PBO no atendimento a gestantes portadoras de diabetes mellitus tipo 1 (DM1) com mau controle glicêmico. A metodologia utilizada para a pesquisa foi o clinico-qualitativo. O estudo envolveu quatro gestantes portadoras de DM1 com mau controle glicêmico. As gestantes foram encaminhadas pela Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, local onde as mesmas são atendidas. Foram utilizados como instrumentos: entrevista clínica psicológica; Escala Diagnóstica Adaptativa Operacionalizada; e Psicoterapia Breve Operacionalizada. As gestantes que concordaram em participar assinaram o Termo de Consentimento Livre e Esclarecido que após lido e explicado, foi assinado pela pesquisadora e gestante. Foram realizadas duas ou três entrevistas inicias para o diagnóstico adaptativo operacionalizado e planejamento da PBO. O número de sessões utilizadas para PBO foi definido conforme o diagnóstico adaptativo da gestante e sua situação-problema. As entrevistas e as sessões psicoterápicas tiveram duração de 45 minutos e frequência de uma vez por semana. A análise dos resultados foi realizada através da comparação entre o diagnóstico adaptativo operacionalizado realizado antes e depois da PBO. Foi verificado se ocorreu nas gestantes, durante estes períodos, mudanças adaptativas; além da averiguação das alterações no controle glicêmico, antes e após a PBO. A pesquisa expôs que houve mudanças de grupo adaptativo da qual as gestantes pertenciam. Cecília e Beatriz obtiveram melhora no diagnóstico adaptativo. Por intermédio do acompanhamento da evolução do controle glicêmico, pode-se verificar alterações com o decorrer da PBO: a porcentagem de hipoglicemias e hipoglicemias graves melhoraram; as porcentagens de valores alterados e de hiperglicemias, por sua vez, tiveram piora com o decorrer da gravidez, e, mesmo com a PBO, o rigoroso controle alimentar e insulinoterapia, inclusive em internações, foram dificilmente controlados. Das quatro gestantes estudadas duas tiveram crise adaptativa e as soluções encontradas por elas foram satisfatórias. O que pode restringir o processo psicoterapêutico é a transferência negativa persistente, contudo, ela pode ser trabalhada e minimizada. As possibilidades da PBO no atendimento às gestantes com DM1 encontradas na pesquisa foram: melhorar a eficácia da adaptação; auxiliar as pacientes em crise a solucionarem-na sem a queda da eficácia da adaptação; e, possibilitar as pacientes encontrarem soluções mais adequadas para suas situações-problemaThe health ministry adverts that Diabetes Mellitus is a public health concern due to its high prevalence rate. Studies demonstrate the existing relation between the psychodynamic functioning of patients with type 1 diabetes mellitus and the glycemic control. Considering that the adequate glycemic control minimizes risks for the mother, fetus and the future baby, it reinforces the importance of psychotherapeutic treatment during the pregnancy. However, there arent any researches on Operationalized Brief Psychotherapy (OBP) as a therapeutic technique for this kind of population. The aim of the research was to investigate the possibilities and the limits of OBP in the treating of pregnant women with type 1 diabetes mellitus with deficient glycemic control. The methodology used for the research was the clinical-qualitative method. The study involved four pregnant women with DM1 with deficient glycemic control. The women were appointed by the Obstetric Clinic of the Hospital das Clínicas da Faculdade de Medicina from the University of São Paulo, place where they were already being treated. The instruments employed were Psychological Interviews, the Operationalized Adaptive Diagnosis Scale and Operationalized Brief Psychotherapy. The women who agreed to take part in the research signed a consent form that, after read and explained, was then signed by the research agent and the subjects. Two or three initial interviews took place for the Operationalized Adaptive Diagnosis and the planning of the. The number of sessions employed for the OPB was defined in accordance to the adaptive diagnosis of the subject and their problem-situation. The interviews and the psychotherapeutic sessions lasted 45 minutes with the frequency of once a week. The analysis of the results was made through the comparison between the operationalized adaptive diagnosis done before and after the OPB. During these periods, it was verified if there were any adaptive changes in the subjects and, moreover, the analysis of any alterations in the glycemic control before and after the OPB. The research showed that there were changes in the adaptive group to which the subjects belonged. Cecília and Beatriz had an improvement in the adaptive diagnosis. Through the analysis of the evolution of the glycemic control, it was possible to verify alterations during the OPB: the percentage of both hypoglycemia and severe hypoglycemia showed improvement; however, the percentage of altered rates and of hyperglycemia showed a downturn throughout the pregnancy and, even with the OPB, a strict diet control and insulin therapy, including during admissions, were hardly controlled. From the four pregnant women in the study, two of them had an adaptive crisis and the solution found by them was satisfactory. What can restrict the therapeutic process is the persisting negative transference, however, it can be minimized. The possibilities of the OPB in the treatment of pregnant women with DM1 found with the research were: improving the efficiency of the adaptation, assisting patients in crisis to resolve them without losses in adaptation efficiency and, make patients more able to find more adequate solutions to their problem-situation
Online videoconferencing short-term psychodynamic psychotherapy for depression in adults: a systematic review following the Cochrane Collaboration
No full textCONTEXTO: O Transtorno Depressivo Maior é um grave problema de saúde pública mundial. No Brasil, 50% da população diagnosticada com esse transtorno não tem acesso a tratamento. As psicoterapias breves psicodinâmicas têm sua eficácia comprovada por revisões sistemáticas (RS) no tratamento do Transtorno Depressivo Maior e realizadas por meio de videoconferência, podem ampliar o acesso da população a essas psicoterapias baseadas em evidências. OBJETIVO: Avaliar a eficácia das psicoterapias breves psicodinâmicas realizadas pela internet, por meio de videoconferência, no tratamento de adultos com Transtorno Depressivo Maior. MÉTODO: Revisão sistemática de ensaios clínicos randomizados realizada segundo a metodologia da Colaboração Cochrane (Handbook of Systematic Reviews of Interventions). ESTRATÉGIA DE BUSCA: Os artigos foram recuperados em uma busca sensibilizada às bases de dados eletrônicas: BVS-Psi; Cochrane Library; EBSCO-CINAHL; EMBASE; LILACS; PsycNET (PsycINFO, PsycARTICLES, APABooks); Ovid MEDLINE; PubMED; Redalyc; SciELO; ScienceDirect; Scopus e Web of Science. Buscas adicionais foram realizadas no ClinicalTrials.gov e WHO (http://www.who.int/ictrp/en/), no Google Scholar e ResearchGate e na literatura cinzenta. As buscas foram realizadas em abril de 2016 e atualizadas até setembro de 2016. Não houve restrição a idiomas, datas e status de publicação. As listas de referências bibliográficas de RS e de artigos selecionados foram revisadas. Realizou-se contato com especialistas em busca de estudos em andamento. DESFECHO: Remissão sintomatológica por meio de escalas validadas e adesão ao tratamento. RESULTADOS: Dois revisores (CCAS e MNR) selecionaram de forma independente os artigos segundo os critérios de elegibilidade. Um terceiro revisor (KY) resolveu as discordâncias. Da busca inicial de 1163 artigos, 30 foram selecionados para avaliação do texto completo. Nenhum artigo contemplou os critérios de elegibilidade preconizados para esta revisão sistemática. CONCLUSÃO: Até o vii momento, não é possível afirmar se as psicoterapias breves psicodinâmicas realizadas pela internet, por meio de videoconferência, apresentam eficácia no tratamento da Depressão Maior em adultos devido à inexistência de ensaios clínicos randomizadosBACKGROUND: Major Depressive Disorder (MDD) is a major world public health problem. In Brazil, 50% of diagnosed population don´t receive treatment properly. Short-term psychodynamic psychotherapies have efficacy proved by systematic reviews of Depressions treatment and applied through videoconferencing may improve the access of population to these evidence-based psychotherapies. OBJECTIVES: To evaluate the efficacy of online videoconferencing short-term psychodynamic psychotherapies on MDDs treatment in adults. METHOD: Systematic review of randomized clinical trials following the Cochrane Collaboration Methodology (Handbook of Systematic Reviews of Interventions). SEARCH METHODS: Sensitive electronic searches were handled in the following databases: BVS-Psi; Cochrane Library; EBSCO-CINAHL; EMBASE; LILACS; PsycNET (PsycINFO, PsycARTICLES, APABooks); Ovid MEDLINE; PubMED; Redalyc; SciELO; ScienceDirect; Scopus and Web of Science. Additional searches were done in ClinicalTrials.gov and WHO (http://www.who.int/ictrp/en/), Google Scholar, ResearchGate and grey literature. Electronic searches were done in April 2016 and updated to September 2016. No restrictions on language, date and publication status were applied to the searches. References list of systematic reviews and potentially relevant papers retrieved were checked. A group of specialists was contacted in order to find ongoing studies. OUTCOME: Symptoms remission measured by validated scales and adherence to treatment. RESULTS: Two reviewers independently (CCAS e MNR) screened suitable articles according to eligibility criteria of this review. A third reviewer (KY) was consulted if two review authors could not reach consensus. From 1163 articles initially retrieved, 30 had assessed the full-text for eligibility. None article met the eligibility criteria of this systematic review. CONCLUSION: At this moment, is not possible to assure if online videoconferencing short-term psychodynamic psychotherapies are efficacious on MDDs treatment because of the absence of randomized clinical trial
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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