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A polifonia da festa em Olho d'água da bica no Município de Tabuleiro do Norte - Ce.PINTO, Débora Kátia Maia January 2004 (has links)
PINTO, Débora Kátia Maia. A polifonia da festa em Olho d'água da bica no Município de Tabuleiro do Norte–Ce. 2004. 136 f. Dissertação (Mestrado em Sociologia) – Universidade Federal do Ceará, Departamento de Ciências Sociais, Programa de Pós-Graduação em Sociologia, Fortaleza-CE, 2004. / Submitted by Liliane oliveira (morena.liliane@hotmail.com) on 2011-11-18T11:42:44Z
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Previous issue date: 2004 / The main point explored by this work is an analysis of the religious feast dedicated to Our Lady of Health which takes place every year at the Olho d’Água da Bica district in the Tabuleiro do Norte county in the the State of Ceará from August 5th to August 15th. The sanctuary’s foundation is marked by histories that are seen by believers as a proof that the place is indeed sacred due to the existence of a perennial spring whose water has healing properties as revealed in a dream to a certain priest. The district has been visited for many years by people from several places in the state and other regions which led me to evaluate the feast from a perspective of a multiple sound composition, that is, a physical space that houses not only the religious core but also several other categories who present distinct discourses. They are pilgrims, merchants, the clergy and inhabitants, actors who in spite of their different backgrounds get together in the place every year to create a social web that will promote the rupture of local life. Aspects of the imaginary and symbolic representations besides the sanctuary’s foundation and the relations that spring from the pilgrimage are discussed in this work according to an analysis of healing rituals and stories as produced by the social actors that perform in the feast of Our Lady of Health. / A essência deste trabalho consiste na análise da Festa de Nossa Senhora da Saúde, realizada anualmente entre os dias 05 e 15 de agosto, no distrito de Olho d’Água da Bica no Município de Tabuleiro do Norte, no Estado do Ceará. A fundação do santuário é marcada por histórias que justificam, para os que crêem na Santa, que o lugar de fato apresenta aspecto sagrado devido à existência de uma fonte perene, cuja água tem poder curativo, e que foi revelada a um padre através de um sonho. O distrito é, há muitos anos, visitado por pessoas de diversas cidades do Estado e também de outros, o que me conduziu a pensar a festa a partir de uma perspectiva polifônica, ou seja, como um espaço que transcende o núcleo religioso e que é capaz de acomodar diversas categorias que apresentam discursos distintos. São romeiros, vendedores, o clero e os moradores, alguns desses atores que se encontram na localidade neste mesmo período, tecendo, apesar dos interesses diversos, uma rede de sociabilidade que promove a ruptura com o quotidiano do lugar. Neste trabalho, serão discutidos além da fundação do santuário e das relações que se estabelecem na romaria, os aspectos relacionados ao imaginário e às representações simbólicas construídas nesse espaço, evidenciadas através dos rituais de cura, bem como dos relatos orais produzidos pelos atores sociais que encenam a festa de Nossa Senhora da Saúde.
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Modelo de mistura padrão com tempos de vida exponenciais ponderadosGouveia, Bruno Pauka 05 March 2010 (has links)
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Previous issue date: 2010-03-05 / Financiadora de Estudos e Projetos / In this work, we brie_y introduce the concepts of long-term survival analysis. We dedicated ourselves exclusively to the standard mixture cure model from Boag (1949) and Berkson & Gage (1952), showing its deduction and presenting the imunes probability function, which is taken from the model itself and we investigated the identi_ability issues of the mixture model. Motivated by the possibility that a experiment design can lead to a biased sample selection, we studied the weighted probability distributions, more speci_cally the weighted exponential distributions family and its properties. We studied two distributions that belong to this family; namely, the length biased exponential distribution and the beta exponential distribution. Using the GAMLSS package in R, we made some simulation studies intending to evidence the bias that occur when the possibility of a weighted sample is ignored. / Neste trabalho apresentamos brevemente os conceitos que de_nem a análise de sobreviv ência de longa duração. Dedicamo-nos exclusivamente ao modelo de mistura padrão de Boag (1949) e Berkson & Gage (1952), sendo que nos preocupamos com sua formulação, apresentamos a função probabilidade de imunes, que é derivada do próprio modelo e investigamos a questão da identi_cabilidade. Motivados pela possibilidade de que um planejamento experimental leve a uma seleção viciada da amostra, estudamos as distribui ções ponderadas de probabilidade, mais especi_camente a família das distribuições exponenciais ponderadas e suas propriedades. Estudamos duas distribuições pertencentes a essa família, a distribuição exponencial length biased e a distribuição beta exponencial. Fazendo uso do pacote GAMLSS em R, realizamos alguns estudos de simulação com o intuito de evidenciar o erro cometido quando se ignora a possibilidade de que a amostra seja proveniente de uma distribuição ponderada.
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"L'acte-sentir" dans les médiations sensorielles olfactives en milieu carcéral : de la sensation perdue à la sensation retrouvée / "L'acte-sentir" the sensing act in therapeutic groups with sensing olfactive medium in prison : from lost feeling to recovering pleasureBracq-Leca, Herminie 13 October 2014 (has links)
Cette thèse propose d’interroger un dispositif de groupe thérapeutique à médiation sensorielle olfactive. Il a été créé comme une modalité d’accueil et d’écoute de sujets criminels, rencontrés dans le cadre d’une pratique en service psychiatrique en milieu carcéral. Ce dispositif innovant se fonde sur le besoin de créativité suscité par la confrontation avec une forme de clinique de l’extrême. Le choix de l’olfaction, comme modalité de contact, ouvre un champ de réflexion original, au carrefour de la philosophie, de la psychologie développementale, des neurosciences et de la psychanalyse. La notion « d’acte-sentir » est une proposition de modélisation des processus en jeu au contact du médium sensoriel olfactif. Proposé dans des pratiques groupales ou individuelles, le médium sensoriel olfactif favorise l’émergence de formes primaires de symbolisation, considérées comme des traces d’une subjectivité en déroute. Cette écoute du langage sensori-moteur et de ses formes particulières, suscitées par la mobilisation de l’odorat, est une proposition d’un abord psychothérapeutique de sujets aux prises avec des souffrances inexprimables voire insoutenables, engageant le clinicien « corps et âme ». / This thesis questions an innovative group setting, using an olfactive medium. It was started to meet and to listen to criminal patients in a psychiatric ward in prison. This new practice relys on the need to invent a way to react to the extreme seriousness of the mental illnesses in this ward. The choice of smell, as mean to get in touch, opens a wide field of reflections at the cross roads of philosophy, developmental psychology, neurosciences and psychoanalytical theory. “L’acte-sentir” the sensing-act is a proposal to pattern the different processes linked to smell as a medium. This work fits in groups or individual set-ups. Primary forms of symbolization appear with this medium, and illustrate a lost subjectivity. Listening to these words and helping associative work, is therapeutic with these suffering patients, who cannot speak easily. This work request a full body and mind implication. Use of the sens of smell to attempt to make sens to nonsense.
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Habitudes et addiction à internet chez les adolescents italiens : impact sur la fonction visuelle d'un protocole de dramathérapieDenti, Elisabetta 18 September 2017 (has links)
En 2017, il n'est plus nécessaire de se rappeler un numéro de téléphone par cœur, de patienter gentiment pour goûter les fruits et légumes de saison ou d'attendre quelqu’un à la gare avec impatience sans avoir eu de ses nouvelles : les émotions sont d'avantage liées à des moyens de communication bien plus immédiats. Le rythme naturel du temps qui passe dans nos vies semble s’apparenter pour l'homme (et pour la femme) du nouveau millénaire, davantage à une accélération effrénée et constante, une course contre le temps, dans l'illusion d'un monde instantané, hyper-rapide, super efficace : un monde « smart ». De cette manière, plutôt que d'écouter et de respecter le rythme naturel de notre respiration, de notre corps, nous choisissons à chaque instant de courir toujours plus vite, dans l'illusion omnipotente de gagner la course contre le temps, l'infaillible gardien de notre existence. Nous exprimons le désir d'être constamment connecté, créant l'illusion de l'hyper-présence. L'évolution technologique a radicalement transformé notre style de vie, notre manière de communiquer, notre propre expérience humaine et émotive. Si d'un côté la révolution technologique à laquelle nous appartenons, et dont nous continuons à en être les acteurs a permis la transformation globale des processus de communication de masse, celle-ci a en même temps permis l'émergence de nouvelles fragilités et la manifestation évidente de psychopathologies en relation à Internet. C’est à partir de la consultation de plus de 240 articles scientifiques internationaux et avec les données fournies sur la prévalence de ces nouvelles formes d’addiction en Asie (le continent technologiquement plus avancé et concerné à ce sujet), que le comité scientifique APA (American Psychiatric Association – Société Américaine de Psychiatrie) a décidé d’introduire l’Internet Gaming Disorder dans la dernière version du DSM, en Mai 2013. Le domaine de l’addiction à Internet est une frontière extrêmement emmêlée et complexe qui représente un nœud névralgique des discussions d'une partie de la communauté scientifique internationale. Voraces et habiles consommatrices des nouvelles technologies, les nouvelles générations sont particulièrement exposées au risque de développer ces nouvelles formes de dépendance. Il est nécessaire que la communauté scientifique internationale s'interroge sur de nouvelles stratégies d'intervention pour pouvoir intercepter et accueillir ces formes de malaise juvénile, qu’elle sache les définir pour les identifier et les soigner grâce à des protocoles d'intervention pour répondre de manière toujours plus efficace aux besoins réels des ces jeunes consommateurs. D'où l’intérêt de développer des projets de recherche portant sur ce sujet. Cette thèse, décrit donc un problème en émergence et la proposition d’une approche thérapeutique possible face à ces nouvelles formes d’addiction avec les arts thérapies, plus précisément avec la dramathérapie. Le cadre expérimental de cette thèse s’articule en deux parties : la première partie correspond à l’étude des répercussions physiologiques notamment sur la variation des compétences visuelles par rapport à un usage abusif ou addictif des écrans. Cette étude, qui constitue la principale expérience psychopédagogique de prévention de cette thèse, a été adressée à 250 adolescents italiens sains. La deuxième partie est une expérience clinique de prise en charge des addictions à Internet, auprès d’un public de 13 adolescents et jeunes adultes atteints du syndrome d’Asperger, addictifs aux jeux vidéo. Un dernier projet de dramathérapie adressé à des adolescents et des jeunes adultes, souffrant d’addiction aux substances constitue l’ouverture du regard clinique face aux comorbidités possibles qui caractérisent la pratique clinique de notre champ d’étude. (...) / In 2017, there is no longer a need to remember a phone number by heart, wait for the right time to taste seasonal fruit or vegetables, or wait for someone at the station without having news briefly before hugging him on the train quay Emotions are more closely related to much more immediate communication flows. The natural rhythm of time flowing in our lives seems to be synonymous for the man (and the woman) of the new millennium of a frantic and constant acceleration against time, in the illusion of a flashy world, super-fast, super-efficient: a smart world. In this way, instead of listening to and respecting the natural rhythm of our breath, our body, we choose at any time to run faster and faster, in the omnipotent illusion of winning the race against time, the unreliable guardian of our existence. We express the desire to be constantly connected, creating the illusion of hyper-presence. Technological development has radically changed our lifestyle, our way of communicating, our human and emotional, individual and collective experience. On the one hand, the technological revolution has allowed the global transformation of the mass communication process and is an inexhaustible source of knowledge and discovery; not to be demonized but to be explored with intelligence and curiosity; it has at the same time led to the emergence of new vulnerabilities and manifestations of Internet-related psychopathological discomfort. It is through the consultation of over 240 international scientific articles and data on the prevalence of these new forms of dependence in Asia (the continent most technologically advanced and involved in this regard), that the American Psychiatric Association (APA) decided to introduce the Internet Gaming Disorder in its latest version of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in May 2013. The field of Internet addiction is an extremely tangled and complex border that represents a nerve node discussion in part of the international scientific community. Voracious consumers and clever users of new technologies, that is the new generations, seem to be particularly at risk of developing these dependencies. This is why it is important to develop research projects and it is urgent to propose psycho-educational prevention projects for the adolescent population. This thesis describes an emergency problem and the proposal of a possible approach facing these new addiction forms through arts therapies, more precisely through dramatherapy. The experimental part of this thesis is articulated in two parts: the first one corresponds to the study of physiological repercussion on variations of visual skills related to the use or abuse of screen use.This study, that represents the psycho pedagogical and prevention experience of this thesis, was addressed to 250 Italian sound teenagers. The second part consists of a clinical experience of cure of Internet addiction addressed to 13 video games addicted adolescents and young adults with Asperger syndrome. A further project of dramatherapy addressed to drugs addicted adolescents and young adults represents a clinical perspective in front of possible comorbidities that characterize the clinical practice in our field of study. The dramatherapy approach in the field of prevention and cure of web related addictions is considered regarding two important aspects: the recovery and reclamation of the body and sensory experience (size altered in the virtual experience facing the monitors) and the possibility to expose the person to a gaming experience through a shared transitional space. The body dimension, completely abandoned or altered in the virtual experience, is recovered and exalted through dramatherapy. The therapeutical approach is born, grows and develops in the body. In our view the stage represents the appropriate mediation between the virtual space of the abuse and real space of existence. (...)
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CURE RATE AND DESTRUCTIVE CURE RATE MODELS UNDER PROPORTIONAL ODDS LIFETIME DISTRIBUTIONSFENG, TIAN January 2019 (has links)
Cure rate models, introduced by Boag (1949), are very commonly used while modelling
lifetime data involving long time survivors. Applications of cure rate models can be seen
in biomedical science, industrial reliability, finance, manufacturing, demography and criminology. In this thesis, cure rate models are discussed under a competing cause scenario,
with the assumption of proportional odds (PO) lifetime distributions for the susceptibles,
and statistical inferential methods are then developed based on right-censored data.
In Chapter 2, a flexible cure rate model is discussed by assuming the number of competing
causes for the event of interest following the Conway-Maxwell (COM) Poisson distribution,
and their corresponding lifetimes of non-cured or susceptible individuals can be
described by PO model. This provides a natural extension of the work of Gu et al. (2011)
who had considered a geometric number of competing causes. Under right censoring, maximum likelihood estimators (MLEs) are obtained by the use of expectation-maximization
(EM) algorithm. An extensive Monte Carlo simulation study is carried out for various scenarios,
and model discrimination between some well-known cure models like geometric,
Poisson and Bernoulli is also examined. The goodness-of-fit and model diagnostics of the
model are also discussed. A cutaneous melanoma dataset example is used to illustrate the
models as well as the inferential methods.
Next, in Chapter 3, the destructive cure rate models, introduced by Rodrigues et al. (2011), are discussed under the PO assumption. Here, the initial number of competing
causes is modelled by a weighted Poisson distribution with special focus on exponentially
weighted Poisson, length-biased Poisson and negative binomial distributions. Then, a damage
distribution is introduced for the number of initial causes which do not get destroyed.
An EM-type algorithm for computing the MLEs is developed. An extensive simulation
study is carried out for various scenarios, and model discrimination between the three
weighted Poisson distributions is also examined. All the models and methods of estimation
are evaluated through a simulation study. A cutaneous melanoma dataset example is used
to illustrate the models as well as the inferential methods.
In Chapter 4, frailty cure rate models are discussed under a gamma frailty wherein the
initial number of competing causes is described by a Conway-Maxwell (COM) Poisson
distribution in which the lifetimes of non-cured individuals can be described by PO model.
The detailed steps of the EM algorithm are then developed for this model and an extensive
simulation study is carried out to evaluate the performance of the proposed model and the
estimation method. A cutaneous melanoma dataset as well as a simulated data are used for
illustrative purposes.
Finally, Chapter 5 outlines the work carried out in the thesis and also suggests some
problems of further research interest. / Thesis / Doctor of Philosophy (PhD)
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Återhämtande faktorer inom psykiatrisk heldygnsvård : En sammanställning av patienters upplevelserBohlin, Anna, Evling, Petra January 2022 (has links)
ABSTRACT Introduction: It is an assumption that as long as people have existed, there has been mental illness and disease, but the way of perceiving, explaining and caring looks different historically and in different societies. Research describes the current care environment and the quality of care in psychiatric inpatient care as meager and confusing, with a lack of meaningful activities. Recovery in a psychiatric context is about finding hope and meaning in life, regaining self-confidence and taking power over one's continued life. Problem formulation: As a specialist nurse, you must work for a good care environment and in a structured way with the nursing process. Therefore, it is important to increase knowledge about patients' experiences of factors that support the recovery process in psychiatric inpatient care. Aim: Is to compile current scientific knowledge about the factors that patients experience that support their recovery in patients in psychiatric inpatient care. Method: A literature study with a qualitative inductive approach, with a manifest and latent content analysis of 16 scientific original articles. Results: The results revealed three overarching categories: Patients need information and to be involved in their care; Patients need good treatment and holistic nursing and the psychiatric ward must be a safe place with the opportunity for meaningful activities. The overall theme is that patients need to be at the center of their care and feel safe and in control, for their recovery Conclusion: There are a number of factors that can support patients in psychiatric care in their recovery, which include both the physical and psychosocial care environment. This indicates that recovery is a complex phenomenon and there is a need to design a more recovery-oriented nursing, and research more in the subject. Keywords: recovery, restorative factors, patients' experiences, psychiatric inpatient care, psychiatric round-the-clock care / SAMMANFATTNING Introduktion: Det är ett antagande, att så länge människor har funnits, har det funnits psykisk ohälsa och sjukdom, men sättet att uppfatta, förklara och vårda ser olika ut historiskt och i olika samhällen. Forskning beskriver den nuvarande vårdmiljön och vårdkvaliteten inom psykiatrisk heldygnsvård som torftig och förvirrande, med avsaknad av meningsfulla aktiviteter. Återhämtning i psykiatrisk kontext handlar om att finna hopp och mening med livet, att återerövra självförtroende och ta makt över sitt fortsatta liv. Problemformulering: Som specialistsjuksköterska ska man arbeta för en god vårdmiljö och strukturerat med omvårdnadsprocessen. Därför är det angeläget att öka kunskapen om patienters upplevelser av faktorer som understödjer återhämtningsprocessen inom heldygnsvård. Syfte: Är att sammanställa aktuell vetenskaplig kunskap om vilka faktorer som patienter upplever understödjer deras återhämtning inom psykiatrisk heldygnsvård. Metod: En litteraturstudie med kvalitativ induktiv ansats, med en manifest och latent innehållsanalys av 16 vetenskapliga originalartiklar. Resultat: I resultatet framkom tre övergripande kategorier: Patienter har behov av att få information och att vara delaktiga i sin vård; Patienter har behov av att få ett gott bemötande och en holistisk omvårdnad samt Vårdavdelningen ska vara en trygg plats med möjlighet till meningsfulla aktiviteter. Övergripande tema handlar om att patienter behöver vara i centrum av sin omvårdnad och känna trygghet och kontroll, för sin återhämtning Slutsats: Det finns en mängd faktorer som kan stödja patienter inom psykiatrisk heldygnsvård i deras återhämtningen, som innefattar både den fysiska och psykosociala vårdmiljön. Det indikerar att återhämtning är ett komplext fenomen och det finns behov av att utforma en mer återhämtningsinriktad omvårdnad samt forska mer inom ämnet. Nyckelord: Återhämtning, återhämtande faktorer, patienters upplevelser, psykiatrisk slutenvård, psykiatrisk heldygnsvård / RESUMEN Introducción: Es una suposición que desde que existieron los seres humanos, ha habido enfermedades y enfermedades mentales, pero la forma de percibir, explicar y cuidar se ve diferente históricamente y en diferentes sociedades. La investigación describe el entorno de atención actual y la calidad de la atención dentro de la atención de pacientes psiquiátricos hospitalizados como estrechos y confusos, con falta de actividad significativa. La recuperación en un contexto psiquiátrico se trata de encontrar esperanza y significado en la vida, recuperar la confianza en uno mismo y tomar el control de su vida continua. Formulación del problema: Como enfermera especialista, debe trabajar para un buen ambiente de atención y de forma estructurada con el proceso de enfermería. Por lo tanto, es importante aumentar el conocimiento sobre las experiencias de los pacientes de los factores que apoyan el proceso de recuperación dentro de la atención psiquiátrica de pacientes hospitalizados. Propósito: es compilar el conocimiento científico actual sobre los factores que experimentan los pacientes que apoyan su recuperación en pacientes psiquiátricos hospitalizados. Método: Estudio de literatura con enfoque cualitativo inductivo, con análisis de contenido manifiesto y latente de 16 artículos científicos originales. Resultados: Los resultados revelaron tres categorías generales: los pacientes necesitan información y estar involucrados en su atención; Los pacientes necesitan un buen tratamiento y atención integral, y el departamento de psiquiatría debe ser un lugar seguro con la oportunidad de realizar actividades significativas. El tema general es que los pacientes deben estar en el centro de su atención y sentirse seguros y en control, para poder recuperarse. Conclusión: Hay una serie de factores que pueden apoyar a los pacientes de atención psiquiátrica en su recuperación, incluido el entorno de atención física y psicosocial. Esto sugiere que la recuperación es un fenómeno complejo y que es necesario diseñar una enfermería más orientada a la recuperación y realizar más investigaciones sobre el tema. Palabras clave: recuperación, factores restaurativos, experiencias del paciente, hospitalización psiquiátrica, atención psiquiátrica las 24 horas. / ABSTRAIT Introduction: C'est une hypothèse que depuis que les humains existent, il y a eu des maladies mentales et des maladies, mais la façon de percevoir, d'expliquer et de s'en soucier semble différente historiquement et dans différentes sociétés. La recherche décrit l'environnement de soins actuel et la qualité des soins au sein des soins psychiatriques aux patients hospitalisés comme exigus et déroutants, avec un manque d'activité significative. Le rétablissement en contexte psychiatrique consiste à retrouver espoir et sens à la vie, à reprendre confiance en soi et à reprendre le contrôle de sa vie. Formulation du problème : En tant qu'infirmière spécialisée, vous devez travailler pour un bon environnement de soins et de manière structurée avec le processus de soins infirmiers. Par conséquent, il est important d'accroître les connaissances sur les expériences des patients concernant les facteurs qui soutiennent le processus de rétablissement dans le cadre des soins psychiatriques aux patients hospitalisés. Objectif : Compiler les connaissances scientifiques actuelles sur les facteurs vécus par les patients qui favorisent leur rétablissement chez les patients hospitalisés en psychiatrie. Méthode : Une étude bibliographique avec une approche inductive qualitative, avec une analyse du contenu manifeste et latent de 16 articles scientifiques originaux. Résultats : Les résultats ont révélé trois grandes catégories : les patients ont besoin d'informations et d'être impliqués dans leurs soins ; Les patients ont besoin d'un bon traitement et de soins complets, et le service psychiatrique doit être un endroit sûr avec la possibilité d'activités significatives. Le thème général est que les patients doivent être au centre de leurs soins et se sentir en sécurité et en contrôle, afin qu'ils se rétablissent. Conclusion : Il existe un certain nombre de facteurs qui peuvent soutenir les patients en soins psychiatriques dans leur rétablissement, y compris l'environnement physique et psychosocial des soins. Cela suggère que le rétablissement est un phénomène complexe et qu'il est nécessaire de concevoir des soins infirmiers davantage axés sur le rétablissement et de faire plus de recherche sur le sujet. Mots-clés : rétablissement, facteurs réparateurs, expériences des patients, soins psychiatriques aux patients hospitalisés, soins psychiatriques 24 heures sur 24 / ZUSAMMENFASSUNG Einleitung: Es ist eine Annahme, dass es psychische Erkrankungen und Erkrankungen gibt, seit es Menschen gibt, aber die Art und Weise der Wahrnehmung, Erklärung und Behandlung sieht historisch und in verschiedenen Gesellschaften unterschiedlich aus. Die Forschung beschreibt das derzeitige Pflegeumfeld und die Pflegequalität in der psychiatrischen 24-Stunden-Pflege als beengt und verwirrend, mit einem Mangel an sinnvollen Aktivitäten. Bei der Genesung in einem psychiatrischen Kontext geht es darum, Hoffnung und Sinn im Leben zu finden, das Selbstvertrauen wiederzugewinnen und die Macht über Ihr weiteres Leben zu übernehmen. Problemformulierung: Als Fachpflegekraft müssen Sie sich für ein gutes Pflegeumfeld einsetzen und den Pflegeprozess strukturieren. Daher ist es wichtig, das Wissen über die Erfahrungen der Patienten mit Faktoren zu erweitern, die den Genesungsprozess in der Rund-um-die-Uhr-Betreuung unterstützen. Zweck: Ist die Erhebung aktueller wissenschaftlicher Erkenntnisse darüber, welche Faktoren erlebte Patienten ihre Genesung im Rahmen der psychiatrischen Rund-um-die-Uhr-Versorgung unterstützen. Methode: Eine qualitativ-induktive Literaturstudie mit manifester und latenter Inhaltsanalyse von 16 wissenschaftlichen Originalartikeln. Ergebnisse: In den Ergebnissen kristallisierten sich drei übergreifende Kategorien heraus: Patienten haben das Bedürfnis, Informationen zu erhalten und an ihrer Versorgung beteiligt zu werden; Patienten brauchen eine gute Behandlung und ganzheitliche Pflege, und die Pflegeabteilung muss ein sicherer Ort mit Möglichkeiten für sinnvolle Aktivitäten sein. Das übergeordnete Thema ist, dass Patienten im Mittelpunkt ihrer Versorgung stehen und sich für ihre Genesung sicher und unter Kontrolle fühlen müssen Schlussfolgerung: Es gibt eine Reihe von Faktoren, die Patienten in der psychiatrischen 24-Stunden-Versorgung bei ihrer Genesung unterstützen können, darunter sowohl das physische als auch das psychosoziale Versorgungsumfeld. Es weist darauf hin, dass die Genesung ein komplexes Phänomen ist und dass es notwendig ist, eine stärker auf die Genesung ausgerichtete Pflege zu entwerfen und mehr Forschung zu diesem Thema zu betreiben. Schlüsselwörter: Genesung, Genesungsfaktoren, Patientenerfahrungen, stationäre psychiatrische Versorgung, psychiatrische 24-Stunden-Versorgung / ملخص مقدمة: من الافتراض أنه ما دام الناس موجودون ، كان هناك مرض وأمراض نفسية ، لكن طريقة إدراك وشرح وعلاج تبدو مختلفة تاريخيًا وفي مجتمعات مختلفة. يصف البحث بيئة الرعاية الحالية وجودة الرعاية في الرعاية النفسية على مدار 24 ساعة بأنها ضيقة ومربكة ، مع عدم وجود أنشطة ذات مغزى. يتعلق التعافي في سياق الطب النفسي بإيجاد الأمل والمعنى في الحياة ، واستعادة الثقة بالنفس والاستيلاء على السلطة على حياتك المستمرة. صياغة المشكلة: بصفتك ممرضة متخصصة ، يجب أن تعمل من أجل بيئة رعاية جيدة وهيكل عملية التمريض. لذلك ، من المهم زيادة المعرفة حول تجارب المرضى بشأن العوامل التي تدعم عملية التعافي في الرعاية على مدار الساعة. الغرض: هو تجميع المعرفة العلمية الحالية حول العوامل التي يختبرها المرضى والتي تدعم تعافيهم في إطار رعاية نفسية على مدار الساعة. الطريقة: دراسة أدبية بنهج استقرائي نوعي ، مع تحليل محتوى واضح وكامن لـ 16 مقالة علمية أصلية. النتائج: في النتائج ، ظهرت ثلاث فئات شاملة: المرضى بحاجة إلى تلقي المعلومات والمشاركة في رعايتهم ؛ يحتاج المرضى إلى علاج جيد ورعاية شاملة ، ويجب أن يكون قسم الرعاية مكانًا آمنًا مع فرص القيام بأنشطة ذات مغزى. الموضوع الرئيسي هو أن المرضى يجب أن يكونوا في مركز رعايتهم وأن يشعروا بالأمان والتحكم من أجل شفائهم الخلاصة: هناك عدد من العوامل التي يمكن أن تدعم المرضى في الرعاية النفسية على مدار 24 ساعة في شفائهم ، والتي تشمل كلاً من بيئة الرعاية الجسدية والنفسية الاجتماعية. إنه يشير إلى أن التعافي ظاهرة معقدة وهناك حاجة لتصميم المزيد من التمريض الموجه نحو التعافي وإجراء مزيد من البحوث حول هذا الموضوع. الكلمات المفتاحية: التعافي ، عوامل الشفاء ، تجارب المرضى ، رعاية المرضى الداخليين النفسيين ، رعاية نفسية على مدار 24 ساعة / 概括 简介:这是一个假设,只要人存在,就有精神疾病和疾病,但感知、解释和治疗的方式在历史和不同社会中看起来不同。研究将当前的 24 小时精神科护理环境和护理质量描述为局促和混乱,缺乏有意义的活动。精神病学背景下的康复是关于在生活中找到希望和意义,重新获得自信并掌握继续生活的权力。 问题表述:作为一名专科护士,您必须努力营造良好的护理环境并构建护理流程。因此,重要的是要增加对患者在全天候护理中支持康复过程的因素的体验的了解。 目的:收集当前的科学知识,了解患者经历的哪些因素支持他们在精神科全天候护理中康复。 方法:采用定性归纳法的文献研究,对 16 篇原创科学文章进行明显和潜在的内容分析。 结果:在结果中,出现了三个总体类别:患者需要接收信息并参与他们的护理;患者需要良好的治疗和整体护理,护理部门必须是一个安全的地方,有机会进行有意义的活动。最重要的主题是患者需要处于他们护理的中心,并感到安全和可控,以便他们康复 结论:有许多因素可以支持 24 小时精神科护理中的患者康复,包括身体和心理社会护理环境。这表明康复是一个复杂的现象,需要设计更多以康复为导向的护理,并对此进行更多的研究。 关键词:康复,康复因素,患者体验,精神科住院治疗,24小时精神科治疗 / РЕЗЮМЕ Введение: Это предположение, что пока существуют люди, были психические заболевания и болезни, но способ восприятия, объяснения и лечения выглядит по-разному исторически и в разных обществах. Исследования описывают нынешнюю среду и качество круглосуточной психиатрической помощи как стесненные и запутанные, с отсутствием значимых мероприятий. Выздоровление в психиатрическом контексте означает обретение надежды и смысла жизни, обретение уверенности в себе и обретение власти над своей дальнейшей жизнью. Формулировка проблемы: Как специализированная медсестра, вы должны работать над созданием хорошей среды ухода и структурировать процесс ухода. Поэтому важно расширять знания пациентов о факторах, поддерживающих процесс выздоровления при круглосуточном уходе. Цель: Обобщить современные научные знания о том, какие факторы, с которыми сталкиваются пациенты, способствуют их выздоровлению в рамках круглосуточной психиатрической помощи. Метод: изучение литературы с использованием качественного индуктивного подхода, с анализом явного и скрытого содержания 16 оригинальных научных статей. Результаты. В результате были выявлены три всеобъемлющие категории: пациенты нуждаются в получении информации и в участии в уходе за ними; Пациенты нуждаются в хорошем лечении и комплексном уходе, а отделение ухода должно быть безопасным местом с возможностями для полноценной деятельности. Главной темой является то, что пациенты должны быть в центре внимания и чувствовать себя в безопасности и под контролем для своего выздоровления. Заключение. Существует ряд факторов, которые могут помочь пациентам, находящимся на круглосуточной психиатрической помощи, в их выздоровлении, включая как физическую, так и психосоциальную среду ухода. Это указывает на то, что выздоровление является сложным явлением, и существует необходимость разработки более ориентированного на выздоровление ухода и проведения дополнительных исследований по этому вопросу. Ключевые слова: выздоровление, факторы выздоровления, переживания пациентов, психиатрическая стационарная помощь, круглосуточная психиатрическая помощь. / خلاصه مقدمه: این فرض است که تا زمانی که مردم وجود داشته اند، بیماری و بیماری روانی وجود داشته است، اما نحوه درک، تبیین و درمان از نظر تاریخی و در جوامع مختلف متفاوت به نظر می رسد. تحقیقات محیط مراقبت فعلی و کیفیت مراقبت در مراقبتهای روانپزشکی 24 ساعته را محدود و گیجکننده و با فقدان فعالیتهای معنادار توصیف میکنند. بهبودی در زمینه روانپزشکی به معنای یافتن امید و معنا در زندگی، بازیابی اعتماد به نفس و به دست گرفتن قدرت بر ادامه زندگی است. فرمول مشکل: به عنوان یک پرستار متخصص، باید برای یک محیط مراقبت خوب کار کنید و فرآیند پرستاری را ساختار دهید. بنابراین، افزایش دانش در مورد تجربیات بیماران از عواملی که از روند بهبودی در مراقبت شبانه روزی حمایت می کنند، مهم است. هدف: گردآوری دانش علمی فعلی در مورد عواملی که بیماران تجربه میکنند از بهبودی آنها در مراقبتهای شبانهروزی روانپزشکی حمایت میکند. روش: مطالعه ادبیات با رویکرد استقرایی کیفی، با تحلیل محتوای آشکار و پنهان 16 مقاله علمی اصیل. یافتهها: در نتایج، سه دسته کلی به دست آمد: بیماران نیاز به دریافت اطلاعات و مشارکت در مراقبت از خود دارند. بیماران نیاز به درمان خوب و مراقبت جامع دارند و بخش مراقبت باید مکانی امن با فرصت هایی برای فعالیت های معنادار باشد. موضوع اصلی این است که بیماران باید در مرکز مراقبت خود باشند و برای بهبودی خود احساس امنیت و کنترل کنند. نتیجهگیری: عوامل متعددی وجود دارد که میتواند بیماران را در مراقبتهای 24 ساعته روانپزشکی در بهبودی آنها حمایت کند که شامل محیط مراقبت فیزیکی و روانی اجتماعی میشود. این نشان می دهد که بهبودی یک پدیده پیچیده است و نیاز به طراحی بیشتر پرستاری بهبود محور و انجام تحقیقات بیشتر در مورد این موضوع وجود دارد. واژههای کلیدی: بهبود، عوامل بهبود، تجارب بیماران، مراقبتهای بستری روانپزشکی، مراقبتهای روانپزشکی 24 ساعته / RIEPILOGO Introduzione: Si presume che da quando le persone sono esistite, ci sono state malattie e malattie mentali, ma il modo di percepire, spiegare e trattare sembra diverso storicamente e in società diverse. La ricerca descrive l'attuale ambiente di cura e la qualità dell'assistenza nell'assistenza psichiatrica 24 ore su 24 come angusto e confuso, con una mancanza di attività significative. Il recupero in un contesto psichiatrico consiste nel trovare speranza e significato nella vita, riguadagnare fiducia in se stessi e assumere il potere sulla propria vita. Formulazione del problema: come infermiere specializzato, devi lavorare per un buon ambiente di cura e strutturare il processo infermieristico. Pertanto, è importante aumentare la conoscenza delle esperienze dei pazienti sui fattori che supportano il processo di recupero nell'assistenza 24 ore su 24. Scopo: è quello di raccogliere le attuali conoscenze scientifiche su quali fattori che i pazienti sperimentano supportano il loro recupero nell'ambito dell'assistenza psichiatrica 24 ore su 24. Metodo: Uno studio della letteratura con un approccio induttivo qualitativo, con un'analisi del contenuto manifesto e latente di 16 articoli scientifici originali. Risultati: nei risultati sono emerse tre categorie generali: i pazienti hanno bisogno di ricevere informazioni e di essere coinvolti nelle loro cure; I pazienti hanno bisogno di un buon trattamento e di cure olistiche e il reparto di assistenza deve essere un luogo sicuro con opportunità per attività significative. Il tema principale è che i pazienti devono essere al centro della loro cura e sentirsi sicuri e in controllo, per la loro guarigione Conclusione: ci sono una serie di fattori che possono supportare i pazienti in assistenza psichiatrica 24 ore su 24 nel loro recupero, che includono sia l'ambiente di assistenza fisica che psicosociale. Indica che il recupero è un fenomeno complesso e che è necessario progettare un'assistenza infermieristica più orientata al recupero e fare più ricerca sull'argomento. Parole chiave: Recupero, fattori di recupero, esperienze dei pazienti, cure psichiatriche ospedaliere, cure psichiatriche 24 ore su 24
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競爭風險下長期存活資料之貝氏分析 / Bayesian analysis for long-term survival data蔡佳蓉 Unknown Date (has links)
當造成失敗的原因不只一種時,若各對象同一時間最多只經歷一種失敗原因,則這些失敗原因稱為競爭風險。然而,有些個體不會失敗或者經過治療之後已痊癒,我們稱這部分的群體為治癒群。本文考慮同時處理競爭風險及治癒率的混合模式,即競爭風險的治癒率模式,亦將解釋變數結合到治癒率、競爭風險的條件失敗機率,或未治癒下競爭風險的條件存活函數中,並以建立在完整資料上之擴充的概似函數為貝氏分析的架構。對於右設限對象則以插補方式決定是否會治癒或會因何種風險而失敗,並推導各參數的完全條件後驗分配及其性質。由於邊際後驗分配的數學形式無法明確呈現,再加上需對右設限者判斷其狀態,所以採用屬於馬可夫鏈蒙地卡羅法的Gibbs抽樣法及適應性拒絕抽樣法(adaptive rejection sampling) ,執行參數之模擬抽樣及設算右設限者之治癒或失敗狀態。實證部分,我們分析Klein and Moeschberger (1997)書中骨髓移植後的血癌病患的資料,並用不同模式之下的參數模擬值計算各對象之條件預測指標(CPO),換算成各模式的對數擬邊際概似函數值(LPML),比較不同模式的優劣。 / In case that there are more than one possible failure types, if each subject experiences at most one failure type at one time, then these failure types are called competing risks. Moreover, some subjects have been cured or are immune so they never fail, then they are called the cured ones. This dissertation discusses several mixture models containing competing risks and cure rate. Furthermore, covariates are associated with cure rate, conditional failure rate of each risk, or conditional survival function of each risk, and we propose the Bayesian procedure based on the augmented likelihood function of complete data. For right censored subjects, we make use of imputation to determine whether they were cured or failed by which risk and derive full conditional posterior distributions. Since all marginal posterior distributions don’t have closed forms and right censored subjects need to be identified their statuses, we take Gibbs sampling and adaptive rejection sampling of Markov chain Monte Carlo method to simulate parameter values. We illustrate how to conduct Bayesian analysis by using the bone marrow transplant data from the book written by Klein and Moeschberger (1997). To do model selection, we compute the conditional predictive ordinate(CPO) for every subject under each model, then the goodness is determined by the comparing the value of log of pseudo marginal likelihood (LMPL) of each model.
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含存活分率之貝氏迴歸模式李涵君 Unknown Date (has links)
當母體中有部份對象因被治癒或免疫而不會失敗時,需考慮這群對象所佔的比率,即存活分率。本文主要在探討如何以貝氏方法對含存活分率之治癒率模式進行分析,並特別針對兩種含存活分率的迴歸模式,分別是Weibull迴歸模式以及對數邏輯斯迴歸模式,導出概似函數與各參數之完全條件後驗分配及其性質。由於聯合後驗分配相當複雜,各參數之邊際後驗分配之解析形式很難表達出。所以,我們採用了馬可夫鏈蒙地卡羅方法(MCMC)中的Gibbs抽樣法及Metropolis法,模擬產生參數值,以進行貝氏分析。實證部份,我們分析了黑色素皮膚癌的資料,這是由美國Eastern Cooperative Oncology Group所進行的第三階段臨床試驗研究。有關模式選取的部份,我們先分別求出各對象在每個模式之下的條件預測指標(CPO),再據以算出各模式的對數擬邊際概似函數值(LPML),以比較各模式之適合性。 / When we face the problem that part of subjects have been cured or are immune so they never fail, we need to consider the fraction of this group among the whole population, which is the so called survival fraction. This article discuss that how to analyze cure rate models containing survival fraction based on Bayesian method. Two cure rate models containing survival fraction are focused; one is based on the Weibull regression model and the other is based on the log-logistic regression model. Then, we derive likelihood functions and full conditional posterior distributions under these two models. Since joint posterior distributions are both complicated, and marginal posterior distributions don’t have closed form, we take Gibbs sampling and Metropolis sampling of Markov Monte Carlo chain method to simulate parameter values. We illustrate how to conduct Bayesian analysis by using the data from a melanoma clinical trial in the third stage conducted by Eastern Cooperative Oncology Group. To do model selection, we compute the conditional predictive ordinate (CPO) for every subject under each model, then the goodness is determined by the comparing the value of log of pseudomarginal likelihood (LPML) of each model.
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Empowering voices: testimonial literature and social justice in contemporary American culture / Littérature de témoignage et justice sociale dans la culture contemporaine aux Etats-UnisLouckx, Audrey 05 September 2014 (has links)
Within the last three decades, contemporary North America came to reinvent a socially focused genre of literary personal narratives. These new editorial and writing projects, published in the form of collections of personal narratives, emerged as a tool for the socially voiceless to secure some measure of agency in their contemporary social and cultural situation. Projects such as the Freedom Writers’ Diary or volumes of the Voice of Witness book series fit in the process that is currently labeled social empowerment. Witnesses express a deep urge to share their story in the hope to denounce their experience of an enduring social injustice. The written word, primary a means for self-disclosure, serves to exorcise the suffering associated to this specific predicament. The narrators engage in a powerful self-investigative gesture oriented towards resilience and renewed enfranchisement in regaining control over their life and environment. At the moment of publication, however, these testimonies come to be validated as authentic examples of the injustices they disclose. These examples serve an educational purpose: raising the audience’s awareness and opening deliberative fora for these issues to be discussed and for solutions to be hammered out and eventually implemented. <p>The purpose of this dissertation is to propose a theoretical model for the subgenre of testimonials of social empowerment. With the concept of empowerment as groundwork, the model develops a textual approach framed in a psychosocial structure. I argue that testimonials may be described as examples of Jürgen Habermas’s communicative action. As speech acts aimed at reaching understanding, testimonials capitalize both on the binding and bonding aspects of illocutionary force in the hope to secure with their audience an ongoing dialogue over issues of social justice. The volumes, as unofficial public spheres, mobilize the normative and practical dynamics at work in social movements. These dynamics express as two narrative guiding threads: an aesthetic based on impact, and an ethics based on responsibility. The texts’ aesthetic develops a form of perlocutionary realism instantiating a sense of authenticity and sincerity embodied in the narrators’ voices. The resulting impact is coupled to moral concerns based on a polysemic understanding of social responsibility, on which narrators seek to build their narratives’ ethical potential. A series of case studies allowed to demonstrate that both narrative threads are realized as an appropriation of four paradigmatic forms of rhetorical ethos, each based on a specific realm of the social world: intimacy, justice, spirituality and activism.<p> / Doctorat en Langues et lettres / info:eu-repo/semantics/nonPublished
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Internprissättning och tullvärde : Det är bättre att förekomma än att förekommas / Transfer Pricing and Customs Value : Prevention is Better than CureSöderberg, Anna January 2015 (has links)
Globaliseringen bidrar till en ökad världshandel och medför även ett växande antal gränsöverskridande koncerninterna transaktioner inom multinationella företag. Prissättningen av transaktioner vilka vidtas mellan närstående företag måste ske i enlighet med armlängdsprincipen som om transaktionerna vidtagits mellan två oberoende företag. Skattemyndigheterna kan justera internpriserna i slutet av beskattningsåret i de fall de anser att internprissättningen avviker från armlängdsprincipen och marknadsmässiga villkor. Utöver inkomstbeskattning åläggs företagen att betala tullavgifter i samband med transaktioner vidtagna med närstående företag etablerade utanför EU. I likhet med skattemyndigheterna granskar tullmyndigheterna företagens importpriser i syfte att säkerställa att parternas närståenderelation inte påverkat prissättningen. Båda myndigheterna arbetar således för samma mål, att upprätthålla prissättningens förenlighet med marknadsmässiga villkor. Skatte- och tullmyndigheterna tillämpar dock olika prissättningsmetoder i syfte att uppnå målet. Inkomstskatten baseras på företagens totala inkomster, relaterade till transaktionerna och tullavgiften beräknas baserat på varje specifik transaktion och vara. Det faktum att myndigheterna inkluderar olika tillgångar i de respektive beskattningsunderlagen kan medföra att de bedömer värdet av samma transaktion olika. Varierande bedömningar av samma pris kan vidare medföra krav på olika prisjusteringar i syfte att uppnå marknadsmässig prissättning. Prisjusteringar kan leda till onödiga skattetillägg och liknande straffavgifter. Det föreligger svårigheter för multinationella företag att bestämma transaktionspriser som uppfyller båda myndigheternas i syfte att undvika straffavgifter. Problematiken är ännu relativt ouppmärksammad av företag i världen. I amerikansk praxis framkommer att möjligheterna är små för företag att förlita sig på dokumentation upprättad för internprissättning, i syfte att styrka tullavgifter och tullvärde. Det är således betydelsefullt att företag upprättar dokumentationer för både internprissättning och tullvärde för att undvika straffavgifter. Dokumentationen utgör huvudsakligt bevis och ligger till grund för bedömningen av huruvida företagen uppfyllt bevisbördan avseende prisernas förenlighet med marknadsmässiga villkor. Företagen bör etablera en öppen kommunikation med de respektive myndigheterna i syfte att minimera risker för missförstånd eventuella framtida prisjusteringar. Det är bättre att förekomma än att förekommas. / The ‘arm’s length principle’ is fundamental to transfer pricing and cross-border intercompany transactions. The principle states that the prices charged for transactions of goods between related parties must be the same as if the parties were unrelated. Simply, the price needs to equal market values. If the Tax Authority finds the pricing to be inconsistent with the arm’s length principle, the price may be adjusted. In relation to cross-border intercompany transactions outside of the EU, companies have to pay customs duty and regard customs values. The Customs Authorities work to ensure that the price has not been influenced by the intercompany relationship. Thus, the Tax and Customs Authorities share the same goal, which is to ensure that the transaction price is consistent with market values. However, the methods of pursuing the goal differ. The Tax Authorities determine the amount of income tax based on the company’s total revenues deriving from cross-border intragroup transactions. The Customs Authorities on the contrary determine the amount of taxable income based on the value of every specific imported product. The authorities usually consider different values and assets when determining the amount of taxable income. Therefore the same transaction price may be evaluated differently by the Tax and Customs authorities. Price adjustments may be made if the transaction price is considered to differ in relation to market values. Thus, the companies may be obligated to pay tax surcharges or similar monetary penalties. The authorities’ different assessments of the same transaction price may result in difficulties for multinational enterprises in their efforts of meeting both requirements. The problem is regarded in varying degrees in different countries. In American precedent the court has determined the opportunities to be low for companies to depend on transfer pricing documentation when supporting customs value. It is important for companies to keep detailed documentation of both transfer pricing and customs valuation. The documentation serve as vital evidence when proving the compatibility of transaction prices with market values. Companies should also establish good communications with the authorities in order to prepare them for potential future price adjustments. Prevention is better than cure.
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