Research on age differences in heart transplant patients has focused primarily on medical outcomes, with mixed findings regarding mortality and morbidity rates and limited research regarding age differences in psychosocial and quality of life outcomes. To gain a more complete understanding of psychosocial adjustment after heart transplant, this study examined age differences in: satisfaction with quality of life, satisfaction with social support, depressive symptoms, negative affect, symptom distress, stress related to heart transplant, overall health functioning, coping strategies, and aspects of adherence. Results indicate that older patients, compared to younger patients, report better adjustment and quality of life across numerous outcomes 5-10 years after heart transplant. These findings are consistent with previous literature examining age differences in developmental changes with emotion regulation and coping. This study hopes to contribute to the discussion of age and heart transplant, highlighting the importance of considering quality of life in addition to medical outcomes.

The thesis deals with a psychosocial situation of siblings of children with a pervasiv disorder. The labour surveys new findings about the autism and an effect of autistic child on its sibling in the theoretical part. The part devoted to the autism is mostly focused on neurobiological findings of this disease. The part about siblings is specialised in pieces of knowledge from available researches and describes the present condition of scientific knowledge. The empirical part describes a psychosocial situation of siblings of autistic children. A qualitative method was used during the research. The main used method is a test called "FAST" (Family System Test) and a follow-up interview. The diploma work goes towards a deeper understanding of a psychological and social situation of a healthy sibling. Detailed studies of cases which indicate possible risks resulting from living with an autistic child are presented in the project. There are also mentioned tendencies of further research progress. Keywords: Siblings, autism, psychosocial situation of siblings.

The provider-role continues to be strongly linked to ideas of manhood even in the era where family and work roles have changed. This is mainly because society continues to esteem notions of hegemonic masculinities that reduce men to a single role of providing. Such a discourse is problematic however, especially during the quandary of unemployment that South Africa finds itself. With this in mind, men find themselves battling not only with the stigma arising from their inability to perform manhood (providing) but also with the harsh labour market that refuses them the means to perform this role. As a consequence, men suffer often undiagnosed depression leading to suicide, harmful behaviour and loss of hope for a better future. Through the qualitative research approach, this study adopted the Social Identity Theory, the Eco-systems Approach as well as the Functionalism Theory towards exploring the effects of strong identification with the idea of man as provider on the psychosocial wellbeing of black men during unemployment. Individual interviews were conducted with twenty-two young men aged between 18 and 35 from Soweto as well as three social workers who were previously placed as student social workers with the Ipelegeng Youth Leadership and Development Programme. Through the use of the thematic content analysis, this study found that young men identified with the provider role and therefore participated in informal work under hazardous conditions in order to fulfil this role. Where the men failed to fulfil the provider role, communities often ridiculed and shamed them leading them to feeling stressed and depressed. The study also found that the young men were not utilising psychosocial services; owing to the notions of traditional masculinities; general lack of services and perceived ineffectiveness of programs. This report thus concludes that interventions that are tailored to tackle men’s problems should be developed and be made widely available, being stringently cognisant of contextual cultural dynamics however.

Objetivo: Verificar a influência da realização da faringoplastia nos aspectos psicossociais dos indivíduos com fissura labiopalatina. Local: setor de Psicologia do HRAC/USP. Participantes: 13 pacientes, de ambos os gêneros, com idades a partir de 15 anos, com indicação cirúrgica para a faringoplastia Material: Entrevistas Psicológicas Pré e Pós-Cirúrgicas e o Inventário de Habilidades Sociais (IHS - Del Prette 2001) Procedimento: O paciente foi convidado a participar do estudo, respondendo a Entrevista Psicológica Pré-Cirúrgica e o Inventário de Habilidades Sociais. Transcorrido o período de três meses a um ano após a realização da cirurgia, o mesmo paciente respondeu à Entrevista Psicológica Pós-Cirúrgica e novamente ao Inventário de Habilidades Sociais. Resultados: Após a realização da cirurgia, a freqüência em fonoterapia aumentou e houve melhora na ressonância e inteligibilidade da fala. A avaliação da fala foi mais positiva e a melhora da fala com a realização da faringoplastia interferiu de forma positiva sobre os aspectos psicossociais. Os pacientes tinham conhecimento sobre a cirurgia e sabiam para que ela servia, deixando a decisão de sua realização para o profissional do hospital. A expectativa foi de melhora da fala e foi verificado um alto índice de satisfação com o resultado da cirurgia. Os pacientes relataram mais melhoras no aspecto pessoal e profissional e colocaram o surgimento de complicações respiratórias. As habilidades sociais relativas ao escore total melhoraram. Conclusão: A faringoplastia tem influência positiva sobre os aspectos psicossociais de indivíduos com fissura labiopalatina. / Objective: To verify the influence of the pharyngoplasty accomplishment in the psychosocial aspects of the individuals with cleft lip and/or palate. Place: Psychology sector of the HRAC/USP Participants: 13 patients, of both sex, with ages from 15 years or older, surgical indication for the haryngoplasty. Material: Psychological Interviews Before and After Surgery and the Inventory of Social Skills (IHS - Del Prette 2001). Procedure: The patient was invited to participate of the study, answering the Psychological Interview Before Surgery and the Inventory of Social Skills. After a period of three months to one year post surgery, the same patient answered to the Psychological Interview After Surgery and again to the Inventory of Social Skills. Results: After the surgery, the frequency in phonotherapy increased and had improvement of the speech resonance and intelligibility. The speech evaluation was more positive and the speech improvement with the pharyngoplasty accomplishment intervened on a positive way of the psychosocial aspects. The patients had knowledge on the surgery and knew that it was usefull, leaving the decision of its accomplishment for the hospital professional. The expectation was of the improvement of speech it was verified a high index of satisfaction with the surgery result. The patients had told more improvements in the personal and professional aspects and also related the appearance of respiratory complications. The social skills relating to the total score had improved. Conclusion: The pharyngoplasty has positive influence on the psychosocial aspects of individuals with cleft lip and/or palate.

O apoio social consiste em recursos provenientes dos laços sociais estabelecidos por um indivíduo e que provém auxílio principalmente em situações adversas, possibilitando amenizar efeitos negativos do estresse, atenuar efeitos psicológicos inerentes às patologias crônicas e promover ações de solidariedade e cidadania. Trata-se de um recurso presente na vida de todos os indivíduos, incluindo usuários de crack, sendo que, nesse caso, a análise de redes sociais mostra-se relevante, tendo em vista as consequências que tal consumo provoca no envolvimento social desses sujeitos, repercutindo nas relações familiares, de trabalho e restrição de possibilidades de cultura, lazer e acesso à saúde. Entre os serviços existentes para atender a essa população está o Consultório na Rua, programa implantado em 2011 e pautado na lógica de redução de danos, o que leva a considerar que esse configura-se como importante fonte de apoio social aos indivíduos atendidos. Entretanto, investigar a percepção dos usuários em relação ao papel de tal serviço em sua rede de apoio social ainda se faz necessário. Dessa forma, objetivou-se analisar as características da rede de apoio social de usuários de crack e o papel do Consultório na Rua para esses indivíduos. Para tanto, foi desenvolvido estudo transversal qualitativo, descritivo-exploratório em uma cidade de médio porte do interior de Minas Gerais, tendo como participantes 17 usuários de crack acompanhados por um programa de Consultório na Rua, bem como os quatro profissionais que compõem tal equipe. A coleta de dados se deu por meio de observação participante, entrevistas semiestruturadas com os usuários de crack e grupo focal com os profissionais. A análise dos dados ocorreu através de análise dos aspectos estruturais da rede de apoio dos usuários, seguida de análise de conteúdo das informações transcritas a partir das diferentes fontes, e, para abordagem metodológica, foi adotada a Análise de Redes Sociais. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, sob Protocolo nº 50051015.4.0000.5393, e foi financiado pela Fundação de Amparo à Pesquisa do Estado de São Paulo, Processo nº 2016/05135-0. Os resultados apontaram um grupo composto majoritariamente de indivíduos pretos ou pardos, do gênero feminino, solteiros, com ensino fundamental incompleto, sem profissão, sem renda, que professavam a religião católica e com idade média de 37,2 anos. No tocante à rede de apoio dos usuários, evidenciou-se que esta é composta de familiares, pares, membros da comunidade e da equipe do Consultório na Rua, que proveem apoio material, informacional e emocional. Também foi observado que o trabalho desenvolvido pelo Consultório na Rua apresenta potencialidades como o respeito às condições individuais dos usuários, a existência de uma relação de confiança entre usuários e profissionais e a interlocução com a Rede de Atenção Psicossocial. Por outro lado, o serviço enfrenta desafios como a falta de capacitação de profissionais de outras instituições de saúde e a existência de serviços não sensíveis às diferenças de gênero, orientação sexual e estilo de vida dos usuários. Portanto, recomenda-se que a rede de compartilhamento de influências desses sujeitos seja levada em consideração para a elaboração de ações de prevenção e promoção de saúde, ainda que os profissionais de diferentes instituições de saúde trabalhem de modo colaborativo, a fim de combater o estigma sobre os usuários de drogas, e que em estudos futuros se busque explorar profundamente a dinâmica das relações da população em situação de rua, com foco nos apoiadores informais, e que sejam pensadas estratégias de ampliação da perspectiva de atuação do Consultório na Rua, visando os eixos da reabilitação psicossocial / Social support consists in resources derived from social bonds established by an individual and which provides assistance in adverse situations, making it possible to alleviate negative effects of stress, attenuate the psychological effects inherent in chronic pathologies, and promote solidarity and citizenship actions. It is a resource present in the lives of all individuals, including users of crack, and in this case, the analysis of social networks is relevant, considering the consequences that such consumption causes in the social involvement of these subjects, reverberating on family relationships, work and restriction of possibilities of culture, leisure and access to health. Among the services available to attend this population, there is the Outreach Service, a program implemented in 2011 and based on the logic of harm reduction, which leads to consider that this is an important source of social support for the individuals attended by it. However, investigating users\' perceptions regarding the role of such service in their social support network is still necessary. The aim of this study was to analyze the characteristics of the social support network of crack users and the role of this Outreach Service for these individuals. For that, a qualitative, descriptive-exploratory cross-sectional study was carried out in a medium-sized city in the countryside of Minas Gerais, with 17 crack users accompanied in an Outreach Service program, as well as the four professionals that compose the team. Data collection was made through participant observation, semi-structured interviews with crack users and a focus group with professionals. Data analysis was performed through analysis of the structural aspects of the users\' support network, followed by content analysis of the information transcribed from the different sources and, for methodological approach, the Social Networks Analysis was adopted. The study was approved by the Research Ethics Committee, under protocol no. 50051015.4.0000.5393, and was funded by the Research Support Foundation of the State of São Paulo, process nº 2016/05135-0. The results showed a group composed mainly of black or brown individuals, female, single, with incomplete elementary school, without profession, without income, who professed the Catholic religion and with an average age of 37.2 years. Regarding to the user support network, it has been evidenced that it is composed of family members, peers, members of the community and the team of the Outreach Service, who provide material, informational and emotional support. It was also observed that the work developed by the Outreach Service presents potentialities such as respect for the individual conditions of users, the existence of a trust relationship between users and professionals and the interlocution with the Psychosocial Attention Network. On the other hand, the service faces challenges such as the lack of training of professionals from other health institutions and the existence of services that are not sensitive to the gender, sexual orientation and lifestyle of users. Therefore, it is recommended that the network of sharing of influences of these subjects could be taken into account for the elaboration of actions of prevention and health promotion, although the professionals of different health institutions work in a collaborative way, in order to combat stigma on drug users, and for future studies it is sought to explore deeply the dynamics of the relations of the population in a street situation, with a focus on informal supporters, and to devise strategies to expand the perspective of the Outreach Service, focusing on psychosocial rehabilitation

O consumo de bebidas alcoólicas durante o período gestacional está relacionado a diversos prejuízos para a saúde materna e do bebê. O uso desta substância por gestantes pode aumentar o risco de trabalho de parto prematuro, aborto espontâneo, descolamento de placenta e aumento de pressão arterial. Em relação ao filho, o álcool pode causar deficiência no crescimento intrauterino, malformações físicas, a Síndrome Fetal do Álcool (SFA), danos cognitivos e problemas comportamentais que podem perdurar por toda a vida da criança. Embora exista uma tendência a diminuição do consumo de álcool durante o período gestacional, observa-se que uma parcela de mulheres persiste no consumo abusivo. Dessa forma, a identificação dos aspectos psicossociais relacionados com o uso de álcool torna-se importante para compreender melhor quais os fatores relacionados com este comportamento. O estudo teve como objetivo avaliar comparativamente os aspectos psicossociais associados com o uso de álcool em amostra de gestantes com diferentes padrões de consumo: abstinentes, consumidoras de risco, consumidoras nocivas e com provável dependência de álcool. Os fatores predisponentes para a SFA (conforme modelo adaptado de Abel & Hannigan) e o modelo psicossocial para compreensão do problema foram utilizados para seleção dos aspectos psicossociais considerados relevantes nesta pesquisa. Durante o desenvolvimento do estudo, a pesquisadora realizou estágio de doutorado no exterior na University of North Carolina at Chapel Hill (EUA) para treinamento clínico e científico. Trata-se de um estudo com delineamento transversal, observacional e comparativo. A coleta de dados foi realizada através de entrevistas semiestruturadas com gestantes atendidas em unidades básicas de saúde, maternidade e em serviço especializado em atendimento a mulheres farmacodependentes. Os resultados apontaram que gestantes com maior gravidade de consumo tiveram maior propensão à morbidade psiquiátrica (F=15,1; p<0,001), maior número de eventos estressores (F=21,9; p<0,001), menor suporte social (F=9,2; p<0,001), menor habilidade de coping (F=6,5; p<0,001), menor conhecimento sobre os danos associados ao uso de álcool na gestação (F=7,2; p<0,001) e tinham companheiro com uso de álcool (?²=5,8; p<0,01) e/ou drogas ilícitas (?²=24,3; p<0,001). A análise de regressão logística multivariada identificou quatro principais variáveis associadas à maior gravidade de uso de álcool: Estresse, Sintomas psiquiátricos, Uso de álcool e drogas do companheiro, Crenças e conhecimentos sobre o uso de álcool na gestação. Sendo assim, as gestantes com maior consumo de bebidas alcoólicas apresentaram aspectos psicossociais que as diferiram das gestantes abstinentes ou com consumo de risco de álcool. O estudo contribui ao evidenciar fatores que podem aumentar, ou ainda, moderar o consumo de álcool de gestantes. A gestação é um momento propício para auxiliar a mulher no abandono do uso de substâncias como bebidas alcoólicas. Os profissionais que atendem essa população podem avaliar tais aspectos psicossociais e detectar gestantes com maior vulnerabilidade para o uso de álcool. Portanto, o conhecimento sobre esta relação é importante para intervenções profissionais efetivas, formulação de estratégias de prevenção, diagnóstico precoce e tratamento, assim como uma melhor fundamentação de políticas públicas na área de saúde materno-infantil. / Alcohol consumption during pregnancy is related to several damage for maternal and newborn health. Pregnant women that use this substance can increases the risk for preterm labor, miscarriage, placental abruption and high blood pressure. For the child, alcohol can result in intrauterine growth restriction, physical malformations, the Fetal Alcohol Syndrome (FAS), cognitive impairment and behavioral problems that can last for a child\'s whole life. Although there is a tendency to decreased alcohol consumption during pregnancy, it is observed that a portion of women persists in the abuse. Thus, the identification of psychosocial aspects of alcohol use becomes important to better understand what factors are related to this behavior. The goal of the study was comparatively evaluate the psychosocial aspects associated with the alcohol use in a sample of pregnant women with different patterns of consumption: abstinence, hazardous use, harmful use and alcohol dependence. Permissive factors for FAS (as adapted model of Abel & Hannigan) and the psychosocial model for understanding the issue were used for selecting the psychosocial aspects considered relevant for this search. During the development of the study, the researcher conducted internship abroad at the University of North Carolina at Chapel Hill (USA) for clinical and scientific training. A cross-sectional, observational and comparative study. Data collection was conducted through semi-structured interviews with pregnant women attending the Basic Health Units, a maternity clinic and specialized service in addiction treatment for women. Results indicated that pregnant women with greater severity consumption were more chance to psychiatric morbidity (F=15.1, p<0.001), stressful events numbers (F=21.9, p<0.001), lower social support (F=9.2; p<0.001), lower levels of coping (F=6.5; p<0.001), lower Beliefs and Knowledge about the harms associated with alcohol use during pregnancy (F=7.2; p <0.001) and had a partner with alcohol use (X²=5.8; p<0.01) and/or illicit drug use (X²=24.3, p<0.001). Multivariate logistic regression analysis identified four main variables associated with greater severity of alcohol use: Stress, Psychiatric symptoms, Partner who use alcohol or drugs, Beliefs and Knowledge about alcohol use during pregnancy. Thus, pregnant women with greater severity of alcohol consumption had psychosocial aspects that differ from abstinent women or with hazardous alcohol consumption. This research identified factors that may increase or, even moderate alcohol consumption for pregnant women. Pregnancy seems to be appropriate moment to aid the woman in the abandonment of the use of substances such as alcohol. Professionals serving this population could evaluate this psychosocial aspects and detecting pregnant women with greater vulnerability to alcohol use. Therefore, knowledge of this association is important for effective professionals interventions, formulation of strategies for prevention, early diagnosis and treatment, as well as a better foundation for public policy about maternal and child health.

Thesis advisor: Brinton Lykes / In the 20th century, conflicts in Latin America between government armies and guerrilla groups escalated into devastating civil wars. During these wars, the armed forces frequently classified children as enemy targets. This paper will discuss the civil wars waged in Guatemala from the 1960s to 1996, and in El Salvador, between the years of 1979 to 1992. Similarities and differences between the conflicts in these two nations will be examined to explore the use of violence against children in Latin America, including how they were tortured, killed and forced to join guerrilla or government forces. An analysis of these two wars reveals the government and army’s intention to destroy community, trust, culture, and every aspect of normal life. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program.

A investigação procurou compreender a noção de integralidade na Rede de Proteção Social à Criança e ao Adolescente, na Cidade de Suzano/SP, acerca da qual deriva parte importante da prática de agentes sociais e de saúde. Para tanto procedeu-se a uma exploração empírica dos elementos discursivos desses atores. As experiências colhidas em campo permitiram a compreensão e reflexão da noção de integralidade no campo de conhecimento da Saúde Pública. Os objetivos da pesquisa tiveram por prioridade: caracterizar e problematizar o lugar da integralidade no interior dessa rede de proteção; descrevendo as experiências e refletindo sobre a atenção integral na articulação de ações no interior da rede de serviços. A fenomenologia foi escolhida como referencial metodológico compondo-se por dois momentos articulados entre si: observação participante e entrevistas semi-estruturadas. Os sujeitos de pesquisa foram os membros do Conselho Municipal de Defesa dos Direitos da Criança e do Adolescente na qualidade de articuladores da política municipal de atenção ao adolescente. A pesquisa foi capaz de compreender a noção de integralidade como idéia/referência, conceito que emergiu no discurso dos agentes sociais pesquisados, e da qual derivam suas ações no campo da saúde do adolescente, sobretudo no que tange a uma atenção psicossocial. / The investigation has tried to comprehend the integrality notion of the Adolescent and Child Social Protection, in the city of Suzano, wich an important part of social and health agent´s practice forms from. For that, an empiric exploration of those actors´ discursive elements was conducted. The experiences collected in the field have allowed the understanding and reflexion of the notion of integrality in the Public Health Insurance knowledge. The research objectives were, as a priority, to characterize and put the integrality place inside that protection net in doubt; describing the experiences and reflecting over the integral attention at the action articulation inside the service net. The phenomenology was chosen as a methodological reference, setting itself up as two moments articulated between themselves: participant observation and semi-structured interviews. The subjects of the research were the Conselho Municipal de Defesa dos Direitos da Criança e Adolescente members, as articulators of the adolescent and child care city policy. The research was able to comprehend the integrality notion as idea/reference, concept which has emerged from the social agent searched and from which derives its actions in the adolescent health field, mainly on what concerns a psychosocial care.

Magister Scientiae Dentium - MSc(Dent) / Background: This study aimed to investigate a possible relationship between the diagnosis of TMD and biographical, psychological and social status of patients. Materials and Method: All records of patients who attended the TMD clinic in the Mitchells Plain Oral Health Centre in the period from January 2015 to July 2018, and who were examined according to the DC/TMD protocol, were collected. All diagnostic observations, as well as their biographical, psychological and social data were recorded. Statistical analysis was performed by means of comparisons and association analysis among data to evaluate if there were any statistically relevant associations or differences.

Turnover of personnel within the Swedish Police Authority has during the last few years increased and there is today a lower number of police officers working in the field (SVT, 2018b). This lack of personnel can be explained by a decreased interest in applying for the police academy as well as more officers deciding to voluntarily terminate their employment (SVT, 2018a). This can generate thoughts regarding possible reasons for voluntary turnover. The chairman of the Swedish Police Union, Lena Nitz (SVT, 2018c) addresses that a crucial factor to reduce the amount of voluntary turnover is an improved work environment. The aim of this study is to analyze the psychosocial work environment for patrolling police officers and to gain knowledge if elements in it might make certain police officers choose to terminate their employment. Previous research within the field tend to separately study police officers psychosocial work environment and turnover within police authorities and has indicated that the psychosocial work environment can cause stress and emotional exhaustion. Further research shows that emotional labor is common within police work and that voluntary turnover is the main form of turnover for police officers. This study has consisted of qualitative interviews with employed as well as previously employed police officers who voluntarily terminated their employment. Our conclusions demonstrate that the psychosocial work environment for Swedish police officers tends to be characterized as unpredictable, exposed and psychologically demanding. The foremost reasons for voluntary turnover have been considerably low salaries in relation to the demands, lack of appreciation from the organization and the shortages of manpower within the Swedish police authority. / Den svenska polismyndighetens personalomsattning har under de senaste aren okat och vi har idag den lagsta polistatheten pa over tio ar (SVT, 2018b). Denna polisbrist kan forklaras genom att allt farre valjer att utbilda sig till polis samtidigt som fler yrkesverksamma poliser frivilligt valjer att avsluta sin anstallning (SVT, 2018a). Detta kan foranleda tankar om vad den okade mangden frivilliga uppsagningar grundar sig i. Polisforbundets ordforande Lena Nitz (SVT, 2018c) poangterar att en avgorande faktor for att minska antalet frivilliga uppsagningar ar en forbattrad arbetsmiljo. Syftet med foljande uppsats ar darfor att analysera den psykosociala arbetsmiljon for poliser i yttre tjanst samt komma fram till om nagot i den gor att vissa poliser valjer alternativt skulle valja att avsluta sin anstallning. Den tidigare forskningen kring dessa omraden tenderas att behandlas separat och polisers psykosociala arbetsmiljo har visats orsaka stress och andra utmattningssyndrom. Vidare belyser forskning hur emotionellt arbete ar vanligt forekommande inom polisyrket samt att frivilliga uppsagningar ar den framsta orsaken till personalomsattning for poliser. Denna studie baseras pa kvalitativa intervjuer med yrkesverksamma poliser samt poliser som avslutat sin anstallning. Studien har resulterat i slutsatser som pavisat att polisernas psykosociala arbetsmiljo praglas av att vara psykiskt kravande, utsatt och oforutsagbar. De framsta anledningarna for frivilliga uppsagningar inom polisen ar att lonen inte ar skalig i relation till arbetets krav, brist pa uppskattning fran organisationen samt en brist pa personal.