Le rapport à la souffrance est un symptôme majeur du rapport à l’existence. Nietzsche met en perspective ces rapports entre la civilisation chrétienne européenne et celui de la culture grecque antique. L’invention de l’art tragique apparaît comme un moyen de sublimer les souffrances dans une extase dionysiaque, elle est à la fois la manifestation de leur volonté de puissance face aux épreuves et une thérapie.Tandis que la logique de souffrance issue du socratisme et du christianisme entraîne un profond nihilisme. Le passage d’un type de logique de souffrance à l’autre s’est opéré par le pivot socratique. La tâche du philosophe médecin est alors d’inverser ce pivot afin de préparer la transvaluation des valeurs issues de la morale chrétienne. Cela pose alors le problème de l’esthétisation de l’existence. / The relationship with suffering is a major symptom of the relationship with existence. Nietzsche puts these relationships between modern European civilization and early Greek culture into perspective. The invention of Greek tragedy can be seen as a way of sublimating suffering in Dionysiac ecstasy. It is both a demonstration of their will to power faced with tragic events and therapy. On the other hand the logic of suffering stemming from Socratism and Christianity leads to profound nihilism. The transition from one type of logic of suffering to another is brought about by a Socratic reversal. The task of the philosophical doctor is to therefore bring about this inversion in order to prepare the transvaluation of values stemming from Christian morality. This raises de novo the problem of the aestheticisation of existence.

A presente tese tem por objetivo estudar alguns aspectos semióticos de paixão e persuação na relação médico-paciente, uma relação sempre marcada pela verticalização e pela complexidade - de um lado, o poder de persuasão de quem detém o conhecimento; de outro, a fragilidade de quem está doente e precisa da cura. Para esse estudo, será apresentado, em uma primeira parte, um panorama da história da Medicina ocidental, bem como comparações entre os médicos atuais e os xamãs e feiticeiros de antigas civilizações. Verificar-se-á que o prestígio do profissional da Medicina atual assemelha-se ao respeito de que gozava o xamã naquelas sociedades: tanto um quanto o outro, ao estabelecer a cura de um doente, possibilitam sua reintegração ao grupo social a que pertencia e do qual foi separado em razão de sua enfermidade. Em seguida, serão apresentados os modelos teóricos presentes nos escritos de A. J. Greimas e C. T. Pais para que se estudem três casos narrados por médicos de três diferentes especialidades - um ortopedista, um cirurgião de cabeça e pescoço e uma cardiologista. Com a análise semiótica das narrativas, chegar-se-á ao estudo da \"visão de mundo\" subjacente aos citados casos e seus desdobramentos, bem como a análise do comportamento dos sujeitos envolvidos na busca do objeto de valor: o restabelecimento da saúde. De um lado, o profissional da Medicina, que deve seguir os preceitos de sua profissão, bem como os mandamentos da chamada Bioética, para que seja sancionado positivamente pela sociedade da qual faz parte; de outro, o paciente, que freqüentemente deposita no médico mais expectativas de cura do que esse profissional pode alcançar. Serão levadas em conta, também, as teorias de J. Campbell sobre o \"mito do herói\", bem como a teoria dos \"arquétipos\" de C. Jung. Em suma, este trabalho procurou analisar, sob o ponto de vista da semiótica e da bioética, as condições em que se pode desenvolver a relação entre médico e paciente. Assim, esperamos poder contribuir, de alguma forma, para estudos posteriores que se proponham a investigar o universo da Medicina / This thesis intends to study some semiotics aspects of passion and persuasion in the doctor-patient relationship, a relationship marked by verticalization and complexity - on the one hand, the power of persuasion of a doctor who has the know-how; on the other hand, the fragility of someone who is ill and needs to be cured. On this study, a synthetic history of Western Medicine will be shown, including a comparison between the modern doctors and old witch doctors from primitive tribes. It´ll be clear that the status of the modern doctors has not changed from that time because both of them, when they get to cure a person, can bring back the patient to his social group, since any ill person is separated from his family and friends due to the ilness. After that, the theoric patterns of Greimas and Pais will be shown in order to study three cases told by three different doctors from three different areas of Medicine: Orthopedics, Head and Neck Surgery and Cardiology. With the semiotic analysis of the cases, the \"interpretation of the world\" will be identified according to the relationship studied, as well as the analysis of the behavior of the characters searching their goals: the recovering from the illness. We will find the doctor who must obey the laws of his profession, as well the commandments of Bioethics, to be approved by the social group in which he lives; but we will find, too, the patient who often expects more than he should from his doctor. J. Campbell´s theories about \"The mith of the hero\" and Jung´s \"Theory of the Archetypes\" will be important to this work too. In short, this work tried to study, considering Semiotic and Bioethic, the conditions and problems envolving the relationship between doctor and patient. We hope we can give some contribuiton to future works that may intend to investigate the Medicine world.

This thesis concerns the metaphysics of scale. It investigates the implications of a physical determinable being dimensionful. In particular, it considers the case study of mass, as it features within Newtonian Gravity. Nevertheless, most of the terminology, methodology and arguments developed should be relatively straightforwardly applicable to other determinables and theories. Weak Absolutism about mass holds that mass ratios obtain in virtue of absolute masses. Weak Comparativism denies this. In the first five chapters I argue in favour of Weak Absolutism over Weak Comparativism. The sixth chapter argues against reducing mass to other non-mass facts. The overall conclusion is Strong Absolutism about mass within Newtonian Gravity: mass ratios obtain in virtue of absolute masses, which themselves are fundamental (i.e. they do not require anything further in order to obtain). Comparativism promises to recover all the virtues of absolutism, in particular its empirical adequacy, but at a lower 'metaphysical cost'. Special attention is given to Dasgupta's recent comparativist proposal. Dasgupta interprets the requirement of empirical adequacy in terms of the undetectability of the absolute mass scale. I argue that undetectability is an unsuitable way of understanding empirical adequacy and that we would do better to understand it in terms of a theory's ability to correctly generate the set of empirically possible worlds (or at least the actual world). I refute Dasgupta's comparativism both on my terms and on his own terms. I subsequently develop and strongly criticise alternative versions of comparativism. Chapter five sheds doubt on the supposed 'metaphysical parsimony' of comparativism. This debate should be of particular interest to readers who engage with the substantivalism-relationalism debate. These debates are much more entwined than previously acknowledged, which provides a significant source of mutual inspiration, although I do also draw out some important disanalogies.

A presente tese tem por objetivo estudar alguns aspectos semióticos de paixão e persuação na relação médico-paciente, uma relação sempre marcada pela verticalização e pela complexidade - de um lado, o poder de persuasão de quem detém o conhecimento; de outro, a fragilidade de quem está doente e precisa da cura. Para esse estudo, será apresentado, em uma primeira parte, um panorama da história da Medicina ocidental, bem como comparações entre os médicos atuais e os xamãs e feiticeiros de antigas civilizações. Verificar-se-á que o prestígio do profissional da Medicina atual assemelha-se ao respeito de que gozava o xamã naquelas sociedades: tanto um quanto o outro, ao estabelecer a cura de um doente, possibilitam sua reintegração ao grupo social a que pertencia e do qual foi separado em razão de sua enfermidade. Em seguida, serão apresentados os modelos teóricos presentes nos escritos de A. J. Greimas e C. T. Pais para que se estudem três casos narrados por médicos de três diferentes especialidades - um ortopedista, um cirurgião de cabeça e pescoço e uma cardiologista. Com a análise semiótica das narrativas, chegar-se-á ao estudo da \"visão de mundo\" subjacente aos citados casos e seus desdobramentos, bem como a análise do comportamento dos sujeitos envolvidos na busca do objeto de valor: o restabelecimento da saúde. De um lado, o profissional da Medicina, que deve seguir os preceitos de sua profissão, bem como os mandamentos da chamada Bioética, para que seja sancionado positivamente pela sociedade da qual faz parte; de outro, o paciente, que freqüentemente deposita no médico mais expectativas de cura do que esse profissional pode alcançar. Serão levadas em conta, também, as teorias de J. Campbell sobre o \"mito do herói\", bem como a teoria dos \"arquétipos\" de C. Jung. Em suma, este trabalho procurou analisar, sob o ponto de vista da semiótica e da bioética, as condições em que se pode desenvolver a relação entre médico e paciente. Assim, esperamos poder contribuir, de alguma forma, para estudos posteriores que se proponham a investigar o universo da Medicina / This thesis intends to study some semiotics aspects of passion and persuasion in the doctor-patient relationship, a relationship marked by verticalization and complexity - on the one hand, the power of persuasion of a doctor who has the know-how; on the other hand, the fragility of someone who is ill and needs to be cured. On this study, a synthetic history of Western Medicine will be shown, including a comparison between the modern doctors and old witch doctors from primitive tribes. It´ll be clear that the status of the modern doctors has not changed from that time because both of them, when they get to cure a person, can bring back the patient to his social group, since any ill person is separated from his family and friends due to the ilness. After that, the theoric patterns of Greimas and Pais will be shown in order to study three cases told by three different doctors from three different areas of Medicine: Orthopedics, Head and Neck Surgery and Cardiology. With the semiotic analysis of the cases, the \"interpretation of the world\" will be identified according to the relationship studied, as well as the analysis of the behavior of the characters searching their goals: the recovering from the illness. We will find the doctor who must obey the laws of his profession, as well the commandments of Bioethics, to be approved by the social group in which he lives; but we will find, too, the patient who often expects more than he should from his doctor. J. Campbell´s theories about \"The mith of the hero\" and Jung´s \"Theory of the Archetypes\" will be important to this work too. In short, this work tried to study, considering Semiotic and Bioethic, the conditions and problems envolving the relationship between doctor and patient. We hope we can give some contribuiton to future works that may intend to investigate the Medicine world.

O foco deste estudo está nas possíveis transformações na relação de poder estabelecida entre médico e paciente representada em três comunidades virtuais com tema em saúde-doença. Trata-se de uma pesquisa qualiquantitativa com uso da técnica do Discurso do Sujeito Coletivo (DSC), o que possibilita a construção de discursos coletivos distintos que expressam as representações sociais de uma coletividade. Como resultado é possível verificar: (i) porque as pessoas participam de comunidades virtuais; (ii) como as pessoas participam; (iii) como se organizam essas comunidades; (iv) quais tipos de informações são mais buscados; (v) quais conteúdos informacionais existem nos fóruns de discussão (vi) como se dá a interação entre integrantes da comunidade; (vii) como as relações de poder estabelecidas entre médico e paciente são tratadas nas comunidades; (viii) identificação de possíveis transformações na relação de poder estabelecida entre médico e paciente. Conclui-se que a maior parte dos integrantes das comunidades analisadas está em um nível associativo-participativo de compartilhamento das informações e experiências. Esse nível, apesar de não se constituir em ação de cooperação e prática de produção coletiva, permite aos integrantes se tornarem pacientes mais ativos em seus processos de saúde e doença. Os resultados sugerem que o princípio ético da autonomia está, legalmente e na prática, mais fortalecido, contribuindo com a constituição de um indivíduo integrante, interativo, mais autônomo / Possible changes in the power relationship established between doctor and patient represented in three online communities which address the subject of health and illness is the focus of this study. This is a qualitative and quantitative research using the Collective Subject Discourse (DSC), which allows the construction of separate collective discourse, which expresses the social representations of a collectivity. As a result, it is possible to verify: (i) why people participate in such virtual communities , (ii) how people participate, (iii) how those communities are organized, (iv) what types of information are most searched, (v) which information exist in those discussion forums (vi) how community members interact, (vii) how the power relations established between doctor and patient are treated in these communities, (viii) identification of possible changes in the relationship established power between doctor and patient. We conclude that most members of the communities studied are in an associative-participatory level regarding information and experiences sharing. This level, though is not considered as an action of mutual cooperation and collective production practice, allows members of such communities to become more active as patients in their processes of health and disease. The results suggest that the principle of autonomy is, legally and in practice, more energized, contributing to the constitution of an individual, integral, interactive, and increasingly autonomous

Trata-se de realizar uma articulação entre as imagens construídas pelo romance Doutor Fausto, de Thomas Mann, e o quadro teórico elaborado pela Escola de Frankfurt, a fim de compor uma interpretação filosoficamente investida do romance e alcançar uma melhor compreensão das ideias da Teoria Crítica. A vida do compositor Adrian Leverkühn, o Fausto de Mann, é narrada pelo amigo e biógrafo Serenus Zeitblom, e essa narrativa revela a identidade fundamental entre o músico e a Alemanha, aproximando suas características e histórias. Nossa abordagem tematiza especialmente a questão da salvação ou condenação da alma do pactário, tratando de matizar essas possibilidades na obra. Elaboramos uma noção de mito comum ao romance e àquele quadro teórico frankfurtiano, apontando sua força de estruturação totalizante, bem como sua inserção em uma dinâmica dialética. A seguir, propomos considerar que todos os elementos do romance que repõe a mitificação apontariam para a condenação do Fausto, enquanto, inversamente, os aspectos da obra que revelam os limites ou se contrapõem à força do mito anunciariam a possibilidade de salvação do pactário. A noção de sofrimento é especialmente importante, pois comparece em ambas as perspectivas. Isso quer dizer que o sofrimento pode ser interpretado tanto como a evidenciação de um destino como se as dores e a infelicidade de Adrian Leverkühn antecipassem a condenação , quanto pode ser compreendido como um sintoma que denuncia o mito como se revelasse a inverdade do destino aparente e as possibilidades do devir. Finalmente, análise da música, um tema central no romance, também revela sua ambivalência, pois ela pode tanto ser a reposição do mito quanto uma crítica ao mundo mitificado. / This work articulates the images constructed by Thomas Manns novel Doctor Faustus with the theoretical framework developed by the Frankfurt School, in order to compose a philosophically invested interpretation of the novel, as well as achieve a better understanding of Critical Theorys ideas. The life of the composer Adrian Leverkühn, Manns Faustus, is narrated by his friend and biographer Serenus Zeitblom, and this narrative reveals the fundamental identity between the musician and Germany, relating their characteristics and histories. Our approach on the novel specially studies the questions of the salvation or the damnation of Fausts soul, trying to precise these possibilities within the work. We develop a notion of myth common to the novel and to that frankfurtian theoretical framework, pointing its totalizing strength, as well as its insertion in a dialectical dynamic. Next, we propose to consider that all the novels elements that instigate the mythification would point to the condemnation of Faust, while, conversely, the novels aspects that reveal the limits of the myth or contradict it would announce the possibility of the mans salvation. The notion of suffering is especially important, as it appears in both perspectives. This means that suffering can be interpreted both as the disclosure of fate as if Adrians pain and sadness would anticipate the condemnation as can be understood as a symptom that denounces the myth as if it would reveal the lie of the apparent destination and the possibilities of future. Finally, the inquire on músic, a central theme of the novel, also reveals its ambivalente, for it can either strengthen the myth, as it can exercise a critic of the mythologized world.

This historical study examines the desegregation of a historically African- American high school during the period between 1965-1975. The Mims v. The Duval County School Board (1971) decision brought about radical changes in the operation of the Duval County Public Schools. The mass transfer of teachers and reassignment of students as a result of the federal judge's order in this case resulted in a school system that was dramatically different from the one that previously existed. The author seeks to determine why the desegregation of William Raines High School was short-lived and questions the continued effort of the school system to desegregate this school. The author conducted a multi-faceted investigation to answer the research questions. Following a case study approach, both archival and oral data were collected and examined. Focused interviews were conducted with former William Raines High School students, faculty and parents. In addition, written documents and local newspaper accounts were studied. The oral interviews support and expand the findings of the archival documents. The findings of the study indicate that the history and traditions at William Raines High School are founded on a strong sense of pride and identity. However, changes in the school over time have resulted in a school that has lost its focus on academic excellence. In order for lasting desegregation to take place, substantive changes will be required. The pride that was the school's legacy must be restored. Excellence in all aspects of school life should be the overarching goal. PALMM.

After individuals sustain a spinal cord injury, all aspects of their lifestyle must change for them to manage their new life roles. One important area of recovery that is often not addressed during the rehabilitation process is sexual functioning. The purpose of this quantitative study was to examine how doctor communication about sexual health with women who have sustained spinal cord injuries predicts their levels of sexual functioning and sexual self-esteem. The theoretical framework was the sexual health model. Questionnaires were used to gather data from 45 women who had completed rehabilitation from spinal cord injuries. Level of current sexual functioning was measured using the Female Sexual Function Index. Sexual self-esteem was measured using the Multidimensional Sexual Self-Concept Questionnaire. Satisfaction with doctor-patient communication was measured using the Patient Satisfaction Questionnaire and Perceived Self-Efficacy in Patient-Physician Interactions-Sex. Findings from correlation analysis indicated a positive correlation between general satisfaction with doctor-patient communication and confidence to communicate with the doctor about sexual health. Results also indicated a negative correlation between sexual self-esteem and sexual functioning. Findings may be used to improve communication between doctors and patients about sexual health, which may reduce the stigma of talking about sexuality and may promote more holistic treatment for women recovering from spinal cord injuries.

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program design consisted of several steps: (a) assembling the planners and stakeholders, (b) conducting relevant literature review, (c) gathering educational materials, (d) creating education modules, (e) developing an evaluation method, (f) presenting the results to the organization, and (g) standardizing the modules to be implemented in each of the organization's clinics. Ten participants including nurses, physicians, educators, and administrators reviewed the program in a formative (n = 5) and summative (n = 5) round to evaluate the ease of use and content. During the summative review, participants demonstrated 92.3% agreement using the AGREE II instrument. This tool supported the stakeholders' understanding and support for the developed modules. Overall, the program serves as an important tool to educate clinical staff to better manage and decrease the spread of tuberculosis among diabetic patients, and also as a comprehensive guide for developing similar projects in community clinical settings. The resulting educational program, which could be implemented by health care providers and clinical administrators, could serve as a catalyst for improved community health outcomes.

Thyroid disease, a chronic illness, affects nearly 200 million people worldwide and is more common among women than in men. Numerous factors make diagnosing and treating thyroid disease in women challenging. The standard blood test for diagnosing thyroid disease and determining treatment effectiveness is inconsistent in its accuracy. Many women with thyroid disease are misdiagnosed or struggle with symptoms even once receiving treatment. Although thyroid disease is highly prevalent among women and the doctor-patient relationship is known to influence treatment outcomes, there is a gap in the literature regarding the treatment experiences of women with thyroid disease and the doctor-patient relationship. The purpose of this phenomenological study was to explore female thyroid patients' experiences of treatment and the doctor-patient relationship. Sixteen female thyroid patients, ages 18 and older and members of an international online support group, were individually interviewed via online chat. Data interpretation was guided by social constructionism and feminist theory and was accomplished via Moustakas's analytic method. Themes related to the doctor-patient relationship were identified, including the culture of the medical profession, diagnostic bias, and gender differences in communication. Emergent themes included patient education level, patient self-advocacy behaviors, and the use of natural thyroid medication. The results of this study may contribute to positive social change by enhancing doctors' understanding of thyroid disease in women and the influence of the doctor-patient relationship in determining positive treatment outcomes, thus equipping doctors with enriched knowledge for providing their female thyroid patients with the highest quality of care.