A importância do suporte emocional aos pais de bebês internados num CTI pediátrico: aspectos teóricos e práticos de um trabalho com grupos

Este trabalho, realizado num hospital, apresenta a prática de Grupo com pais de bebês internados em Centro de Tratamento Intensivo. Tal prática visa basicamente o atendimento aos pais no sentida de lhes oferecer as condições necesárias para a manutenção e preservação do vínculo afetivo bebê-pais, e consequentemente aceitação deste bebê doente, tanto durante o período de internação como também após sua alta. Visa, portanto, revelar a importância de um suporte emocional aos pais de tais bebês, sem o que, acredita-se, dificilmente ais pais teriam condições de superar a situação de crise emocional por que passam diante ao nascimento de um filho doente ou que adoece logo ao nascer. o trabalho com os Grupos realiza-se uma vez por s~ mana. tendo a duração de 1DJla hora. A coordenação destes grupos é feita em co~terap:ta por UltlJllédico peaiatra e um psicõl~ go. Baseia-se na livre expressão dos participantes. e tanto o médico quanto o psicólogo. oferecem informações sobre o estado de saúde do bebê ao mesmo tempo em que buscam compreen -der na fala dos pais os aspectos emocionais nela subentendi -dos. .' Essencialmente, tornaram-se temas centrais deste trabalho os que dizem respeito a ligação afetiva dos pais com o bebê, aos sentimentos de culpa pela doença do mesmo e os relativos i preocupação dos pais com o desenvolvimento futuro de seu filho. Os referidos temas foram denominados com os seguintes títulos: Vínculos e Separações, Sentimentos de Culpa e O Espaço da Criança, e neles foram abordados os aspectos teóricos de cada questão, visando uma melhor compreensão das ansiedades dos pais e na esperança de fornecer suporte emocional aos mesmos, a fim de que possam melhor amparar seus filhos.

Um estudo piloto sobre os aspectos psicológicos associados a artrite reumatoide

A presente dissertação de Mestrado em Psicologia Social e da Personalidade caracterizou-se por um Estudo Piloto concernente aos aspectos psicológicos relacionados a Artrite Reumatóide (AR), realizado através de uma investigação exploratória de campo no Hospital Universitário Clementino Fraga Filho (HUCFF), Ambulatório de Reumatologia, na qual treze (13) pacientes reumatóides foram entrevista dos. O grupo amostral foi constituído de dez (lO) casos do sexo feminino e três (3) do sexo masculino com diagnóstico apenas desse tipo de patologia. O foco de interesse desta pesquisa foram os aspectos psicológicos que precederam e desempenharam algum tipo de influência no começo e progressão da AR, a partir do ponto de vista psicossomático. Os resultados obtidos parecem evidenciar um background psicodinâmico, uma vez que os relatos de história de vida giraram em torno de temas que sugeriram uma influência parental restritiva na primeira infância; hostilidade e agressividade contidas; inibição; auto-estima baixa; sentimentos de inferioridade e tendência a repressão e controle dos sentimentos. A nível manifesto essas pessoas procuram demonstrar externa mente o oposto do que são ou como se sentem internamente (‘necessidade se serem ativos'). Assim, parece existir uma relação psicodinâmica entre os aspectos somáticos e psíquicos influenciando o processo da Artrite Reumatóide. Os efeitos psicológicos advindos da doença, tais como: grande preocupação acerca do processo da enfermidade em si e de suas consequências; ansiedade gerada pelo desconhecimento parcial do real significado da doença; menor comunicação tanto no meio intra como extra familiar, também foram enfatizados. Os resultados deste estudo não são conclusivos e o pesquisa dor admite que o grupo amostral foi muito reduzido e o método empregado diferiu dos comumente aplicados a este tipo de pesquisa. Entre tanto, os mesmos pouco divergiram dos de outras investigações.

Development and evaluation of a range anxiety-reducing business model for connected full electric vehicles

This thesis develops and evaluates a business model for connected full electric vehicles (FEV) for the European market. Despite a promoting political environment, various barriers have thus far prevented the FEV from becoming a mass-market vehicle. Besides cost, the most noteworthy of these barriers is represented by range anxiety, a product of FEVs’ limited range, lacking availability of charging infrastructure, and long recharging times. Connected FEVs, which maintain a constant connection to the surrounding infrastructure, appear to be a promising element to overcome drivers’ range anxiety. Yet their successful application requires a well functioning FEV ecosystem which can only be created through the collaboration of various stakeholders such as original equipment manufacturers (OEM), first tier suppliers (FTS), charging infrastructure and service providers (CISP), utilities, communication enablers, and governments. This thesis explores and evaluates how a business model, jointly created by these stakeholders, could look like, i.e. how stakeholders could collaborate in the design of products, services, infrastructure, and advanced mobility management, to meet drivers with a sensible value proposition that is at least equivalent to that of internal combustion engine (ICE) cars. It suggests that this value proposition will be an end-2-end package provided by CISPs or OEMs that comprises mobility packages (incl. pay per mile plans, battery leasing, charging and battery swapping (BS) infrastructure) and FEVs equipped with an on-board unit (OBU) combined with additional services targeted at range anxiety reduction. From a theoretical point of view the thesis answers the question which business model framework is suitable for the development of a holistic, i.e. all stakeholder-comprising business model for connected FEVs and defines such a business model. In doing so the thesis provides the first comprehensive business model related research findings on connected FEVs, as prior works focused on the much less complex scenario featuring only “offline” FEVs.

Redes retratam preocupação com segurança após divulgação de documento

A divulgação, nesta terça-feira, da edição 2014 do Anuário de Segurança Pública gerou grande repercussão nas redes sociais – sobretudo por conta dos dados negativos do país em relação a 2012 em âmbitos regional e nacional. As ferramentas de monitoramento de redes da FGV-DAPP identificaram aumento de menções sobre o assunto após a revelação do documento, em especial sobre roubos e homicídios, cujos números aumentaram entre os últimos dois anos. É sintoma de que a preocupação com a (falta de) segurança, uma das principais pautas das últimas eleições, segue presente entre os brasileiros na web.

Diretor da FGV/DAPP discute o aumento da preocupação com a segurança pública nas redes sociais do Brasil

Jornal da Globo News apresentado por Leilane Neubarth

Hospital hero: a game for reducing stress and anxiety of children while waiting in emergency room

This report tells a story which started as an idea that came to us to fight the battle-cry feeling commonly known as stress and anxiety. Before creating the solution of the idea, we first need to understand the feelings underneath and its effects on our well-being. Throughout the course of our lives, we experience states of weakness and fear. These feelings can arise, for instance, while we are in an emergency room. Needless to say, how much it would have imaginable effects on children, who are unfamiliar to such environments. We ran through a serious of scenarios to find the most suitable solution, among them the study of interaction with positive expressions by Dr. Baldwin, proved to be a valued resource. It was reduced due to its length and to be suitable to our public audience. The game was then created in order to reduce or even eliminate the stress and anxiety of children. Since the game was initially released, some modifications had been made but the original idea - interaction with positive expressions – remained. When the time came, we asked children to play one of the two versions of the game while waiting in the emergency room. This not only created a diversion for them but also a learning experience as it displayed some hospital equipment. The difference between the two versions is that one provides expressions, while the other does not. After all our hard work, we felt rewarded because the project proved its worth and we would see that in the expressions on children’s faces while they played. Most importantly, their anxiety level numbers were significantly reduced during that short period of time.

Serotonergic neurons in the median raphe nucleus regulate inhibitory avoidance but not escape behavior in the rat elevated T-maze test of anxiety

Rationale: A wealth of evidence supports the involvement of the serotonergic neurons of the median raphe nucleus (MRN) in anxiety. However, it is presently unclear whether serotonergic pathways arising from this nucleus play distinguishing regulatory roles in defensive behaviors that have been associated with specific subtypes of anxiety disorders. Objectives: To evaluate the role of the MRN serotonergic neurons in the regulation of two defensive behaviors, inhibitory avoidance and escape, which have been related, respectively, to generalized anxiety and panic disorders. Methods: Male Wistar rats were submitted to the elevated T-maze test of anxiety after intra-MRN administration of drugs that either non-selectively or selectively change the activity of the serotonergic neurons. Results: Intra-MRN injection of FG 7142 (0.04 and 0.08 nmol) and kainic acid (0.03 and 0.06 nmol), drugs that non-selectively stimulate the MRN serotonergic neurons, facilitated inhibitory avoidance acquisition, but impaired escape performance. Microinjection of muscimol (0.11 and 0.22 nmol), a compound that non-selectively inhibits the activity of the MRN serotonergic neurons, impaired inhibitory avoidance and facilitated escape performance. Both kainic acid and muscimol also changed rat locomotion in the open-field test. Intra-MRN injection of 8-OH-DPAT (0.6-15 nmol) and WAY-100635 (0.18-0.74 nmol), respectively an agonist and an antagonist of somatodendritic 5-HT1A receptors located on serotonergic neurons of the MRN, only affected inhibitory avoidance-while the former inhibited the acquisition of this behavior, the latter facilitated it. Conclusion: MRN serotonergic neurons seem to be selectively involved in the regulation of inhibitory avoidance in the elevated T-maze. This result supports the proposal that 5-HT pathways departing from this nucleus play an important role in anxiety processing, with implications for pathologies such as generalized anxiety disorder.

The dorsal raphe nucleus exerts opposed control on generalized anxiety and panic-related defensive responses in rats

It has been proposed that the ascending dorsal raphe (DR)-serotonergic (5-HT) pathway facilitates conditioned avoidance responses to potential or distal threat, while the DR-periventricular 5-HT pathway inhibits unconditioned flight reactions to proximal danger. Dysfunction on these pathways would be, respectively, related to generalized anxiety (GAD) and panic disorder (PD). To investigate this hypothesis, we microinjected into the rat DR the benzodiazepine inverse receptor agonist FG 7142, the 5-HT1A receptor agonist 8-OH-DPAT or the GABA(A) receptor agonist muscimol. Animals were evaluated in the elevated T-maze (ETM) and light/dark transition test. These models generate defensive responses that have been related to GAD and PD. Experiments were also conducted in the ETM 14 days after the selective lesion of DR serotonergic neurons by 5,7-dihydroxytriptamine (DHT). In all cases, rats were pre-exposed to one of the open arms of the ETM 1 day before testing. The results showed that FG 7142 facilitated inhibitory avoidance, an anxiogenic effect, while impairing one-way escape, an anxiolytic effect. 8-OH-DPAT, muscimol, and 5,7-DHT-induced lesions acted in the opposite direction, impairing inhibitory avoidance while facilitating one-way escape from the open arm. In the light/dark transition, 8-OH-DPAT and muscimol increased the time spent in the lighted compartment, an anxiolytic effect. The data supports the view that distinct DR-5-HT pathways regulate neural mechanisms underlying GAD and PD. (C) 2002 Elsevier B.V. B.V. All rights reserved.

Involvement of median raphe nucleus 5-HT1A receptors in the regulation of generalized anxiety-related defensive behaviours in rats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Social separation and diazepam withdrawal increase anxiety in the elevated plus-maze and serotonin turnover in the median raphe and hippocampus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Anxiety-induced antinociception in mice: effects of systemic and intra-amygdala administration of 8-OH-DPAT and midazolam

Rationale: Mice exhibit antinociception after a single experience in the elevated plus maze (EPM), an animal model of anxiety. Objective: This study investigated the mechanisms involved in this form of anxiety-induced antinociception. Methods: Nociception was evaluated by means of the writhing test in mice confined either to the open or enclosed arms of the EPM. The effects of systemic (naloxone, midazolam and 8-OH-DPAT) or intra-amygdala (8-OH-DPAT. NAN-190 and midazolam) drug infusions were investigated in mice previously treated i.p. with 0.6% acetic acid, an algic stimulus that induces abdominal contortions. The effects of these drugs on conventional measures of anxiety (% entries and % time in open arms) in a standard EPM test were also independently investigated. Results: Open-arm confinement resulted in a high-magnitude antinociception (minimum 85%, maximum 450%) compared with enclosed arm confinement. The opiate antagonist naloxone (1 mg/kg and 10 mg/kg) neither blocked this open arm-induced antinociception (OAIA) nor modified indices of anxiety in EPM. Administration of midazolam (0.5-2 mg/kg, s.c.) increased OAIA and produced antinociception in enclosed confined animals, as well as attenuating anxiety in the EPM. The 5-HT(1A) receptor agonist 8-OH-DPAT (0.05-1 mg/kg, s.c.) had biphasic effects on OAIA, antagonising the response at the lowest dose and intensifying it at the highest dose. In addition, low doses of this agent reduced anxiety in the EPM. Although bilateral injections of 8-OH-DPAT (5.6 nmol/0.4 mu l) or NAN-190 (5.6 nmol and 10 nmol/0.4 mu l) into the amygdala did not alter OAIA, increased anxiety was observed in the EPM. In contrast, intra-amygdala administration of midazolam (10 nmol and 30 nmol/0.4 mu l) blocked both OAIA and anxiety. Conclusions: These results with systemic and intracerebral drug infusion suggest that 5-HT(1A) receptors localised in the amygdala are not involved in the pain inhibitory processes that are recruited during aversive situations. However, activation of these receptors does phasically increase anxiety. Although the intrinsic antinociceptive properties of systemically administered midazolam confounded interpretation of its effects on OAIA, intra-amygdala injections of this compound suggest that benzodiazepine receptors in this brain region modulate both the antinociceptive and behavioural (anxiety) responses to the EPM.

Evaluation of the elevated T-maze as an animal model of anxiety in the mouse

The elevated T-maze has been developed as an animal model of anxiety to generate both conditioned and unconditioned fears in the same rat. This study explores a version of the elevated T-maze fit for mice. Inhibitory (passive) avoidance-conditioned fear-is measured by recording the latency to leave the enclosed arm during three consecutive trials. One-way escape-unconditioned fear-is measured by recording the time to withdraw from open arms. The results showed that mice do not appear to acquire inhibitory avoidance in the standard T-maze, since their latencies to leave enclosed arm did not increase along trials. Nevertheless, the open arms seemed to be aversive for mice, because the latency to leave the enclosed arm after the first trial was lower in a T-maze with the three enclosed arms than in the standard elevated T-maze, In agreement, the exposure of mice to an elevated T-maze without shield, that reduces the perception of openness, increased significantly the latencies to leave the enclosed arm, However, the absence of the shield also increased the time taken to leave the open arms when compared to that recorded in standard T-maze. Systematic observation of behavioral items in the enclosed arm has shown that risk assessment behavior decreases along trials while freezing increases. In the open arms, freezing did not appear to influence the high latency to leave this compartment, since mice spend only about 8% of their time exhibiting this behavior, These results suggest that mice acquire inhibitory avoidance of the open arms by decreasing and increasing time in risk assessment and freezing, respectively, along three consecutive trials, However, one-way escape could not be characterized. Therefore, there are important differences between mice (present results) and rats (previously reported results) in the performance of behavioral tasks in the elevated T-maze. (C) 1999 Elsevier B.V.

5-HT2 receptor activation in the midbrain periaqueductal grey (PAG) reduces anxiety-like behaviour in mice

It is widely acknowledged that the indoleamine neurotransmitter serotonin (5-HT) plays a dual role in the regulation of anxiety, a role that in part depends upon neuroanatomical locus of action. Thus, whereas stimulation of 5-HT1A or 5-HT2 receptors in the limbic forebrain (amygdala, hippocampus) enhances anxiety-like responding in rodents, activation of corresponding receptor populations in the midbrain periaqueductal grey (PAG) more often than not reduce anxiety-like behaviour. The present study specifically concerns the anxiety-modulating influence of 5-HT2 receptors within the mouse PAG. Experiment 1 assessed the effects of intra-PAG infusions of the 5-HT2B/2C receptor agonist mCPP (0, 0.03, 0.1 or 0.3 nmol/0.1 mu l) on the behaviour of mice exposed to the elevated plus-maze. As mCPP acts preferentially at 5-HT2B and 5-HT2C receptors, Experiment 2 investigated its effects in animals pretreated with ketanserin, a preferential 5-HT2A/2C receptor antagonist. In both cases, test sessions were videotaped and subsequently, scored for anxiety-like behaviour (e.g., percentage of open arm entries and percentage of open arm time) as well as general locomotor activity (closed arm entries). The results of Experiment I showed that mCPP microinfusions (0.03 and 0.1 nmol) into the PAG of mice decreased behavioural indices of anxiety without significantly altering general activity measures. In Experiment 2, the anxiolytic-like profile of intra-PAG mCPP (0.03 nmol) was substantially attenuated by intra-PAG pretreatment with an intrinsically inactive dose of the preferential 5-HT2A/2C receptor antagonist, ketanserin (10 nmol/0.1 mu l). Together, these data suggest that 5HT(2C) receptor populations within the midbrain PAG play an inhibitory role in plus-maze anxiety in mice. (C) 2007 Elsevier B.V. All rights reserved.