Terapirommet er ikke et nøytralt rom. Om Friluftssykehuset og potensialet i de fysiske omgivelsene for barn og unge i behandling.

Background and aim: The purpose of this article is to demonstrate how we can use nature cabins and their natural surroundings therapeutically. Method: Published research of relevance for this therapeutic practice is discussed in relation to and informed by experiences from practice, collected through conversations with therapists using the Outdoor care retreat at Rikshospitalet in Norway. Results: The literature review demonstrates how therapy in nature cabins can influence cognitive and emotional processes. All physical environments carry symbolic meanings; therefore, no therapy setting is neutral, and the setting will affect the client and therapist. Place attachment may contribute to create a safe foundation for exploration and self-development. The experiences from practice demonstrate how nature and natural objects are rich in potential for the creative application of symbols in therapy and opens for different stories on growth and development. Conclusions and implications: The evidence-based approach of this article supplies a therapeutic rationale to use cabins in natural surroundings more strategically for positive therapeutic outcomes. Keywords: nature, architecture, therapy settings, hospital environments

Comorbid patient with arterial hypertension: difficulties in diagnosis and treatment

The problem of comorbidity becomes especially relevant in the conditions of demographic aging of the population. In recent years the number of studies devoted to diagnostic and treatment features of comorbidities, especially in elderly and senile patients, has increased. In spite of this fact, until now there are no clear recommendations for the management of comorbidities in the therapeutic practice.The article is devoted to the presentation and discussion of a clinical case of a comorbid patient with arterial hypertension. The stages of the performed diagnostic search with verification of the clinical diagnosis and the tactics of the prescribed pharmacotherapy are presented. On the basis of the presented data it is shown that exacerbation of one of the chronic diseases of the patient’s general comorbid background may significantly increase the severity of the general pathology and in its turn will determine the prognosis and influence the treatment tactics. The complexity of this case is that the patient has chronic single kidney disease in the stage of chronic renal failure. In analysing this case, it is also important to note the difficulties in the choice of drug therapy, as this situation poses significant limitations in the use of many drugs. This is a challenge that every clinician faces on a daily basis, regardless of clinical experience and medical knowledge. Only a multilevel approach will enable comprehensive medical and social care to be organised for patients with co-morbidities with chronic diseases, provide follow-up not only during exacerbations but also during remissions, contribute to the prevention of exacerbations and complications, which will consequently improve prognosis and quality of life.

PREFERENCES FOR VIRTUAL MUSIC THERAPY AND THE USE OF TECHNOLOGY IN THE PRACTICE OF CZECH MUSIC THERAPISTS – A DESCRIPTIVE CROSS-SECTIONAL STUDY

The preventive restrictions imposed at the beginning of March 2020 led to the interruption of the therapeutic practice of most music therapists in the Czech Republic. The aim of this descriptive cross-sectional study was to find out what impact this situation had on the music therapy community at the end of May 2020, how many music therapists gained experience with virtual music therapy (VMT) and how ICT and other technologies were used in music therapy practice. A survey with an extended version of a questionnaire created by Gilboa, Weiss and Dassa (not yet published) for the purpose of an international survey in music therapy was used for data collection. Based on the findings, most music therapists at the time had no experience with VMT, but a small number of practitioners were interested in using VMT even after the end of the lockdown. ICT has been used more for receptive music therapy activities and its wider application faces problems such as a lack of knowledge and skills in the use of ICT in the context of music therapy. Based on these findings, a project focused on the implementation of best-evidence concerning VMT into Czech music therapy practice was launched. Also, we recommend creating projects focused on the use of ICT (including applications in music therapy conducted face-to-face) in the near future.

Creative Writing and Decolonizing Intersectional Feminist Critical Reflexivity: Challenging Neoliberal, Gendered, White, Colonial Practice Norms in the COVID-19 Pandemic

Creative writing during the COVID-19 pandemic can serve as a decolonizing intersectional feminist method for critical self-reflexivity. We share responses to the prompt: “If my therapeutic practice came with a warning label in COVID-19, what would it say?” and provide an analysis of the neoliberalism, whiteness, and colonialism embedded in our creative writing and practice. Engaging in critical self-reflexivity through metaphor carries potential for revealing hidden gendered, racialized, colonial, and neoliberal biases and norms related to social work practice, particularly when done in a collaborative, dialogic manner. We conclude by providing possible creative writing prompts that might be used in social work practice, supervision, and teaching to advance existing practices of self-reflexivity in social work both during and beyond the pandemic.

Treating Agitation in Patients with Dementia with a Therapy Dog in a Milieu Therapy Setting on a Geropsychiatric Ward

<b><i>Background:</i></b> Animal-assisted intervention has become a common therapeutic practice used for patients with dementia in home-dwelling and institutions. The most established procedure is a visiting service by specially trained dogs and their owners to improve social interactions and reduce symptoms of agitation. <b><i>Objectives:</i></b> The study aims to investigate the effects of a therapy dog on agitation of inpatients with dementia in a gerontopsychiatric ward. <b><i>Materials and Methods:</i></b> The severity of agitation was assessed by a rater blinded for the presence of the dog via the Overt Agitation Severity Scale (OASS). The scale was conducted on 1 day with the dog and his handler present (resident doctor on the ward) and on another day with only the handler present. Each patient was his/her own control. Heart rate variability (HRV) and serum level of brain-derived neurotrophic factor (BDNF) of the patients were measured on both days. 26 patients with the Mini-Mental Status Examination (MMSE) score &#x3c;21 and the diagnosis of dementia were included in the study. <b><i>Results:</i></b> A significant reduction of agitation in the OASS could be shown when the dog was present (<i>p</i> = 0.006). The data neither demonstrated a difference in the HRV for the parameters mean heart rate (<i>p</i> = 0.65), root mean square of successive differences (<i>p</i> = 0.63), and high frequencies (<i>p</i> = 0.27) nor in serum BDNF concentrations (<i>p</i> = 0.42). <b><i>Discussion:</i></b> Therapy dogs can be implemented as a therapeutic tool in a gerontopsychiatric ward to reduce symptoms of agitation in patients with dementia. The study was registered in the German Clinical Trials Register (DRKS00024093).

Personal growth and life satisfaction during COVID-19: Self-forgiveness and compassion as correlates

COVID-19 is a highly contagious disease that affects not only physical health, but also mental well-being. Two variables, which have been observed significantly in people facing difficult and complex situations that are also related to greater personal growth and satisfaction with life, are self-forgiveness and compassion for others. Thus, through a correlational study, we set out to examine how self-forgiveness and compassion are associated with personal growth and life satisfaction in this complicated situation caused by the COVID-19 pandemic. In a sample of Spanish participants (N = 329, range from 18 to 83 years), the main results showed that self-forgiveness and compassion were positively related to personal growth and life satisfaction and that self-forgiveness was associated with increased personal growth and life satisfaction through compassion. Ultimately, these findings and their possible implications for therapeutic practice are discussed.

Relationship between Muscle Tone of the Erector Spinae and the Concave and Convex Sides of Spinal Curvature in Low-Grade Scoliosis among Children

The objective of the present research was to assess the relationship between muscle tone of the erector spinae and the concave and convex sides of spinal curvature in low-grade scoliosis found among children. The study included 251 children, aged 7–8. Examination of the spine and body posture was carried out using the Diers Formetric III 4D optoelectronic method. Surface electromyography (sEMG) was used to assess erector spinae muscle tone. The trial was carried out using the 14-channel Noraxon TeleMyo DTS apparatus. The highest generalised tone (sEMG amplitude) of the erector spinae occurred in the case of scoliosis. The higher the angle of curvature, the greater the erector spinae muscle tone. Regardless of the position adopted during examination of the thoracic spine, greater erector spinae tone (sEMG amplitude) was exhibited on the convex side of the spinal curvature. However, in the area of the lumbar spine, greater tone (sEMG amplitude) of the erector spinae occurred on the curvature’s concave side. The exception was the test performed in a standing position, during which greater muscle tone was noted on the side of the convex curvature. In therapeutic practice, within the thoracic section, too tense erector spinae muscles should be stretched on the convex side of the scoliosis, while in the lumbar region, this should be performed on the concave side. However, each case of scoliosis requires individually tailored treatment. The current research has applicative value and does fill a research gap with regard to erector spinae muscle tone in young children experiencing low-grade scoliosis. The development of scoliosis is associated with asymmetry and an increase in erector spinae tone. The uneven distribution of its tone, occurring on both sides of the spine and in its various segments, causes destabilisation and its abnormal progression.

Child Behavioral Analysis: Machine Learning based Investigation for Autism Screening and Early Diagnosis

Autism is a developmental disorder which affects cognition, social and behavioural functionalities of a person. When a person is affected by autism spectrum disorder, he/she will exhibit peculiar behaviours and those symptoms initiate from that patient’s childhood. Early diagnosis of autism is an important and challenging task. Behavioural analysis a well known therapeutic practice can be adopted for earlier diagnosis of autism. Machine learning is a computational methodology, which can be applied to a wide range of applications in-order to obtain efficient outputs. At present machine learning is especially applied in medical applications such as disease prediction. In our study we evaluated various machine learning algorithms [(Naive bayes (NB), Support Vector Machines (SVM) and k-Nearest Neighbours (KNN)] with “k-fold” based cross validation for 3 datasets retrieved from the UCI repository. Additionally we validated the effective accuracy of the estimated results using a clustered cross validation strategy. The process of employing the clustered cross validation scrutinises the parameters which contributes more importance in the dataset. The strategy induces hyper parameter tuning which yields trusted results as it involves double validation. On application of the clustered cross validation for a SVM based model, we obtained an accuracy of 99.6% accuracy for autism child dataset.