Therapeutic Setting Research Articles

Identification and Characterization of the Chemical Constituents of Qianlie Shule Capsules by UPLC-Q-Orbitrap-MS/MS.

The Qianlie Shule capsule is a classical Chinese medicine compound preparation frequently used in therapeutic settings to alleviate astringent pain in the urethra, prostatic hypertrophy, and chronic prostatitis or urinary frequency. However, a comprehensive analysis of the chemical composition of Qianlie Shule capsules has not been reported. To establish a quick and effective analytical method based on hybrid quadrupole-orbitrap mass spectrometry ultrahigh-performance liquid chromatography (UPLC-Q-Orbitrap-MS/MS) for the identification and characterization of chemical components in Qianlie Shule capsules. Using ultrahigh-performance liquid chromatography with hybrid quadrupole-orbitrap mass spectrometry and data post-processing, the samples of Qianlie Shule capsules were examined. First, the whole extract of the Qianlie Shule capsules was separated using a UPLC machine, and the fragmentation data were collected in both positive and negative ion mode. The target molecule is then quickly identified by comparing the fragmentation information of the neutral loss (NLs) and characteristic fragments (CFs) reported in the literature. A total of 145 chemical components were identified. It includes flavonoids, triterpenoids, phenylpropanoids, organic acids, alkaloids, phenylethanoids, iridoids, and anthraquinones. This study is a method for the rapid qualitative analysis of the chemical composition of Qianlie Shule capsules, which provides a method for the rapid, sensitive, and high-throughput identification of the prescription components of Chinese medicine. Systematic identification of the chemical composition of QLSL capsules provides a theoretical basis for studying the substance basis of QLSL capsules and the improvement of the quality control level.

Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic.

The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Concentration-QTcF Modeling of Icenticaftor from a Randomized, Placebo- and Positive-Controlled Thorough QT Study in Healthy Participants.

Icenticaftor (QBW251) is a potentiator of the cystic fibrosis transmembrane receptor. Based on its mechanism of action, icenticaftor is expected to provide benefits in patients with chronic obstructive pulmonary disease by restoring mucociliary clearance, which would eventually lead to a reduction of bacterial colonization and related inflammatory cascade. A placebo- and positive-controlled, 4-way crossover thorough QT study was conducted in 46 healthy participants with the objective to assess the effect of therapeutic (300mg twice daily for 6 days) and supratherapeutic (750mg twice daily for 6 days) oral doses of icenticaftor on electrocardiogram parameters, including concentration-corrected QT (QTc) analysis. Moxifloxacin (400mg, oral) was used as a positive control. In the concentration-QTc analysis performed on pooled data from Day 1 and Day 6 (steady state), the estimated population slope was shallow and slightly negative: -0.0012ms/ng/mL. The effect on the Fridericia corrected QT (QTcF) interval (∆ΔQTcF) was predicted to be -1.3milliseconds at the icenticaftor 300-mg twice-daily peak concentration (geometric mean was 1094ng/mL) and -5.5milliseconds at the 750-mg twice-daily peak concentration (geometric mean Cmax was 4529ng/mL) indicated a mild shortening effect of icenticaftor on QTcF interval length. The results of the by-time-point analysis indicated least squares placebo corrected mean ∆∆QTcF across time points ranged from -7.9 to 0.1milliseconds at 1 and 24hours after dosing both on Day 6 in the 750-mg dose group compared with -3.7 to 1.6milliseconds at 1.5 and 24 hours after dosing on Day1 in the 300-mg dose group. Assay sensitivity was demonstrated with moxifloxacin. The large accumulation of exposures, especially the 4.3-fold increase in peak plasma concentration observed at the icenticaftor 750-mg twice-daily dosage compared with Icenticaftor 300mg twice daily (2.3-fold) on Day 6 provided a large concentration range (up to 9540ng/mL) to evaluate the effect of icenticaftor on ΔΔQTcF. Based on the concentration-QTc analysis, an effect on ΔΔQTcF exceeding 10milliseconds can be excluded within the full observed ranges of plasma concentrations on icenticaftor, up to approximately 9540ng/mL. Icenticaftor at the studied doses demonstrated a mild shortening in QTcF, which is unlikely to be of clinical relevance in a therapeutic setting.

OP33 Mechanistic insights on the role of ultra processed foods as a trigger/fuel for IBD

Abstract Background Ultra processed foods (UPFs) are a heterogeneous category of products that contain food additives and/or have undergone several industrial processes. The higher intake of UPFs seen in industrialized countries has been associated with increased incidence of inflammatory bowel diseases (IBD), mainly Crohn’s disease (CD). However, the specific mechanisms through which the UPFs can induce or maintain intestinal inflammation are still unknown. Therefore, most dietary interventions for IBD essentially exclude all UPFs from the menu, increasing the difficulty of long-term compliance of these diets. The main focus of my research is the study of which components may be detrimental in UPFs, in the hope that we can limit the number of UPFs that we need to exclude from our diets. Methods To understand the mechanism of action of UPFs, a translational approach is needed with complementary pre-clinical and clinical studies. We used organoid cultures from patients with CD to test the impact of food additives on the intestinal epithelium (e.g. permeability, pro-inflammatory effect). These organoid cultures are more physiologically relevant than immortalized cell lines, which lack several important aspects (e.g. genetic background, complex assembly of different cells). The results of the first tests with this platform have been submitted to ECCO (EC24-1418). Additionally, we established several protocols and collaborations to run well designed dietary intervention studies to explore the mechanisms of action of these food additives in humans. In the FOAM study, we explored the effects of 5 emulsifiers in an double blind randomized placebo controlled trial. The results of the FOAM study have also been submitted to ECCO (EC24-0858). We also explored the acceptance, feasibility, and compliance of an emulsifier free diet in healthy volunteers (EC24-1181). Results Our results support the need to better understand the role of food additives and UPFs in IBD, and the need for better evidence supporting the detrimental role of food additives. Conclusion Compliance is an important issue to consider in all dietary interventions, more than in pharmacological interventions. Strategies focusing on improving the compliance of dietary interventions can have a big impact in the applicability of these interventions in therapeutic and/or prophylactic settings. However, the current knowledge on the possible detrimental role of UPFs does not allow to pinpoint which UPFs are detrimental and which might have no effect on intestinal inflammation. Hence, there is an unmet need for pre-clinical and clinical studies focusing on the mechanisms through which these UPFs might play a role in intestinal inflammation.

Increasing striatal dopamine release through repeated bouts of theta burst transcranial magnetic stimulation of the left dorsolateral prefrontal cortex. A 18F-desmethoxyfallypride positron emission tomography study.

Transcranial Magnetic Stimulation (TMS) can modulate fronto-striatal connectivity in the human brain. Here Positron Emission Tomography (PET) and neuro-navigated TMS were combined to investigate the dynamics of the fronto-striatal connectivity in the human brain. Employing 18F-DesmethoxyFallypride (DMFP) - a Dopamine receptor-antagonist - the release of endogenous dopamine in the striatum in response to time-spaced repeated bouts of excitatory, intermittent theta burst stimulation (iTBS) of the Left-Dorsolateral Prefrontal Cortex (L-DLPFC) was measured. 23 healthy participants underwent two PET sessions, each one with four blocks of iTBS separated by 30 minutes: sham (control) and verum (90% of individual resting motor threshold). Receptor Binding Ratios were collected for sham and verum sessions across 37 time frames (about 130 minutes) in striatal sub-regions (Caudate nucleus and Putamen). Verum iTBS increased the dopamine release in striatal sub-regions, relative to sham iTBS. Dopamine levels in the verum session increased progressively across the time frames until frame number 28 (approximately 85 minutes after the start of the session and after three iTBS bouts) and then essentially remained unchanged until the end of the session. Results suggest that the short-timed iTBS protocol performed in time-spaced blocks can effectively induce a dynamic dose dependent increase in dopaminergic fronto-striatal connectivity. This scheme could provide an alternative to unpleasant and distressing, long stimulation protocols in experimental and therapeutic settings. Specifically, it was demonstrated that three repeated bouts of iTBS, spaced by short intervals, achieve larger effects than one single stimulation. This finding has implications for the planning of therapeutic interventions, for example, treatment of major depression.

Tumor Segmentation and Classification Using Machine Learning Approaches

Medical image processing has recently developed progressively in terms of methodologies and applications to increase serviceability in health care management. Modern medical image processing employs various methods to diagnose tumors due to the burgeoning demand in the related industry. This study uses the PG-DBCWMF, the HV area method, and CTSIFT extraction to identify brain tumors that have been combined with pancreatic tumors. In terms of efficiency, precision, creativity, and other factors, these strategies offer improved performance in therapeutic settings. The three techniques, PG-DBCWMF, HV region algorithm, and CTSIFT extraction, are combined in the suggested method. The PG-DBCWMF (Patch Group Decision Couple Window Median Filter) works well in the preprocessing stage and eliminates noise. The HV region technique precisely calculates the vertical and horizontal angles of the known images. CTSIFT is a feature extraction method that recognizes the area of tumor images that is impacted. The brain tumor and pancreatic tumor databases, which produce the best PNSR, MSE, and other results, were used for the experimental evaluation.

THE ROLE OF BALLROOM DANCES IN THE FORMATION OF SOCIAL SKILLS AND INTERACTION WITH OTHERS

The research is dedicated to exploring the multifaceted impact of ballroom dancing on the development of social skills and the enhancement of interpersonal interactions. It delves into how this form of dance transcends its artistic boundaries to become a significant tool in social and personal development. The primary aim of this study is to systematically analyze and understand the ways in which ballroom dancing contributes to the formation and enhancement of social skills. It seeks to establish a connection between the physical and psychological aspects of ballroom dancing and their collective influence on an individual’s ability to interact and communicate effectively within a social context. The research employs a combination of qualitative and quantitative methodologies, including literature review, observational studies. It integrates the analysis of academic journals, dance therapy reports, and firsthand observations from dance studios and educational settings. The findings of the study highlight the significant role of ballroom dancing in improving communication skills, fostering teamwork and respect, enhancing self-esteem and posture, providing cultural education, facilitating emotional expression, and improving physical health and coordination. This research underscores the practical application of ballroom dancing as a tool for enhancing social skills in educational and therapeutic settings. It provides insights for educators, therapists, and dance professionals on utilizing ballroom dancing as an effective medium for fostering social and personal development.

Preclinical Evaluation of virus-like particle Vaccine Against Carbonic Anhydrase IX Efficacy in a Mouse Breast Cancer Model System.

Carbonic anhydrase IX (CAIX) is a cancer-associated membrane protein frequently overexpressed in hypoxic solid tumours leading to enhanced tumour cell survival and invasion, and it has been proposed to be an attractive tumour-specific molecule for antibody-mediated targeting. This study aimed to generate a virus-like particle (VLP)-based CAIX vaccine candidate and evaluate its efficacy in a mouse model of breast cancer. The prototype murine vaccine was developed based on the ssRNA bacteriophage Qbeta VLPs with chemically coupled murine CAIX protein catalytic domains on their surfaces. The vaccine was shown to efficiently break the natural B cell tolerance against autologous murine CAIX and to induce high-titre Th1-oriented IgG responses in the BALB/c mice. This vaccine was tested in a therapeutic setting by using a triple-negative breast cancer mouse model system comprising 4T1, 4T1-Car9KI and 4T1-Car9KO cells, the latter representing positive and negative controls for murine CAIX production, respectively. The humoural immune responses induced in tumour-bearing animals were predominantly of Th1-type and higher anti-mCAIXc titres correlated with slower growth and lung metastasis development of 4T1 tumours constitutively expressing mCAIX in vivo in the syngeneic host.

Mammalian target of rapamycin inhibition protects glioma cells from temozolomide-induced cell death

Glioblastoma is an incurable brain tumor with a median survival below two years. Trials investigating targeted therapy with inhibitors of the kinase mTOR have produced ambiguous results. Especially combination of mTOR inhibition with standard temozolomide radiochemotherapy has resulted in reduced survival in a phase II clinical trial. To date, this phenomenon is only poorly understood. To recreate the therapeutic setting in vitro, we exposed glioblastoma cell lines to co-treatment with rapamycin and temozolomide and assessed cell viability, DNA damage and reactive oxygen species. Additionally, we employed a novel translatomic based mass spectrometry approach (“mePROD”) to analyze acute changes in translated proteins. mTOR inhibition with rapamycin protected glioblastoma cells from temozolomide toxicity. Following co-treatment of temozolomide with rapamycin, an increased translation of reactive oxygen species (ROS)-detoxifying proteins was detected by mass spectrometry. This was accompanied by improved ROS-homeostasis and reduced DNA damage. Additionally, rapamycin induced the expression of the DNA repair enzyme O-6-methylguanine-DNA methyltransferase (MGMT) in glioblastoma cells with an unmethylated MGMT gene promotor. Inhibition of mTOR antagonized the cytotoxic effects of temozolomide in vitro. The induction of antioxidant defences and MGMT are two underlying candidate mechanisms. Further functional experiments in vitro and in vivo are warranted to characterize this effect that appears relevant for combinatorial therapeutic strategies.

The Relevance of Poetic Language for the Revitalization of Psychotherapy

This article addresses the problems associated with language in the therapeutic setting that is stale, overly rigid, or too reliant on jargon, and therefore inhibits the full and open exploration of clients. Instead, the author suggests that psychotherapy learn from and borrow from the field of poetry. Specifically, the use of poetic language—defined as language that is rooted in images, pictures, and metaphors and that is spontaneous, associative, and informal—can improve therapists’ tracking of the somatic-emotional-mental experiences of clients and create a rich and textured holding environment that is better fit for the transformational process. The article explores observations and statements by both poets and psychotherapists, examines the overlap and parallels between them, and describes a means for using poetic language to revitalize therapeutic language and the process of therapy.

Long Shadows of Racism and Genocide: Learning from Erich Fromm’s Social Psychoanalysis

ABSTRACT As a psychoanalyst, Fromm felt compelled to speak to the social and political crises of his time. Fromm’s social psychoanalysis was a radical departure from the Freudian mainstream and has important implications for how psychoanalysis can address social and political forces today. What is less known and often neglected is the way in which Fromm was himself shaped by the traumatic events of racial discrimination and genocide that marked the twentieth century, particularly the rise of Nazism, virulent anti-Semitism and the Holocaust. This article will weave together Fromm’s life-experience, and that of his family, with his development of key ideas relating to the threat of authoritarianism and racial narcissism. To illustrate the relevance of Fromm’s work in the present moment, I consider the reality of systemic racism and the long shadow of genocide. Drawing on my work as practicing psychoanalyst, I address the racial discrimination experienced by Indigenous peoples in Canada. In the process, I examine how the psychoanalysis and the therapeutic setting is embedded in society and inevitably implicated in the structures of systemic racism.

Leveraging Coffee Waste for Social Impact: A Sustainable Toolkit for Enhancing Sensory Skills and Therapeutic Exercises in Educational and Therapeutic Settings

In an era of increasing focus on sensory development, mental well-being, and sustainability, we present herein a Coffee-Infused Soap-Making Toolkit as an innovative solution to the intersecting challenges born out of these factors. This study aims to develop and assess a novel toolkit designed to integrate sensory stimulation with therapeutic hand exercises while promoting sustainable practices. The problem addressed is a gap in the literature regarding educational and therapeutic tools that are effective and eco-friendly, which simultaneously support sensory and cognitive development. The research employs a descriptive design which is intended to be carried out with a sample of 100 participants, including children with sensory processing issues, older adults with motor function decline, and educators. Data collection will involve both quantitative and qualitative methods, utilizing surveys, structured interviews, and observational data to evaluate the toolkit’s impact on sensory engagement, motor function improvement, and overall well-being. Statistical and thematic analyses will be applied to interpret the data. The aim of this intended research is to determine whether the Coffee-Infused Soap-Making Toolkit, which aligns with sustainable practices by incorporating eco-friendly materials, effectively enhances sensory skills and motor functions by leveraging the tactile and olfactory benefits of coffee grounds, as well as its effectiveness in supporting therapeutic hand exercises. This study underscores the potential of integrating sensory enrichment with sustainability in educational and therapeutic settings, offering practical implications for educators and therapists. The toolkit is not only designed to foster cognitive and motor development, but also exemplifies how environmental responsibility can be embedded into therapeutic interventions. Future research should focus on empirical validation across diverse populations and explore the broader implications of sustainable practices in therapeutic tools.

The evolution of Alzheimer’s disease therapies: A comprehensive review

Abstract Alzheimer`s disease (AD) is a progressive neurodegenerative disease which accounts for most of the cases of dementia. The progression of the disease cannot be fully controlled by current medications, nor do they produce adequate therapeutic results. Understanding the molecular and cellular alterations linked to AD pathogenesis has advanced significantly in recent decades. Amyloid-peptide-containing cerebral plaques and thread-like neuronal structures made of the microtubule-associated protein TAU are two pathogenic features of the condition. Therefore, inhibiting amyloid formation, aggregation, or subsequent neurotoxic events is the primary goal of therapeutic drug development. Here, some newer therapeutic modalities are described, including anti-amyloid therapy, anti-tau therapy, antineuroinflammatory therapy, neuroprotective agents including N-methyl- d -aspartate (NMDA) receptor modulators, and brain stimulation. Drug repositioning may speed up the development of pharmaceuticals, but non-pharmacological therapies, particularly repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), also have the potential to be used in therapeutic settings. Here we discussed current symptomatic therapy for AD as well as novel prospective disease-modifying medicines that are presently being investigated in phase I–III trials in this review. The study emphasizes how taking into account the intricate nature of AD pathogenesis and investigating drug repurposing strategies which can open the door to the creation of innovative AD therapies.

Effects of aripiprazole on prolactin levels and differences in effectiveness in patients with schizophrenia: a post-hoc analysis of the real-world data of a multicenter study.

To investigate the effect of aripiprazole on prolactin levels in patients with schizophrenia and analyze whether varying baseline prolactin levels affect the effectiveness and safety of aripiprazole, in a real-life diagnostic and therapeutic setting in a post-hoc analysis. In this post-hoc analysis, patients with schizophrenia in the acute phase were divided into an elevated-prolactin group and a normal-prolactin group. After 8 weeks of aripiprazole treatment, changes in the proportion of patients with an abnormal prolactin level were analyzed in both groups, and the efficacy and safety of aripiprazole were compared between the two groups. The elevated-prolactin group had more women, a longer duration of disease, and lower Positive and Negative Syndrome Scale (PANSS) total and subscale scores at baseline compared with the normal-prolactin group (all P < 0.05), and there was no significant difference in the proportion of patients with prior use of antipsychotic medication between the two groups. Regardless of previous antipsychotic use, patients in both groups developed hyperprolactinemia (23/168 [13.7%] in those who had taken antipsychotics vs. 43/375 [11.4%] in those who had not). After 8 weeks of aripiprazole treatment, the proportion of patients with abnormal prolactin in the elevated-prolactin group significantly decreased with prolonged treatment (P < 0.001), and aripiprazole had no significant effect on the normal-prolactin group (P = 0.250). Normal-prolactin group showed better efficacy than the elevated-prolactin group, and the differences in efficacy between the two groups was observed from week 4 to the endpoint (all p<0.05). In total, 87.2% (68/78) patients experienced mild to moderate adverse events in the elevated-prolactin group, which was significantly more frequent compared with the normal-prolactin group 71.0% (365/514). In this real-world study, for patients with acute schizophrenia, aripiprazole was effective in lowering the proportion of patients with abnormal prolactin levels, while it had no significant effect on patients with normal baseline prolactin. After adjusting for factors such as sex, age, prior antipsychotic drugs use history and disease severity, effectiveness and safety of aripiprazole in patients with normal baseline prolactin was significantly better than that in patients with elevated baseline prolactin.

Characterization and antibacterial activity of biogenic iron nanoparticles using Proteus mirabilis

Abstract Background: The green production of iron oxide nanoparticles (FeONPs) due to its numerous biotechnological uses has attracted a lot of attention and clean and eco-friendly approaches in the medical field. Objectives: The objectives of this study are to demonstrate the biogenic creation of FeONPs. The search for alternative antimicrobial medicines has been prompted by growing worries about multidrug resistance. Materials and Methods: The purpose of this work was to investigate if Proteus mirabilis was the source of green-manufactured iron nanoparticles (INPs). The Fourier transform infrared, attenuated total reflectance, scanning electron microscopy, transmission electron microscopy, energy dispersive X-ray spectroscopy, ultraviolet–visible, and dynamic light scattering measurements were used to characterize the green synthesized nanoparticles (NPs). Using the agar-well diffusion method, the antibacterial investigation’s efficacy was evaluated. Results: The results found that at 128 μg/mL minimum inhibitory concentration, we have demonstrated the potent antibacterial properties of FeONPs produced through biological procedures against Gram-positive and Gram-negative bacteria that are resistant to many drugs. These NPs, including their antimicrobial qualities, how they work, how they affect drug-resistant microbes, the risks involved with using them, the unique qualities of NPs, their mode of action as antibacterial properties, and the elements that influence how well they function in a therapeutic setting all are thoroughly investigated. Conclusion: Further research on biogenic INPs was necessary to enhance their nanopharmacological importance for biological applications, as they have demonstrated promising biomedical capabilities were successfully synthesized in a friendly environment with few costs, and the highly INPs product showed exceptional activity against bacterial strains.

Discharbing Phobia and Panic Disorders through Therapeutic Photography: Towards Righting Undergraduates Emotions for Performance in FCE, Kontagora.

This study on “Discharging Phobia and Panic Disorders through Therapeutic Photography: Towards Righting Undergraduates Emotions for Performance in FCE, Kontagora” deals with utilization of photographic skills for emotional expression and processing in therapeutic setting. The study adopted Mixed Method design with qualitative and Art-Based methods adopting interview, observation and focus group, while quantitative design adopted quasi-experimental study, with 2×2 factorial design with pretest-posttest non-randomized control group design. Four research questions and four hypotheses were formulated for the study, which 11 students were sampled, using nonprobability sampling technique of convenience sampling, while 14 students who also failed the Instructional Technology test, but did not accept the phototherapy voluntarily, as a way of helping them release emotional struggles were used as control group. Paired and Independent t-test were used to analyse the data, while Levene’s test for equality of variance was adopted to determine the degree of freedom at 0.5 degree. The research questions answered showed a significant difference between pretest and post-test scores among participants, but females were seen to have a high degree of emotional responses – discharging phobia and panic disorders. The stated hypotheses did not recognise significant differences in both emotions and academic performances; thus, the study recommends, among others that photographic component of Educational Resource Centers of tertiary institutions should be expanded to also cater for therapeutic interactions for students.

Guidelines for the Provision of Remote Psychological Services

Abstract: Albeit the benefits of delivering psychological services remotely using digital technologies (eMental Health) were established in the literature in the past years, its integration into clinical practice was slow. The COVID-19 pandemic marked an abrupt change, with eMental Health being almost the only way to provide psychological support worldwide. New competencies were demanded from psychologists, accompanied by a growing number of guidelines to support their practices. This work’s main goal was to summarize the available guidelines for the practice of remote psychological services. A scoping literature review was conducted until March 2022. All documents that provided guidelines for the remote provision of psychological services were analyzed. A deductive thematic analysis, followed by an inductive thematic analysis, was conducted. The most unanimous result was the importance of incorporating the guidelines available for the presential provision of psychological services in eMental Health services. Additional procedures were suggested, namely, to ensure the privacy and security of the information, therapeutic boundaries and therapeutic setting, and the safety of the clients. Furthermore, aspects such as risk assessment and management, managing interruptions and exits in sessions, multicultural competence of psychologists, and specificities of remote psychological assessment shall be considered before beginning the therapeutic process. This scoping review presents a summary of the available guidelines for the provision of remote psychological services and can be used by Psychologists to make informed decisions regarding their remote practices. It highlights the need to develop specific competencies related to the remote environment, which reinforces the need for formal training and adapting the training curricula of new psychologists.

How enoxaparin underdosing and sex contribute to achieving therapeutic anti-Xa levels.

Anti-Xa serves as a clinical surrogate for assessing the efficacy and bleeding risk in patients treated with enoxaparin for thromboembolic events. Evidence from the literature and empirical observations suggest that patients are underdosed in clinical practice to avoid bleeding complications. This study aimed to investigate such underdosing of enoxaparin and its potential impact on achieving therapeutic anti-Xa levels. This multicentric, retrospective, observational study included patients with acute ischemic stroke due to atrial fibrillation. All patients received enoxaparin in the therapeutic setting with subsequent anti-Xa measurements. The one-sample, one-tailed Wilcoxon signed-rank test was used to identify a significant difference between the doses administered and the recommended daily dose. Logistic regression model analysis was performed to identify additional predictors affecting achievement of the therapeutic anti-Xa target range. Stepwise forward-backward selection with Akaike's information criterion as metric was applied to refine the logistic regression model. A total of 145 patients from the university hospitals of St. Pölten and Tulln in Lower Austria were included. The median daily enoxaparin dose administered was 1.23mg/kg, resulting in an overall target range achievement rate of 66%. As compared to recommended therapeutic doses, significant underdosing of enoxaparin was evident in both participating centers (p < 0.001). The calculated threshold dose to achieve the therapeutic target range with a 90% probability was 1.5mg/kg enoxaparin daily. Female sex was found to be a strong independent predictor of achieving a therapeutic target range (OR 9.44; 95% CI 3.40-30.05, p < 0.001). Despite the underdosing observed in both centers, therapeutic anti-Xa levels were achieved with lower than recommended doses of enoxaparin, and women required even lower doses than men. These findings warrant further confirmation by prospective studies.

Regression in the service of bibliotherapy-What can "Captain Underpants" teach us?

Regression in the service of the ego is a unique phenomenon that often occurs within therapeutic settings. In the current study, I show how it emerges within child therapy and how bibliotherapy manages to give it presence and thus to process it. The methodology that guided this study was based on a critical reading of psychoanalysis and bibliotherapy theories. In addition, the methodology is based on a therapeutic vignette aimed at demonstrating the qualities of bibliotherapy with children. I claim that bibliotherapy, based as it is primarily on the use of reading and writing processes, offers additional ways of processing and thinking about this phenomenon. The study provides an innovative contribution that is related to the interdisciplinary approach to therapy. There are important links between the two major disciplines examined in this study, psychoanalysis and bibliotherapy. Their intertwining generates interrelations and mutual inspiration. Moreover, this study adds to the theoretical and practical foundation of bibliotherapy and further establishes the understanding regarding the power of reading and writing processes to "relate the soul" within the analytical process.

Deslizamentos de posição subjetiva em enunciados tidos como ecolálicos de uma criança com Distúrbio de Linguagem: um estudo de caso

ABSTRACT Within a linguistic-discursive framework, subject markers in a chain of utterances considered to be echolalia based on the recurring linguistic structure does X want Y? were investigated. This chain was produced during a speech therapy session by J., a female child, 10-years-old at the time of data collection, and with a speech-language pathology diagnosis of language disorder and a medical diagnosis of early psychosis. A set of linguistic fluctuations indicated a sliding of the subject position in the analyzed chain. Such fluctuations involved syntactic, lexical, semantic, morphological and prosodic elements. Discursively, the fluctuations left traces of a sliding of the subject position in the chain formed by these utterances, from a spoken subject (do you want Y?) to a speaking/desiring one (I want Y.). In this way, utterances considered echolalia can provide clues, via their linguistic fluctuations and discursive slippages, about the subject's desire in their relationship with the O/other. Given this, although they do not emerge in a conventional way, such utterances can demonstrate possibilities for changes in subject position. A contribution of the present research for clinical practice involving language in therapeutic settings therefore, was to highlight a listening to utterances, which could be seen as connected/grounded in the speech of the other. In clinical practice involving language, it is possible to create space for new/other senses for utterances, to allow the constitution of the subject of/in language, based on utterances often interpreted as being devoid of subjectivity.