Contexte : Les troubles liés à l’usage des substances psychoactives constituent une priorité de santé publique dans le champ des pathologies chroniques. Les indicateurs de type Patient-Reported Outcomes (PRO) offrent des perspectives complémentaires aux indicateurs classiques pour la mesure de l’état de santé des patients et l’appréciation de la qualité des soins. Objectifs : Étudier les propriétés psychométriques de questionnaires de qualité de vie (QV) et les déterminants de la satisfaction précoce vis-à-vis des soins ambulatoires de patients dépendants aux substances de type alcool ou opiacés. Méthode : Les caractéristiques des patients et des médecins ont été recueillies à l’inclusion dans la cohorte SUBUSQOL. La satisfaction précoce a été mesurée quinze jours après la première consultation et ses déterminants ont été testés dans des modèles de régression linéaires multivariés. Les propriétés psychométriques du questionnaire spécifique Q-LES-Q-SF ont été étudiées au préalable sur un échantillon de patients. Résultats : La version française du Q-LES-Q-SF constitue un outil unidimensionnel robuste et fiable, les items du SF-12 et Q-LES-Q-SF présentent peu ou pas de fonctionnement différentiel selon l’âge, le sexe, le niveau d’éducation et le type d’addiction. Peu de variables recueillies sont associées à la satisfaction. Les patients dépendants à l’alcool se révèlent être plus satisfaits des modalités de contact et du délai de rendez-vous et ceux sans aucun antécédent de prise en charge pour leur dépendance plus satisfaits de leur consultation avec le médecin. Conclusion : Les questionnaires SF-12 et Q-LES-Q-SF peuvent être utilisés dans des populations de patients suivis en ambulatoire pour une dépendance aux substances psychoactives / Context: Of chronic diseases, substance use disorders are a public health priority. Patient-reported outcome indicators (PRO) offer additional insights into the classical indicators used to measure the patient’s health status and appreciation of their quality of care. Objectives: to study the psychometric properties of quality of life instruments and to study the determinants of early outpatient satisfaction with ambulatory care in alcohol- or opiate-dependent patients. Method: Patient and physician characteristics were collected in the SUBUSQOL cohort. Early satisfaction with care was measured fifteen days after the first consultation. The determinants of satisfaction were tested using multivariate linear models of regression. Prior data on the self-reported health status of a sample of alcohol- or opiate-dependent outpatients were used to investigate the psychometric properties of a specific questionnaire, the Q-LES-Q-SF. Results: Our results establish that the French version of the Q-LES-Q-SF is a unidimensional, valid and reliable instrument of self-reported health status assessment for use in care or medical research and that few items of the SF-12 and the Q-LES-Q-SF displayed differential functioning according to age, sex, educational level and type of substance use disorder. Our results show that few variables are associated with the level of patient satisfaction. Alcohol dependence was strongly associated with higher satisfaction with appointment making, and patients with no history of previous care for substance use disorders had a higher level of satisfaction with the doctor consultation. Conclusion: The use of the SF-12 and the Q-LES-Q-SF is recommended for outpatients suffering from substance use disorders

Made available in DSpace on 2016-04-28T19:58:52Z (GMT). No. of bitstreams: 1 Sandra Maria Fontinha de Lemos.pdf: 666400 bytes, checksum: bb556759d39af6bc2c85747eaa036b1e (MD5) Previous issue date: 2014-04-29 / This academic research clings to the analysis of the novel O Sol Se Põe Em São Paulo, by Bernardo Carvalho as a representative sample of the Brazilian contemporary novel. In this paper we intend to show the features that define the different phases of the genre and the features which are still being used in the contemporary novel. For that we tried to understand the architectural-narrative of the corpus s text, decode what kind of conundrum the novel deals with and what kind of issues have the characters faced. All these issues are previously established as a basis to a hypothesis namely, the echogenic analysis of the text. We studied the process of the text production taking into consideration the wiles used by Bernardo Carvalho and that he took as stratagem to echo reflection, as an art craft amplifier. We acknowledge that these art crafts work as a mirrored system repeating the same function. Another subject analyzed in this paper is the role and the function of the voices, its interaction. We tried to pinpoint the fact that all the wiles used by the author follow the same stratagem, the same objective and that although these wiles had being used before, separately, they represent the idea that contemporary literature speaks of: that is an egotic literature. To sustain the critical-theorical foundation upon which this thesis is structured we chose some authors: Mikhail Bakhtin, Clement Rosset, Otto Rank, Lucien Dallenbach, Tzvetan Todorov, Michel de Certeau, and Merleau Ponty, among others. Along these three chapters we developed a cohesive text in which we could put up with the proposed theories and themes in accordance with the Bernardo Carvalho`s novel we analized. It stood out how the duplication, the mise en abyme and the exotopy reverberate, by the voice and the word, throughout the text drawing a realistic image in this contemporary novel / Esta pesquisa atém-se ao estudo do romance O Sol se põe em São Paulo, de Bernardo Carvalho, como um representante do romance brasileiro contemporâneo. Pretende-se mostrar os traços que marcaram as diferentes etapas do desenvolvimento do gênero e que ainda se mantêm no romance contemporâneo. Para tanto buscou-se entender a arquinarrativa da escritura do corpus analisado e decifrar de que tipo de enigma se trata e que problemática enfrentam suas personagens. Todas estas questões se colocam previamente como fundamento para a hipótese do trabalho que é a análise ecogênica da escritura do texto. A pesquisa do processo de produção da escritura leva em conta os artifícios usados por Bernardo Carvalho, que tomamos como artifício de propagação de eco, como artifícios amplificadores. Artifícios esses que entendemos funcionar como um sistema espelhado repetindo a mesma função. Outro assunto abordado nesta pesquisa é o papel e a posição das vozes, sua interação. Ressaltamos o fato de que os artifícios usados pelo autor seguem todos a mesma diretriz, o mesmo objetivo e que embora já tenham sido usados em separado, anteriormente, eles representam a literatura egótica contemporânea. Para dar suporte conceitual ao núcleo teórico-crítico deste estudo fundamentamo-nos em: Mikhail Bakhtin, Clement Rosset, Otto Rank, Lucien Dallenbach, Tzvetan Todorov, Michel de Certeau e Merleau Ponty, dentre outros. No desenvolvimento dos três capítulos colocamos as teorias e os temas propostos em diálogo com o romance de Bernardo Carvalho que analisamos, e demonstramos como a duplicação, a exotopia e o mise en abyme (artifícios ecogênicos) se propagam pela voz e pela palavra por toda escritura, desenhando uma imagem realista neste romance contemporâneo

Magister Artium - MA (Psychology) / Psychological distress during pregnancy has been a fairly neglected phenomenon and has only recently started emerging as an area of research interest. The existing body of scholarship on distress during pregnancy has largely been conducted from a positivist paradigm, emphasising the identification, incidences and risks. There is thus a dearth of qualitative inquiry into pregnant women's experiences and accounts of distress. In an attempt to address these gaps within the literature, my study explored psychological distress among a group of pregnant women from socio-economically disadvantaged contexts. The specific objectives of my study was to explore how pregnant women conceptualised psychological distress within the context of pregnancy; the feelings or symptoms of psychological distress; what pregnant women perceived as its causes; and the psychosocial needs of pregnant women in relation to antenatal distress. This study was guided by a feminist approach and a feminist standpoint epistemology in particular. This lent itself to exploring the phenomenon while departing from a clinical, decontextualised position which translated into an investigation with pregnant women who subjectively perceived themselves to be distressed.

Magister Artium - MA (Psychology) / Psychological distress during pregnancy has been a fairly neglected phenomenon and has only recently started emerging as an area of research interest. The existing body of scholarship on distress during pregnancy has largely been conducted from a positivist paradigm, emphasising the identification, incidences and risks. There is thus a dearth of qualitative inquiry into pregnant women's experiences and accounts of distress. In an attempt to address these gaps within the literature, my study explored psychological distress among a group of pregnant women from socio-economically disadvantaged contexts. The specific objectives of my study was to explore how pregnant women conceptualised psychological distress within the context of pregnancy; the feelings or symptoms of psychological distress; what pregnant women perceived as its causes; and the psychosocial needs of pregnant women in relation to antenatal distress. This study was guided by a feminist approach and a feminist standpoint epistemology in particular. This lent itself to exploring the phenomenon while departing from a clinical, decontextualised position which translated into an investigation with pregnant women who subjectively perceived themselves to be distressed.

Orientador: Karina Pavão Patrício / Resumo: Introdução: Estudos recentes demonstram que a conexão com a natureza favorece o bem estar e a saúde humana e pode facilitar a adoção de hábitos de vida mais sustentáveis e saudáveis, entre eles a alimentação. O consumo habitual de alimentos ultraprocessados, além de associar-se à maior prevalência de doenças crônicas, favorece contaminação ambiental por meio das embalagens, em sua maioria plásticos não retornáveis e não recicláveis. Acredita-se que profissionais da saúde com boa conexão com a natureza podem ser promotores da disseminação destes hábitos. Objetivo: Investigar a associação entre conexão com a natureza e motivos para escolhas alimentares, bem-estar subjetivo e saúde autorreferida. Método: Estudo transversal com 146 profissionais da atenção primária à saúde (APS) do município de Botucatu – SP, que responderam aos seguintes instrumentos autoaplicados: 1) Questionário sociodemográfico, que incluiu questão sobre saúde autorreferida; 2) Escala de Conexão com a Natureza (ECN) - escala com 14 itens, que mede o quanto a pessoa se sente integrada ao meio ambiente em uma perspectiva subjetiva e individual e cuja pontuação varia de 14 a 70 pontos; 3) Questionário sobre “Motivos para as escolhas alimentares” (FCQ): com¬posto por 36 itens distribuídos em nove fatores que avaliam aspectos rela¬cionados às escolhas alimentares. Foram avaliadas as pontuações nos diferentes fatores e a associação da pontuação obtida dos fatores “Saúde”, “Conteúdo Natural” e “Preocupação Ética” à ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Current studies show that connectedness to nature improves human well-being and health and can facilitate the adoption of more sustainable and healthy living habits, including eating. The habitual consumption of ultra processed foods, in addition to being associated with a higher prevalence of chronic diseases, lead to environmental contamination through the packaging, mostly non-returnable and non-recyclable plastics. It is believed that health professionals with a high connectedness can be promoters of the dissemination of this knowledge. Objective: To investigate the association between connectedness to nature and food choice motives, subjective well-being and self-reported health. Method: Cross-sectional study with 146 primary health care professionals (PHC) from Botucatu city, SP, who answered the following self-applied tools: 1) A socio-demographic questionnaire, which included a question on self-reported health; 2) Connectedness to Nature Scale (ECN) - scale with 14 items, which measures how much the person feels integrated to the environment in a subjective and individual perspective and whose score varies from 14 to 70 points; 3) Food Choice Questionnaire (FCQ): compiled by 36 items distributed in nine factors that evaluate aspects related to food choices. The scores on the different factors and the association of the score obtained from the "Health", "Natural Content" and "Ethical Concern" factors to the score obtained in the ECN were evaluated; 4) Sub... (Complete abstract click electronic access below) / Mestre

<p>General and reproductive health and reproductive outcome were described in rural women of childbearing age (15-44 years) during 1992-93 in a cross-sectional study in Zimbabwe. Through a two-stage sampling procedure twelve villages were selected at random, and 79% of the women in the villages accepted to participate (n=1213). In a structured interview women¡¯s self-reported morbidity, socio-economic conditions, use of health care and fertility regulation methods, reproductive outcome and infertility problems were assessed. The prevalence rates of anaemia, malaria and syphilis were investigated. Retrospectively, HIV serology was anonymously assessed and associations with socio-economic conditions and morbidity were analysed. </p><p>The mean age was 28 years. Family planning was currently used by 37%. Primary and secondary infertility was reported by 0.9% and 4.4%, respectively. The perinatal mortality rate for all completed pregnancies (n=3601) was 23/1000. During the latest completed pregnancy 94% had attended antenatal care and 85% had delivered in hospitals or clinics. The self-reported complications during delivery seemed to have been cared for within the health care system. </p><p>Women perceived their health as being generally good. Mean haemoglobin (Hb) was 13.5 g/dl and only 3.4% were anaemic (Hb ¡Ü11.0 g/dl). Malaria prevalence was 5.4%, but a positive malaria test was not associated with anaemia. Syphilis prevalence was 2.2%, and a positive syphilis test increased the risk of being HIV positive three-fold (OR=3.0; 95% CI: 1.4-6.2). </p><p>The prevalence of HIV was high (22%). Women aged 15-19 had the lowest prevalence (7.6%), while the highest was found in married women aged 20-29 years (30%). The differences in HIV prevalence between the villages ranged between 8.4% and 33%. HIV positive women reported no more morbidity than HIV negative women. The low morbidity found at the time of the study indicates a fairly short duration of the HIV epidemic. </p>

Thesis (Ph.D. (Nutrition))--North-West University, Potchefstroom Campus, 2009.

In any human culture the telling of stories for representing past events is likely to have a centralplace. The aim of this dissertation is to describe storytelling among Swedish adolescents from astructural, interactional and functional perspective, and to demonstrate how the meaning of thestory is interactionally constructed. The material consists of a corpus of 258 stories taken from 30 hours of tape recordings of conversations between adolescents, aged 10-15, of both sexes, mostly in naturally occurring situations. The majority of the recordings were made in the late 80's and early 90's, while others datefrom 1974-1984. The study tries to combine the theoretical and methodological ideas of conversational analysis(CA) and sociolinguistic discourse analysis. The method is basically qualitative and the analysesare carried out through detailed scrutiny of pieces of recordings and transcriptions. The aspects ofstorytelling that arc studied include the way the stories are introduced and accounted for in the ongoing conversation, how they are designed by the teller in order to propose and make the listeneraccept a certain version of what happened, and how the listener through his contributions duringthe telling can accept, modify, reject and negotiate the meaning proposed by the teller. Another aspect studied is how the stories serve as means for self- and other-presentations. The results show that, both as tellers and listeners, Swedish adolescents make use of many different strategies to structure the telling and evaluate the story. These include verb tense, word orderand different kinds of discourse markers as well as highly emotional and dramatizing features suchas reported speech, onomatopoetic expressions and laughter. A very important evaluative deviceis the discourse marker ba. Dramatization is also found in many of the listener's contributions tothe telling. It is also shown that there are substantial differences between boys and girls, both in the use of (some of) these dramatizing features and in the way they construct and present themselves and others in the stories. This seems to be due to the fact that storytelling serves different functions in groups of boys and girls. Finally, it is argued that there are some indications of an ongoing change in the narrative style of Swedish adolescents.

<p>Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt / 80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence.</p>

General and reproductive health and reproductive outcome were described in rural women of childbearing age (15-44 years) during 1992-93 in a cross-sectional study in Zimbabwe. Through a two-stage sampling procedure twelve villages were selected at random, and 79% of the women in the villages accepted to participate (n=1213). In a structured interview women¡¯s self-reported morbidity, socio-economic conditions, use of health care and fertility regulation methods, reproductive outcome and infertility problems were assessed. The prevalence rates of anaemia, malaria and syphilis were investigated. Retrospectively, HIV serology was anonymously assessed and associations with socio-economic conditions and morbidity were analysed. The mean age was 28 years. Family planning was currently used by 37%. Primary and secondary infertility was reported by 0.9% and 4.4%, respectively. The perinatal mortality rate for all completed pregnancies (n=3601) was 23/1000. During the latest completed pregnancy 94% had attended antenatal care and 85% had delivered in hospitals or clinics. The self-reported complications during delivery seemed to have been cared for within the health care system. Women perceived their health as being generally good. Mean haemoglobin (Hb) was 13.5 g/dl and only 3.4% were anaemic (Hb ¡Ü11.0 g/dl). Malaria prevalence was 5.4%, but a positive malaria test was not associated with anaemia. Syphilis prevalence was 2.2%, and a positive syphilis test increased the risk of being HIV positive three-fold (OR=3.0; 95% CI: 1.4-6.2). The prevalence of HIV was high (22%). Women aged 15-19 had the lowest prevalence (7.6%), while the highest was found in married women aged 20-29 years (30%). The differences in HIV prevalence between the villages ranged between 8.4% and 33%. HIV positive women reported no more morbidity than HIV negative women. The low morbidity found at the time of the study indicates a fairly short duration of the HIV epidemic.