ABSTRACT “WHEN THE WIND BLOWS COLD”: THE SPIRITUALITY OF SUFFERING AND DEPRESSION IN THE LIFE AND MINISTRY OF CHARLES SPURGEON William Brian Albert, Ph.D. The Southern Baptist Theological Seminary, 2015 Chair: Dr. Donald S. Whitney This dissertation examines the spirituality of suffering and depression in the life and ministry of Charles Spurgeon. Chapter one frames the dissertation by presenting general facts concerning Spurgeon’s depression and the relationship that his depression has to his spirituality. Chapter 2 emphasizes particular facts and features of Spurgeon’s life and ministry that demonstrate his depression. This section places Spurgeon within the historical context of the nineteenth century, and especially within significant movements and events that established the setting for his depression. Chapter 3 features specific aspects of Spurgeon’s personality that influenced his depression and further document that he was in fact a depressed man. This section highlights certain dangers based on Spurgeon’s proclivity toward despondency. Chapter 4 highlights specific causes in Spurgeon’s depression. Specific focus is on physical, mental, circumstantial, ministerial, and other elements that contributed to his depression. A section on Spurgeon’s theological tension within this depression is also discussed. Chapter 5 discusses Spurgeon’s theology as it relates to his suffering and depression. For Spurgeon, a Trinitarian and Calvinistic doctrine was paramount in dealing with depression. These teachings would frame his understanding of man and human conduct both in life of the believer and unbeliever. The chapter also demonstrates Spurgeon’s understanding of church history within the context of a suffering faith. Chapter 6 examines the cures for Spurgeon’s physical and mental depression. Spurgeon had no aversion to medicine and doctors in assisting his physical maladies and depression. Diet, rest, exercise, the weather and the sea were all factors that aided in temporary recovery of Spurgeon when depressed. Chapter 7 explores the range of spiritual disciplines that Spurgeon practiced himself and which he encouraged other Christians to perform to maintain a vital experience of communion with God during times of depression. Spurgeon believed that means such as meditation of Scripture, prayer, service and the sacraments were essential practices for maintaining genuine Christian piety. Chapter 8 summarizes answers given to the research question and related questions. This section also provides concluding reflections and recommended further research on this topic.

O estudo teve como objetivo analisar as percepções de enfermeiros no trabalho ao aplicar a classificação de risco em serviços de Urgência e Emergência, verificar o contexto de trabalho desses enfermeiros e avaliar indicadores de desgaste, valorização e reconhecimento. Método: Estudo quantitativo descritivo do tipo estudo de caso realizado em 4 serviços de Pronto Atendimento, participaram uma amostra de 33 enfermeiros. Coleta de dados, através observação participante (consulta a documentos, conversas informais com enfermeiros e a observação propriamente dita). Além de aplicação do instrumento EIPST (Escala de Indicadores de Prazer e Sofrimento no Trabalho) construída no Brasil por Mendes (2001) com objetivo de avaliar os fatores de Desgaste, valorização e reconhecimento. Resultados. Todos os casos conheciam o Protocolo de Classificação de Risco (PCR), porém não se verificou a padronização preconizada. O registro dos atendimentos realizados na PCR foi falho devido carência ou mau funcionamento de insumos (computadores); as instalações mostraram ser inadequadas em termos de ambiência (acolhimento dos pacientes e à realização do trabalho); os tempos de espera por atendimento médico após a PCR foram demorados (média de três horas para qualquer tipo de ficha). Dos enfermeiros destacam-se que poucos possuíam especialização em urgência e emergência, embora atuassem nos locais há um tempo considerável (média de 7,9 anos). E quanto ao trabalho executado (72,73% dos enfermeiros) relataram que rotineiramente estendem sua carga horária de trabalho. O fator valorização foi o que indicou diferenças significativas em relação ao desgaste e reconhecimento. Porém, os fatores valorização e Reconhecimento se mostraram próximos da média estipulada pela escala. O fator desgaste apresentou menor escore, embora enfermeiros possam estar em situações de desgaste em pequeno grau, pois na correlação entre o fator desgaste e esforços físico (81,25%) e mental (69,88%), houve resultados estatisticamente significantes. Além disso a maioria (87,88%) consideraram sua atividade repetitiva. Também mais da metade (60,61%) percebeu a supervisão do seu trabalho inadequada. Destaca-se o desgaste ocasionado pelo trabalho noturno, pela dupla jornada de trabalho através da correlação desgaste e carga horária estendida e ter outro vínculo empregatício. Mostraram escore de indicadores de valorização significativamente superior os enfermeiros submetidos a novas tarefas, assim como os que receberam treinamento para executar as suas tarefas e o consideraram adequado. Quanto ao reconhecimento, os que trabalhavam à tarde apresentaram escores significativamente superiores de reconhecimento em relação aos que trabalhavam à noite. Também os que perceberam a supervisão como adequada, apresentaram escores de reconhecimento significativamente superiores. Conclusão. O material coletado e analisado permitiu conhecer e compreender a realidade de uma amostra de enfermeiros de serviços de Urgência e Emergência, suas peculiaridades, deficiências ou limitações e os componentes do seu trabalho geradores de desgaste, favorecedores da valorização e reconhecimento. Melhoras devem ocorrer para a aplicação da PCR pois não há padronização na aplicação, além dos espaços e insumos para a sua realização não se mostrarem adequados para os profissionais e pacientes / The study aimed to analyze the perceptions of nurses at work when applying the classification of risk in and Emergency services, verify the work context of these nurses and evaluate indicators of wear, recovery and recognition. Methods: A quantitative descriptive study of the type of case study carried out in 4 emergency services, participated a sample of 33 nurses. Data collection through participant observation (query documents, informal conversations with nurses, and the observation itself) In addition to applying the instrument the Scale of Pleasure and Suffering at Work, built in Brazil by Mendes (2001) with the objective of evaluating the factors of Wear, valorization and recognition. Results: All cases were familiar with the Risk Classification Protocol (RCP) but the recommended standardization was not verified. The registry of the consultations realized in the PCR was flawed due to lack or poor functioning of inputs (Computers). Facilities proved to be inadequate in terms of ambience (patient care and the performance of work); the waiting times for medical care after the RCP were delayed (average of three hours for any type of card); Of the nurses, it should be noted that few had specialization in emergency and emergency, although they have acted locally for a considerable time (average of 7.9 years) Regarding the work performed (72.73% of the nurses). reported that they routinely extend their workload. The valorization factor indicated significant differences in wear and recognition. However, the valuation and recognition factors were close to the mean stipulated by the scale. Wear factor presented lower score, although nurses may be in low-grade wear situations, because in the correlation between the wear factor and physical (81.25%) and mental (69.88%) efforts, there were statistically significant results. In addition, the majority (87.88%) considered their activity repetitive. Also, more than half (60.61%) perceived the supervision of their work inadequate. Emphasis is given to wear and tear caused by night work, by double working hours through the correlation of wear and extended working hours and having another employment relationship. They showed a significantly higher score for nurses who underwent new tasks, as well as those trained to perform their tasks and considered it appropriate. As for recognition, those who worked in the afternoon presented significantly higher scores of recognition than those who worked at night. Also those who perceived supervision as adequate presented significantly higher recognition scores, Conclusion: The material collected and analyzed allowed to know and understand the reality of a sample of emergency and emergency services nurses, their peculiarities, deficiencies or limitations and the components of their work that generate wear, favoring the recovery and recognition. Improvements must occur for the application of RCP since there is no standardization in the application beyond the spaces and inputs for its realization not to be adequate for professionals and patients.

A evolução tecnológica e a inovação dos recursos médicos tornaram crescentes e impulsionaram a busca por procedimentos realizados pela Medicina no Brasil e, como consequência, o número de erros médicos também aumentou. O erro médico advém de uma conduta inadequada, capaz de produzir dano à vida ou agravo à saúde do seu paciente, por ação ou omissão do profissional médico, mediante a imperícia, imprudência ou negligência. Essa situação tem se tornado cada vez mais comum nos cenários nacional e internacional. No Brasil, não se tem uma dimensão exata do número de pessoas acometidas pelo erro médico, como também, não se têm pesquisas aprofundadas envolvendo a subjetividade e o sofrimento das vítimas na literatura nacional. O objetivo desta tese foi investigar o sentido dado pelas vítimas de erro médico a essa sua condição existencial e também analisar o sofrimento psíquico implicado nesse processo, à luz da perspectiva fenomenológico-existencial e das contribuições de Walter Benjamin. Foi conduzida uma entrevista semiestruturada com uma questão inicial disparadora, realizada com 12 pessoas vítimas de erro médico. Os dados foram tratados a partir da análise de sentido. Pôde-se observar, dentre outros aspectos, que as vítimas inicialmente demoram para acreditar no que estão vivenciando, ficando perplexas e indignadas diante do erro médico do qual foram vítimas. Verificou-se que algumas souberam por outros profissionais da ocorrência do erro, e nenhum dos médicos que cometeu o erro foi o responsável pelo suporte e condução da correção. Assumir que errou foi pouco visto nos 1 É preciso destacar que esta pesquisa não tem o propósito e nem a finalidade de gerar conflito de interesse. discursos e atitudes dos médicos envolvidos. Os sentimentos de ódio, raiva e desespero tomam conta da vivência das vítimas. A rotina de vida se modifica, e as vítimas se tornam, muitas vezes, dependentes e impossibilitadas de continuar com suas responsabilidades e afazeres. As narrativas das vítimas indicaram que cada indivíduo tem seu modo subjetivo de enfrentar e reagir ao erro, e o sofrimento é um elemento peculiar a esse processo. O conceito de erro médico, formulado pelas vítimas, apresenta uma conotação negativa e representa uma atuação profissional sem qualidade, retratando a realidade do contexto sanitário que o País vive, sem respeito e consideração pelo paciente. Sobre o julgamento dos casos, as vítimas destacaram a demora na deliberação do processo e sentiram-se surpresas quanto às brandas punições aplicadas aos médicos condenados. Com base nas reflexões, é possível apontar que o estigma do erro médico tem uma forte ligação com os juízos de valores e culturais impostos no País, o que dificulta a sua aceitação tanto para a vítima quanto para o profissional. A relação médico e paciente tem se mostrado desgastada, sem haver o respeito e consideração à individualidade da pessoa como paciente, distanciando o médico de uma prática humanizada e dos aspectos bioéticos. As narrativas permitem um pensar sobre o sofrimento psíquico das vítimas e ajudam a compreender melhor os aspectos emocionais, comportamentais e sociais de uma vítima de erro médico no Brasil. A partir das análises, identificou-se a necessidade de um olhar mais cauteloso e atento da Psicologia para o cuidado à saúde mental dos envolvidos no erro / The technological evolution and the innovation of medical resources increased and boosted the search for medical procedures in Brazil, and, as a consequence, the number of medical errors has also raised. The medical error results from an inadequate procedure than can either damage the patient´s life or worsen his/her health, and that follows an action or omission of the doctor, because of his/her malpractice, imprudence or negligence. Such a situation has become more and more common both in the national and in the international scene. In Brazil, there is not an exact dimension of the number of people affected by medical errors, nor there is depth research about the victims´ subjectivity and suffering in the national literature. The aim of this thesis was to investigate the meaning the victims of medical errors give to their current existential condition, as well as to analyze the psychic suffering involved in such a process, in the light of the phenomenological-existential perspective and of Walter Benjamin´s contributions. We conducted a semi-structured interview in which there was an initial triggering question with 12 people who were victims of medical error. The data were treated from the analysis of meaning. Among other aspects, we could observe that first it takes a long time for the victims to believe what they are experiencing. They are astonished and indignant as they stand before the error they fell victims to. We found out that some of the victims were informed by other professionals of the occurrence of the error, and that none of the doctors who made the error became responsible for supporting and performing the correction. To assume the error was something that was hardly verified in the speech and attitudes of the doctors involved in the error. Hate, anger and despair are experienced by the victims. The daily routine changes, and a lot of times the victims become dependent and incapable of taking over their previous responsibility and tasks. The victims´ narratives show that each individual has his/her subjective way to face and react to the error, and suffering is a peculiar element of such a process. The victims´ concept of medical error has a negative connotation, and it stands for professional performance without any quality, which portrays the reality of the country´s health context, without any respect or consideration for the patient. As for the judgement of the cases, the victims highlighted the slow process of deliberation, and they were surprised with the light punishment inflicted on the doctors condemned. From our study, we can state that the medical error stigma is strongly tied with the country´s culture and value judgements, which makes it more difficult for the victim and the professional to accept it. The relation between doctor and patient has worn out, without any respect or consideration for the patient´s individuality, which distances the doctor from a humanized practice and bioethical issues. The narratives let us think about the victims´ psychic suffering, and they help us understand better the emotional, social and behavior issues of a victim of medical error in Brazil. From the analyses undertaken, it was identified the need for a more cautious and attentive look of Psychology to the mental health care of the people involved in the error

This thesis is about a specific locality- the Central Methodist Church- and it details the lives and experiences of a large group of migrants who lived within this locality. The study also examines the activities of a wide range of humanitarian organisations that instituted interventions at the church and analyses how individuals’ suffering is dealt with by humanitarian organizations. The individuals who inhabited the church were a product of large-scale structural factors- political conflict, economic decline and fragmentation and social despair. These individuals were however following traditional mobile livelihoods routes that have been part and parcel of the Southern African labour migration history. The central questions that this study examines are how and in what ways experiential suffering is dealt with and how the different ways and technologies of managing suffering, impinge upon individual and collective subjectivities in the specific locality of the church. In addition the study examines the categorizations and representations of indigent Zimbabwean migrants within South Africa and how these representations have been constructed and transformed over time. The findings made in the study are drawn from a year of ethnographic fieldwork, which combined a number of different methods. These included archival research, participant observation, in-depth interviews and narratives with individual migrants, state officials and officials from humanitarian organizations. The study also made use of diaries in order to detail the everyday lives of individual migrants and capture the texture of everyday life at the church. The findings indicate that the migrants emplaced within the Central Methodist Church were not only victims of structural, political and socio-economic factors as has been the common refrain in recent literature but were also victims of the ‘invisible’, silenced, unrecognized and unacknowledged violence and exclusionary nation-building mechanisms and processes in post-independence Zimbabwe and post-apartheid South Africa. The study finds that the ways through which organizations deal with suffering is mediated by numerous factors and humanitarian interventions interact and articulate with the aspirations of individuals in complex and unpredictable ways often with perverse outcomes. One of the key findings that emerges from the study carried out within a specific locality challenges the notion of places such as refugee camps and asylum holding centres as being ‘exceptional spaces’ where individuals are bereft of rights and even their sense of individuality and worth. Rather such places ought to be understood in terms of contextual, material and historical realities. These places ought also to be understood in terms of the meanings that are attached to them by those who inhabit them. In this regard the study shows the Central Methodist church building to be a material and political resource used by the inhabitants and it’s also an economic and political resource utilized by NGOs and other actors. The thesis shows that the ways through which humanitarian interventions are deployed leads to the creation of categories of victimhood and oftentimes these categories are negotiated and constantly reconfigured at times without necessarily interacting with the realities of the beneficiaries in the manner intended. The thesis shows that the everyday lives of indigent individuals are characterized not only by hardships but the manner in which these individuals attempt to assist each are processes fraught with tension and ambiguity. By so doing, the study challenges the romanticization of the lives of the poor which is often depicted as resilient and where the poor assist each other. The thesis makes a contribution to the anthropology of humanitarianism. In addition, the thesis contributes to broader debates on the intersections between migration, indigence, victimhood and the logics and practices of humanitarian institutions.

Bakgrund: Cystisk fibros (CF) är inte längre en barnsjukdom eftersom 95% lever upp i vuxen ålder. Sjukdomen har stor påverkan på kroppens organ där lungorna och mag-och tarmkanalen är främst utsatta. Behandlingen är krävande och består till stor del av egenvård. Syfte: Syftet var att belysa personers erfarenheter av att leva med CF. Metod: Studien är utformad som allmän litteraturstudie med induktiv ansats. Sökningar genomfördes i tre databaser och genererade i elva artiklar. Resultat: Fyra kategorier skapades: Oro över att vara annorlunda, Symtomens påverkan på livet, Hopp och lidande samt Vårderfarenheter. Konklusion: Personer med CF upplever en bristande normalitet, önskan om ett normalt liv och en relation med döden. Att vara delaktig i vården är en förutsättning för personer med CF och bidrar till självständighet. Fortsatt forskning inom sjukdomen behövs för att lindra lidandet hos personer med CF. / Background: Cystic fibrosis (CF) is no longer a pediatric disease since 95% live up to adulthood. The disease has a great impact on the organs especially the lungs and the gastrointestinal tract. The treatment is very demanding and consists mainly of selfcare. Aim: The aim of this study was to illustrate persons´ experience of living with CF. Method: The study was constructed as a general literature study with an inductive approach. The searches were conducted in three different databases and resulted in eleven articles. Result: These eleven articles resulted in four categories: The worry of being different, The symptoms effect on life, Hope and suffering and Health care experience. Conclusion: People with CF experience a lack of normality, a wish for a normal life and they have a relationship with death. Being involved in the care is a prerequisite for people with CF and it contributes to independence. Continued research within the disease is necessary to relieve the suffering of people with CF.

A partir de 2004, quando o Exército Brasileiro foi para o Haiti, atendendo aos apelos da ONU e aos interesses diplomáticos e políticos internos, aquele país passou a ser um meio para o Brasil se posicionar no contexto das Relações Internacionais, atuando como pacificador em situações de conflito. Desde a chegada das tropas brasileiras ao Haiti, surgiu uma \'ponte\' entre os dois países, abrindo um caminho para os haitianos que não contemplavam nenhuma possibilidade de construção de uma vida digna em seu país migrarem para outro. O Brasil, para eles, tornava-se um destino, no movimento migratório, cheio de idealizadas afinidades culturais, com grande número de negros, festivo, receptivo e àquela época, aparentemente próspero. Apesar da ´ponte´ entre os dois países, os imigrantes, ao chegarem ao Brasil, não encontram nada que idealizaram previamente à sua saída. A cidade de São Paulo, a maior cidade da América Latina poderia ser, em tese, o destino perfeito, com grandes oportunidades de trabalho e uma vida digna Há inúmeras barreiras que esses imigrantes transpõem até chegar à metrópole. Na própria legislação brasileira, que normatiza a condição de imigrante, se verifica resquícios que impedem de atender aos princípios básicos dos Direitos Humanos. No cenário, o objetivo geral desta pesquisa é o registro do fato de como os imigrantes haitianos se relacionam com as características da Capital paulista e da cultura nacional, enfrentando toda ordem de dificuldades e sofrimento social que uma trajetória sem planejamento ou estudo pode oferecer a seus protagonistas. Para consolidar estes objetivos adota-se uma metodologia lastreada no método qualitativo de pesquisa, bem como a etnografia, que humaniza o presente trabalho científico, com relatos reais dos personagens que compõem este cenário. Por fim, em concatenação ao registrado, descreve-se o cenário atual deste fenômeno sociológico. / From 2004, when the Brazilian Army went to Haiti, in response to the appeals of the UN and to the internal diplomatic and political interests, that country became a means for Brazil to position itself in the context of International Relations, acting as a peacemaker in situations of conflict. Since the arrival of Brazilian troops in Haiti, a \"bridge\" has emerged between the two countries, opening a way for Haitians who did not contemplate any possibility of building a decent life in their country to migrate to another. Brazil, for them, became a destination in the migratory movement, full of idealized cultural affinities, with large numbers of blacks, festive, receptive and at that time, apparently prosperous. In spite of the \'point\' between the two countries, immigrants, when arriving in Brazil, find nothing they had idealized prior to their departure. The city of São Paulo, the largest city in Latin America could be, in theory, the perfect destination, with great work opportunities and a dignified life There are numerous barriers that these immigrants transpose until reaching the metropolis. In the Brazilian legislation itself, which regulates the status of immigrant, there are remnants that prevent compliance with the basic principles of Human Rights. In the scenario, the general objective of this research is to record the fact that Haitian immigrants are related to the characteristics of the capital of São Paulo and of the national culture, facing any order of difficulties and social suffering that a trajectory without planning or study can offer its protagonists. To consolidate these objectives, a methodology based on the qualitative method of research is adopted, as well as the ethnography, which humanizes the present scientific work, with real reports of the characters that make up this scenario. Finally, in concatenation to the registered, the current scenario of this sociological phenomenon is described.

Bakgrund: Varje år behöver mer än 10 000 nyfödda barn i Sverige vård på en neonatalvårdsavdelning. Vårdtiden präglas av åtskilliga blodprovstagningar som orsakar barnet smärta och ökat vårdlidande. Sjuksköterskans ansvar innefattar att agera för barnets bästa i alla situationer, men det kan saknas tydliga riktlinjer för hur detta ska ske på arbetsplatsen. Syfte: Syftet med studien är att beskriva sjuksköterskors resonemang och arbetssätt vid blodprovstagning på barn på neonatalvårdsavdelning, samt att undersöka hur barnets bästa finns i fokus vid proceduren. Metod: Studien utformades med en kvalitativ studiedesign i avsikt att generera kunskap om sjuksköterskornas erfarenheter vid blodprovstagning. Tolv intervjuer genomfördes utifrån en semistrukturerad intervjuguide med sjuksköterskor verksamma vid en neonatalvårdsavdelning på ett svenskt universitetssjukhus. Den insamlade datan analyserades genom en induktiv innehållsanalys. Resultat: Vilken stickmetod sjuksköterskorna använde var anpassat efter barnet och situationen. De såg till barnets förutsättningar och planerade provtagningen efter vad barnet klarade av, i samråd med föräldrarna. Sjuksköterskorna strävade efter föräldranärvaro vid provtagningen och åtog adekvata smärtlindringsmetoder i den mån som situationen tillät. Slutsats: Sjuksköterskorna hade genomgående barnets bästa i fokus vid provtagningsproceduren. De såg en komplexitet i sin roll att både vara den som orsakar barnet smärta, men även vara den som ska minska barnets vårdlidande. / Background: Every year, more than 10 000 newborn children require hospitalization in a neonatal intensive care unit. During this time, they are subjected to several painful blood sampling procedures that will cause them suffering to some extent. The nurses’ responsibility is to act on what is best for each child at all times but clearer guidelines for how that should be executed in practical nursing care might be needed. Aim: To describe the reasoning and the working manner of the nurses when performing blood sampling on children. The study also aims to examine how the child’s best interest is taken into account before and during this procedure. Method: A qualitative design was used for this study. Semi-structured interviews were conducted with 12 registered nurses who work in the neonatal intensive care unit at a Swedish University Hospital. Collected data were analysed using inductive content analysis. Results: Regardless of which technique the nurses chose when performing blood sampling it was assessed as the most appropriate one for each child. They took the children’s prerequisites and ability to cope into account and planned the procedure in consensus with their parents. Nurses strove to encourage parents to stay close to and support their children when blood sampling was conducted, and adequate analgesic actions were undertaken. Conclusion: Nurses had the children’s best at heart all through the process of blood sampling. Their role as both inflicting and relieving pain was considered to be complex in the aim to avoid suffering.

O desempenho no esporte de alto rendimento está associado a situações de desgastes físicos e psicológicos extremos tanto em treinamentos como em competições. A dor é um atributo constante na vida destes atletas e trata-se de uma experiência sensorial e emocional avaliada muitas vezes como negativa, associada a uma lesão real ou não que abrange aspectos fisiológicos, sociais e psíquicos. Assim, estudos com a intenção de dar significado a dor na percepção dos próprios atletas devem levar em conta a cultura do esporte e da modalidade, pois a cultura é um complexo de habilidades ou hábitos adquiridos pelo sujeito enquanto membro de um grupo social, fornecendo dados da identidade do ser atleta. Este estudo teve como objetivo analisar como as atletas olímpicas de Ginástica Rítmica experienciaram a dor e os seus significados em sua carreira esportiva. Para tanto foram investigadas as 18 atletas brasileiras que participaram dos Jogos Olímpicos de Verão em diferentes edições, sob a ótica dos Estudos Culturais, inspiração teórica para pensar produções culturais e as práticas sociais. A decisão por investigar esse grupo se estruturou por ser uma modalidade com grande dificuldade técnica, de profissionalização precoce e alto nível de desempenho, alcançados ainda na adolescência. A exigência excessiva e prematura do corpo, o envolvimento com as rotinas e o alto nível de dificuldade dos exercícios praticados predispõe as atletas a um maior risco de dor e sofrimento. O método utilizado foi a narrativa biográfica que proporcionou apreender por meio das memórias desse grupo de atletas a compreensão do significado da dor no esporte e na modalidade específica, apontando que esses significados são transmitidos através das gerações e relacionam-se com tradições e convenções grupais. As atletas criam sentidos para essas vivências através do discurso construído socialmente na modalidade; as experiências acumuladas dentro do grupo levam as participantes a uma expectativa do sofrimento; os vínculos estabelecidos geram a capacidade de simbolizar a dor; suportar o limite imposto pelo corpo faz parte da cultura da modalidade. Os sentidos que constituem o significado da dor permitiu compreender a essência dos conteúdos do que é e como se dá a experiência dolorosa de uma modalidade esportiva quando praticada em alto rendimento / High performance sports is associated with extreme physical and psychological wear in training and competition. Pain is a constant attribute in the lives of these athletes and it is a sensory and emotional experience often evaluated as negative, associated with a real physiological, social and psychic real or non-abreviant injury. Thus, studies with an intention of meaning and perception of the athletes themselves are taken into account the culture of the sport and the modality, because the culture is a complex of skills or habits acquired through a social factor. This study aimed to analyze how Olympic Rhythmic Gymnastics athletes experienced pain and their own meanings in their sports career. To that end, 18 Brazilian athletes participating in the Summer Olympics in different editions were investigated, from the perspective of Cultural Studies, theoretical inspiration to think about cultural productions and social practices. A decision to investigate this group was structured because it is a modality with great technical difficulty, of previous professionalization and a high level of performance, reached in adolescence. The excessive and premature requirement of the body, the involvement with routines and the high level of difficulty of the exercises practiced predispose as athletes to a greater risk of pain and suffering. The method used for the biographical narrative that allowed to apprehend through the medium of the memories of this group of athletes in the understanding of the meaning of pain without sport and in the specific modality, pointing out that these meanings are transmitted through sales and relate to group conventions and traditions. The athletes create meanings for these lives through the socially constructed discourse in the modality; the experiences as accumulated within the group they take as participants an expectation of suffering; the established bonds generate the capacity to symbolize pain; support more than the legal limit for the body is part of the sport culture. The senses that constitute the meaning of permible pain, namely the essence of the contents of what is like a painful experience of a sporting modality when practiced in high yield

Introdução: Os acidentes de trânsito e os traumas causados por eles constituem um grave problema social e de saúde pública em todo o mundo, atingem principalmente os adultos em faixa etária produtiva de vida. Além da morte, esses eventos podem causar nos acidentados comprometimentos na mobilidade, na vida ocupacional, nas relações sociais, na saúde física e mental e outras implicações para as vítimas e seus familiares. Objetivo: compreender e descrever a experiência vivenciada pelo acidentado ou vítima de trânsito com sequela física permanente e seus familiares. Método: os referenciais de Interacionismo Simbólico e História Oral, articulados a abordagem de pesquisa qualitativa, fundamentaram teórica e metodologicamente este estudo. Foram realizadas entrevistas com dezoito vítimas de acidente de trânsito, sendo nove vítimas de acidente de trânsito com sequela permanente e um familiar de cada vítima. Resultados: o resgate das memórias individuais permitiu a elaboração das narrativas, que por meio de um processo analítico possibilitaram a construção da memória coletiva, organizada em quatro temas: Sofrimento e ruptura da maneira de viver, O acidente de trânsito como renascimento, Quotidiano familiar desestruturado e Esperança: criando um ambiente para dar continuidade a vida. Os resultados do estudo revelaram que as vítimas primárias de acidente de trânsito que sobrevivem e adquirem uma deficiência física e as vítimas secundárias, seus familiares, vivenciam sofrimento físico e emocional com significativo impacto em suas vidas. A sequela obriga a uma ruptura com o modo de vida anterior ao acidente e as modificações exigidas por essa ruptura são experienciadas com dor, tristeza, pesar, desespero e um misto de sentimentos negativos que fazem parte de todo sofrimento vivenciado por eles. Conclusões: partindo-se da concepção de que os acidentes de trânsito são em maior ou menor grau perfeitamente passíveis de prevenção tem-se a reflexão que todo o sofrimento e gastos envolvidos podem ser evitados, fato de grande magnitude ao analisar-se que toda a população, sem exceções, está sujeita a sofrer um acidente de trânsito. Os resultados permitem a reflexão sobre a importância da família no processo saúde e doença das vítimas, que não contam com ajuda do Estado para lidar com a situação. Percebe-se assim, que há necessidade evidente em fornecer assistência às vítimas de acidente com sequelas de maneira integral, dando especial atenção ao período pós-sequela e à inclusão da assistência à família, também uma vítima do acidente, nesse caso, uma vítima secundária. / Introduction: Traffic accidents and related traumas are a serious social and public health problem worldwide, ultimately affecting working-age adults. Besides death, such events may cause mobility impairment and harm in their occupational life, social relations, physical and mental health, and other implications for the victims and family members. Objective: to understand and describe the experience lived by victims of traffic accidents with permanent physical sequelae and their family members. Method: Symbolic Interactionism and Oral History, articulated with a qualitative research approach, were the theoretical and methodological backgrounds in this study. Interviews were carried out with eighteen victims of traffic accidents, comprising nine victims of traffic accidents with permanent sequelae, and one family member of each victim. Results: the recollection of individual memories enabled the elaboration of narratives, which furthered the construction of the collective memory by means of an analytical process, organized in four themes: Suffering and disruption in the way of life, Traffic accident as rebirth, Disrupted family daily life and Hope: creating an environment to carry on their lives. The study results uncovered that primary victims of traffic accidents who survive and get physically disabled, and the secondary victims, their family members, experience physical and emotional suffering with significant impact in their lives. Sequelae bring about a disruption in the way of life they used to have before the accident, and changes arising from that disruption are experienced with pain, sadness, grief, despair, and a mix of negative feelings which entail the suffering lived by them. Conclusions: Under the perspective that all traffic accidents are perfectly preventable in a higher or lower degree, we get to the reflection that all suffering and expenses involved can be prevented, which is highly significant if we analyze that all the population, without any exceptions, may have a traffic accident. The results enable the reflection on the importance of the family in victims health and disease process, who do not have any State assistance in order to cope with the event. Thus, it is perceived that there is evident need to provide impaired accident victims with special attention during the post-sequelae period on a full scale, extending it to their family members, also accident victims, in this case, secondary victims.

RESUMO: Trata-se de uma pesquisa social realizada a partir de pressupostos da sociologia compreensiva em diálogo com autores das áreas da antropologia, psicanálise e psicologia social em que doze sujeitos apresentaram suas trajetórias e respectivos sentidos para o consumo de drogas lícitas e ilícitas em contextos privados. A partir de suas narrativas pôde-se compreender que o consumo de drogas relaciona-se diretamente com o contexto social na qual vivem os sujeitos, trazendo à tona aspectos morais, estéticos e sociais em seus usos. É possível afirmar como resultados da investigação: que a problemática do consumo de drogas envolve a excessiva medicalização e psiquiatrização de comportamentos, além de uma demasiada testagem entre os usuários de fármacos prescritos; a relação entre vulnerabilidade social e pobreza é um indicador superficial para a compreensão do consumo de drogas, em que a vulnerabilidade não está e não deve ser circunscrita à pobreza, e pessoas de camadas sociais mais favorecidas também fazem uso de drogas das mais diversas e por razões semelhantes àqueles que vivem em situação economicamente desfavorecida; a narrativa oriunda da comunidade científica no tratamento das drogas como um problema de saúde pública legitima o saber biomédico; o consumo do uso de drogas faz parte de um modo e estilo de vida contemporâneos para o alívio, anestesia e recreação de nosso tempo social; a produção de categorias científicas referentes aos usuários de drogas e aos seus estilos de vida acaba por transformar esse saber-poder em mercado para a comunidade científica e médico-jurídica; e, por fim, que o consumo de drogas não é um problema de saúde pública, a priori, principalmente, no que diz respeito ao uso das chamadas ilícitas, mas faz parte de um regime de moralidades. Nesse contexto, é o uso excessivo de fármacos prescritos e sua testagem em consumidores que devem ser olhados como problema de saúde pública, já o consumo de drogas ilícitas torna-se uma questão de saúde pública apenas na medida em que o usuário e/ou seu entorno justificam seu consumo como problemático a partir de uma construção social em que os saberes da medicina e da justiça tratam-no como sendo / ABSTRACT: This is a social research study based on the assumptions of interpretative sociology (Verstehen), in dialogue with authors from the areas of anthropology, psychoanalysis and social psychology, in which twelve subjects presented their personal histories and respective meanings in relation to the consumption of licit and illicit drugs in private contexts. From these narratives it was possible to comprehend that the consumption of drugs is directly related to the social context in which the subjects live, thereby bringing to light the moral, aesthetic and social aspects of their uses. It is possible to affirm the following results from the research: that the issue of drug consumption includes the excessive medicalization and psychiatrization of behaviors, in addition to excessive testing among users of prescribed drugs; the relationship between social vulnerability and poverty is a superficial indicator in the understanding of drug use, considering that vulnerability is not and should not be circumscribed to poverty since people from the most favored social strata also use a wide range of drugs for reasons similar to those of individuals in economically disadvantaged situations; the scientific community´s narrative in the treatment of drugs as a public health problem legitimizes biomedical knowledge; drug use exists as part of contemporary lifestyles and ways of life to provide relief, anesthesia and recreation during our social time; the production of scientific categories for drug users and their lifestyles ends up transforming this know-how into a market for the scientific and medical-legal community; and, finally, that drug use is not a public health problem a priori, especially with regard to the use of so-called illicit drugs, but exists within the context of a set of moral codes. In this context, it is the excessive use of prescription drugs and their testing on consumers that should be regarded as a public health problem, while the consumption of illicit drugs becomes a public health issue only to the extent that the user and/or his/her environment justify their consumption as \'problematic\' as a result of the social construction in which medical and legal knowledge considers them as such