Estudo sobre o insight em pessoas com psicose

Para além das variáveis clínicas e sociodemográficas existem concerteza importantes componentes individuais que desempenham um contributo importante no nível de insight apresentado por cada pessoa doente, por exemplo, o nível de inteligência, personalidade, cultura, experiências passadas, memória, etc. A natureza clínica, emocional e/ou intelectual do termo ajuda-nos a compreender a complexidade da dificuldade que existe na sua tradução e, inclusive, na sua compreensão. Daí que as definições atribuídas ao conceito sejam muito distintas e variem consoante a formação teórica do autor/investigador. Pretende-se, a partir dessa identificação/compreensão, promover a qualidade de vida destas pessoas através do desenvolvimento de novas aprendizagens que possibilitem uma cooperação activa. É igualmente fundamental ir ao encontro das capacidade intactas de maneira a possibilitar a aquisição de novos(s) comportamento(s) que tenham um impacte positivo nas queixas, sinais, sintomas, incapacidade e disfuncionalidade apresentados pelo/a utente. Uma vez que a própria conceptualização do termo traduzirá aquilo que se pretende avaliar,será efectuada uma reflexão detalhada acerca dos instrumentos e definições que têm sido mais utilizadas para explorar o insight nas psicoses.Procurei, no meu trabalho de investigação, realçar e promover a importância que cada sujeito, alvo de intervenção, desempenha ao longo do seu processo de recuperação e na prevenção de recaídas. No seguimento dos objectivos acima descritos, para além da revisão teórica efectuada ao fenómeno em termos de conceptualização e estudos desenvolvidos na área de investigação, foi,neste estudo, realizada a contribuição para a validação do instrumento “Assessment of Insight in Psychosis: a re-standartization of a New Scale” de Marková & Berrios (2003).O fenómeno de insight escolhido pela Insight Scale, relata menos as mudanças vividas em relação à doença mental, e mais a actual consciência e articulação de tais mudanças. Tendo como base uma abordagem psicopedagógica, o fenómeno do insight aqui explorado assentou numa perspectiva reabilitativa, actual e multidimensional, que fosse para além das dimensões clínicas tradicionais. Neste sentido é apresentada uma escala original, intitulada “Escala de Avaliação do Insight e Identificação das Necessidades em Pessoas com Psicose”, bem como um modelo de intervenção psicopedagógico breve, assente nos pressupostos descritos ao longo do trabalho.-----------------------------------------ABSTRACT: The importance of insight in people with mental illnesses was first studied in psychiatry, in the first decades of the 20th century, by people as important as Lewis (1934) and Jaspers (1959). However, this field of investigation was left unexplored for many years. Only in the last decade has this phenomenon become the object of numerous scientific investigations, having been given special attention by its investigators. For this reason a significant number of instruments for evalauting insight in psychotic disorders were developed. Since then many papers have been published, which has allowed for a more in depth knowledge on the subject. Therefore, in recent years, the concept of insight has been developed in an attempt to clarify its compexity. A once dichotomic phenomenon, described in terms of presence or absence, became considered multidimensional, which made the identification of different levels of insight and different dimensions possible. Current concepts categorize insight into five dimensions: the awareness of the patient in relation to his/her mental illness, the awareness of the patient in relation to the social consequences of his/her illness, the awareness of the need for treatment, the awareness of the symptoms and the explanation of those symptoms in relation to the illness. The lack of insight in psychiatry, in general terms, and as this phenomenon has been described, the lack of awareness of having a mental illness, represents one of the most common symptoms of schizophrenia and affects a big part of the population that suffer from this illness. It is estimated that bewteen 50 and 80 per cent of patients with schizophrenia do not believe that they are ill, which, consequently has a big impact in the process of adherence to treatment. It is still not possible, however, to identify all the factors that determine the lack of insight in schizophrenics. There are psychological, social and cultural influences that almost certainly play their role in the lack of insight registered in this pathology.Since the impact of scizophrenia is felt in many aspects of the individual’s life, its effective treatment should be directed at various levels, including the improvement of insight. One of the objectives of this study is to explore the relationship between the level of insight in psychosis and the clinical and sociodemographic variables, the psychopathology and its global functioning. As well as the clinical and sociodemographic variables, there are of course important individual components that contribute to the level of insight seen in each patient, for example, their level of inteligence, personality, culture, past experiences, memory, etc. The clinical, emotional and/or intelectual nature of the term helps us understand the difficulty that lies in its interpretation as well as in its comprehension. Therefore, the definitions attributed to the term are very different and vary according to the theoretical training of the investigator. It is intended, from this identification/understanding, to promote the quality of life of these people through the development of new findings that might enable an active cooperation. It is equally fundamental to observe their unimpaired capacities in order to enable the acquisition of new behaviour(s) that have a positive impact on the complaints, signs, symptoms, incapacity and disfunctioning seen in the patient.As the actual comprehension of the term explains what we intend to evaluate, a detailed reflection is made on the instruments and definitions that have been used the most to explore insight in psychosis.In this investigation I tried to underline and promote the importance that each subject, undergoing medical intervention, plays during his/her process of recovery and prevention of relapses. Considering the above mentioned objectives, as well as a theoretical review of the phenomenon in terms of conceptualization and investigative studies developed, this study contributed to the validation of the instrument.The insight phenomenon chosen by the “Insight Scale”, records less changes experienced in relation to the mental illness and more actual awareness and articulation of these changes. Based on a psychopedagogical approach, the insight phenomenon explored here settled on a rehabilitation, current and multidimensional perspective that would go beyond the traditional clinical dimensions. For this reason an original scale entitled “Insight Evaluation Scale and Need Identification in Psychosis Patients” is presented, as well as a psychopedagogical intervention model soon to be used with admitted patients based on the presuppositions described in this study.

Precious transition metals: the importance of Zn2+, Mn2+ and Cu2+ in the human pathogen Enterococcus faecalis

Dissertation presented to obtain the Ph.D degree in Biology

Contribuição para o estudo da ocorrência da interrupção voluntária da gravidez em Portugal continental (1993 a 1997) : estimativas utilizando dados da rede de médicos sentinela e dos diagnósticos das altas hospitalares (grupos de diagnósticos homogéneos)

RESUMO - Apesar de existir em Portugal alguma informação sobre a epidemiologia da interrupção voluntária da gravidez (IVG), parece importante aumentar o conhecimento sobre este tema, complementando os estudos de base populacional disponíveis. O objectivo deste trabalho foi estimar a incidência de IVG na população feminina de Portugal continental com idade entre os 15 e os 44 anos entre os anos de 1993 a 1997. Utilizaram-se para tal dados gerados por dois sistemas de informação: o sistema de vigilância epidemiológica «Médicos Sentinela» e o sistema de informação de rotina baseado nos diagnósticos de alta hospitalar (grupos de diagnósticos homogéneos). Os resultados sugerem que no período em estudo terão ocorrido, em média, 3861,4 IVG/100 000 mulheres/ano, valor que terá sido mais elevado no grupo etário dos 25 aos 34 anos (5472,1 casos/100 000 mulheres/ano), enquanto o número de IVG por 1000 nados-vivos parece ter sido mais elevado entre os 35 e os 44 anos (2810,5 IVG/1000 nados- -vivos). Durante o período em estudo, a taxa de incidência de IVG terá diminuído de 6752,1 casos/100 000 mulheres em 1993 para 4339,2 casos/100 000 mulheres em 1997. A comparação dos indicadores calculados neste trabalho com os disponíveis para outros países sugere que, em Portugal, a IVG tem uma frequência superior à verificada no resto da Europa ocidental e do Sul. Torna-se necessário aprofundar este estudo para obter estimativas indirectas mais fiáveis da incidência de IVG, pelo menos até que esteja disponível um sistema de vigilância específico sobre este problema, em Portugal.

Influence of Lean and Green on supply chain performance: an interpretive structural modelling model

This work aims to identify and rank a set of Lean and Green practices and supply chain performance measures on which managers should focus to achieve competitiveness and improve the performance of automotive supply chains. The identification of the contextual relationships among the suggested practices and measures, was performed through literature review. Their ranking was done by interviews with professionals from the automotive industry and academics with wide knowledge on the subject. The methodology of interpretive structural modelling (ISM) is a useful methodology to identify inter relationships among Lean and Green practices and supply chain performance measures and to support the evaluation of automotive supply chain performance. Using the ISM methodology, the variables under study were clustered according to their driving power and dependence power. The ISM methodology was proposed to be used in this work. The model intends to provide a better understanding of the variables that have more influence (driving variables), the others and those which are most influenced (dependent variables) by others. The information provided by this model is strategic for managers who can use it to identify which variables they should focus on in order to have competitive supply chains.

The Gap Between Knowledge and Action: Obstacles, Restraints and Deficits During the Execution of Refurbishments

This article outlines the initial draft of a PhD project which investigates refurbishment or rehabilitation projects in two German cities. The study focuses on obstacles, restraints and deficits as well as factors of success, which can be identified during the execution of the refurbishments. Moreover the study examines the process of the refurbishment itself, the general conditions under which the refurbishments are being executed as well as the implementation of sustainability criteria. First the article gives a short summary of the theoretical considerations of the study. In this respect it shortly outlines the global conditions of urban development and conducting challenges for cities in the 21st century, guiding principles of a sustainable urban development as well as goals of sustainable refurbishments. Finally the article shortly describes the case studies and presents the initial results of the empirical work.

The sociological perspective on the knowledge-based society: assumptions, facts and visions

The paper will present the central discourse of the knowledge-based society. Already in the 1960s the debate of the industrial society already raised the question whether there can be considered a paradigm shift towards a knowledge-based society. Some prominent authors already foreseen ‘knowledge’ as the main indicator in order to displace ‘labour’ and ‘capital’ as the main driving forces of the capitalistic development. Today on the political level and also in many scientific disciplines the assumption that we are already living in a knowledge-based society seems obvious. Although we still do not have a theory of the knowledge-based society and there still exist a methodological gap about the empirical indicators, the vision of a knowledge-based society determines at least the perception of the Western societies. In a first step the author will pinpoint the assumptions about the knowledge-based society on three levels: on the societal, on the organisational and on the individual level. These assumptions are relied on the following topics: a) The role of the information and communication technologies; b) The dynamic development of globalisation as an ‘evolutionary’ process; c) The increasing importance of knowledge management within organisations; d) The changing role of the state within the economic processes. Not only the differentiation between the levels but also the revision of the assumptions of a knowledge-based society will show that the ‘topics raised in the debates’ cannot be considered as the results of a profound societal paradigm shift. However what seems very impressive is the normative and virtual shift towards a concept of modernity, which strongly focuses on the role of technology as a driving force as well as on the global economic markets, which has to be accepted. Therefore – according to the official debate - the successful adaptation of these processes seems the only way to meet the knowledge-based society. Analysing the societal changes on the three levels, the label ‘knowledge-based society’ can be seen critically. Therefore the main question of Theodor W. Adorno during the 16th Congress of Sociology in 1968 did not loose its actuality. Facing the societal changes he asked whether we are still living in the industrial society or already in a post-industrial state. Thinking about the knowledge-based society according to these two options, this exercise would enrich the whole debate in terms of social inequality, political, economic exclusion processes and at least the power relationship between social groups.

Change Processes and Future Perspectives in the Knowledge Society. The Example of Clothing and Textile Industry

The paper examines change processes und future perspectives in the knowledge society. It presents the clothing and textile industry as an example for a transforming industry in a global economy. The paper reviews existing future studies, which have surveyed change processes and future developments in the clothing and textile industry. Main goals of the review are the identification of changes in work and the description of the restructuring of global value chains within the clothing and textile sector. The paper also highlights major current trends, drivers of change and future prospects in this sector.

The First WORKS Conference on Transformation of Work in a Global Knowledge Economy

The relationship between the changes of the global economy and individual working conditions formed the background of the first WORKS conference “The transformation of work in a global knowledge economy: towards a conceptual framework”, held in Chania, Greece from 21st – 22nd September, 2006 and attended by around 50 European researchers. Experts from academia and trade unions from all over the world were invited to give insights into their field of research, contributing to one of the main topics of the conference: (i) globalisation and organisational restructuring, (ii) workers’ organisation, the quality of working life and the gender dimension and (iii) global experiences and recommendations.

Into a new phase of the research on restructuring of work in the knowledge society: the Third WORKS General Assembly in Sofia (Bulgaria)

The WORKS Project started two years ago (2005), involving the efforts of research institutes of 13 European countries with the main purpose of improving the understanding of the major changes in work in the knowledge-based society, taking account both of global forces and the regional diversity within Europe. This research meeting in Sofia (Bulgaria) aimed to present synthetically the massive amount of data collected in the case studies (occupational and organisational) and with the quantitative research during last year.

International Conference on “Foresight Studies on Work in the Knowledge Society“ in Monte de Caparica (FCT-UNL) on 19-20 October 2006

On 19 and 20 October 2006, the Research Centre on Enterprise and Work Organisation (IET) organised the first international conference on “Foresight Studies on Work in the Knowledge Society”. It took place at the auditorium of the new Library of FCT-UNL and had the support of the research project “CodeWork@VO” (financed by FCT-MCTES and co-ordinated by INESC, Porto). The conference related to the European research project “Work Organisation and Restructuring in the Knowledge Society” (WORKS), which is financed by the European Commission. The main objective of the conference was to analyse and discuss research findings on the trends of work structures in the knowledge society, and to debate on new work organisation models and new forms of work supported by ICT.

Ergonomics and Usability – key factors in Knowledge Society

During the recent years human society evolved from the “industrial society age” and transitioned into the “knowledge society age”. This means that knowledge media support migrated from “pen and paper” to computer-based Information Systems. Due to this fact Ergonomics has assumed an increasing importance, as a science/technology that deals with the problem of adapting the work to the man, namely in terms of Usability. This paper presents some relevant Ergonomics, Usability and User-centred design concepts regarding Information Systems.

Work organisation and restructuring in the knowledge society

It is generally agreed that major changes in work are taking place in the organisation of work as corporate structures are transformed in the context of economic globalisation and rapid technological change. But how can these changes be understood? And what are the impacts on social institutions and on workers and their families? The WORKS project brought together 17 research institutes in 13 European countries to investigate these important issues through a comprehensive four year research programme.

Future gender relations in global restructuring processes case study evidence from knowledge-intensive, manufacturing and service occupations

Global restructuring processes have not only strong implications for European working and living realities, but also have specific outcomes with regard to gender relations. The following contribution analyses in which way global restructuring shapes current gender relations in order to identify important trends and developments for future gender (in)equalities at the workplace. On the basis of a large qualitative study on global restructuring and impacts on different occupational groups it argues that occupational belonging in line with skill and qualification levels are crucial factors to assess the further development of gender relations at work. Whereas global restructuring in knowledge-based occupations may provide new opportunities for female employees, current restructuring is going to deteriorate female labour participation in service occupations. In contrast, manufacturing occupations can be characterised by persistent gender relations, which do not change in spite of major restructuring processes at the work place. Taking the institutional perspective into account, it seems to be crucial to integrate the occupational perspective in order to apply adequate policy regulations to prevent the reinforcement of gender related working patterns in the near future.

Human-robot teamwork: a knowledge-based solution

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Electrotécnica e de Computadores

Knowledge discovery from trajectories

Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Science in Geospatial Technologies