CLÍNICA PSICANALÍTICA: O SENTIMENTO DE SOLIDÃO E A SAÚDE MENTAL DE MULHERES CASADAS

Este trabalho teve como objetivo principal investigar o sentimento de solidão e a saúde mental de mulheres casadas, procurando comparar a maneira de compreender e vivenciar este sentimento em mulheres solteiras e casadas, bem como verificar em que medida este sentimento pode ser mitigado pela presença do outro no casamento (coabitação) e em que condições isto ocorria. Partiu-se da hipótese de que esse sentimento é compartilhado por todas as pessoas, já que o ser humano é uno e individual. Logo, a separação eterna do outro, que se inicia quando o bebê percebe que é diferente da mãe e, assim, um indivíduo único, está associado a uma sensação de solidão que acompanha o ser humano por toda a vida. Desta forma, é muito comum ver pessoas se envolver em relacionamentos para diminuir este sentimento, que se vê intensificado a cada dia em função da superficialidade dos vínculos emocionais. A presença de outrem pode ser aproveitada numa relação interpessoal quando se diminui a intensidade da hostilidade, associada ao sentimento de solidão. O antídoto contra tal sentimento vem do fortalecimento do auto-conhecimento, da autonomia, e da amizade por um companheiro que mostra aceitação incondicional pelo verdadeiro self. Para análise deste sentimento em mulheres casadas, foi realizada uma pesquisa quantitativa e qualitativa com mulheres solteiras e universitárias. A escolha da amostra foi aleatória e por conglomerado, em três estágios. Participaram do estudo 184 mulheres, 38% casadas, 7,6% separadas e 52,7% solteiras. Da pesquisa quantitativa foi possível analisar que a percepção das mulheres sobre a solidão vem, em muitos aspectos, de encontro com a teoria psicanalítica. Pelas respostas encontradas percebeu-se que a grande maioria das participantes tem um baixo sentimento de solidão (58,7%) e 41,3% se classificaram com um escore de alto a médio sentimento de solidão, nestes dois grupos a maioria são de mulheres casadas e separadas, sendo que quanto mais nova a mulher maior a tendência a buscar um relacionamento para fugir da solidão, sendo entre as casadas também que isto ocorre com mais freqüência. A partir destes escores, 18 mulheres foram convidadas a participar de uma entrevista diagnóstica. Destas dezoito, seis mulheres apresentavam alto sentimento de solidão, sendo duas casadas, duas solteiras e duas separadas. Da mesma forma as mulheres com média e baixa solidão. Os resultados encontrados nestas entrevistas foram que todas as mulheres que apresentaram um alto sentimento de solidão demonstram uma adaptação ineficaz perante a vida, enquanto que aquelas que apresentaram médio ou baixo sentimento de solidão dificilmente apresentam adaptação ineficaz. Do grupo de médio sentimento de solidão, três mulheres apresentaram adaptação eficaz, e do grupo de baixo sentimento de solidão apenas uma participante apresentou adaptação ineficaz leve. Com isso concluímos que a solidão, quando em alta medida, além de dolorosa indica uma grande dificuldade do indivíduo em lidar com seus aspectos emocionais e produtivos, necessitando de ajuda psíquica.

Integrating group Delphi, fuzzy logic and expert systems for marketing strategy development:the hybridisation and its effectiveness

A hybrid approach for integrating group Delphi, fuzzy logic and expert systems for developing marketing strategies is proposed in this paper. Within this approach, the group Delphi method is employed to help groups of managers undertake SWOT analysis. Fuzzy logic is applied to fuzzify the results of SWOT analysis. Expert systems are utilised to formulate marketing strategies based upon the fuzzified strategic inputs. In addition, guidelines are also provided to help users link the hybrid approach with managerial judgement and intuition. The effectiveness of the hybrid approach has been validated with MBA and MA marketing students. It is concluded that the hybrid approach is more effective in terms of decision confidence, group consensus, helping to understand strategic factors, helping strategic thinking, and coupling analysis with judgement, etc.

'They cooperate with us, so they are like me': perceived intergroup relationship moderates projection from self to outgroups

Whereas projection of self-attributes to ingroups is ubiquitous, projection of self-attributes to outgroups (outgroup projection) is an elusive phenomenon. Two experiments examined the moderating effect of perceived intergroup relationship on outgroup projection and explored underlying mechanisms. Perceived cooperation versus competition between ingroup and outgroup was manipulated using fictitious (Experiment 1) or natural groups (Experiment 2). In both experiments, participants judged the outgroup as more similar to the self in the cooperation condition than in the competition condition. This effect was independent of recategorization, perceived intergroup similarity, and ingroup-to-outgroup projection. These studies demonstrate the very existence of outgroup projection and extend previous work on moderators of projection from self to groups.

Journey making group workshops as a research tool

Problem-structuring group workshops can be used in organizations as a consulting tool and as a research tool. One example of the latter is using a problem-structuring method (PSM) to help a group tackle an organizational issue; meanwhile, researchers collect the participants' initial views, discussion of divergent views, the negotiated agreement, and the reasoning for outcomes emerging. Technology can help by supporting participants in freely sharing their opinions and by logging data for post-workshop analyses. For example, computers let participants share views anonymously and without being influenced by others (as well as logging those views), and video-cameras can record discussions and intra-group dynamics. This paper evaluates whether technology-supported Journey Making workshops can be effective research tools that can capture quality research data when compared against theoretical performance benchmarks and other qualitative research tools. © 2006 Operational Research Society Ltd. All rights reserved.

Problem structuring methods for large group interventions

Problem structuring methods (PSMs) aim to build shared understanding in a group of decision makers. This shared understanding is used as a basis for them to negotiate an agreed action plan that they are prepared to help implement. Engaging in a social process of negotiation with a large number of people is difficult, and so PSMs have typically focused on small groups of less than 20. This paper explores the legitimacy of deploying PSMs in large groups of people (50–1000), where the aim is to negotiate action and build commitment to its implementation. We review the difficulties of facilitating large groups with PSMs, drawing heavily on our experience of working with over 25 large groups. We offer a range of lessons learned and suggest concrete approaches to facilitating large groups to achieve the objectives of PSMs. This paper contributes to the evaluation and development of PSMs.

Prevalence of the use of cancer related self-tests by members of the public:A community survey

Background: Self-tests are those where an individual can obtain a result without recourse to a health professional, by getting a result immediately or by sending a sample to a laboratory that returns the result directly. Self-tests can be diagnostic, for disease monitoring, or both. There are currently tests for more than 20 different conditions available to the UK public, and self-testing is marketed as a way of alerting people to serious health problems so they can seek medical help. Almost nothing is known about the extent to which people self-test for cancer or why they do this. Self-tests for cancer could alter perceptions of risk and health behaviour, cause psychological morbidity and have a significant impact on the demand for healthcare. This study aims to gain an understanding of the frequency of self-testing for cancer and characteristics of users. Methods: Cross-sectional survey. Adults registered in participating general practices in the West Midlands Region, will be asked to complete a questionnaire that will collect socio-demographic information and basic data regarding previous and potential future use of self-test kits. The only exclusions will be people who the GP feels it would be inappropriate to send a questionnaire, for example because they are unable to give informed consent. Freepost envelopes will be included and non-responders will receive one reminder. Standardised prevalence rates will be estimated. Discussion: Cancer related self-tests, currently available from pharmacies or over the Internet, include faecal occult blood tests (related to bowel cancer), prostate specific antigen tests (related to prostate cancer), breast cancer kits (self examination guide) and haematuria tests (related to urinary tract cancers). The effect of an increase in self-testing for cancer is unknown but may be considerable: it may affect the delivery of population based screening programmes; empower patients or cause unnecessary anxiety; reduce costs on existing healthcare services or increase demand to investigate patients with positive test results. It is important that more is known about the characteristics of those who are using self-tests if we are to determine the potential impact on health services and the public. © 2006 Wilson et al; licensee BioMed Central Ltd.

Blood glucose self-monitoring in non-insulin-treated type 2 diabetes:a qualitative study of patients' perspectives

Background: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. Aim: To explore the pros and cons of glucose monitoring from the patients' perspectives. Design of study: Qualitative repeat-interview study. Setting: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Method: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Results: Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood glucose levels. Glucose monitoring amplifies a sense of 'success' or 'failure' about self-management, often resulting in anxiety and self-blame if glucose readings remain consistently high. Moreover, monitoring can negatively effect patients' self-management when readings are counter-intuitive. Conclusion: Our analysis highlights the importance of understanding the meanings that newly diagnosed patients attach to glucose self-monitoring. To maximise the positive effects of self-monitoring, health professionals should ensure that patients understand the purpose of monitoring and should clarify with patients how readings should be interpreted. © British Journal of General Practice.

The role of self-regulation as a meta-competency in developing leaders: a longitudinal field experimental study

The question of how to develop leaders so that they are more effective in a variety of situations, roles and levels has inspired a voluminous amount of research. While leader development programs such as executive coaching and 360-degree feedback have been widely practiced to meet this demand within organisations, the research in this area has only scratched the surface. Drawing from the past literature and leadership practices, the current research conceptualised self-regulation, as a metacompetency that would assist leaders to further develop the specific competencies needed to perform effectively in their leadership role, leading to an increased rating of leader effectiveness and to enhanced group performance. To test this conceptualisation, a longitudinal field experimental study was conducted across ten months with a pre- and two post-test intervention designs with a matched control group. This longitudinal field experimental compared the difference in leader and team performance after receiving self-regulation intervention that was delivered by an executive coach. Leaders in experimental group also received feedback reports from 360-degree feedback at each stage. Participants were 40 leaders, 155 followers and 8 supervisors. Leaders’ performance was measured using a multi-source perceptual measure of leader performance and objective measures of team financial and assessment performance. Analyses using repeated measure of ANCOVA on pre-test and two post-tests responses showed a significant difference between leader and team performance between experimental and control group. Furthermore, leader competencies mediated the relationship between self-regulation and performance. The implications of these findings for the theory and practice of leadership development training programs and the impact on organisational performance are discussed.

Individual differences in cognitive style and their effects on task and social orientations of self-managed work teams

When assembling self-managing work teams, the personalities of team members are often overlooked. One personality variable known to be critical for effective decision making in teams is cognitive style. This study sought to examine how differences and similarities in analytic/intuitive cognitive styles affected the behavior of team members on the task/emotionally expressive dimension identified by Bales. As hypothesized, intuitive individuals and homogeneous intuitive teams were found to initiate more social-emotional acts. Contrary to expectations, intuitive rather than analytic individuals and homogeneous intuitive rather than analytic teams engaged in more task-oriented behaviors. Teams also tended to select intuitive individuals as leaders. The possibility that different combinations of styles may be important for overall team effectiveness was subsequently discussed, and it was suggested that this may depend on whether the nature of the work environment is relatively well structured and mechanistic or relatively unstructured and organic.

Group membership salience and task performance

Purpose – Social loafing is described in the literature as a frequent problem reducing individuals' performance when working in groups. This paper aims to utilize the social identity approach and proposes that under conditions of heightened group salience social loafing can be reduced and turned into social laboring (i.e. increased performance). Design/methodology/approach – Two experimental studies are conducted to examine the impact of participant's group membership salience on task performance. In Study 1, school teachers work either in coactive or in collective working conditions on brainstorming tasks. In Study 2, participants perform both a brainstorming task and a motor task. Findings – The results show social laboring effects. As predicted, participants in the high salient group conditions outperform participants in the low salient group conditions and the coactive individual condition. Practical implications – The results indicate that rather than individuating group members or tasks to overcome social loafing, managers can increase group performance by focusing on group members' perceptions of their groups as important and salient. Originality/value – The studies presented in this paper show that social identity theory and self categorization theory can fruitfully be applied to the field of group performance. The message of these studies for applied settings is that collective work in groups must not necessarily negatively impact performance, i.e. social loafing. By heightening the salience of group memberships groups can even outperform coactively working individuals.

Targets and self monitoring in hypertension: randomised controlled trial and cost effectiveness analysis

OBJECTIVES: To assess whether blood pressure control in primary care could be improved with the use of patient held targets and self monitoring in a practice setting, and to assess the impact of these on health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences, and costs. DESIGN: Randomised controlled trial. SETTING: Eight general practices in south Birmingham. PARTICIPANTS: 441 people receiving treatment in primary care for hypertension but not controlled below the target of < 140/85 mm Hg. INTERVENTIONS: Patients in the intervention group received treatment targets along with facilities to measure their own blood pressure at their general practice; they were also asked to visit their general practitioner or practice nurse if their blood pressure was repeatedly above the target level. Patients in the control group received usual care (blood pressure monitoring by their practice). MAIN OUTCOME MEASURES: Primary outcome: change in systolic blood pressure at six months and one year in both intervention and control groups. Secondary outcomes: change in health behaviours, anxiety, prescribed antihypertensive drugs, patients' preferences of method of blood pressure monitoring, and costs. RESULTS: 400 (91%) patients attended follow up at one year. Systolic blood pressure in the intervention group had significantly reduced after six months (mean difference 4.3 mm Hg (95% confidence interval 0.8 mm Hg to 7.9 mm Hg)) but not after one year (mean difference 2.7 mm Hg (- 1.2 mm Hg to 6.6 mm Hg)). No overall difference was found in diastolic blood pressure, anxiety, health behaviours, or number of prescribed drugs. Patients who self monitored lost more weight than controls (as evidenced by a drop in body mass index), rated self monitoring above monitoring by a doctor or nurse, and consulted less often. Overall, self monitoring did not cost significantly more than usual care (251 pounds sterling (437 dollars; 364 euros) (95% confidence interval 233 pounds sterling to 275 pounds sterling) versus 240 pounds sterling (217 pounds sterling to 263 pounds sterling). CONCLUSIONS: Practice based self monitoring resulted in small but significant improvements of blood pressure at six months, which were not sustained after a year. Self monitoring was well received by patients, anxiety did not increase, and there was no appreciable additional cost. Practice based self monitoring is feasible and results in blood pressure control that is similar to that in usual care.

An evaluation of quinolone prescribing in a group of acute hospitals:Development of an objective measure of usage

Objectives: To develop an objective measure to enable hospital Trusts to compare their use of antibiotics. Design: Self-completion, postal questionnaire with telephone follow up. Sample: 4 hospital trusts in the English Midlands. Results: The survey showed that it was possible to collect data concerning the number of Defined Daily Doses (DDD's) of quinolone antibiotic dispensed per Finished Consultant Episode (FCE) in each Trust.. In the 4 trusts studied the mean DDD/FCE was 0.197 (range 0.117 to 0.258). This indicates that based on a typical course length of 5 days, 3.9% of patient episodes resulted in the prescription of a quinolone antibiotic. Antibiotic prescribing control measures in each Trust were found to be comparable. Conclusion: The measure will enable Trusts to objectively compare their usage of quinolone antibiotics and use this information to carry out clinical audit should differences be recorded. This is likely to be applicable to other groups of antibiotics.

Critical pedagogy/popular education group

Few today doubt that English Higher Education (HE), like the wider world in which it is located, is in crisis. This is, in part, an economic crisis, as the government response to the current recession seems to be that of introducing the kind of neoliberal ‘shock doctrine’ (Klein 2007) or ‘shock therapy’ (Harvey 2005) that previously resulted in swingeing cuts in public services in Southern nations. Our aim in producing this volume is that these contributions help develop a collective response to the seeming limits of these conditions. We view the strength of these contributions in part as providing palpable evidence of how we and our colleagues are acting with critical hope under current conditions so that we might encourage others to work with us to build, together, more progressive formal and informal education systems that address and seek to redress multiple injustices of the world today.

'I felt that I do live in the UK now':international students' self-reports of their English language speaking experiences on a pre-sessional programme

This article focuses on the English language experiences of a group of pre-sessional students, an under-represented group in the literature on language and education. In particular, it investigates the opportunities that such students have to use English outside the classroom, shown to be a key factor in student satisfaction with their study abroad experience. Drawing on data from questionnaires, interviews and on-line diaries, we show that students have a variety of opportunities to use English; however, these opportunities may require students to engage in complex negotiations right from the beginning of their sojourn in the UK. Micro-analysis of the data shows that agency is a key construct in understanding students' representations of their English encounters as they begin their lives in the UK. The article concludes with some suggestions as to how pre-sessional courses may develop students' linguistic and socio-cultural skills in order that they may interact successfully in English outside the classroom. © 2011 Taylor &Francis.

Services for activities in group editing 'sage'

The project described in this thesis investigates the needs of a group of people working cooperatively in an OSI environment, and recommends tools and services to meet these needs. The project looks specifically at Services for Activities in Group Editing, and is identified as the `SAGE' project. The project uses case studies to identify user requirements and to determine common functionalities for a variety of group editing activities. A prototype is implemented in an X.400 environment to help refine user requirements, as a source of new ideas and to test the proposed functionalities. The conceptual modelling follows current CCITT proposals, but a new classification of group activities is proposed: Informative, Objective and Supportive application groups. It is proposed that each of these application groups have their own Service Agent. Use of this classification allows the possibility of developing three sets of tools which will cover a wide range of group activities, rather than developing tools for individual activities. Group editing is considered to be in the Supportive application group. A set of additional services and tools to support group editing are proposed in the context of the CCITT draft on group communication, X.gc. The proposed services and tools are mapped onto the X.400 series of recommendations, with the Abstract Service Definition of the operational objects defined, along with their associated component files, by extending the X.420 protocol functionality. It is proposed that each of the Informative, Objective and Supportive application groups should be implemented as a modified X.420 inter-personal messaging system.