Na assistência psicológica oferecida ao usuário do Sistema Único de Saúde (SUS), não é raro, nos trabalhos desenvolvidos com ele, refletir sobre a adequação e a eficácia dos modelos de atuação clínica utilizados para atender à sua demanda. As abordagens teórico-práticas que orientam os procedimentos clínicos na compreensão e na problematização do seu sofrimento, não parecem contemplar, satisfatoriamente, as suas necessidades reveladas no processo da assistência psicológica. Nessa compreensão, este trabalho representa uma iniciativa para articular as referências operacionais que hoje modelizam a ação do psicólogo com a demanda apresentada pelo usuário da Rede Pública Ambulatorial. É uma pesquisa na área de Psicologia Clínica que intenta conhecer, pela abordagem fenomenológica-existencial, a experiência do usuário no que diz respeito à atenção psicológica que lhe é oferecida na instituição pública de saúde. A experiência vivida no contexto da prática, bem como leituras, parecem indicar que o sentido dessa assistência, quando comunicado na relação entre o usuário e o psicólogo, poderá favorecer ações que norteiem o atendimento psicológico à demanda trazida pela população distrital. Mais ainda, o significado sentido do cliente parece entrelaçar-se ao sentido que o próprio terapeuta busca em sua práxis e que, também, lhe serve para configurar o fazer clínico no espaço público Ambulatorial. A pesquisa foi realizada com cinco pacientes da Clínica de Psicologia do Centro de Saúde Agamenon Magalhães, unidade de Ambulatorial da Secretaria de Saúde do Estado de Pernambuco. A metodología escolhida para conhecer a experiência do usuário foi a pesquisa qualitativa, amparada no método fenomenológico. A narrativa, contendo os depoimentos, foi a via de registro e de comunicação da experiência do usuário, relacionada ao atendimento psicológico. 0 significado que o usuário está dando às suas experiências relativas ao atendimento psicológico perpassa pelo sentido buscado pelas questões do próprio pesquisador; ou seja, como uma experiência que lhe favorece mudanças na compreensão de si e do outro. 0 sentido da ajuda psicológica também sinaliza uma compreensão de que ela é um meio significativo de lidar com o desamparo frente às dificuldades vividas em cidadania / Its not rare among the studies developed with the users of national health assistance in the Unified System of Health (SUS) to discuss about adequacy and efficiency of clinical performance patterns used lo assist its demand. Theoretical and practical approaches applied lo clinical procedures for comprehension and problematization of suffering do not seem satisfactory lo cover all the needs revealed by psychological assistance processes This work represents an innitiative fn articule din operational references which guide the psychologist actions with the actual dernand of Public Ambulatorial Services' users. Its a research in the area of Clinical Psychology which has as its goal lo get acquainted by means of Existencial Phenomenology approach with the user's experiences as related to psychological attention offered by the public health institution. Actual experience in practicing context, as well as readings in the area, seem to indicate that the meaning of this kind of assistance, when informed in the user/psychologist relationship might favor actions to guide the psychological assistance to people brought by distrital population. Moreover, the meaning as felt by the client seems lo carry the meaning that the therapist himself searches for in his praxis, and that helps him to configurate the clinical actions within public ambulatorial environment. The research was carried out with five patients from the Clinic of Psychology of the Healt Center Agamenon Magalhães, an ambulatorial unity of the Secretary oh Health of the State of Pernambuco. The qualitative method ot research as well as the Phenomenological method were chosen lo approach the user's experience. The narrative was the means of experience registering and of communication wíth the users related to psychological session. The meaning the users give to their experience related to psychological attendance passes by the rneaning the reseacher herself looks for, that is to say, as an experience which offers changes for comprehending oneself and the other. The meaning of psycological help also shows a comprehension that it is a way to deal with abandonment as a result of experienced difficulties in citizenship

Made available in DSpace on 2017-06-01T18:08:49Z (GMT). No. of bitstreams: 1 ANA MARIA.pdf: 344388 bytes, checksum: 2f9907cc90ec487b208e24ea7b13b37d (MD5) Previous issue date: 2001-03-29 / It´s not rare among the studies developed with the users of national health assistance in the Unified System of Health (SUS) to discuss about adequacy and efficiency of clinical performance patterns used lo assist its demand. Theoretical and practical approaches applied lo clinical procedures for comprehension and problematization of suffering do not seem satisfactory lo cover all the needs revealed by psychological assistance processes This work represents an innitiative fn articule din operational references which guide the psychologist actions with the actual dernand of Public Ambulatorial Services' users. It´s a research in the area of Clinical Psychology which has as its goal lo get acquainted by means of Existencial Phenomenology approach with the user's experiences as related to psychological attention offered by the public health institution. Actual experience in practicing context, as well as readings in the area, seem to indicate that the meaning of this kind of assistance, when informed in the user/psychologist relationship might favor actions to guide the psychological assistance to people brought by distrital population. Moreover, the meaning as felt by the client seems lo carry the meaning that the therapist himself searches for in his praxis, and that helps him to configurate the clinical actions within public ambulatorial environment. The research was carried out with five patients from the Clinic of Psychology of the Healt Center Agamenon Magalhães, an ambulatorial unity of the Secretary oh Health of the State of Pernambuco. The qualitative method ot research as well as the Phenomenological method were chosen lo approach the user's experience. The narrative was the means of experience registering and of communication wíth the users related to psychological session. The meaning the users give to their experience related to psychological attendance passes by the rneaning the reseacher herself looks for, that is to say, as an experience which offers changes for comprehending oneself and the other. The meaning of psycological help also shows a comprehension that it is a way to deal with abandonment as a result of experienced difficulties in citizenship / Na assistência psicológica oferecida ao usuário do Sistema Único de Saúde (SUS), não é raro, nos trabalhos desenvolvidos com ele, refletir sobre a adequação e a eficácia dos modelos de atuação clínica utilizados para atender à sua demanda. As abordagens teórico-práticas que orientam os procedimentos clínicos na compreensão e na problematização do seu sofrimento, não parecem contemplar, satisfatoriamente, as suas necessidades reveladas no processo da assistência psicológica. Nessa compreensão, este trabalho representa uma iniciativa para articular as referências operacionais que hoje modelizam a ação do psicólogo com a demanda apresentada pelo usuário da Rede Pública Ambulatorial. É uma pesquisa na área de Psicologia Clínica que intenta conhecer, pela abordagem fenomenológica-existencial, a experiência do usuário no que diz respeito à atenção psicológica que lhe é oferecida na instituição pública de saúde. A experiência vivida no contexto da prática, bem como leituras, parecem indicar que o sentido dessa assistência, quando comunicado na relação entre o usuário e o psicólogo, poderá favorecer ações que norteiem o atendimento psicológico à demanda trazida pela população distrital. Mais ainda, o significado sentido do cliente parece entrelaçar-se ao sentido que o próprio terapeuta busca em sua práxis e que, também, lhe serve para configurar o fazer clínico no espaço público Ambulatorial. A pesquisa foi realizada com cinco pacientes da Clínica de Psicologia do Centro de Saúde Agamenon Magalhães, unidade de Ambulatorial da Secretaria de Saúde do Estado de Pernambuco. A metodología escolhida para conhecer a experiência do usuário foi a pesquisa qualitativa, amparada no método fenomenológico. A narrativa, contendo os depoimentos, foi a via de registro e de comunicação da experiência do usuário, relacionada ao atendimento psicológico. 0 significado que o usuário está dando às suas experiências relativas ao atendimento psicológico perpassa pelo sentido buscado pelas questões do próprio pesquisador; ou seja, como uma experiência que lhe favorece mudanças na compreensão de si e do outro. 0 sentido da ajuda psicológica também sinaliza uma compreensão de que ela é um meio significativo de lidar com o desamparo frente às dificuldades vividas em cidadania

A master thesis „Clinic of holistic medicine“ is processed as a project documentation. The building is projected for the plat no.170/1 in Kladruby u Vlašimy (Benešov district). Is a three-storyed wooden building from large-format wooden panels. Ceilings are ribbed constructions from spruce wood. Stairspaces are made of reinforced concrete. The house is roofed with a saddle roof made by woodentrusses. Stairspaces and machine room of air conditioning are roofed with a one-sheat flat roof. The project is planned as an extension of the Rehabilitation institute complex in Kladruby.

The demand for circumcision in Swaziland has dramatically increased since it was reported that circumcision ensures 60% protection against HIV infection. The aim of this study was to explore the reasons for, and the motives behind, this increasing interest in undergoing circumcision. A generic qualitative research design was used, in which 17 circumcised men selected by convenience sampling at FLAS Clinic, Mbabane, participated. In-depth unstructured face-to-face interviews were used to collect data. The results showed that the main reasons for circumcision are perceived health, hygiene and sexual benefits, community influences, as well as medical reasons. It was concluded that the major motives underlying circumcision are personal and partner safety and satisfaction during sex. These motives were found to be both promotive and threatening to the interests of public health. After evaluating the risks and benefits, it was recommended that mass circumcision be promoted alongside reinforced and accurate health education on circumcision / Health Studies

Thesis (MCur)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: he sexual health clinic at Stellenbosch University is attended by staff members and students. Yet, limited evidence exists regarding the views and expectations of the clients on service delivery at the sexual health clinic. The aim of the study was to explore the experiences and perceptions of clients attending the sexual health services offered at the campus health clinic. The following objectives were set:  To explore the experiences and perceptions of the clients attending the sexual health service on service delivery.  To identify the needs of the clients attending the sexual health service A descriptive qualitative approach was applied utilizing in-depth interviews. A sample of n=15 was drawn through purposive sampling and data saturation was achieved with the sample. Since the researcher is employed as a registered professional nurse at the clinic, data collection was completed by a researcher not affiliated to the university. Data was analyzed utilizing an interpretive approach. All applicable ethical principles such as anonymity, confidentiality and privacy were taken into consideration. The validity of the findings was enhanced through efforts to attain credibility, transferability, dependability and conformability. The findings of the study revealed that accessibility of the clinic is influenced by the geographical location of the clinic and that marketing and awareness of services requires attention. Other themes that emerged were operational hours, waiting period, building relationships, consultations and financial implications. / AFRIKAANSE OPSOMMING: Die seksuele gesondheidskliniek by Universiteit Stellenbosch word deur personeel en studente besoek. Daar is egter min bewyse oor die sieninge en verwagtinge van die kliente aangaande dienslewering by die seksuele gesondheidskliniek. Die doel van die studie was om die ervaringe en sieninge van kliente wat die seksuele gesondheidsdienste bywoon, aangebied deur die seksuele gesondheidskliniek, te ondersoek. Die volgende doelwitte was gestel:  Om die ervaringe en sieninge van kliente aangaande dienslewering by die seksuele gesondheidskliniek te ondersoek.  Om die behoeftes van die kliente wat die seksuele gesondheidsdienste bywoon, te identifiseer. ʼn Beskrywende kwalitatiewe benadering was toegepas deur van in-diepte onderhoude gebruik te maak. ʼn Steekproef van n=15 was deur doelgerigte steekproefneming verkry en data-versadiging was met die steekproef bereik. Siende die navorser as ʼn geregistreerde professionele verpleegster by die kliniek in-diens is, was data-versameling deur ʼn navorser wat nie aan die universiteit verbonde is nie, voltooi. Data was deur ʼn interpreterende benadering geanaliseer. Alle verwante etiese beginsels soos anonimiteit, vertroulikheid en privaatheid was in berekening geneem. Die geldigheid van die bevindinge was versterk deur pogings om geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid te verkry. Die bevindinge van die studie het getoon dat die toeganklikheid van die kliniek beïnvloed word deur die geografiese ligging van die kliniek en dat bemarking en die bewusmaking van dienste aandag benodig. Ander temas wat na vore gekom het, is operasionele tye, wagperiodes, verhoudinge, konsultasies en finansiële implikasies.

Cette thèse enquête sur l’émergence d’espaces de soin à l’ère de la mondialisation numérique. Elle s’articule autour d’incursions au sein du Pan-African e Network Project (PAN), un réseau de cybersanté par l’entremise duquel des hôpitaux tertiaires situés en Inde offrent des services de téléconsultations et de formation médicale à des centres de santé africains. Des incursions sur la piste d’un projet en constante mutation, pour en saisir la polyvalence ontologique, la pertinence politique, la valeur thérapeutique. Le PAN, c’est une entreprise colossale, aux ramifications multiples. C’est le travail quotidien d’ingénieurs, médecins, gestionnaires. Ce sont des routines techniques, des équipements. À la fois emblème d’une résurgence de la coopération indo-africaine et expression d’une étonnante histoire cybermédicale indienne, le réseau incarne une Inde néolibérale, portée par l’ambition technique et commerciale de propulser la nation au centre de la marche du monde. Le PAN, c’est une ouverture numérique de la clinique, qui reconfigure la spatialité de la prise en charge de patients. C’est un réseau clé en main, une quête insatiable de maîtrise, une infrastructure largement sous-utilisée. C’est le projet d’une humanité à prendre en charge : une humanité prospère, en santé, connectée. De part en part, l’expérience du PAN problématise le telos cybermédical. Au romantisme d’une circulation fluide et désincarnée de l’information et de l’expertise, elle oppose la concrétude, la plasticité et la pure matérialité de pratiques situées. Qu’on parle de « dispositifs » (Foucault), de « réseaux » (Latour), ou de « sphères » (Sloterdijk), la prise en charge du vivant ne s’effectue pas sur des surfaces neutres et homogènes, mais relève plutôt de forces locales et immanentes. Le PAN pose la nécessité de penser la technique et le soin ensemble, et d’ainsi déprendre la question du devenir de la clinique autant du triomphalisme moderne de l’émancipation que du recueillement phénoménologique devant une expérience authentique du monde. Il s’agit, en somme, de réfléchir sur les pratiques, événements et formes de pouvoir qui composent ces « espaces intérieurs » que sont les réseaux cybermédicaux, dans tout leur vacarme, leur splendeur et leur insuffisance. / This thesis investigates the emergence of spaces of care in the era of digital globalization. It revolves around several lines of inquiry into the Pan-African e-Network Project (PAN), an eHealth network through which tertiary hospitals in India provide teleconsultation services and continuing medical education to health centres across the African continent. These lines of inquiry lead into a project in constant mutation in order to grasp its ontological versatility, outline its political relevance, assess its therapeutic value. PAN is a colossal, multifaceted enterprise. It involves the daily work of engineers, doctors, and managers who must tend to technical routines, hardware infrastructures, and patient treatments. At once the flagship of a resurgence in Indo-African cooperation and the consequence of India’s eHealth venture, the network is a poster child for neoliberal India, driven by technical and commercial ambitions that seek to position the nation at the heart of global developments. PAN also enacts a digital opening of the clinic, as it reconfigures the spatiality of healthcare access and delivery. A turnkey solution, it displays an insatiable quest for mastery; it is a massive yet largely underutilized infrastructure. PAN embodies an emergent object of political intervention: a prosperous, healthy, connected humanity. This examination of the Pan-African e-Network challenges teleological accounts of eHealth on several fronts. To the romantic conception of a fluid, seamless circulation of expertise and knowledge, it opposes the embeddedness, plasticity and sheer materiality of concrete practices. Whether one speaks of “apparatus” (Foucault), “networks” (Latour), or “spheres” (Sloterdijk), spaces of care have little to do with neutral, homogeneous surfaces, and rely on a multitude of local and immanent forces. PAN obliges us to consider technology and care together, untying the question of the “becoming of the clinic” from both the modern triumphalism of emancipation, and the phenomenological contemplation of an authentic experience of the world. The present challenge is to examine the practices, events, and forms of power that shape the “inner spaces” of eHealth networks, in all their turbulence, splendor, and inadequacies.

Objectives: To investigate the organisation of asthma care in primary care and evaluate outcomes for patients attending primary care centres with and without asthma clinics. Other objectives were to study the association between quality of life and asthma control in patients in primary care and to analyse sex differences regarding asthma outcomes related to menopausal status. Material and methods: Cross-sectional surveys and a patient record study. Results: Of all the primary health care centres, 77% had a spirometer and 53% an asthma clinic. At centres with asthma clinics 77% of the patients reported sufficient knowledge of asthma as compared with 65% at centres without asthma clinics (p<0.001). With more time allocated for the nurse, 44% of patients achieved asthma control as compared with 27% at asthma clinics with less time (p<0.003). Patients using short-acting beta-2 agonists more than twice in the last week had clinically significant lower MiniAQLQ scores (5.17 versus 5.91). This finding also held for night awakenings during the previous week (4.42 versus 5.86), courses of oral corticosteroids (5.26 versus 5.64) and reported emergency consultations during the last six months (4.85 versus 5.71). Premenopausal women had significantly lower total MiniAQLQ scores than men in the same age group (5.44 versus 5.89, p<0.001), while no difference was found between postmenopausal women and men of similar ages. The adjusted odds for premenopausal women for asthma exacerbations was 2.0 (95%CI 1.22-3.43) as compared with men in the same age group. No differences were found when comparing postmenopausal women with men of similar ages. Conclusions: Half the primary health care centres had an asthma clinic and the majority had access to a spirometer. Patients at primary health care centres with asthma clinics reported better knowledge of their disease, and asthma control is more often achieved if the nurse is allocated more time. Achieving asthma control is associated with better quality of life in patients in primary care. Premenopausal women had lower quality of life and less often asthma control then men of the same ages, while no corresponding difference was found between postmenopausal women and men of similar ages.

Cette thèse enquête sur l’émergence d’espaces de soin à l’ère de la mondialisation numérique. Elle s’articule autour d’incursions au sein du Pan-African e Network Project (PAN), un réseau de cybersanté par l’entremise duquel des hôpitaux tertiaires situés en Inde offrent des services de téléconsultations et de formation médicale à des centres de santé africains. Des incursions sur la piste d’un projet en constante mutation, pour en saisir la polyvalence ontologique, la pertinence politique, la valeur thérapeutique. Le PAN, c’est une entreprise colossale, aux ramifications multiples. C’est le travail quotidien d’ingénieurs, médecins, gestionnaires. Ce sont des routines techniques, des équipements. À la fois emblème d’une résurgence de la coopération indo-africaine et expression d’une étonnante histoire cybermédicale indienne, le réseau incarne une Inde néolibérale, portée par l’ambition technique et commerciale de propulser la nation au centre de la marche du monde. Le PAN, c’est une ouverture numérique de la clinique, qui reconfigure la spatialité de la prise en charge de patients. C’est un réseau clé en main, une quête insatiable de maîtrise, une infrastructure largement sous-utilisée. C’est le projet d’une humanité à prendre en charge : une humanité prospère, en santé, connectée. De part en part, l’expérience du PAN problématise le telos cybermédical. Au romantisme d’une circulation fluide et désincarnée de l’information et de l’expertise, elle oppose la concrétude, la plasticité et la pure matérialité de pratiques situées. Qu’on parle de « dispositifs » (Foucault), de « réseaux » (Latour), ou de « sphères » (Sloterdijk), la prise en charge du vivant ne s’effectue pas sur des surfaces neutres et homogènes, mais relève plutôt de forces locales et immanentes. Le PAN pose la nécessité de penser la technique et le soin ensemble, et d’ainsi déprendre la question du devenir de la clinique autant du triomphalisme moderne de l’émancipation que du recueillement phénoménologique devant une expérience authentique du monde. Il s’agit, en somme, de réfléchir sur les pratiques, événements et formes de pouvoir qui composent ces « espaces intérieurs » que sont les réseaux cybermédicaux, dans tout leur vacarme, leur splendeur et leur insuffisance. / This thesis investigates the emergence of spaces of care in the era of digital globalization. It revolves around several lines of inquiry into the Pan-African e-Network Project (PAN), an eHealth network through which tertiary hospitals in India provide teleconsultation services and continuing medical education to health centres across the African continent. These lines of inquiry lead into a project in constant mutation in order to grasp its ontological versatility, outline its political relevance, assess its therapeutic value. PAN is a colossal, multifaceted enterprise. It involves the daily work of engineers, doctors, and managers who must tend to technical routines, hardware infrastructures, and patient treatments. At once the flagship of a resurgence in Indo-African cooperation and the consequence of India’s eHealth venture, the network is a poster child for neoliberal India, driven by technical and commercial ambitions that seek to position the nation at the heart of global developments. PAN also enacts a digital opening of the clinic, as it reconfigures the spatiality of healthcare access and delivery. A turnkey solution, it displays an insatiable quest for mastery; it is a massive yet largely underutilized infrastructure. PAN embodies an emergent object of political intervention: a prosperous, healthy, connected humanity. This examination of the Pan-African e-Network challenges teleological accounts of eHealth on several fronts. To the romantic conception of a fluid, seamless circulation of expertise and knowledge, it opposes the embeddedness, plasticity and sheer materiality of concrete practices. Whether one speaks of “apparatus” (Foucault), “networks” (Latour), or “spheres” (Sloterdijk), spaces of care have little to do with neutral, homogeneous surfaces, and rely on a multitude of local and immanent forces. PAN obliges us to consider technology and care together, untying the question of the “becoming of the clinic” from both the modern triumphalism of emancipation, and the phenomenological contemplation of an authentic experience of the world. The present challenge is to examine the practices, events, and forms of power that shape the “inner spaces” of eHealth networks, in all their turbulence, splendor, and inadequacies.

Made available in DSpace on 2016-04-28T18:24:00Z (GMT). No. of bitstreams: 1 Milena Quinto Marchiori.pdf: 551623 bytes, checksum: 657b0613e602188f680e35237e7543cf (MD5) Previous issue date: 2009-02-13 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / This study focuses on a specific kind of symptomatic speech occurrence widely known as articulatory disorders as points relative to the used in the clinical speechlanguage pathologists descriptive the instrument apllied in the clinical field of speech therapy. In order to discuss this issue, recent literature in speech-language pathologists was discussed, followed by a retrospective analysis of the projects Language, Acquisition, and Language Pathology The manner through which instrumentation based on different theoretical perspectives leads to unique ways of leading the patient to the clinic was also discussed. To assess the clinical issues in this dissertation, two children were submitted to a stimulability test and, after the test, their speech was evaluated in a dialogue situation. This movement allowed me to observe that tests hinder speech and fade the speaker. After discussing the clinical material, I specially pointed out the importance of a linguistic reflection which would not operate stratification of speech in levels and systems, nor fade the speaker and the function of speech. I was thus able to establish a differentiated analysis of speech in these children and apprehend in discursive situations, singular movements which fade in directed/directioned activities. Finally, I problematized the nosographic categories through which language clinics operate and pointed towards the need to discuss them under a structural point of view thought. The reflections throughout this dissertation are theoretically based on the fundaments that guide the CNPq sponsored project Language, Acquisition, and Language Pathology, supervised by Profa. Dra. Maria Francisca Lier-DeVitto and by Profa. Dra. Lucia Arantes, (at the LAEL/PUC-SP). In this perspective, speech and the subject are intertwined, and the relation which the subject maintains with his or her own speech and the other s speech is articulated by linguistic functions; in essence, it is a commitment with the significant density of speech which does not fade the speaker / Esta dissertação trata de questões relativas aos instrumentais utilizados na Clínica Fonoaudiológica que privilegiam o nível fonético-fonológico utilizados no processo de avaliação de linguagem, especialmente, para caracterizar os quadros dos ditos distúrbios articulatórios . Para tratar essa questão, discuti a literatura recente sobre o tema no campo da Fonoaudiologia e, em seguida, fiz uma retrospectiva dos trabalhos realizados no interior do Projeto Aquisição Patologias e Clínica de Linguagem. Pude problematizar o modo como instrumentais baseados em diferentes perspectivas teóricas levam a um modo particular de encaminhar a clínica. Para encaminhar as questões clínicas desta dissertação, submeti duas crianças a um teste de estimulabilidade e após a aplicação, a fala dessas mesmas crianças foi avaliada em situação dialógica. Esse movimento me fez ver que provas e testes engessam a fala e apagam o falante. Após a discussão do material clínico destaquei a importância de uma reflexão lingüística que não operasse a estratificação da língua em níveis e sistemas e nem apagasse o falante e a função da fala. Pude com isso estabelecer uma análise diferenciada da fala dessas crianças e apreender, nas situações discursivas, movimentos singulares que ficam apagados em atividades dirigidas/direcionadas. Finalmente, problematizei as categorias nosográficas com as quais opera a clínica de linguagem e apontei para a necessidade de colocá-las em discussão à luz de um pensamento estrutural. As reflexões tecidas nesta dissertação partem de reflexões que tem como pano de fundo teórico os fundamentos que orientam o Grupo de Pesquisa Aquisição, Patologia e Clínica de Linguagem, coordenado pela Profa. Dra. Maria Francisca Lier-DeVitto e pela Profa. Dra Lúcia Arantes, no LAEL/PUC-SP. Nessa perspectiva fala e sujeito estão imbricados e a relação que o sujeito entretém com a própria fala e a fala do outro, é articulado pelo funcionamento da língua; trata-se de um compromisso com a densidade significante da fala que não apaga o falante

Made available in DSpace on 2016-04-28T18:24:14Z (GMT). No. of bitstreams: 1 Roseli Vasconcellos.pdf: 1453622 bytes, checksum: e7c7e34df88afe178f5c1080bbbafb3a (MD5) Previous issue date: 2010-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study discusses issues related to the distinction between the body conceived as an organism and the body approached as parlêtre (Lacan s expression). This subject-matter emerged from my clinical practice carried on with persons with Cerebral Palsy (CP). It is assumed that a theoretical dialogue with the fields of Medicine (Neurology) and with the Speech Pathology and Therapy is necessary and extremely relevant. Therefore, two chapters were dedicated to the literature of those areas. Recent papers and manuals, concerning CP, were selected. It is pointed out that the most recent research conclusions suggest, in fact, a strong convergence between what is taken as new and what is said to be old knowledge in the field of CP. Freud s statement, written in 1897, should, no doubt, be viewed as up-to-date. Some critical comments related to the Alternative Communication Systems (CA) were also included and a brief presentation of the Blissymbols and the Picture Communication Symbols (PCS) were followed by considerations about their importance for the Language Clinic theoretical development. I tried to point to the fact that such a Clinic takes clear distance from all others, since the CA introduction is guided by the specific language and subject conceptions assumed in this study. The theoretical orientation, here assumed, allowed me to address the problematic distinction between organic body and language body. This doctoral dissertation, which departs from the clinical practice with persons with Cerebral Palsy, is committed to the theorization undertaken in the CNPq Research Group, headed by Maria Francisca Lier-DeVitto, at LAEL PUCSP. It must be said that the Language Clinic is affiliated to the Interacionism in Language Acquisition, proposed by Cláudia de Lemos. Such a theoretical framework has strong links with the so called european structuralism as interpreted by Jacques Lacan. Such a theoretical trend triggered the inclusion of the psychoanalytical reflection on the subject speaker and about the relationship between child-language-speech. The difference this study introduces is illuminated by the clinical effects of the implementation of Alternative Communication Systems. It is worth saying that it is the therapist s body and speech that provide and support the materialization of the significant. The heterogeneous clinical effects analyzed led to considerations about the nature of listening, about transference and about the tension between conflict and pleasure that accompany some subtle and fragile vocalized speech. Data were discussed here and the interpretation conveyed sustains, I believe, the clinical and theoretical supposition proposed and advanced in this doctoral dissertation, i. e., that the body as organism and the body as parlêtre do not coincide / Esta tese discute a questão da diferença entre organismo e corpo, a partir do atendimento de sujeitos com Paralisia Cerebral (PC) na Clínica de Linguagem. Para falar em corpo, não o corpo-orgânico da Medicina, um diálogo inicial com a Neurologia é desenvolvido. Enfoco, para tanto, investigações recentes em torno da PC e assinalo que os mais novos achados sugerem uma forte convergência entre o novo e o mais antigo, nesse caso. Refiro-me a afirmações feitas há muito por Freud acerca da PC a partir de sua clínica com essas pessoas. Do mesmo modo, assumo a importância da interlocução com o campo da Comunicação Alternativa (CA). Uma breve apresentação do Bliss e do Picture Communication Symbols (PCS) é seguida por pontuações sobre sua importância modo de introdução na Clínica de Linguagem. Dou ênfase, nesta parte, ao distanciamento desta Clínica em relação a todas as outras que operam com a CA. A particularidade da Clínica e Linguagem decorre das concepções de linguagem e sujeito assumidas nesta tese. Com o intuito de delinear a natureza da literatura produzida sobre a CA, em nosso país e em âmbito internacional, ofereço um panorama de trabalhos representativos e de interesse para a Clínica de Linguagem com pacientes com PC. A direção teórica assumida, que tornou possível abordar a distinção entre corpo-orgânico e corpo-linguagem ou corpo pulsional, parte dos estudos desenvolvidos no interior da Clínica de Linguagem, pelo grupo de pesquisa liderado por Maria Francisca Lier-DeVitto, no LAEL PUCSP. A Clínica de Linguagem tem laço de filiação com o Interacionismo em Aquisição de Linguagem, proposto por Cláudia De Lemos, vertente teórica que, ao aproximar-se do Estruturalismo Europeu através da leitura de Lacan, dispara implicações entre Lingüística e Psicanálise, pondo em questão a relação criança-língua-fala do outro. A diferença tanto teórica, quanto clínica, que introduzo nesta tese, relativamente ao tratamento de pacientes com PC que não oralizam, é iluminada pelos efeitos dessa clínica que inclui a CA e a materialização do significante, que se faz pela via do empréstimo do corpo e da voz do outro-terapeuta. Abordo a heterogeneidade dos efeitos desta Clínica que suscitaram considerações sobre a escuta, sobre a transferência e sobre o prazer ou o conflito que acompanham a produção de certas falas vocalizadas de alguns pacientes. Os dados analisados nesta tese falam a favor da presença de um corpo-linguagem: um corpo que irrompe em manifestações significantes e que fala (como pode) - o que corrobora a afirmação que remete ao título desta tese: a de que sujeito e organismo não coincidem