Research among ministers showed that they are experiencing high levels of stress due to career demands and having to cope with problems on their own (Grosch & Olsen, 2000:260). This has a detrimental effect on their health (Andrew, 1997:SO). Participation in physical activity have positive effects on the physical and psychological well being. Physical activity decrease work stress and increase work satisfaction and -stamina (Dreyer & Strydom, 1992:28). The objectives of this study was to determine the profiles of physical activity participation and the incidence of stress symptoms in relation to congregation type and congregation size in ministers, as well as the influence of physical activity on the relationship between stress symptoms and congregation demography (type and size). Congregation demography was divided into congregation type (location) as well as congregation size (number of church members). In this study a single cross sectional design that has been based on an availability profile has been used. The subjects were 340 ministers of the Dutch Reformed Church, who volunteered to participate in the study. The quality of participation in physical activity was determined with Sharkey's (1997:432) physical activity index The incidence of stress symptoms was determined with Burn's (1988) stress index and the congregation demography was determined by a self-reported questionnaire. The data was analysed by means of a one-way analysis of variance. From the data it is clear that the majority of the respondents were physically inactive and have a low incidence of stress symptoms in relation to congregation demography. The results of the stress symptoms may be attributed to the fact that religion and belief in God may play a vital role in the management of stress. Physical activity participation indicated a statistical significant (p≤0.05) influence on the relationship between stress symptoms and congregation demography. A highly practical significant difference (ES≥0.8) existed between high active and low active ministers working in congregations in rural areas. Physical activity participation also showed a moderate practical significant influence (ES≥0.5) on the relationship between stress symptoms and congregation demography (type and size). It was concluded that physical activity presented a salutogenic effect on psychological well-being among ministers and that congregation demography can influence physical and psycho-emotional health threats of Dutch Reformed ministers. / Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2005.

Information technologies are making their way into health care. While they have been primarily in the domain of the health care providers, applications are being created for use by patients. This qualitative study looks at the usability of an electronic tool with a broader view of patient-as-user; the research question asks how this tool stands up to an assessment of the tool’s usability. Usability seeks to find out how easy a system is to use, whether the system is acceptable, and whether the system is enjoyable to use. Qualitative description techniques were employed for a broader perspective on the usability results. Key findings indicate that patients need to be in control of the process of using self-reporting tools; patients want to be able to use these applications at home; computer technologies do not replace the need for human contact in the health care setting; self-reporting assessment tools can give a voice to patients who are otherwise silent; privacy concerns must be handled. Few studies have attempted to look at patients as they use electronic applications, but if we want patients to use them, tools need to be designed with the patient-as-user in mind, considering diverse levels of functioning among patients.

No description available.

Objectives. To study medication utilization and adherence to prescribed therapy in a female population in central Sweden. To study usage of hormone replacement therapy (HRT) in this population and to assess how HRT users compare to non-users regarding symptom reporting, general health and other variables. To evaluate symptom prevalence adjusted for potential symptom affecting variables. Material and methods. A cross-sectional postal questionnaire study was performed in 1995 in seven counties in central Sweden. A questionnaire was sent to a random sample of 4,200 women aged 35-64, of whom 2,991 responded (71.2%). The questionnaire contained questions on psycho-socio-economic background, quality of life, self-reported health, height and weight, climacteric symptom prevalence, and menopausal status and symptoms. It also comprised questions on medication prescribed during the past year. Results. 40% used prescribed medication and 12% took four drugs or more. Age, educational level, self-rated health, and BMI remained significantly correlated to drug use in multivariate analysis. Adherence ranged from 15%-98% depending on age, a scheduled check-up, perceived importance of medication, concern about medication, taking cardiovascular and respiratory disease drugs. The highest adherence was found for hormonal medication the lowest for musculoskeletal medication. HRT was used by 15% of the women. 13 % used other symptom relieving therapy. HRT users reported higher score of vasomotor symptoms, except for sweating during the daytime. Prevalence of general symptoms did not necessarily increase with age. Especially symptoms related to stress-tension-depression decreased with age. Four different symptom prevalence patterns were found. Conclusions. Age, health status, educational level and body mass index (BMI) appear to affect drug use. Adherence to therapy is highest among elderly women who regard their medication as important and have a scheduled check-up. HRT relieves some vasomotor symptoms but does not affect other symptoms or self-rated health. Prevalence of symptoms related to Stress-tension-depression appears to decrease with age.

Background: Headache is common in the elderly. Cervical degenerative changes are universal with ageing and cervicogenic headache is proposed (albeit without evidence) as a frequent cause of headache in this age group. Previous research identified a pattern of cervical musculoskeletal impairment which differentiated cervicogenic headache from other frequent headaches but this study was undertaken on younger/middle aged individuals. The value of this diagnostic pattern could be questioned for an older population with concomitant age related changes in the musculoskeletal system. The first and foremost aim of this research was to determine if cervical musculoskeletal impairment was specific to headaches classifiable as cervicogenic or was more generic to headache in elders. Participants with headache were sub-grouped on the basis of the pattern of cervical musculoskeletal impairment and the relationship between this grouping and headache classification was investigated. The presence of sensory hypersensitivity and psychological distress are features of headache that can provide information on the underlying mechanisms and provide management directives for headache. There is little knowledge of whether or not these features are influenced by a factor of age. Thus the second and third aims of this research were to investigate sensory features and psychological and quality of life features in the elderly with headache. Methods: One hundred and eighteen subjects, aged 60 to 75 years with recurrent headache and 44 controls were studied. Ninety-three reported a single headache and 25, two or more headache types. All subjects completed the Neck Disability Index (NDI), Geriatric Depression Scale-short form (GDS-S) and SF-36 questionnaires. Subjects with headache also completed a headache questionnaire and the Survey of Pain Attitudes (SOPA-35). Neck function measures included range of motion, manual examination of cervical segments, cranio-cervical flexor muscle function, joint position sense, cervical muscle strength, cross-sectional area of selected cervical extensors and posture. Sensory measures included pressure pain thresholds (PPTs) and thermal pain thresholds (TPTs). PPTs were measured over the forehead, upper neck and at a remote site (tibialis anterior). TPTs were measured over the upper neck. Results: Cluster analysis, based on the three musculoskeletal variables aligned previously with cervicogenic headache, divided headache subjects into two groups; cluster 1 (n = 57), cluster 2 (n = 50). There was significantly reduced cervical extension, axial rotation, rotation in neck flexion and lateral flexion in the headache clusters than the control group, and in the frequency of symptomatic joint dysfunction (C0-1 – C7-T1) (all p < 0.05). Subjects in cluster 1 had significantly reduced range of cervical extension and axial rotation and frequency of symptomatic joint dysfunction (C1-2 and C7-T1) compared to those in cluster 2 and controls (all p < 0.05). More subjects in cluster 1 had headaches ≥ 15 days per month and histories of head/neck trauma (both p < 0.05). Most cervicogenic headaches were grouped in cluster 1, but musculoskeletal dysfunction was also found in headaches classifiable as migraine or tension-type headache. The analysis of subjects with single headaches revealed no significant differences between the headache groups (migraine, tension-type, cervicogenic and unclassifiable headaches) and controls in pressure and cold pain thresholds (all p > 0.05). Heat pain thresholds were significantly lower in the headache groups compared to controls (all p < 0.01) but there were no differences between headache types (all p > 0.05). There were no strong relationships between any headache variable and pain thresholds. Elders with headache scored lower on most SF-36 domains, higher on the GDS-S (p < 0.05) and comparably on the SOPA-35 (p > 0.05) compared to the control group. The GDS score was below the threshold value for depression. Differences in these measures were not dependent on the headache types but rather, headache frequency. Subjects with headaches ≥ 15 days/month scored lowest on SF-36 domains and highest on GDS-S questionnaire compared to those with headache < 15 days/month and controls (all p < 0.05). The mean NDI score in the subjects with headache indicated the presence of mild to moderate neck pain and disability. No strong relationships were found between well-being and headache frequency, intensity and length of headache history. The NDI score had the greatest influence on physical well-being and GDS-S score on mental well-being (p < 0.001). Conclusions: Several aspects of cervical musculoskeletal function, heat thresholds, general well being and quality of life were altered in elders with headache. Neck dysfunction was not uniquely confined to cervicogenic headache but was a generic feature of headache in the elderly. No generalized changes in pain sensitivity were present in elders with headache. Headache had a significant impact on elders’ quality of life but was not associated with depression. Neck pain was an important factor influencing function and well-being. Conservative management such as physiotherapy may be a safe and appropriate option for elders with headache, given its frequent association with cervical musculoskeletal impairment. Further research is required for a better understanding of the neck’s role in elders’ headache.

Bakgrund: Hjärtsvikt är idag en av våra folksjukdomar och tros öka i framtiden. Det är ett kroniskt tillstånd som karaktäriseras av flera olika symtom så som dyspné och andfåddhet. Den vanligaste orsaken till hjärtsvikt är ischemisk hjärtsjukdom som utgör 50-75% av all hjärtsvikt. New York Heart Association Functional Classification är en funktionsklassificering som är baserat på patientens egna upplevelser av sjukdomen och är graderad från I-IV. Att lida av en kronisk sjukdom kan innebära flera olika former av lidande som till exempel sjukdoms-, livs- och vårdlidande. Syfte: Att beskriva patienters upplevelser av hur hjärtsvikt och dess symtom påverkar det dagliga livet. Metod: Litteraturbaserad studie som är grundad på elva vetenskapliga artiklar. Resultat: Hjärtsvikt påverkar hela människan både psykiskt och fysiskt i det dagliga livet. Livet blir begränsat på grund av de somatiska symtomen där även emotionella svårigheter blir tydliga. Att inte längre kunna utföra dagliga rutiner och delta i aktiviteter leder till en känsla av isolering och försämrad livskvalité. Slutsats: Hjärtsvikt har en tydlig påverkan i patientens dagliga liv där kroppen konstant är under förändring. Detta leder till en okänd upplevelse där framtiden för patienten är oförutsägbar. Hjärtsvikt är ett tillstånd där hela människan bör beaktas för att kunna lindra lidande. / Background: Heart failure is currently one of the major diseases and is believed to increase in the future. It is a chronic condition characterized by multiple symptoms such as dyspnea and shortness of breath. The most common cause of heart failure are ischemic heart disease, which constitutes 50-75% of all heart failure. New York Heart Association Functional Classification is a classification function which is based on the patient's own experience of the disease and are graded from I to IV. A chronic disease can cause suffering of disease, suffering of life and suffering of care. Aim: To describe patients' experiences of how heart failure and its symptoms affect daily life. Method: A literature-based study, in which the result is based on eleven scientific articles. Results: Heart failure affects the whole person, both mentally and physically in daily life. Life becomes limited because of the somatic symptoms and emotional difficulties is also known. The feeling of isolation becomes evident when the patient cannot participate in activities. Quality of life deteriorates when the daily routines can no longer be performed. Conclusion: Heart failure has a clear impact in the patient's daily life in which the body is constantly changing. This leads to an unknown experience where the future is unpredictable. Heart failure is a condition where the whole person should be considered in order to alleviate suffering.

This research aims to study perversion, approaching it as a social symptom. It integrates the line of research called Health, Clinic and Psychological Practices, understanding the clinic as a field of investigation through which it is possible to have access to the current social phenomena and discourse. This dissertation is composed by works with texts, in which we make explicit different forms of reading, and the texts are taken as objects of study. We carry a discussion about concepts related to the position of the author and the reader, reading, translation, interpretation and deconstruction. We work with research in psychoanalysis using a close and deconstructive reading strategy, based on the perspective that the meanings are built through the reading, in relation to, and dialoging with the text itself and with other readings. We discuss the social symptom concept, exposing how it is approached by different authors, aiming to connect it to perversion. We also register the associations made with texts by important authors in the field of psychoanalysis and in the approach of perversion. We opted to work, fundamentally, with two authors – Sigmund Freud and Charles Melman – who, coming from the psychoanalytical clinic, approach perversion in different ways. We did a deconstructive reading of the Three Essays on the Theory of Sexuality (1905) by Freud; and of the Man Without Gravity (2003), by Melman. / Esta pesquisa tem como objetivo o estudo da perversão, abordando-a como sintoma social. Insere-se na linha de pesquisa intitulada Saúde, Clínica e Práticas Psicológicas, compreendendo a clínica como um campo de investigação através do qual é possível ter acesso aos fenômenos sociais e aos discursos que circulam em determinada época. Esta dissertação é composta de trabalhos com textos, sendo explicitadas as modalidades de leitura utilizadas, de modo que os textos são tomados como objeto de estudo. É realizada uma discussão acerca de questões relacionadas à posição do autor e do leitor no texto, à leitura, releitura, tradução, interpretação e desconstrução. Trabalha-se com a pesquisa em psicanálise, utilizando uma estratégia de leitura próxima e desconstrutiva, partindo da perspectiva de que os sentidos são construídos a partir da leitura, em relação e diálogo com o próprio texto e com outras leituras. Foi discutido o conceito de sintoma social, explicitando como este é abordado por autores diferentes, no intuito de fazer uma leitura acerca de como este se relaciona à perversão. Foram registradas também as associações feitas com textos de autores importantes no campo da psicanálise e na abordagem da perversão. Optou-se por trabalhar, fundamentalmente, com dois autores – Sigmund Freud e Charles Melman – que, partindo da clínica psicanalítica, abordam a perversão de formas diferentes. Foi realizada uma leitura desconstrutiva dos Três ensaios sobre a teoria da sexualidade (1905), de Freud; e de O homem sem gravidade: gozar a qualquer preço (2003), de Melman.

O corpo não é feito de, apenas, carne e osso. Por muito tempo condenado ao exílio, o corpo retorna à cena, não mais sob o enfoque estritamente biológico, sendo, pois, considerado como materialidade significante e discursiva. Tecido pela linguagem, o corpo passa a ser lido como texto, sujeito à interpretação. Com base nisso, nesta tese, (a)bordamos o corpo a partir de nossa inscrição no aporte teórico forjado por Pêcheux, a Análise do Discurso, e sua (im)possível relação com a Psicanálise freudo-lacaniana e com a Filosofia Trágica proposta por Nietzsche. Lançamos nosso olhar sobre o corpo doente das anoréxicas que, inscritas em blogs do gênero Pró-Ana, nos permitem visualizar o entrelaçamento entre corpo, sintoma e cultura. Ou melhor, o corpo que, ocupando lugar numa determinada sociedade – capitalista, em rede e do espetáculo – se mostra e é mostrado pela falha, pela falta, pelo equívoco, que acabam se desdobrando em resistência. Tendo como arquivo recortes discursivos oriundos do espaço virtual, tomamos o corpo como materialidade do sujeito e analisamos os processos de interpelação e de identificação pela ideologia, pelo inconsciente e também pela cultura. Mais do que descrever tais processos, buscamos interpretá-los, de modo a expor ao leitor a opacidade de enunciados que materializam formas de o sujeito ocupar lugar no tempo e no espaço a partir de sua inscrição em distintas formações discursivas, que (re)velam diferentes maneiras de conformação da subjetividade. De “Ana a santa” a “porca louca” ou “borboleta”, a anoréxica, na atualidade, faz ver a relação paradoxal e, portanto, contraditória que se estabelece quando de sua tomada de posição no que chamamos de não-lugar ou lugar de entremeio. Tendo presente o corpo que fal(t)a e (trans)borda, a partir dos desdobramentos entre o estatuto da discursividade e os registros imaginário, simbólico e real, propomos que o corpo seja compreendido como escritura, ou seja, como lugar de memória, como lugar de inscrição, lugar a partir do qual o sujeito resiste às formas de dominação, mesmo que por meio de um corpo feito de, apenas, “couro e osso”. / The body is not made only of flesh and bone. For a long time condemned to exile, the body returns to the scene, but no longer under a strictly biological approach, and is therefore considered as a significant and discursive materiality. Woven by language, the body starts being read as text, open to interpretation. Based on this, in this thesis, we approach the body from our inscription in the theoretical contribution forged by Pêcheux, Discourse Analysis, and its (im)possible relation with the Freudo-Lacanian Psychoanalysis and with the Tragic Philosophy proposed by Nietzsche. We launch our look at the sick body of the anorexic ones that, inscribed in Pro-Ana blogs, allow us to visualize the interlacing of body, symptom and culture. Or rather, the body that, occupying a place in a certain society - capitalist, in network and spectacle – shows and is shown by failure, by lack, by equivocation, that end up unfolding in resistance. Having as a file discursive cuts from the virtual space, we take the body as materiality of the subject and analyze the processes of interpellation and identification by ideology, by the unconscious and also by culture. Rather than describing such processes, we seek to interpret them in order to expose the reader to the opacity of statements that materialize forms of the subject occupying place in time and space from its inscription in different discursive formations that reveal different ways of subjectivity conformation. From “Ana the saint” to “crazy pig” or “butterfly”, the anorexic nowadays shows the paradoxical and therefore contradictory relation that is established when its position is set in what we call non-place or place of in-between. Bearing in mind the body that lacks and bursts, from the unfolding between the statute of discursiveness and the imaginary, symbolic and real registers, we propose that the body be understood as writing, that is, as a place of memory, as a place of inscription, a place from which the subject resists forms of domination, even if through a “bag of bones” body.

Na pesquisa desenvolvemos um percurso por Bertolt Brecht na especificidade do seu exílio. Objetivamos traçar relações entre sua posição de exilado e as camadas do pensamento brechtiano verificado por Fredric Jameson (2013), no livro Brecht e a questão de método. A constituição do exílio de Brecht é entendida como um deslocamento, dentro do estado de exceção, de uma situação de exílio para uma posição de exílio (DIDI-HUBERMAN, 2008) que, entre diferentes características, evidencia a própria exceção (AGAMBEN, 2004). Ao final do percurso, trabalhamos, a partir de autores da psicanálise e do pensamento utópico, com a hipótese de que Brecht fez de sua situação de exílio um sintoma. / In this research, a path was developed for Bertolt Brecht specifics of his exile. The main focus was to draw relations between his position as an exiled person and the layers of brechtian thoughts verified by Fredric Jameson (2013), in the book Brecht method. The nature of Brecht's exile is understood as a displacement, within a state of exception, of an exile situation to a position of exile (DIDI-HUBERMAN, 2008) in which, among different characteristics, Brecht puts in evidence himself his own exception (AGAMBEN, 2004). At the end, psychoanalyst authors and utopian thinkers were used, bearing in mind the hypothesis that Brecht made a symptom out of his exile situation. / En la pesquisa desarrollamos un recorrido por Bertolt Brecht en la especialidad del su exilio. Objetivamente trazar relaciones entre su posición de exilado y las capas del pensamiento brechtiano verificado por Fredric Jameson (2013), en el libro Brecht y el Método. La constitución del exilio de Brecht es entendida como un desplazamiento, dentro del estado de excepción, de una situación del exilio para una posición de exilio (DIDI-HUBERMAN, 2008) que, entre distintas características, evidencia la propia excepción (AGAMBEN, 2004). Al fin del recurrido producimos, a partir de autores de la psicoanálisis y del pensamiento utópico, con la hipótesis de que Brecht hizo de su situación de exilio un síntoma.

Submitted by Oliveira Santos Dilzaná (dilznana@yahoo.com.br) on 2016-04-29T17:36:32Z No. of bitstreams: 1 Dissertação de Sheyla Santana Machado.pdf: 828557 bytes, checksum: e4d1e6aef4209fbe443ec38d1e5f7109 (MD5) / Approved for entry into archive by Ana Portela (anapoli@ufba.br) on 2016-04-29T19:52:28Z (GMT) No. of bitstreams: 1 Dissertação de Sheyla Santana Machado.pdf: 828557 bytes, checksum: e4d1e6aef4209fbe443ec38d1e5f7109 (MD5) / Made available in DSpace on 2016-04-29T19:52:28Z (GMT). No. of bitstreams: 1 Dissertação de Sheyla Santana Machado.pdf: 828557 bytes, checksum: e4d1e6aef4209fbe443ec38d1e5f7109 (MD5) / A experiência clínica com sujeitos adolescentes desvela dois fenômenos que frequentemente caracterizam a passagem da infância à idade adulta: a dificuldade do desligamento da autoridade parental e o surgimento de manifestações sintomáticas que privilegiam o agir. Essa pesquisa tem como objetivo geral examinar, na perspectiva psicanalítica, o processo de desligamento da autoridade parental e os impasses frente à lei, articulando-os às manifestações sintomáticas que estes sujeitos apresentam, em particular, no que se refere à assunção da responsabilidade frente ao gozo e ao desejo. Este objetivo se desdobra em três passos intermediários: identificar o processo de desligamento parental de sujeitos adolescentes, tomando em consideração as noções de desejo e gozo; analisar o tratamento dado pela psicanálise à responsabilidade pelo gozo nas manifestações sintomáticas, considerando a questão do desligamento da autoridade parental; identificar as relações do sujeito adolescente com o gozo, enfocando suas modalidades de acordo com a teoria de Jacques Lacan. O método utilizado é a construção do caso clínico no qual o saber produzido numa análise é metaforizado em formulações teóricas, tendo como efeito uma atualização dos conceitos estabelecidos, no sentido da produção de novas abordagens e tratamento do tema investigado. Nesta pesquisa, foram selecionados fragmentos clínicos de dois sujeitos adolescentes cujas manifestações sintomáticas (depressão e bullying) acarretaram prejuízos importantes na possibilidade de inscrever-se no laço social e atender às exigências da vida. Essa pesquisa se justifica no sentido de ampliar a visão sobre a subjetividade na adolescência e, deste modo, fornecer subsídios adicionais àqueles que lidam com adolescentes em suas práticas profissionais cotidianas. Sua relevância se centra na contribuição que poderá oferecer ao debate atual em torno da extensão da adolescência. Na discussão dos casos, chegou-se à conclusão de que as manifestações sintomáticas representam, no sujeito adolescente, um primeiro tempo de elaboração do encontro com o real do sexo sob a égide do supereu, como representante paterno. Nesse processo, a autoridade parental vem a ser substituída pela autoridade dos significantes singulares do sujeito. Além disso, verificou-se que o trabalho significante responde pela transformação do sintoma, sendo que todas as fases que o sintoma atravessa implicam uma forma particular de responsabilidade em relação ao gozo e, portanto, de inscrição no laço social. Finalmente, foi possível confirmar a importância da oferta de um espaço de fala que permita aos sujeitos adolescentes fazer face ao real do sexo e da morte, bem como assumir a responsabilidade pelo próprio destino. The clinical experience with teenager subjects unveils two phenomena that currently characterize the passage from childhood to adulthood: the difficulty of detachment from parental authority and the emergence of symptomatic manifestations which privilege the act. This research has as general objective to examine, at a psychoanalytic perspective, the detachment process from parental authority and the impasses facing the law, linking them to the symptomatic manifestations that these subjects present, in particular, with regard to the assumption of the responsibility facing the jouissance and the desire. This objective unfolds in three intermediate steps: identify the parental detachment process of adolescent subjects, taking into consideration the notions of desire and jouissance; analyse the treatment given by the psychoanalysis to the responsibility for the jouissance in the symptomatic manifestations, taking in account the issue of the detachment of parental authority; identify the relationship of the adolescent subject with jouissance, focusing on its modalities in accordance with the theory of Jacques Lacan. The method used is the construction of clinical case, in which the knowledge produced in an analysis is methaphorized in theoretical formulations, having the effect of a refresh of the established concepts, towards the production of new approaches and treatment of the investigated theme. In this research, we selected clinic fragments of two teenager subjects, whose symptomatic manifestations (depression and bullying) led to important prejudices in the ability to inscribe themselves in the social bond and meet the demands of life. This research intent is to enlarge the vision about the subjectivity in adolescence and provide additional subsidies to those who deal with adolescents in their everyday professional practices. Its relevance is focused on the contribution that can offer the current debate around the extension of adolescence. In the discussion of the cases, it was concluded that symptomatic manifestations represent, on the adolescent subject, a first time of preparation of the encounter with the real of sex under the aegis of the superego, as paternal representative. In this process, the parental authority is replaced by the authority of the subject‟s singular signifiers. in addition, it was found that work on signifiers is responsible for the transformation of the symptom, and all stages that the symptom crosses, involve a particular form of responsibility with regard to the jouissance and, therefore, of inscription in the social bond. Finally, it was possible to confirm the importance of offering to teenager subjects a talking space that allows them to face with the real of sex and death, as well as take responsibility for their own fate.