Da dimensão humana à literatura de autoajuda: reflexões sobre a formação e o trabalho docente

Pós-graduação em Educação - IBRC

Optical aids for low vision: use of the Internet to guide teachers of the visually impaired

PURPOSES: To describe and interpret teachers' opinions about and responsiveness to guidance on optical aids for low vision. METHODS: It was conducted a cross-sectional analytical study. The convenience, non-random sample consisted of 58 teachers from the public school network of the city of Campinas. It was constructed and applied a structured questionnaire, available online at the assessed website. For qualitative data collection it was conducted an exploratory study using the focus group technique. RESULTS: Responses expressed, for the most part, a marked interest in the website, its easiness of access, and the comprehensive nature of the information provided. Most people reported frequent use of the Internet to seek information, and found it easier to access the Internet at home. Among the qualitative aspects of the evaluation, we should mention the perceived importance of the website as a source of information, despite some criticism about the accessibility and reliability of the information found on the Internet. CONCLUSION: Teachers' need for training to deal with visually impaired students and their positive response to advice and information lead to the conclusion that web-based guidelines on the use of optical aids were considered beneficial to ease the understanding of visual impairment and the rehabilitation of the affected subjects.

Grupos de apoio para homens com câncer de próstata: revisão integrativa da literatura

This article is an integrative literature review to analyze the contribution of national and international studies examining the use of psychological support groups as a care strategy for patients diagnosed with prostate cancer. The electronic databases consulted were: LILACS, MedLine and PsycINFO, over a period of 20 years (1989-2009) with pre-defined criteria for inclusion. Eleven studies were selected, and based on their contributions some considerations are presented regarding the factors that favor male participation in the support groups and the potential benefits of such participation; as well as their main concerns and the influence of gender identity in the process of coping with illness. Furthermore, studies suggest some models of group intervention, along with orientation for the coordinators which emphasize the importance of these groups as an effective strategy to aid in the process of coping of prostate cancer patients.

L'esplorazione dell'empowerment di un'istuzione di salute mentale

Il ruolo dell’Ospedale Psichiatrico Giudiziaro è un problema crescente in entrambi i paesi sviluppati e in via di sviluppo. Gli esperti della psichiatria di comunità e dei gruppi di auto aiuto vedono l'empowerment come un fattore chiave per il successo di queste istituzioni. Uno studio quantitativo esplorativo è stato condotto in un ospedale Psichiatrico Giudiziario a Tirana. Questo studio ha misurato l'empowerment del paziente e il personale con l'obiettivo di comprendere la situazione attuale presso l'O. P. G. di Tirana. Questo consentirà alle parti interessate di effettuare un intervento di successo per servire al meglio le esigenze di tutte le parti. Empowerment in psichiatria può essere definito come un progetto attentamente progettata che contribuirà a consentire al personale di aiutare al meglio a soddisfare le esigenze dei pazienti e dei operatori. Pertanto, l’empowerment scale e altri questionari sono stati utilizzati sia per il paziente e gli operatori del personale dell'O. P. G. di Tirana. I risultati mostrano una differenza significativa tra il personale e i pazienti in materia di empowerment. Correlazioni interessanti sono state trovate tra l’empowerment e dati demografici dei pazienti e il personale dell'Ospedale Psichiatrico Giudiziario di Tirana. Una correlazione positiva tra empowerment e alcuni elementi della qualità di vita dei pazienti. Si è anche trovato che l’empowerment dipendeva dalla gravità dei sintomi. E' molto importante avere un intervento concreto che prevede di aumentare il livello dell’empowerment nel personale e nei pazienti presso l'Ospedale Psichiatrico Giudiziario di Tirana.

Tailoring molecule nanostructures on insulating surfaces investigated by non-contact atomic force microscopy

Self-assembled molecular structures were investigated on insulating substrate surfaces using non-contact atomic force microscopy. Both, substrate preparation and molecule deposition, took place under ultra-high vacuum conditions. First, C60 molecules were investigated on the TiO2 (110) surface. This surface exhibits parallel running troughs at the nanometer scale, which strongly steer the assembly of the molecules. This is in contrast to the second investigated surface. The CaF2 (111) surface is atomically flat and the molecular assemblyrnwas observed to be far less affected by the surface. Basically different island structures were observed to what is typically know. Based on extensive experimental studies and theoretical considerations, a comprehensive picture of the processes responsible for the island formation of C60 molecules on this insulating surfaces was developed. The key process for the emergence of the observed novel island structures was made out to be the dewetting of molecules from the substrate. This new knowledge allows to further understand andrnexploit self-assembly techniques in structure fabrication on insulating substrate surfaces. To alter island formation and island structure, C60 molecules were codeposited with second molecule species (PTCDI and SubPc) on the CaF2 (111) surface. Depending on the order of deposition, quiet different structures were observed to arise. Thus, these are the first steps towards more complex functional arrangements consisting of two molecule species on insulating surfaces.

Biofunktionalisierung oxidischer Titanoberflächen über eine spezifische Anbindung von biotinyliertem Fibronektin für die medizinische Anwendung

In der hier vorliegenden Dissertation wird die Entwicklung und Charakterisierung einer biomimetischen Beschichtung für Titanimplantatoberflächen, insbesondere Dentalimplantate, beschrieben. Ziel war es, die Adhäsion und Aktivität von Osteoblasten auf Titanoberflächen zu steigern und so eine Beschleunigung der Implantatintegration in das Knochengewebe zu erreichen. Hierfür wurde eine spezielle Art der biomimetischen Beschichtung entwickelt, bei der biotinyliertes Fibronektin (bFn) über Streptavidin auf eine biotinylierte TiOX-Modelloberfläche immobilisiert wurde. Die Biotinmodifizierung der TiOX-Oberfläche erfolgte hierbei über einen „Self-Assembly-Prozess“ durch sequenzielle Chemiesorption von N-(6-aminohexyl)aminopropyltrimethoxysilan sowie verschiedenen Sulfo-NHS-Biotin-Derivaten, welche den Aufbau einer Streptavidin-Monolage ermöglichten. Als ein wichtiges Resultat zeigte sich, dass die Streptavidin-Monolage effektiv die unspezifische Adsorption von Proteinen an die TiOX-Oberfläche unterbindet und hierdurch die Adhäsion von Osteoblasten auf dieser unterdrückt. Dies hat den Vorteil, dass auf eine antiadhäsive Basisbeschichtung, welche für eine spezifische Zellreaktion wichtig ist, verzichtet werden kann. Dieses osteoblastere Adhäsionsverhalten änderte sich signifikant nach Anbindung von bFn an die Streptavidin-Monolage, mit dem Ergebnis, einer drastischen Steigerung der Osteoblastenadhäsion. Weiterhin besaßen Osteoblasten auf diesen Oberflächen ein Proteinexpressionsmuster, das auf eine erhöhte Osteoinduktion schließen lässt. Es zeigte sich darüber hinaus eine verstärkte Zelladhäsion sowie eine Steigerung des osteoinduktiven Effekts auf Substraten, bei denen bFn über eine Streptavidin-Monolage immobilisiert wurde, gegenüber mit nativem Fibronektin (Fn) modifizierten TiOX-Oberflächen. Ein wesentlicher Schwerpunkt bestand daher in der Analyse der Zusammensetzung und Struktur der biomimetischen Beschichtung über „Surface Plasmon Spectroscopy“ und „Atomic Force Microscopy“. Diese ergab, dass bFn und natives Fn auf den jeweiligen Oberflächen eine unterschiedliche Konformation einnimmt. Im Gegensatz zu nativem Fn, das bei der Adsorption unter physiologischen Bedingungen auf TiOX-Oberflächen eine kompakte Konformation besitzt, nimmt bFn auf einer Streptavidin-Monolage eine entfaltete Konformation ein. Bei letzterer handelt es sich um dieselbe, welche Fn in vivo innerhalb der extrazellulären Matrix besitzt. Sie unterscheidet sich von der kompakten Fn-Konformation dahingehend, dass entlang der Fn-Achse weitere Proteinbindestellen zugänglich werden und hierdurch die Zellaffinität von Fn gesteigert wird. Die nachgewiesene Konformationsänderung kann somit als Grund für die gesteigerte Osteoblasten-Adhäsion und Aktivität auf Oberflächen mit bFn angenommen werden. Diese Kenntnisse konnten weiterhin für die Optimierung des biomimetischen Schichtsystems genutzt werden. So war es möglich, durch alternierendes Inkubieren der Biotin-aktivierten Oberfläche mit Streptavidin und bFn, ein Multilayersystem gezielt aufzubauen. Der Vorteil dieses Multilayersystems gegenüber einer einfachen Monolage aus bFn besteht in einer erhöhten Stabilität der biomimetischen Beschichtung, wodurch eine Anwendung in der Praxis erleichtert würde.

Functional dna nanostructures for in vitro biosensing in live cells

DNA is a fascinating biomolecule that is well known for its genetic role in living systems. The emerging area of DNA nanotechnology provides an alternative view that exploits unparallel self-assembly ability of DNA molecules for material use of DNA. Although many reports exist on the results of DNA self-assembling systems, still few of them focus on the in vitro study about the function of such DNA nanostructures in live cells. Due to this, there are still a limited research about the in vitro functionality of such designs. To address an aspect of this issue, we have designed, synthesized and characterized two multifunctional fluorescencent nanobiosensors by DNA self-assembling. Each structure was designed and implemented to be introduced in live cells in order to give information on their functioning in real-time. Computational tools were used in order to design a graphic model of two new DNA motifs and also to obtain the specific sequences to all the ssDNA molecules. By thermal self-assembly techniques we have successfully synthesized the structure and corroborate their formation by the PAGE technique. In addition, we have established the conditions to characterize their structural conformation change when they perform their sensor response. The sensing behavior was also accomplished by fluorescence spectroscopy techniques; FRET evaluation and fluorescence microscopy imaging. Providing the evidence about their adequate sensing performance outside and inside the cells detected in real-time. In a preliminary evaluation we have tried to show the in vitro functionality of our structures in different cancer cell lines with the ability to perform local sensing responses. Our findings suggest that DNA sensor nanostructures could serve as a platform to exploit further therapeutic achievements in live cells.

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1(st) revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the "German Instrument for Methodological Guideline Appraisal" of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources.

Palestinian Refugee Camps: from Shelter to Habitat

Palestinian refugees registered with UNRWA and their housing conditions are officially characterized by a “ temporary status” , a situation which has lasted the past sixty years. This article explores this time-paradox by focusing on the host governments’ and UNRWA’s policies affecting the refugees’ housing conditions. After having reviewed available literature, this contribution analyses the current housing situation. Drawing on data from a recent survey, the authors provide insights on areas where intervention is needed. In all UNRWA’s fields of operation, overcrowding, lack of public spaces, humidity and structural defects are the main sources of housing discomfort that camp refugees endure. Host countries’ restrictions as well as the incapacity or unwillingness of larger urban municipalities to incorporate refugee camps in their master plans are among the main obstacles to the refugees’ housing development. Rehabilitation and self-help re-housing programs may offer substantial incentives for housing improvement. The success of such programs depends, among several factors, on the host governments’ good will to provide UNRWA with authorizations, financial support, and land, as well as on the capacity of involving the refugee communities in projects’ planning and implementation.

Psychosocial interventions for smoking cessation in patients with coronary heart disease

BACKGROUND: Quitting smoking improves prognosis after a cardiac event, but many patients continue to smoke, and improved cessation aids are urgently required. OBJECTIVES: To assess the effectiveness of psychosocial interventions such as behavioural therapeutic intervention, telephone support and self-help interventions in helping people with coronary heart disease (CHD) to quit smoking. SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (issue 2 2003), MEDLINE, EMBASE, PsycINFO and PSYNDEX were searched from the start of the database to August 2003. Results were supplemented by cross-checking references, and handsearches in selected journals and systematic reviews. SELECTION CRITERIA: Randomised controlled studies (RCTs) in patients with CHD with a minimum follow-up of 6 months. After initial selection of the studies three trials with methodological flaws (e.g. high drop out) were excluded. DATA COLLECTION AND ANALYSIS: Abstinence rates were computed according to an intention to treat analysis if possible, or if not on follow-up results only. MAIN RESULTS: We found 16 RCTs meeting inclusion criteria. Interventions consist of behavioural therapeutic approaches, telephone support and self-help material and were either focused on smoking cessation alone or addressed several risk factors. The trials mostly included older male patients with CHD, predominantly myocardial infarction. Overall there was a positive effect of interventions on abstinence after 6 to 12 months (odds ratio (OR) 1.66, 95% confidence interval (CI) 1.25 to 2.22), but substantial heterogeneity between trials. Studies with validated assessment of smoking status at follow-up had lower efficacy (OR 1.44, 95% CI 0.99 to 2.11) than non-validated trials (OR 1.92, 95% CI 1.26 to 2.93). Studies were clustered by intervention strategy and intensity of the intervention. Clustering reduced heterogeneity, although many trials used more than one type of intervention. The ORs for different strategies were similar (behavioural therapies OR 1.69, 95% CI 1.33 to 2.14; telephone support OR 1.58, 95% CI 1.28 to 1.97; self-help OR 1.48, 95% CI 1.11 to 1.96). More intense interventions showed increased quit rates (OR 1.98, 95% CI 1.49 to 2.65) whereas brief interventions did not appear effective (OR 0.92, 95% CI 0.70 to 1.22). Two trials had longer term follow-up, and did not show any benefits after 5 years. AUTHORS' CONCLUSIONS: Psychosocial smoking cessation interventions are effective in promoting abstinence at 1 year, provided they are of sufficient duration. Further studies, with longer follow-up, should compare different psychosocial intervention strategies, or the addition of a psychosocial intervention strategy to pharmacological therapy (e.g. nicotine replacement therapy) compared with pharmacological treatment alone.

Decentralisation and Social Services in England

Although Great Britain is not normally credited with the achievement of having been the first nation state to implement measures characteristic of a welfare state (this honour goes to Germany and Bismarck's strategy of promoting social insurance in the 1880s) it nevertheless pioneered many models of welfare services in view of the early onset of industrialisation in that country and the subsequent social problems it created. Organisations like the Mutual Insurance and Friendly Societies, the Charity Organisation Society or the Settlement Movement characterised an early approach to welfare that is based on initiatives at the civil society level and express a sense of self-help or of self-organisation in such a way that it did not involve the state directly. The state, traditionally, dealt with matters of discipline and public order, and for this reason institutions like prisons and workhouses represented the other end of the scale of 'welfare' provisions.

Internetbasierte psychologische Behandlung bei Depressionen

Depression ist die häufigste psychische Erkrankung, aber nur ein geringer Anteil der Betroffenen erhält eine angemessene Behandlung. Internetbasierte Interventionen stellen eine vielversprechende Ergänzung zu traditionellen Behandlungsformen dar, denn über das Internet können breite Bevölkerungsschichten mit wenig Aufwand erreicht werden. Die vorliegende Übersicht stellt den aktuellen Forschungsstand zu internetbasierten Interventionen bei Depressionen dar. Mehrere randomisierte kontrollierte Studien, Metaanalysen und Reviews legen nahe, dass mit strukturierten internetbasierten Interventionen, die regelmäßige Kontakte mit Therapeuten beinhalten (z.B. geleitete Selbsthilfeansätze, E-Mail- oder Chat-Therapien), Effekte erzielt werden können, die mit den Effekten von traditionellen Psychotherapien vergleichbar sind. Ungeleitete Selbsthilfeprogramme sind typischerweise mit hohen Abbrecherquoten und geringeren Effekten verbunden. Die zukünftige Forschung sollte sich vermehrt mit der Frage beschäftigen, wie internetbasierte Interventionen bei Depressionen optimal in die psychosoziale Versorgung integriert werden können. Mögliche Einsatzbereiche und die Einbettung internetbasierter Interventionen in das Versorgungssystem werden dargestellt und diskutiert.

Internetbasierte geleitete Selbsthilfeansätze bei Angststörungen und Depressionen

Das Spektrum internetbasierter psychologischer Behandlungsangebote bei psychischen Problemen und Erkrankungen bewegt sich zwischen webbasierten Selbsthilfeprogrammen, die das Internet als Informationsmedium verwenden, und Email-, Chat- und Video-Therapien, in welchen das Internet zu Kommunikationszwecken zwischen Hilfesuchenden und Professionellen genutzt wird. Dieser Beitrag fokussiert auf eine Beratungs- und Therapieform, die die Möglichkeiten des Internets als Informations- und Kommunikationsmedium in sogenannten geleiteten Selbsthilfeansätzen kombiniert. Internetbasierte geleitete Selbsthilfeansätze, in welchen Klienten während der Bearbeitung eines Selbsthilfeprogramms von Therapeuten via Internet (z.B. Email) unterstützt werden, wurden in den letzten Jahren intensiv erforscht. Im Bereich von Angststörungen und Depressionen liegen besonders viele Studien vor. Verschiedene Forschergruppen haben hier in der Regel große Behandlungseffekte gefunden, die mit der Wirkung von Face-to-Face-Therapien vergleichbar sind. In diesem Beitrag wird der geleitete Selbsthilfeansatz dargestellt und die empirische Evidenz diskutiert.

OSCAR – ein internetbasiertes Unterstützungsprogramm für Angehörige von Menschen mit einer Hirnverletzung: Pilotstudie

Erhöhte Depressivität und Ängstlichkeit sowie ein erhöhtes subjektives Belastungserleben sind bei Angehörigen von Menschen mit einer Hirnverletzung häufig. Die vorliegende Pilotuntersuchung widmet sich der Evaluation einer neuartigen Intervention, dem OSCAR Online-Coaching, einer internetbasierten Mehrkomponentenintervention. In einer randomisierten, kontrollierten Pilotstudie mit 35 TeilnehmerInnen wurde ein 16-wöchiges therapeutengeleitetes Selbsthilfeprogramm mit einer Wartekontrollgruppe verglichen. Als primäre Ergebnismasse wurde der Perceived Stress Questionnaire und das Zarit Burden Interview eingesetzt. Intention-to-treat-Analysen der unmittelbaren Effekte direkt nach der Intervention zeigten keine signifikanten Gruppenunterschiede auf den primären und auf sekundären Ergebnismassen. Im 6-Monate Follow-up, nach Zugang der Kontrollgruppe zur Intervention, wurde in der Gesamtstichprobe eine signifikante Reduktion des Caregiver Burden, depressiver Symptome, der Angst, sowie eine Zunahme positiver Emotionen gefunden. Die Zufriedenheit mit dem Programm war gut.

Internet-based stress management for women with preterm labour: a case-based experience report

Pregnant women with preterm labour (PTL) in pregnancy often experience increased distress and anxieties regarding both the pregnancy and the child's health. The pathogenesis of PTL is, among other causes, related to the stress-associated activation of the maternal-foetal stress system. In spite of these psychobiological associations, only a few research studies have investigated the potential of psychological stress-reducing interventions. The following paper will present an online anxiety and stress management self-help program for pregnant women with PTL. Structure and content of the program will be illustrated by a case-based experience report. L.B., 32 years (G3, P1), was recruited at gestational week 27 while hospitalized for PTL for 3 weeks. She worked independently through the program for 6 weeks and had regular written contact with a therapist. Processing the program had a positive impact on L.B.'s anxiety and stress levels, as well as on her experienced depressive symptoms and bonding to the foetus. As PTL and the risk of PTB are associated with distress, psychological stress-reducing interventions might be beneficial. This study examines the applicability of an online intervention for pregnant women with PTL. The case report illustrates how adequate low-threshold psychological support could be provided to these women.