Thesis (M.D. with Distinction in Research) -- University of Texas Southwestern Medical Center at Dallas, 2005. / Vita. Bibliography: 25-28.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.

A tese propõe um encontro da trilogia pornográfica da escritora brasileira Hilda Hilst com o pesquisador, e decidiu-se pela forma do ensaio. A trilogia, composta pelos livros O Caderno Rosa de Lori Lamby (1990), Cartas de um Sedutor (1991) e Contos d’escárnio/Textos Grotescos (1992) apresentam uma mudança na trajetória da escritora, que anuncia na passagem para a escrita pornográfica, uma desistência da “literatura séria” e, por fim, entre os anos 1998 - 2004, a escritora assume um novo discurso: a desistência da literatura, quando declara publicamente: “não tenho mais nada a dizer”. Para investigar esses períodos, foi feita uma imersão nos arquivos pessoais da escritora, além da leitura das obras, seguindo a proposição de Didi-Huberman sobre as imagens: o regime da imagem e da imaginação é um local de luta política, principalmente aquelas imagens que portam memórias e têm um poder de transmitir algo de um tempo que se passou. O confronto de diferentes temporalidades se dá como uma estratégia de análise do material de arquivo, uma vez que a hipótese da tese é que, quando Hilda Hilst se “sente livre para fracassar”, acontece junto uma mudança de formato no uso do humor em sua literatura. Através de ferramentas teóricas do campo da psicanálise, da arte, da literatura e da crítica, a pesquisa investiga as noções de erótico, pornográfico e obsceno que compõe o universo da escritora, junto dos seguintes eixos de análise: problematização de imagem, escrita, arquivo, sobrevivência e do realismo grotesco como estratégia para o risível. O método utilizado foi o ensaio, com o objetivo de desenvolver uma pesquisa poética no processo de trabalho. A escrita hilstiana desse período tem por objetivo acordar o leitor com um soco, e aqui, acabou por acertá-lo em cheio. Desse choque se operou uma queda no espaço e uma desestabilização. Diante desta literatura, a tese se constituiu como um percurso de investigação da queda, propondo “Os estudos da gravidade - oscilações entre o peso e a leveza”, como resultados da pesquisa poética. / The thesis proposes a meeting between the Hilda Hilst’s pornography trilogy and the researcher in the essay form. The trilogy is composed by the books “The Pink Book of Lori Lamby (1990)”, “Letters of a seductive (1991)” e “Mockery Short Story/Grotesque Writing (1992)” presenting a change in the author’s trajectory, which is announced in the route to the pornography writings, a called forsake of the “serious literature”, and lastly, between the years 1998 – 2004, the writer assumes a new speech; the forsake of literature, when she declares publicly: “I have nothing else to say”. To investigate these periods of time, an immersion work was made in the personal archives of the author, besides the reading of the author’s works, followed by the proposition of Didi- Huberman about the images: the image system of imagination is a place of political fight mainly in those images that carry memories and have the strength to transmit something of a lost time. The confrontation of different times is an analyses strategy of the archives material, once the thesis hypothesis is that when Hilda Hilst “feels free to fail” occurs together a change of the format in the use of humor in her literature. By the theoretical tools of the psychoanalyses field, the art, the literature and the critic, the research investigates the concepts of erotic, pornography and obscene, that composes the authors universe, along with the following analysis axes: questioning of image, writing, archive, survival and the grotesque realism as a strategy for the laughable. The method was the essay as an objective to develop a poetic research in the work progress. The hilstian writing of this period has as an objective wake up the reader with a punch, and here in this work has just hit her (the author Hilda) in the face. From this shock, a falling into the space and a destabilization operated. Thereby having in mind this literature, the thesis was built as a route in the investigation of fall, proposing The studies of gravity - fluctuation between the weight and lightness, as the results of this poetic research.

A tese propõe um encontro da trilogia pornográfica da escritora brasileira Hilda Hilst com o pesquisador, e decidiu-se pela forma do ensaio. A trilogia, composta pelos livros O Caderno Rosa de Lori Lamby (1990), Cartas de um Sedutor (1991) e Contos d’escárnio/Textos Grotescos (1992) apresentam uma mudança na trajetória da escritora, que anuncia na passagem para a escrita pornográfica, uma desistência da “literatura séria” e, por fim, entre os anos 1998 - 2004, a escritora assume um novo discurso: a desistência da literatura, quando declara publicamente: “não tenho mais nada a dizer”. Para investigar esses períodos, foi feita uma imersão nos arquivos pessoais da escritora, além da leitura das obras, seguindo a proposição de Didi-Huberman sobre as imagens: o regime da imagem e da imaginação é um local de luta política, principalmente aquelas imagens que portam memórias e têm um poder de transmitir algo de um tempo que se passou. O confronto de diferentes temporalidades se dá como uma estratégia de análise do material de arquivo, uma vez que a hipótese da tese é que, quando Hilda Hilst se “sente livre para fracassar”, acontece junto uma mudança de formato no uso do humor em sua literatura. Através de ferramentas teóricas do campo da psicanálise, da arte, da literatura e da crítica, a pesquisa investiga as noções de erótico, pornográfico e obsceno que compõe o universo da escritora, junto dos seguintes eixos de análise: problematização de imagem, escrita, arquivo, sobrevivência e do realismo grotesco como estratégia para o risível. O método utilizado foi o ensaio, com o objetivo de desenvolver uma pesquisa poética no processo de trabalho. A escrita hilstiana desse período tem por objetivo acordar o leitor com um soco, e aqui, acabou por acertá-lo em cheio. Desse choque se operou uma queda no espaço e uma desestabilização. Diante desta literatura, a tese se constituiu como um percurso de investigação da queda, propondo “Os estudos da gravidade - oscilações entre o peso e a leveza”, como resultados da pesquisa poética. / The thesis proposes a meeting between the Hilda Hilst’s pornography trilogy and the researcher in the essay form. The trilogy is composed by the books “The Pink Book of Lori Lamby (1990)”, “Letters of a seductive (1991)” e “Mockery Short Story/Grotesque Writing (1992)” presenting a change in the author’s trajectory, which is announced in the route to the pornography writings, a called forsake of the “serious literature”, and lastly, between the years 1998 – 2004, the writer assumes a new speech; the forsake of literature, when she declares publicly: “I have nothing else to say”. To investigate these periods of time, an immersion work was made in the personal archives of the author, besides the reading of the author’s works, followed by the proposition of Didi- Huberman about the images: the image system of imagination is a place of political fight mainly in those images that carry memories and have the strength to transmit something of a lost time. The confrontation of different times is an analyses strategy of the archives material, once the thesis hypothesis is that when Hilda Hilst “feels free to fail” occurs together a change of the format in the use of humor in her literature. By the theoretical tools of the psychoanalyses field, the art, the literature and the critic, the research investigates the concepts of erotic, pornography and obscene, that composes the authors universe, along with the following analysis axes: questioning of image, writing, archive, survival and the grotesque realism as a strategy for the laughable. The method was the essay as an objective to develop a poetic research in the work progress. The hilstian writing of this period has as an objective wake up the reader with a punch, and here in this work has just hit her (the author Hilda) in the face. From this shock, a falling into the space and a destabilization operated. Thereby having in mind this literature, the thesis was built as a route in the investigation of fall, proposing The studies of gravity - fluctuation between the weight and lightness, as the results of this poetic research.

xiv, 116 p. / This study presents the development and validation of a measure of counseling competency with refugee torture survivors. The Refugee Torture Counseling Competency Assessment (REFTOR) measure was adapted from the Multicultural Awareness Knowledge and Skills Survey - Counselor Edition (MAKSS-CE-R; Kim et al., 2003) and was theoretically developed based on the limited literature available on refugee torture survivors. The 37-item REFTOR measure was administered to a sample of 179 psychologists and trainees in clinical and counseling psychology who were actively engaged in clinical work. Results of an exploratory principal axis factor analysis with oblimin (oblique) rotation revealed a two-factor structure for the measure with 37 total items and that explained 43.64% of the total variance. The first factor included 29 items and was labeled "Efficacy," accounting for 38.90% of the variance, and the second factor included 8 items and was labeled "Awareness," accounting for 4.74% of the variance. Evidence of concurrent validity was supported by factor correlations with other scales and items, and internal consistencies for the subscales and the full scale were acceptable. Information regarding current training experiences relevant to clinical work with refugee torture survivors and attitudes towards torture among study participants was also assessed. Results revealed that training experiences are limited, with the majority of information participants received relevant to working with refugee torture survivors coming from non-empirical articles (67% of participants). Attitudes towards torture varied considerably with a sizable proportion of participants endorsing torture in some circumstances (32.4%) and reporting uncertainty about the morality of psychologists' professional involvement in torture (12.3%). Recommendations for future research and implications of study findings for training are discussed. / Committee in charge: Krista Chronister, Co-Chair; Benedict McWhirter, Co-Chair; Paul Yovanoff, Member; Jennifer Freyd, Outside Member

Among the many researched outcomes of childhood sexual abuse (‘CSA’), relational difficulties have been well documented. However, male CSA survivors may experience several outcomes that are unique to their gendered experience and yet remain largely under-represented in the literature. A gap was identified in the research around the experience of the male survivor in therapy for childhood sexual abuse, particularly where it relates to relationship building. Therefore the research aimed to explore this from the perspective of the survivors, with a focus on trust within the therapeutic relationship. To achieve this, the researcher interviewed 6 male survivors of sexual abuse, all of whom had greater than one years’ experience in a therapy that focused on their abuse. The researcher adopted a semi-structured interview format which facilitates partial guidance by the new data introduced by the participant. Transcripts of the interviews were analysed using interpretative phenomenal analysis with a consistent curiosity stance that allowed the researcher to partially bracket their prior knowledge. The analysis resulted in four master themes emerging; i) Finding and Connecting; ii) Negotiating Masculine identity, iii) Accepting and Committing to the process; and iv) Trust. Findings highlighted the necessity of reducing epistemic vigilance in the early relationship and the importance of negotiating power dynamics with support for challenge by the client in order to facilitate trust. The experience of masculine social expectations in a male CSA survivor is explored with regards to the trust relationship and an unexpected finding was made in the importance of group work. These findings were linked to previous research in the area of male CSA, recommendations are made for future research and implications for practitioners were explored.

Bakgrund: Hjärtstopp är ett livshotande tillstånd och chansen för överlevnad ökar om hjärtrytmen återställs inom några minuter. Tidigt larm, hjärt- och lungräddning samt defibrillering är kedjan som räddar liv. Uppföljning och eftervård efter hjärtstopp ser olika ut beroende på var i världen patienten befinner sig och skiljer sig även mellan sjukhus i Sverige. Sjuksköterskor behöver känna till patienters erfarenheter av hjärtstopp för att kunna individanpassa bemötande och omvårdnad. Syfte: Syftet var att beskriva patienters erfarenheter av att överleva hjärtstopp. Metod: En litteraturöversikt genomfördes och baserades på 16 vetenskapliga artiklar, varav sju stycken var kvalitativa åtta kvantitativa och en mixed method. Sökningarna gjordes i databaserna CINAHL Complete och Pubmed och analys utfördes enligt Friberg (2017). Resultat: I resultatet formades fyra teman: fysiska och psykiska förändringar, erfarenheter av vården, ett nytt sätt att leva och mening och gemenskap. Hjärtstopp medför både fysiska och psykiska förändringar som erfars både positivt och negativt av patienterna. Erfarenhet av sjukvården, behovet av stöd från familj och närstående, hälsa och livskvalitet är områden som berörts av hjärtstoppet. Diskussion: I metoddiskussionen diskuteras litteraturöversiktens styrkor och svagheter. Resultatdiskussionen har diskuterats utifrån Watsons teori om mänsklig omsorg, vetenskapliga artiklar, litteratur och de centrala delarna av patienters erfarenheter som framkom i resultatet. Författarna diskuterar hur vården kan individanpassas och förbättras utefter litteraturöversiktens resultat. / Background: Cardiac arrest is a life-threatening condition and the chance of survival increases if the heart rate is restored within a few minutes. Early alarm, cardiac and lung rescue and defibrillation is the chain that saves lives. Follow-up and post-treatment after cardiac arrest vary depending on where the patient is and is also different between hospitals in Sweden. Nurses need to know patient´s experiences of cardiac arrest in order to be able to personalize treatment and nursing. Aim: The purpose was to describe patients' experiences of surviving cardiac arrest. Method: A literature review was conducted and based on 16 scientific articles, seven of which were qualitative eight quantitative and one mixed method. The searches were made in the databases CINAHL Complete and Pubmed and analysis was conducted according to Friberg (2017). Results: In the result, four themes were formed: physical and mental changes, experiences of care, a new way of living and meaning and community. Cardiac arrest causes both physical and mental changes that are experienced both positively and negatively by the patients. The experience of healthcare, the need for support from family and close relatives, health and quality of life are areas affected by the cardiac arrest.  Discussion: The method discussion discusses the strengths and weaknesses of the literature review. The outcome discussion has been discussed on the basis of Watson's theory of human concern, scientific articles, literature and the central parts of patients' experiences as expressed in the results. The authors discuss how care can be personalized and improved according to the results of the literature review.

A tese propõe um encontro da trilogia pornográfica da escritora brasileira Hilda Hilst com o pesquisador, e decidiu-se pela forma do ensaio. A trilogia, composta pelos livros O Caderno Rosa de Lori Lamby (1990), Cartas de um Sedutor (1991) e Contos d’escárnio/Textos Grotescos (1992) apresentam uma mudança na trajetória da escritora, que anuncia na passagem para a escrita pornográfica, uma desistência da “literatura séria” e, por fim, entre os anos 1998 - 2004, a escritora assume um novo discurso: a desistência da literatura, quando declara publicamente: “não tenho mais nada a dizer”. Para investigar esses períodos, foi feita uma imersão nos arquivos pessoais da escritora, além da leitura das obras, seguindo a proposição de Didi-Huberman sobre as imagens: o regime da imagem e da imaginação é um local de luta política, principalmente aquelas imagens que portam memórias e têm um poder de transmitir algo de um tempo que se passou. O confronto de diferentes temporalidades se dá como uma estratégia de análise do material de arquivo, uma vez que a hipótese da tese é que, quando Hilda Hilst se “sente livre para fracassar”, acontece junto uma mudança de formato no uso do humor em sua literatura. Através de ferramentas teóricas do campo da psicanálise, da arte, da literatura e da crítica, a pesquisa investiga as noções de erótico, pornográfico e obsceno que compõe o universo da escritora, junto dos seguintes eixos de análise: problematização de imagem, escrita, arquivo, sobrevivência e do realismo grotesco como estratégia para o risível. O método utilizado foi o ensaio, com o objetivo de desenvolver uma pesquisa poética no processo de trabalho. A escrita hilstiana desse período tem por objetivo acordar o leitor com um soco, e aqui, acabou por acertá-lo em cheio. Desse choque se operou uma queda no espaço e uma desestabilização. Diante desta literatura, a tese se constituiu como um percurso de investigação da queda, propondo “Os estudos da gravidade - oscilações entre o peso e a leveza”, como resultados da pesquisa poética. / The thesis proposes a meeting between the Hilda Hilst’s pornography trilogy and the researcher in the essay form. The trilogy is composed by the books “The Pink Book of Lori Lamby (1990)”, “Letters of a seductive (1991)” e “Mockery Short Story/Grotesque Writing (1992)” presenting a change in the author’s trajectory, which is announced in the route to the pornography writings, a called forsake of the “serious literature”, and lastly, between the years 1998 – 2004, the writer assumes a new speech; the forsake of literature, when she declares publicly: “I have nothing else to say”. To investigate these periods of time, an immersion work was made in the personal archives of the author, besides the reading of the author’s works, followed by the proposition of Didi- Huberman about the images: the image system of imagination is a place of political fight mainly in those images that carry memories and have the strength to transmit something of a lost time. The confrontation of different times is an analyses strategy of the archives material, once the thesis hypothesis is that when Hilda Hilst “feels free to fail” occurs together a change of the format in the use of humor in her literature. By the theoretical tools of the psychoanalyses field, the art, the literature and the critic, the research investigates the concepts of erotic, pornography and obscene, that composes the authors universe, along with the following analysis axes: questioning of image, writing, archive, survival and the grotesque realism as a strategy for the laughable. The method was the essay as an objective to develop a poetic research in the work progress. The hilstian writing of this period has as an objective wake up the reader with a punch, and here in this work has just hit her (the author Hilda) in the face. From this shock, a falling into the space and a destabilization operated. Thereby having in mind this literature, the thesis was built as a route in the investigation of fall, proposing The studies of gravity - fluctuation between the weight and lightness, as the results of this poetic research.

O aumento da sobrevida ao câncer é uma realidade nos dias atuais. Diante dessa constatação, a preocupação em conhecer as repercussões dos efeitos tardios na qualidade de vida ao longo dos anos tornou-se uma das prioridades para enfermeiros que atuam na oncologia. Buscando contribuir com essa discussão, o objetivo do presente estudo é conhecer a experiência dos sobreviventes do câncer infanto-juvenil e identificar quais as repercussões da enfermidade na qualidade de suas vidas. O estudo é de natureza qualitativa, realizado com 21 sobreviventes ao câncer infanto-juvenil, em acompanhamento em um hospital escola do interior do estado de São Paulo. As técnicas utilizadas para a coleta de dados foram a entrevista e a observação, com complementação de dados clínicos obtidos nos prontuários. Os dados foram organizados ao redor de duas temáticas: experiência da doença e as repercussões na vida do sobrevivente e satisfação com a vida. Para esse estudo a qualidade de vida tem características existenciais sendo composta pelas dimensões ser, pertencer e tornar-se onde o conhecimento da experiência da enfermidade é fundamental para a compreensão do processo de sobrevivência. O primeiro tema emergiu com as recordações do processo diagnóstico-terapêutico onde os participantes pontuaram os momentos dolorosos do tratamento, mas também os positivos como os de socialização (escola, recreação). Observamos que as repercussões físicas e psicossociais do câncer infanto-juvenil estão interligadas e refletem na qualidade de vida, a depender do tipo de câncer, idade e terapêutica. A satisfação com a vida, segundo tema, incluiu a capacidade dos sobreviventes em ter uma vida normal e a visão otimista do futuro, porém, o planejamento do futuro é permeado por dúvidas e inseguranças. Mesmo frente à satisfação com a vida, algumas alterações foram identificadas: na dimensão ser, as sequelas físicas e insatisfação com auto imagem; na dimensão pertencer, as dificuldades de relacionamento e inserção social e na dimensão tornar-se pelas dificuldades escolares e sentimento de insegurança com o futuro. Assim, os resultados do estudo revelam a singularidade e diversidade de fatores que interferem na qualidade de vida do sobrevivente ao câncer infanto-juvenil, destacando a necessidade de planejamentos que associem experiência do sobreviventes, conhecimento técnico dos profissionais de saúde e apoio familiar e comunitário. / The increased survival of cancer is a reality in our days. Considering this fact, the concernment to know the impact of late effects on lives quality over the years has become a priority for nurses who are working at oncology. Seeking to contribute to this discussion, the aim of this study is to know the experience of children and adolescents cancer survivors and identify which are the disease impacts on their quality of lives. The study shows a qualitative field conducted by 21 children and youth cancer survivors that have been supported at a teaching hospital in an inner city in São Paulo state. All the techniques used for data collection were based on interviews and observation and also clinical data obtained from the files. Data were organized around two themes: the experience of illness and the impact on their lives satisfaction. For this study the quality of life has an essential characteristic composed by the dimensions of being, belonging and becoming someone. The experience of illness is the key for the process of survival understanding at this moment. The first theme emerged with the diagnostics and therapeutic processes recollections which participants scored the painful moments of the treatment, but they also scored the positive ones as the socialization and recreation at school. We have observed that the physical and psychosocial consequences of cancer for children and youth are interrelated and reflect at the life quality in order of each type of cancer, age and therapy. The satisfaction with life, as mentioned before, is related with the survivor\'s ability of having a normal life and an optimistic vision of the future, but plans for the future is totally full of doubts and insecurities. Even dealing with life satisfaction at the moment, some annoying changes at the dimensions of being, belonging and becoming were identified such as physical disability, dissatisfaction with self image, the difficulties on relationship, the social acceptance, school difficulties and feelings of insecurity for the future. Thus, the study results show the uniqueness and diversity of factors that affect the quality of lives of children and adolescents cancer survivors, it is necessary to highlight the needs of having a plan that involves survivors experience, health professional\'s technical knowledge and family and community support.

Com avanços na terapêutica, no diagnóstico precoce e nos estudos cooperativos, a sobrevida de crianças e adolescentes com câncer tem aumentado. A Sociedade Americana de Enfermagem Oncológica indica como prioridade, para o período de 2005-2009, pesquisas sobre os efeitos tardios do tratamento e qualidade de vida dos sobreviventes. Buscando contribuir com esta discussão, o objetivo do presente estudo é compreender como os pais e outros familiares de crianças e adolescentes com câncer percebem e vivenciam a experiência do término do tratamento. O estudo é de natureza descritivo-exploratória, com abordagem metodológica qualitativa. Foram selecionadas 10 famílias cujos filhos completaram a terapia de câncer e concordaram em participar do estudo. As técnicas de coleta de dados foram a entrevista no domicílio, a observação e o prontuário médico. Na análise, os dados foram organizados ao redor de três temas: a memória ─ o que foi vivido; o presente ─ o que se vive e o futuro ─ o que há de ser. Ao descrevermos a experiência dos pais e demais familiares da criança e do adolescente, sobre término do tratamento do câncer, pudemos evidenciar a vitalidade dos participantes de sobreviver ao tratamento e a tenuidade de viver após ele. O estudo mostrou que os pais e familiares começaram a resgatar o momento interrompido pelo diagnóstico e terapêutica, fizeram um movimento de reestruturação de suas vidas, porém, com cautela. Projetaram um futuro de vida com otimismo, mas permeado pelo medo e incerteza. Os resultados do estudo possibilitaram identificar, no cotidiano das famílias, aspectos que necessitam de intervenção, objetivando a melhoria da qualidade de vida de crianças, adolescentes e da própria família com o término do tratamento. / Advances in therapeutics, early diagnoses and cooperative studies have increased the survival of children and adolescents with cancer. The American Oncology Nursing Society has set research on the late effects of treatment and survivors’ quality of life as a priority for 2005-2009. In an attempt to contribute to this discussion, this study aims to understand how parents and other family members of children and adolescents with cancer perceive and undergo the experience of ending treatment. We carried out a descriptive and exploratory study and adopted a qualitative methodological approach. Ten families were selected whose children completed cancer treatment and who agreed to participate in the study. Interviews at home, observation and patient files were used for data collection. Data were organized around three themes: the memory ─ what was experienced; the present ─ what is being experienced and the future ─ what will be. Describing the experiences of parents and other relatives of these children and adolescents at the end of cancer treatment allowed us to evidence the participants’ vitality in surviving treatment and the fragility of life after treatment ends. The study showed that parents and relatives started to recover the moment that diagnosis and treatment had interrupted and moved to restructure their lives, although cautiously. They projected a future for their lives with optimism, but permeated by fear and uncertainty. These study results allowed us to identify aspects in the families’ daily reality that need intervention, with a view to improving the quality of life of children, adolescents and the family itself when treatment ends.