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Bakgrund: I dagens samhälle uppsöker många människor akutsjukvård. Det kan vara att personen genomgått ett stort trauma eller har ett kritiskt sjukdomstillstånd. Vid varje besök med vården upplever patienten ett bemötande. Varje unik individ har även förväntningar om hur bemötandet kommer att vara på akutmottagningen.  Syfte: Syftet var att beskriva patienters upplevelse av sjukvårdspersonals bemötande på akutmottagning.  Metod: En litteraturstudie med kvalitativ ansats där resultatet från 12 vetenskapliga artiklar har analyserats enligt Forsberg och Wengströms (2016) innehållsanalys. Den teoretiska referensram som arbetet baseras på är Katie Erikssons omvårdnadsteori.  Resultat: Resultatet visar att det fanns brister inom bemötandet. En faktor som var av betydelse berodde på vilket trauma patienten hade genomgått eller vad de hade för sjukdomstillstånd. Majoriteten av alla patienter hade upplevt ett sämre bemötande på olika sätt.  Det kunde vara att de kände sig bortglömda, negligerade av personalen och bristande information om sjukdomstillstånd eller hur lång väntan skulle bli. Ett gott bemötande grundar sig ofta på att patienten blir respektfullt behandlad, att patienten erhåller information och att de känner sig sedda av personalen. Slutsats: Upplevelserna av bemötande varierar från patient till patient, då varje patient och situation är unik. Sjuksköterskan skall vara flexibel i sitt bemötande och kunna variera det beroende på patientens behov. Utifrån att många av dessa patienter är försatta i en sårbar och svår situation är kommunikationen en stor och central del i akutsjukvården. Den bör vara individanpassad, utifrån varje patient och situation.  Nyckelord: Akutmottagning, bemötande, omvårdnad, patienters upplevelse, sjukvårdspersonal. / Background: In today's society, many people seek emergency care. It may be that the person has undergone a major trauma or has a critical illness condition. At each visit with the patient, the patient experiences an encounter. Each unique individual also has expectations of how the reception will be at the emergency room.  Purpose: The aim was to describe patients 'experience of healthcare professionals' response to emergency care.  Methods: A literature study has been done with qualitative approach where the results from 12 scientific articles have been analyzed according to Forsberg and Wengström’s (2016) content analysis. The theoretical frame on which the work is based is Katie Eriksson`s nursing theory.  Result: The result show differences in how patients experience the encounter. Other factors that mattered depended on the type of trauma the patient had undergone or their condition. They majority of all patients had experienced inferior treatment in different ways. It could be that they felt forgotten, neglected by the staff and lack of information about illnesses or how long the wait would be. A good encounter is often based on the patient being treated respectfully, that the patient receives information and that they feel seen by the staff. Conclusion: The experiences of responding vary from patient to patient. Then every patient and the situation are unique. The nurse must be flexible in her treatment and be able to vary it depending on the patient's need for treatment. Communication is a major and central part of emergency care and should be individualized so that each unique patient has the opportunity to understand the information provided. Then these patients are vulnerable and put in a strange situation.  Keywords: Emergency clinic, medical staff, nursing, patients' experience, reception.

The challenge of diabetes prevention is to reduce the financial and human costs of diabetes by preventing new cases and enacting social change. African Americans and Hispanics Americans have a high incidence of Type 2 diabetes because of factors that place them at risk for prediabetes. The purpose of this project was to plan the implementation and evaluation of a Type 2 diabetes prevention program in a medical office clinical setting. The clinic of interest was located in the downtown area of the city and provided care mostly to African American population. The Iowa model of evidence-based practice formed the theoretical framework for the study. The goal was to decrease the number of African Americans patients who will convert from prediabetes to Type 2 diabetes in the medical office clinic. The program was planned using the information from the Center for Disease Control and Prevention Road to Health toolkit. The outline covered a 6-week program. A pretest will be given to assess baseline knowledge of diabetes and diabetes prevention. The same test will be given after the implementation to evaluate if the program enhanced diabetes and diabetes prevention knowledge. Six months after the implementation of the program, nurses will complete a chart review to evaluate how many patients converted from pre-diabetes to Type 2 diabetes since the implementation of the project. The project will lead to the integration of a Type 2 diabetes prevention program in a medical clinic. It will increase the number of African Americans with prediabetes who will engage in lifestyle modification behavior. The project will also decrease the incidence of Type 2 diabetes among African Americans and reduce the health disparity of diabetes among the population.

This study is aimed to better understand how and why people choose dental school faculty as their oral healthcare provider. Increasing financial constrains in the U.S. dental schools has led dental schools to find an alternative funding sources and revenues from dental school faculty practice can be one of them. To effectively promote faculty practice, it is necessary to understand how and why people choose dental school faculty as their oral care provider. In addition, it is important to differentiate characteristics of comprehensive care patients and limited care patients since dental school faculty practices have a higher proportion of specialists. A survey of 1150 dental school faculty practice patients who recently chose their dentist was conducted and 221 responded. Information sources highly used and rated included other dentist, friends, family, clinic website, the Internet, and the insurance directory. Dentist related attributes that were perceived important included quality of care, professional competence of dentist, and explanation of treatment/you participate in the treatment decision. Dental practice related attributes that were perceived important included ability to get appointments at convenient times, reasonable waiting time to get appointments, and attitude/helpfulness of staff. Among the respondents, 121 pursued a comprehensive care and 93 pursued a limited care. The two groups differed in terms of demographics, other characteristics, and dentist selection. The comprehensive care patients were younger, highly educated, related to healthcare related profession, and to have private dental insurance (p<0.001). The comprehensive care patients were more likely to use and highly rate information sources such as clinic website, the Internet, and the insurance directory (p<0.001). They put more value on attributes such as the dentist is in my insurance network and convenient physical location (p<0.001). This study has shown that traditionally popular (family, friends) and newly emerging information sources (the Internet, clinic website, and insurance directory) were used and perceived important by dental school faculty practice patients. A dental school or dentist can use this study's findings to promote their practice to select appropriate communication channels and focus on attributes that dental consumers value the most. It is also important to apply different strategies to different consumer groups.

The University of South Florida Pinellas County Hearing and Speech Center (USF-PCHSC) is a nonprofit 501 (C) 3 organization that will offer comprehensive audiology and speech-language pathology services to people of all ages. USF-PCHSC is a facility founded by The Department of Communication Sciences and Disorders of the University of South Florida, with Dr. Arthur M. Guilford as chairman. Researchers have determined that hearing loss is one of the three most prevalent medical conditions in the United States, affecting more than 28 million people over the age of sixty-five (Martin and Clark, 2002). According to yellowpages.com there are twenty-five hearing health care professions within the Pinellas County area, yet there are only five facilities that offer both audiology and speech-language pathology service. USF-PCHSC will begin offering services on May 15, 2004. It will be located in the Pinellas County area. The practice will offer a full range of speech, language and audiological services to include diagnostic audiometry; hearing aid fitting; pediatric speech and language services; hearing conservation; and aural rehabilitation. USF-PCHSC will begin operation with two clinical supervisors and up to five student clinicians. All student clinicians will have completed a bachelor's degree and will be enrolled in graduate school, in either the speech-language pathology Master's degree program or the Audiology Clinical Doctoral degree (Au.D.) program. Although services will be available to everyone, USF-PCHSC's target markets will be senior citizens, pediatrics, and industrial sites requiring hearing conservation programs. USF-PCHSC is in a strong competitive position because of their affiliation with the University of South Florida Tampa campus. USF-PCHSC's position is further strengthened by several factors; Dr. Arthur M. Guilford's background and credentials (see Appendix A for Abbreviated Curriculum Vita), the large and growing size of the target markets, affiliation with Bay Pines Veterans Hospital and the James A. Haley Veterans Hospital, and recent and continuing technological advances in speech and hearing health care. USF-PCHSC will seek donations totaling $100,000.00 to fund the start-up costs, staffing, equipment, and unanticipated expenses. The break-even point is predicted to occur after 18 months. The practice is expected to grow to the point that it will be fully self-supporting to include all professional and support staff salaries.

Nesta dissertação são apresentadas duas contribuições originais de Silvia Bleichmar em relação a Laplanche: recalque originário e signos de percepção. Partindo das observações de Laplanche sobre a ideia freudiana que considera o inconsciente fundado pelo recalque originário, Silvia Bleichmar ampliou o conceito, produzindo importantes contribuições em comparação ao pensamento freudiano e laplancheano. A autora articulou o recalque originário com os destinos pulsionais anteriores ao recalque, tornando-o um conceito metapsicológico passível de ser observado clinicamente, sobretudo na clínica de crianças. O recalque originário, em Silvia Bleichmar, longe de ser um processo mítico em algum momento, aproxima-se da ideia freudiana de recalque propriamente dito. Para Bleichmar, tal como em Freud, o recalque originário extrai sua força inicial de contrainvestimentos. No entanto, a autora entende que estes contrainvestimentos seriam originados no outro, pela interdição ao autoerotismo infantil. Outra importante contribuição da autora para a psicanálise foi sua conceituação sobre signos de percepção, tradução para a expressão alemã Wahrnehmungszeichen (Wz), usada por Freud em seu modelo de aparelho psíquico apresentado na Carta 52 a Fliess. Laplanche questiona se o termo Zeichen deveria ser entendido como signos ou indícios, fazendo sua escolha pela palavra signos. Para este autor, os signos de percepção se equivalem às mensagens enigmáticas, portanto, seriam portadores de mensagens. Silvia Bleichmar entende que Zeichen seriam indícios, pegadas, marcas, vestígios, huellas (em espanhol), dando ênfase ao caráter indiciário dos signos de percepção. A autora partiu da concepção de Charles S. Peirce sobre signos indiciários para articular sua própria concepção de signos de percepção. Para a autora, estes seriam as primeiras inscrições pulsionais que podem permanecer no psiquismo como arcaico se não transcritas ou as inscrições advindas de traumatismos severos, a qualquer momento, que ficam igualmente sem possibilidade de transcrição no psiquismo. Assim, o arcaico seria formado pelos signos de percepção que permanecem sem transcrições enquanto o originário seria o conteúdo do inconsciente originariamente recalcado / Two original Silvia Bleichmars contributions to Laplanche are presented in this essay: the primal repression and the perceptual signs. Stemming from Laplanches observations on the Freudian conception that considers the unconscious founded by the primal repression, Silvia Bleichmar expanded the concept, producing important contributions in comparison to the Freudian and the Laplanchean lines of thought. The author connected the primal repression to the Freudian destinies of the drive (instinct) existing prior to repression, which made it a metapsychological concept subject to clinical observation, most of all in the work with children. In Silvia Bleichmars thinking, far from being a mythical process at some point, the primal repression is close to the Freudian idea of repression itself. To Bleichmar, as well as to Freud, the primal repression extracts its initial strength from anticathexes. Nevertheless, the author believes that these anticathexes stem from the other through the interdiction of child auto-erotism. Another important contribution of the author to psychoanalysis was her conceptualization of perceptual signs, which is a translation of the German expression Wahrnehmungszeichen (Wz), used by Freud in his model of psychic apparatus presented in the Letter 52 to Fliess. Laplanche questions if the term Zeichen should be understood as signs or indexes, preferring the word signs. For him, the perceptual signs are equivalent to the enigmatic messages, therefore they would be message carriers. Silvia Bleichmar believes that Zeichen are indexes, footprints, marks, vestiges, huellas (in Spanish), emphasizing the indexing character of the perceptual signs. Therefore, deriving from Charles S. Peirces conception of indexing signs, the author built her own conception of perceptual signs. For her, these would be the first drive inscriptions that may remain in the psyche as archaic if not transcript, as well as the inscriptions stemming from severe trauma, at any point, which equally remain without transcription in the psyche. Hence, the archaic would be composed by the perceptual signs that remain without transcriptions whereas the primal would be the content of the primally repressed unconscious

[pt] O trabalho tem como objetivo investigar de que mode a questão da presença e do lugar dos pais na clínica psicanalítica com crianças está situada na campo teórico. Parte-se das formulações freudianas sobre a infância e o infantil, para em seguida, tratar-se da abertura do campo da psicanálise com crianças a partir da experiência do casi Hans publicado por Freud em 1909. Aborda-se o surgimento desta clínica, os debates entre Anna Freud e Melanie Klein, e desenvolvimentos posteriores com D. Winnicott, Françoise Dolto e Maud Mannoni. Finaliza-se com a discussão do problema da inserção dos pais no tratamento psicanalítico de crianças por meio da apresentação de ilustrações clínicas. / [en] The study aims to investigate how the problem of parents place and presence in the children psychoanalitic treatment lies in the theoretical field. It starts with the Freudian formulations about childhood and child, to then it discusses the opening of the field of psychoanalysis with children from the experience of Hans case published by Freud in 1909. It approaches the emergence of this treatment, the appearance of clinical discussions between Anna Freud and Melanie Klein, and further studies with D.Winnicott, Françoise Dolto and Maud Mannoni. It ends with a discussion about the problem of parents inclusion in the children psychoanalytic treatment through the presentation of clinical illustrations.

Esta pesquisa tem como objetivo construir hipóteses teóricas e clínicas acerca do ressentimento, a partir de uma leitura psicanalítica. Observamos que, apesar da frequência com que o tema do ressentimento aparece em discussões clínicas na atualidade, o termo ainda parece marginalizado no arcabouço teórico de pesquisa em psicanálise, possivelmente porque não tem estatuto de noção nem de conceito dentro desse campo. Diante disso, perguntamos: de que maneira o ressentimento se apresenta na clínica psicanalítica? Quais operadores nos embasam quando nos deparamos com o ressentimento via narrativa ou no discurso de um sujeito na clínica? De que forma o estudo sobre o sujeito do inconsciente se articula ao ressentimento? Uma vez que nosso objeto de investigação não é parte da teoria psicanalítica, expomos de que maneira alguns dos principais pensadores e filósofos o abordam pela via do homem, da sociedade, da moral, da justiça e da vingança. Em seguida, situamos os conceitos que pesquisadores de nossa área elegem para situar o ressentimento enquanto fenômeno que interessa à psicanálise. A partir dessa revisão teórica, construímos nossa própria leitura psicanalítica. Um caso clínico disparador é apresentado de forma a fazer pulsar novos questionamentos, que remetem à teoria da constituição subjetiva, para, posteriormente, situar de que forma o ressentimento afeta o sujeito e qual sua relação com as operações lógicas do psiquismo. Apresentamos um trabalho interpretativo da obra Dom Casmurro, que permite eleger o protagonista como caso paradigmático do ressentido. Concluímos nossa hipótese com uma explanação, entre outras possíveis, do que pode um psicanalista diante do ressentimento. Levantou-se como resultado dessa pesquisa duas principais hipóteses: o ressentimento enquanto estratégia frente ao desejo do Outro e o ressentir como modalidade de gozo. Esperase que a proposta de leitura acerca do ressentimento, do ressentir e do ressentido possa contribuir para o reconhecimento dessa perspectiva e, assim, inspirar intervenções e descobertas sempre únicas no campo da clínica psicanalítica, em casos em que o ressentimento é marcante / The aim of this work is to propose theoretical and clinical hypotheses on resentment, based on a psychoanalytic reading. We note that despite the frequency with which the subject of resentment appears in clinical discussions today, the term seems to be relegated to the sidelines of the theoretical framework of research in psychoanalysis, possibly because it has no notion or concept status within this field. In view of this, we ask: in what way does resentment present itself in psychoanalytic clinics? Which operators support us when we come across resentment via narrative or in the discourse of a subject in the clinic? How does the study of the subject of the unconscious articulate to resentment? Since our object of inquiry is not part of psychoanalytic theory, we show how some of the leading philosophers and thinkers approach it via man, society, morality, justice, and revenge. Next, we locate the concepts chosen by researchers in our field with which to identify resentment as a phenomenon of interest to psychoanalysis. Based on this theoretical review, we have built our own psychoanalytic reading. A triggering clinical case is presented in order to bring about new questions which refer to the theory of the subjective constitution, and then to identify how resentment affects the subject and how it relates to the logical operations of the psyche. We present an interpretation of the novel Dom Casmurro, allowing us to designate the leading character as an emblematic case of someone who feels resentment. We conclude with an explanation one of several possible ones of what a psychoanalyst can do when faced with resentment. Two main hypotheses arose from this research: resentment as a strategy against the desire of the Other and resentment as a mode of jouissance. We hope the proposed reading of resentment, resenting and the one who resents may contribute to the recognition of this view and thus inspire unique interventions and discoveries in the field of psychoanalytic clinic, in cases where resentment is strongly present