Made available in DSpace on 2016-04-29T13:31:02Z (GMT). No. of bitstreams: 1 Karla Rampim Xavier.pdf: 941756 bytes, checksum: f41267099887014650ca6ad1a143509b (MD5) Previous issue date: 2013-06-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In psychoanalytic praxis the symptom is a concept widely worked which intervenes both in clinical practice and the politics of psychoanalysis, meanwhile it is a subject intrinsically linked to the social bond. The symptom is precisely the truth that makes disorder, it is opposition face to mastery discourse. In Freud s theory it seems not to be possible to formalize a symptom as social. However with Lacan such formalization is possible due to the thesis that it was Marx who invented the symptom. To enter this question was necessary to research what is symptom for Lacan, and thereafter ascertain the Lacanian references that trace direct connection between psychoanalysis and Marxist theory, as well as analysis of homology between surplus-jouissance and surplus-value. In this way that it is intended the understanding of Marx as inventor of the symptom. What we see is that a lot has been said about the social symptom, often without the necessary theoretical rigor, but for Lacan there is only a social symptom, "each individual is really a proletarian." But anyway, what does this mean? To conclude, we analyze how controversial and divergent this issue may be. Furthermore, we analyze how the theory of social symptom can be a resource for the psychoanalyst on the issues of bond and polis / Na práxis psicanalítica o sintoma é um conceito amplamente trabalhado e que intervém tanto na prática clínica quanto na política da psicanálise, ao mesmo tempo é um tema intrínsecamente ligado ao laço social. O sintoma é justamente a verdade que faz desordem, ele é oposição frente ao discurso de mestria. Para Freud não parece possível formalizar um sintoma como social, no entanto, com Lacan é possível tal formalização em decorrência da tese de que foi Marx quem inventou o sintoma. Para entrar nesta questão se fez necessário pesquisar o que é sintoma para Lacan, e a partir daí, averiguar as referências lacanianas que traçam conexão direta entre a psicanálise e a teoria marxiana, bem como a análise da homologia entre mais-de-gozar e mais-valia. É deste modo que se pretende a compreensão de Marx como inventor do sintoma. O que vemos é que muito se tem falado sobre o sintoma social, muitas vezes sem o rigor teórico necessário, mas para Lacan só há um sintoma social: cada indivíduo é realmente um proletário . Mas afinal, o que isso quer dizer? Para finalizar, analisamos o quão polêmico e divergente pode ser este tema. Além disso, consideramos o quanto a teoria de sintoma social pode ser um recurso para o psicanalista diante das questões do laço e da polis

This study is seen as a step towards addressing the acute shortage of psychometric instruments that can be validly and reliably used in the assessment of Zulu-speaking individuals. The Symptom Checklist-90-Revised (SCL-90-R) , a 90-item multidimensional self-report symptom inventory, was translated into Zulu. A multistage translation procedure, involving back-translation, decentering, and the committee approach was employed. The translated instrument was pretested on a group of Zulu farm workers (N = 12) and revisions made in order to improve its comprehensibility and acceptability to Zulu respondents. The psychometric equivalence of the Zulu and English versions of the SCL-90-R was investigated with bilingual Zulu students (N = 61) . Scale-level factor analysis yielded similar factor structures for both versions, and suggests that the Zulu SCL-90-R may be best utilised as a global measure of psychological distress. Scores at the scale- and item-level were reasonably comparable for the two language versions, although retest effects and apparent bilingual response sets suggest that the bilingual technique may not be a valid means of assessing translation equivalence. Acceptable test-retest reliability and internal consistency measures were obtained, indicating that the translation into Zulu did not adversely affect the reliability of the SCL-90-R. The concurrent validity of the Zulu SCL-90-R was investigated with samples of male psychiatric inpatients (N = 23) and nonpatients (N = 26). The global severity index of the SCL-90-R demonstrated moderate diagnostic efficiency, with a sensitivity of 70% and a specificity of 77%. These results suggest that the Zulu SCL-90-R may be validly utilised for the purpose of screening for mental illness. / Thesis (M.Soc.Sci.)-University of Natal, Pietermaritzburg, 1998.

Ottosson, B. & Skog, S. Åtgärder för att symtomlindra depression eller nedstämdhet hos äldre - en litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, institutionen för vårdvetenskap, 2020.Bakgrund: Många äldre lider av nedstämdhet, vilket kan vara ett tecken på depression. Det anses ofta inte som något att söka vård för då det till stor del räknas som en naturlig del av åldrandet. De symtom på nedstämdhet som ignoreras då är: ökad oro, känsla av hopplöshet, sömnsvårigheter, minskad aptit och viktminskning.Metod: En litteraturstudie med 10 kvantitativa artiklar, artiklarna delades in i fyra kategorier som de sedan presenterades genom. Nivån av symtom mättes med Geriatric depression scale (GDS).Syfte: Målet med den här litteraturstudien var att undersöka och beskriva åtgärder som kan användas för att lindra depressionssymtom eller nedstämdhet hos äldre.Resultat: Alla studier hade inte signifikanta sänkningar av GDS i slutet av studien men alla hade det under tiden studien pågick. Den minsta sänkningen av GDS var 4,34 % med minnesterapi (Wang 2005) och den högsta sänkningen var efter interventionen med konst då GDS minskade med 66 % (Ching-Teng M.fl. 2019).Konklusion: Det sammanfattade resultatet visade att alla interventioner gav bra resultat under tiden studien varade. Enligt de procentuella beräkningarna så var det konst (66 %), mindfulness (50,7 %) och Qi-Gong (41,3 %) som gav bäst resultat enligt GDS skalan.Nyckelbegrepp: Depressionssymtom, geriatrik, nedstämdhet, sjuksköterska, symtomlindring. / Ottosson, B. & Skog, S. Strategies to ease depression symptoms or blues in the elderly - a literature review. Degree project in nursing 15 Credits. Malmö University: Faculty of Health and Society, Department of Care Science), 2020.En litteraturstudie med 10 kvantitativa artiklar, artiklarna delades in i fyra kategorier som de sedan presenterades genom.Background: Many elderly people suffer from the blues, which can be a sign of depression. It is not often considered something to seek care for as it is largely regarded as a natural part of aging. The symptoms of depression that are then ignored are: increased anxiety, feelings of hopelessness, insomnia, decreased appetite and weight loss.Method: A literature review of 10 quantitative articles, the articles were selected into 4 different categories and then presented through these. Symptoms were measured with the geriatric depression scale (GDS).Aim: The main purpose of this literature study was to investigate and describe what measures that can be used to prevent or alleviate depression symptoms or the blues in the elderly.Results: All the studies did not have significant reductions of GDS at the end of the study but they all had it during the study. The smallest reduction of GDS was 4.34 % with reminiscence therapy (Wang 2005) and the highest decrease was after the intervention with art when GDS decreased by 66 % (Ching-Teng M.fl. 2019).Conclusion: The summarized results showed that all interventions produced good results during the study. According to the percentage calculations, art (66 %), mindfulness (50.7 %) and Qi-Gong (41.3 %) gave the best results according to the GDS scale.Keywords: Blues, depression symptom, geriatric, nurse, symptom relief.

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This thesis in the field of microdata analysis aims to introduce dose optimizing algorithms for the pharmacological management of Parkinson’s disease (PD). PD is a neurodegenerative disease that mostly affects the motor functions of the patients and it is characterized as a movement disorder. The core symptoms of PD are: bradykinesia, postural instability, rigidity, and tremor. There is no cure for PD and the use of levodopa to manage the core symptoms is considered the gold standard. However, long term use of levodopa causes reduced medication efficacy, and side effects, such as dyskinesia, which can also be attributed to overmedication. When that happens precise individualized dosing schedules are required. The goal of this thesis is to examine if algorithmic methods can be used to find dosing schedules that treat PD symptoms and minimize manifestation of side effects. Data from three different sources were used for that purpose: data from a clinical study in Uppsala University hospital in 2015, patient admission chart data from Uppsala University hospital during 2011-2015, and data from a clinical study in Gothenburg University during 2016-2017. The data were used to develop the methods and evaluate the performance of the proposed algorithms.The first algorithm that was developed was a sensor-based method that derives objective measurements (ratings) of PD motor states. The construction of the sensor index was based on subjective ratings of patients’ motor functions made by three movement disorder experts. This sensor-based method was used when deriving algorithmic dosing schedules. Afterwards, a method that uses medication information and ratings of the patients’ motor states to fit individual patient models was developed. This method uses mathematical optimization to individualize specific parameters of dose-effects models for levodopa intake, through minimizing the distance between motor state ratings and dose-effect curves. Finally, two different dose optimization algorithms were developed and evaluated, that had as input the individual patient models. The first algorithm was specific to continuous infusion of levodopa treatment, where the patient’s state was set to a specific target value and the algorithm made dosing adjustments to keep that patients motor functions on that state. The second algorithm concerned oral administration of microtables of levodopa. The ambition with this algorithm was that the suggested doses would find the right balance between treating the core symptoms of PD and, at the same time, minimizing the side effects of long term levodopa use, mainly dyskinesia. Motor state ratings for this study were obtained through the sensor index. Both algorithms followed a principle of deriving a morning dose and a maintenance dose for the patients, with maintenance dose being an infusion rate for the first algorithm, and oral administration doses at specific time points for the second algorithm.The results showed that the sensor-based index had good test-retest reliability, sensitivity to levodopa treatment, and ability to make predictions in unseen parts of the dataset. The dosing algorithm for continuous infusion of levodopa had a good ability to suggest an optimal infusion rating for the patients, but consistently suggested lower morning dose than what the treating personnel prescribed. The dosing algorithm for oral administration of levodopa showed great agreement with the treating personnel’s prescriptions, both in terms of morning and maintenance dose. Moreover, when evaluating the oral medication algorithm, it was clear that the sensor index ratings could be used for building patient specific models.

O objetivo foi realizar a adaptação transcultural do 12 item Allodynia Symptom Checklist para a população brasileira e testar a confiabilidade dessa versão, já que não havia nenhum questionário de avaliação da alodínia cutânea em migranosos, sintoma que tem sido apontado como sinalizador da sensibilização central e como fator de cronificação dessa doença. A adaptação transcultural foi realizada em seis estágios: tradução, síntese, retrotradução, revisão pelo comitê de especialistas na área, pré-teste e submissão dos documentos ao comitê de especialistas. No estágio do pré-teste, foram aplicados 30 questionários em migranosos de ambos os sexos, que relataram dificuldades de compreensão e, dessa maneira, uma segunda versão foi criada e aplicada em mais 30 sujeitos, para a qual não foram relatadas dificuldades adicionais. O tempo médio de preenchimento foi de 336 e a consistência interna foi considerada adequada demonstrando uma boa correlação entre os itens ( de Cronbach = 0,77). Para testar a confiabilidade, outros 30 sujeitos preencheram o questionário, em dois momentos, sendo que para 15 deles o questionário foi autoaplicável e para os outros 15 a avaliação foi feita no formato de entrevista. A confiabilidade foi classificada como moderada (kappa ponderado linear = 0,58) e excelente ( kappa ponderado linear =0,84) respectivamente. Portanto, foi possível através desse estudo, disponibilizar em língua portuguesa um questionário válido, confiável e de fácil aplicação para a avaliação da alodínia em migranosos da população brasileira. / Since there was no portuguese questionnaire to evaluate cutaneous allodynia in migraine population, which has been pointed out as a central sensibilization flag and as risk factor of migraine chronification we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its reliability. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest, and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no others difficulties being reported. The mean filling out time was 336and the internal consistency was considered adequate showing a good interrelation between items (Cronbachs = 0,77). To test reliability, 30 other subjects filled out the questionnaire at two different times, 15 of them in a self-report administration and 15 in a structured interview. It was classified as moderate (linear weighted kappa = 0.58) and as excellent (linear weighted kappa = 0.84) respectively. In this study, it was possible to make available in portuguese a valid, reliable and easy tool for cutaneous allodynia assessment in Brazil.

The Patient-Centred Assessment of Symptoms and Activities (P-CASA) is a new idiographic, open-ended assessment that examines each individual patient’s symptoms within the context of his or her daily life. P-CASA asks patients for their most important activities, what interferes with these activities, and any coping strategies. This thesis presents the rationale and design of P-CASA and its first validation study. Sixty patients at the Pain and Symptom Management/Palliative Care Clinic of the BC Cancer Agency (Vancouver Island Centre) completed P-CASA and the Edmonton Symptom Assessment System (ESAS), which is the current nomothetic assessment at the Clinic. The results demonstrated that P-CASA was not redundant with ESAS because it assessed (a) information about patients’ activities and coping strategies, which the ESAS does not; (b) all relevant cancer-related symptoms (not just pain or a fixed list); (c) co-occurring symptoms; (d) more specific details and different priorities about symptoms than in their ESAS. / Graduate

O objetivo foi realizar a adaptação transcultural do 12 item Allodynia Symptom Checklist para a população brasileira e testar a confiabilidade dessa versão, já que não havia nenhum questionário de avaliação da alodínia cutânea em migranosos, sintoma que tem sido apontado como sinalizador da sensibilização central e como fator de cronificação dessa doença. A adaptação transcultural foi realizada em seis estágios: tradução, síntese, retrotradução, revisão pelo comitê de especialistas na área, pré-teste e submissão dos documentos ao comitê de especialistas. No estágio do pré-teste, foram aplicados 30 questionários em migranosos de ambos os sexos, que relataram dificuldades de compreensão e, dessa maneira, uma segunda versão foi criada e aplicada em mais 30 sujeitos, para a qual não foram relatadas dificuldades adicionais. O tempo médio de preenchimento foi de 336 e a consistência interna foi considerada adequada demonstrando uma boa correlação entre os itens ( de Cronbach = 0,77). Para testar a confiabilidade, outros 30 sujeitos preencheram o questionário, em dois momentos, sendo que para 15 deles o questionário foi autoaplicável e para os outros 15 a avaliação foi feita no formato de entrevista. A confiabilidade foi classificada como moderada (kappa ponderado linear = 0,58) e excelente ( kappa ponderado linear =0,84) respectivamente. Portanto, foi possível através desse estudo, disponibilizar em língua portuguesa um questionário válido, confiável e de fácil aplicação para a avaliação da alodínia em migranosos da população brasileira. / Since there was no portuguese questionnaire to evaluate cutaneous allodynia in migraine population, which has been pointed out as a central sensibilization flag and as risk factor of migraine chronification we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its reliability. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest, and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no others difficulties being reported. The mean filling out time was 336and the internal consistency was considered adequate showing a good interrelation between items (Cronbachs = 0,77). To test reliability, 30 other subjects filled out the questionnaire at two different times, 15 of them in a self-report administration and 15 in a structured interview. It was classified as moderate (linear weighted kappa = 0.58) and as excellent (linear weighted kappa = 0.84) respectively. In this study, it was possible to make available in portuguese a valid, reliable and easy tool for cutaneous allodynia assessment in Brazil.

This thesis is about symptom-based troubleshooting of heavy vehicles. The existing troubleshooting system at Scania is adapted to handle errors based on electronic fault codes. This means that some faults, such as mechanical faults when sensors are missing, are difficult to troubleshoot. In the thesis, a method is developed that will be a part of a symptom-based troubleshooting system which can handle all types of errors. The main objectives of the thesis are both to develop a method that can link customer symptoms with system reactions and also to develop formats for both customer symptoms and FMEA for the developed method. In the thesis, a literature study was first conducted in which troubleshooting methods and principles for the formalization of customer data were identified. The identified troubleshooting methods were Bayesian Network, Case-Based-Reasoning and Fault tree analysis. A case study was then conducted which was based on several documents for troubleshooting in gas engines and gas tanks. In the case study, data from the literature study and the empirically collected data were used to develop the final concept of the method. The case study included, among other things, semi-structured interviews to map out the existing troubleshooting process, and a workshop to choose the final concept. In order to meet the objectives of the thesis two research questions and one question linked to the case study were formulated: Research Questions: • RQ1: How is the troubleshooting process affected by the methods that can be used to link customer symptoms with system reactions in heavy vehicles? • RQ2: How can customer data and FMEA be formalized in order to be useful in the troubleshooting process of heavy vehicles? Case Study: • What kind of data is missing from Scania’s existing documentation to link customer symptoms with system reactions? The thesis resulted in a method based on two troubleshooting methods Bayesian network and Case-Based-Reasoning. The method links customer symptoms with system reactions by excluding human considerations and instead relying on previously documented cases and probabilities. A requirement for using this method is a cooperation between customer support, mechanics and development engineers. The formalization of customer symptoms in the developed method is based on what good data is for mechanics in troubleshooting contexts and what customers are capable of communicating; deviation – the customer’s description of the vehicle’s unexpected condition, position – where the customer considers the deviation to be present, context – what happened before, during and after the deviation was discovered. The conclusions that can be drawn is that it is not necessary to link customer symptoms with system reactions since the developed method allows the customer symptoms to be linked directly to the corrective actions needed. In addition, it was noted that the existing documentation at Scania on customer symptoms and system reactions is insufficient. However, this is not problematic as it was shown that FMEA is redundant for the method developed. In order for customer data to be useful, the formalization should include deviation, position and context. Further conclusions are that the role of the customer support becomes less critical when data driven troubleshooting methods are used, and that the accuracy of the developed method will improve over time as more data will be collected. / Detta arbete behandlar symptombaserad felsökning av tunga fordon. Scanias befintliga felsökningssystem är anpassat för att hantera fel som grundas i elektroniska felkoder. Detta innebär att vissa typer av fel, såsom mekaniska fel när sensorer saknas, är svåra att felsöka. I detta arbete utvecklas en metod som ska ingå i ett symptombaserat felsökningssystem eftersom ett sådant system kan hantera alla typer av fel. Målen med arbetet är att utveckla en metod som kan sammankoppla kundsymptom med systemreaktioner, och utveckla format för kundsymptom och FMEA för den framtagna metoden. I arbetet utfördes först en litteraturstudie där felsökningsmetoder och principer för formaliseringen av kunddata identifierades. Felsökningsmetoderna som identifierades var Bayesiska nätvkerk, Case-Based-Reasoning och Felträdsanalys. Därefter utfördes en fallstudie som grundades på underlag om felsökning inom gasmotorer och gastankar. I fallstudien användes data från litteraturstudien och den empiriskt insamlade data för att utveckla det slutgiltiga konceptet. I fallstudien utfördes bland annat semistrukturerade intervjuer för att kartlägga den befintliga felsökningsprocessen, och en workshop för att kunna välja det slutgiltiga konceptet. För att kunna uppfylla arbetets mål formulerades två forskningsfrågor och en frågeställning kopplad till fallstudien: Forskningsfrågor: • F1: Hur påverkas felsökningsprocessen utifrån de metoder som kan användas för att sammankoppla kundsymptom med systemreaktioner inom tunga fordon? • F2: Hur kan kunddata och FMEA formaliseras för att vara användbara inom felsökningsprocessen av tunga fordon? Fallstudie: • Vilken data saknas i Scanias befintliga dokumentation för att kunna sammankoppla kundsymptom med systemreaktioner? Arbetet resulterade i en metod som baseras på de två felsökningsmetoderna Bayesiska nätverk och Case-Based-Reasoning. Metoden sammankopplar kundsymptom med systemreaktioner genom att exkludera mänskligt avvägande och istället förlita sig på tidigare dokumenterade fall och sannolikhet. En förutsättning för att metoden ska kunna användas är ett samarbete mellan kundmottagare, mekaniker och utvecklingsingenjörer. Formaliseringen av kundsymptom i den framtagna metoden bygger på vad bra data är för mekaniker i felsökningssammanhang och vad kunderna är kapabla att förmedla; avvikelse – kundens beskrivning av fordonets oväntade tillstånd, position – var anser kunden att avvikelsen förekommer, kontext – vad hände innan, under och efter att avvikelsen upptäcktes. Slutsatserna som kan dras utifrån arbetet är att det inte är nödvändigt att sammankoppla kundsymptom med systemreaktioner, utan kundsymptom kan sammankopplas direkt med åtgärder med den framtagna metoden. Dessutom noterades det att den befintliga dokumentationen hos Scania angående kundsymptom och systemreaktioner är bristfällig. Detta är inte problematiskt då det påvisades att FMEA inte är nödvändig för att metoden ska fungera. För att kunddata ska vara användbart bör formaliseringen ske med avvikelse, position och kontext. Ytterligare slutsatser är att kundmottagarrollen blir mindre kritisk när datadrivna felsökningsmetoder används, och att den framtagna metodens träffsäkerhet kommer att förbättras över tid allt eftersom mer data har samlats in.

Syftet med denna studie var att undersöka om det finns naturligt förekommande kombinationer av copingstrategier i ungdomsåren.Vårt andra mål med studien var att utröna om dessa olika kombinationer av copingstrategier är relaterade till ungdomars grad av depression, självkänsla och somatiska symptom. Med färdiginsamlad data från Youth & Sports Project, Örebro Universitet utfördes studien. Vårt urval bestod av 638 ungdomar boende i Sverige (Målder = 14.09, SD = 0.39; åldersspann: 13-17; 46 % flickor). Med klusteranalys fann vi 5 distinkta kluster innehållande olika nivåer av de tre copingstrategier, problemlösande coping, internaliserande coping och externaliserande coping som vi har med i denna studie. Våra resultat visar att olika kluster och nivåer av studiens copingstrategier har en inverkan på den enskildes grad av depression, självkänsla och somatiska symptom. Att identifiera kluster av copingstrategier kommer ge bättre förutsättningar att nå ungdomar som behöver stöttning under ungdomsåren in i vuxenlivet. / The aim of this study is to examine if there are naturally occurring combinations of coping strategies in adolescence. The second goal with the study was to find out if these different combinations of coping strategies are related to young people's degree of depression, self-esteem and somatic symptoms. With pre-collected data from Youth & Sports Project, Örebro University, we conducted the study. Our sample included 638 adolescence living in Sweden (Mage = 14.09, SD = 0.39; age range: 13-17; 46 % girls). With cluster analysis we found 5 distinctive cluster with different levels of our three coping strategies that our study investigated, problemsolving coping, internalizing coping and externalizing coping. Our result show that different cluster and levels of the studies coping strategies have an impact on the individual's degree of depression, self-esteem and somatic symptoms. Identifying clusters of coping strategies will provide better conditions for reaching young people who need support during adolescence into adulthood.