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- ItemSomente MetadadadosCrianças vitimizadas pelos pais: como elas percebem suas famílias?(Universidade Federal de São Paulo (UNIFESP), 2013-02-27) Freitas, Claudia Regina de [UNIFESP]; Tucci, Adriana Marcassa [UNIFESP]; http://lattes.cnpq.br/6278405456405903; Universidade Federal de São Paulo (UNIFESP)Domestic violence against children is a phenomenon present in different societies since earliest times. It occurs in numerous ways, in various contexts, including within families shaping up as secret and taboo. Understand, identify and describe domestic violence against children have been a recurring issue in studies in several countries, given the scale of the phenomenon and the consequence associated with it, being considered in our country as a public health problem. The present study aimed to investigate the perceptions of victims (children victimized) in relation to their family, and especially in relation to caregiver-aggressor, in an attempt to understand the experience of violence from the perspective of the child. For this, we used the following instruments to collect data: Inventory Phrases in the Diagnosis of Domestic Violence, with the purpose of identifying symptoms (cognitive, emotional, physical, social and behavioral) and Projective Technique Drawing Family with Stories. The sample consisted of twelve children aged between six and twelve years, five of them were living in shelters at the time of the survey and the others seven were attending an institution dedicated to face vulnerable populations. It was observed that the children had indications of emotional, behavioral, cognitive and social disorders. Moreover, they expressed their experiences through defense mechanisms (escape, fantasy and denial); demonstrated feelings of depression, fear, hostility and anger. They also showed a desire to receive love, protection and acceptance, and, somehow, children have also revealed traces of resilience in an attempt to restructure themselves face to their oppressive reality. In this sense, it is possible to believe that the damage due to the situation of victimization can be softened through appropriate technical assistance. Identify aspects of relationships implied in the context of domestic violence against children, from the needs expressed by victims can bring contributions to the practice of broader interventions within different contexts, such as social, school, hospital or other points of access community, developing preventive actions that contribute to the structuring of interpersonal relationships healthier and less harmful.
- ItemAcesso aberto (Open Access)Intervenções psicológicas e comportamentais nos transtornos alimentares caracterizados por compulsão alimentar recorrente associados a sobrepeso ou obesidade(Universidade Federal de São Paulo (UNIFESP), 2019-08-16) Palavras, Marly Amorim [UNIFESP]; Claudino, Angelica De Medeiros [UNIFESP]; Hay, Phillipa; http://lattes.cnpq.br/4532343545365473; Universidade Federal de São Paulo (UNIFESP)Background: This thesis is structured in three articles involving the association between Bulimia Nervosa (BN) or Binge Eating Disorder (BED) and overweight/obesity. Current treatments to these clinical conditions usually focus either on improvement of eating disorder symptoms or in weight loss. In this project, we tested a psychological intervention, called HAPIFED, which targets simultaneously binge eating associated to overweight/obesity comparing to the intervention with the best evidence of efficacy, the Cognitive Behavioural Therapy, in its enhanced form (CBT-E). Objectives: Study 1 - presents a systematic review of the literature and meta-analysis evaluating the effects of psychological approaches in the remission or reduction of binge eating and weight loss in obese people with BN or BED. Studies 2 and 3 - describe the protocol of a randomized controlled trial (RCT) which tested the efficacy and safety of HAPIFED compared to CBT-E in reducing symptoms of eating disorders and introducing the healthy management of weight loss in the treatment of obese people with BN or BED. Methods: Study 1 – Articles selected in databases (up to March 2016) consisted of RCTs testing psychological approaches for binge eating remission or reduction and weight loss, in adult population with overweight/obesity and diagnosis of BN or BED. Methodological quality of trials was evaluated and meta-analysis of results of studies comparing CBT with Behaviour Weight Loss Therapy (BWLT) was performed. Studies 2 and 3 - A single blind RCT selected adults of both genders with BN or BED (DSM-5 or ICD-11) and BMI ≥ 27 to < 40 kg/m². Ninety-eight participants were randomized, 50 were included in HAPIFED and 48 in CBT-E. Compared interventions provided 30 group sessions over 6 months. The primary outcome was weight reduction and secondary outcomes included reduction of symptoms of eating disorder. Results: Study 1 - Nineteen articles were included in this review. No study with BN was identified. CBT was the most tested intervention. For binge eating remission, CBT was superior to waiting list, not superior to other interventions and inferior to CBT combined with exercise. For weight loss, CBT was not superior to waiting list or other interventions and was inferior to CBT plus exercise. In meta-analysis comparing CBT with BWLT, CBT promoted greater binge eating frequency reduction at the end of treatment (MD 2.04 95% CI, 0.35 to 3.73; n=4). Meta-analyses performed for binge eating frequency at 12-month follow-up, as well as for weight loss at the end of treatment and 12-month follow-up did not show difference between treatments. Studies 2 and 3 – There was no difference between groups throughout treatment for weight loss (x²(3)=0.19, p=0.979), nor for the secondary outcomes, except for reduction of purging behaviours, favoring HAPIFED (x²(3)=10.35, p=0.016). There was a reduction of eating disorders’ psychopathology in both treatments. Conclusions: Study 1 – Evidence supports better results for CBT with regards to short-term binge eating remission compared to BWLT. Insufficient evidence was found for superiority of BWLT efficacy compared to CBT considering binge eating remission, reduction of binge eating frequency and weight loss in short term. More research is needed to test the efficacy of psychological treatments for BED or BN with co-morbid overweight/obesity, including trials evaluating binge eating remission and weight loss in the long-term. Studies 2 and 3 - HAPIFED was not superior to CBT-E in promoting clinically significant weight loss and was not significantly different in reducing most eating disorder symptoms. No harm was observed with HAPIFED, in that no worsening of eating disorder symptoms was observed.
- ItemAcesso aberto (Open Access)Programa pré-escolar para crianças de risco para os transtornos de linguagem: quem responde à intervenção?(Universidade Federal de São Paulo (UNIFESP), 2020-03-05) Silveira, Heloisa Goncalves Da [UNIFESP]; Puglisi, Marina Leite [UNIFESP]; http://lattes.cnpq.br/8567228391940194; http://lattes.cnpq.br/7058556670710993; Universidade Federal de São PauloObjectives: 1) to explore whether the individuals who best respond to the intervention have a common language profile and, if so, describe this profile; 2) to analyze if children with a language profile suggestive of LD will respond better to the intervention, being more susceptible to stimulation. In contrast, children with a language profile suggestive of SLI will underperform, not responding or responding poorly to the intervention. Method: This is an exploratory retrospective study that aims to investigate and identify the language profile of children who responded to the early oral language intervention program adapted to the Brazilian reality. The participating preschools were from Rio Claro. Students were selected based on teachers' evaluation of children's behavior and performance in language tasks. This trial was based on a questionnaire to identify children with communication difficulties, developed especially for the research. The final sample consisted of the 16 children from each school that presented the lowest language indices (n total = 128; considering the eight participating schools). Half of the children in each school were randomly assigned to language intervention, and half to the control group, using stratified randomization to control the effects of early language skills. Results: The results emphasized differences between the intervention and control group in the gains related to the taught vocabulary (Voc. Ensinado) and the phonological awareness (CF) with an average. No differences were found between the groups in any standardized untrained language measure. Based on the skills trained, clusters were generated with individuals who participated in the intervention. The group Gain CF obtained greater gain in phonological awareness. The Taught Vocabulary Gain Group due to its greater improvement in vocabulary taught during the intervention. The third group, Worst Gain, was the group with the lowest gain in both abilities when compared to the others. Children who made up the groups with the highest gains had poor initial performance in these skills, thus obtaining greater gain margin for each group after the intervention. Conclusion: The study showed that the variables with the greatest influence on the environment tend to respond more clearly to the proposed intervention process.
- ItemAcesso aberto (Open Access)Vidas paralelas: exílio e refugiados urbanos(Universidade Federal de São Paulo, 2022-05-27) Lescher, Auro Danny; Matos, Olgária Chain Féres; http://lattes.cnpq.br/3457051894936314; http://lattes.cnpq.br/8950919266226319O objetivo deste trabalho é analisar o exílio como experiência de um Sujeito e não como questão sociológica e estatística. Assim, trata-se de compreender o exílio antes do exílio, a decisão de partir, a perda de referências simbólicas e estruturantes, como um país, uma cidade, uma rua e uma casa. Procuraremos refletir sobre os sentidos do viver, angústia (Hilfslosigkeit) entendida como fonte de valores morais, bem como sobre as formas de constituição de pertencimento, em que o princípio da vida é exercido em situações extremas, como as que vivemos refugiados urbanos em São Paulo. Trata-se de analisar a questão dos “refugiados urbanos”, em particular, crianças e adolescentes que habitam ou frequentam as ruas do Centro de São Paulo, considerando-se as condições de sua gênese e as razões pelas quais elas se ampliam e se perpetuam, numa contemporaneidade que se ressente dos efeitos da mercantilização da vida, da preponderância do mercado como cultura, fator de organização e valor, prejudicando fortemente as ações de tipo cooperativo.