Objective.To conduct a proof-of-concept randomized trial of an Internal Family Systems (IFS) psychotherapeutic intervention on rheumatoid arthritis (RA) disease activity and psychological status.Methods.Patients with RA were randomized to either an IFS group for 9 months (n = 39) or an education (control) group (n = 40) that received mailed materials on RA symptoms and management. The groups were evaluated every 3 months until intervention end and 1 year later. Self-assessed joint pain (RA Disease Activity Index joint score), Short Form-12 physical function score, visual analog scale for overall pain and mental health status (Beck Depression Inventory, and State Trait Anxiety Inventory) were assessed. The 28-joint Disease Activity Score-C-reactive Protein 4 was determined by rheumatologists blinded to group assignment. Treatment effects were estimated by between-group differences, and mixed model repeated measures compared trends between study arms at 9 months and 1 year after intervention end.Results.Of 79 participants randomized, 68 completed the study assessments and 82% of the IFS group completed the protocol. Posttreatment improvements favoring the IFS group occurred in overall pain [mean treatment effects −14.9 (29.1 SD); p = 0.04], and physical function [14.6 (25.3); p = 0.04]. Posttreatment improvements were sustained 1 year later in self-assessed joint pain [−0.6 (1.1); p = 0.04], self-compassion [1.8 (2.8); p = 0.01], and depressive symptoms [−3.2 (5.0); p =0.01]. There were no sustained improvements in anxiety, self-efficacy, or disease activity.Conclusion.An IFS-based intervention is feasible and acceptable to patients with RA and may complement medical management of the disease. Future efficacy trials are warranted. ClinicalTrials.gov identifier: NCT00869349.
The martyr adaptation syndrome describes the unique clinical features of a group of female Portuguese-speaking immigrants with a history of abuse and reflects their psychological struggle in the process of adaptation to a new country. Two phases drawn from trauma and constructivist theories are explained: a supercoping phase prior to immigration and a collapse phase after arrival to the United States. Central to the collapse of these immigrant women is a pervasive loss of sense of self and their inability to negotiate their identity in the new culture. Two cases are described to illustrate these phenomena. Specific psychotherapy guidelines are suggested for treating these women that focus on attending to basic survival needs and facilitating the rebuilding of their sense of self and purpose in the new country. • immigration • adaptation • women • Portugal * syndromeThe term martyr adaptation syndrome reflects immigration, such as the conflicting values the common clinical features observed in a and sex roles held by the new and old coungroup of female Portuguese-speaking immi-tries, their history of previous abuse, and grants to the United States who received in-the challenge to their identity in the new dividual psychotherapy at a bilingual com-culture. munity health center. These women'sThe Portuguese-speaking immigrant struggle to adapt to the new country is un-women presented with the following psychoderstood in the context of the stressors of logical features: (a) multiple somatic com-•
The paper analyses the application of the AHP method together with the attach A of ISO 9004:2000 in order to evaluate the performance of two industrial organizations, both possessing quality management systems with ISO 9001:2000 certifications, based on the specific requirements of quality, environment, occupational health and management systems. The evaluated organizations were a government-owned company from the science and technology sector that works in the nuclear area, and a private company that works in the automotive and railroad area. The open software Web-Hipre version 1.22 from Helsinki University of Technology, Finland, was used. By means of the sensibility analysis, it was possible to conclude that for the government-owned company, the most important criterion/requirement was related to product manufacturing with an index of 0.20, and the most important subcriterion was related to production operations with an index of 0.048, which represents the reality of the company. If the criterion/requirement index were increased by 0.03, the most important subcriterion would be project and development. For the private company, the most important criterion/requirement was the management system with an index of 0.31, and its most important subcriterion was document control with an index of 0.136, which also represents the reality of the company. If the criterion/requirement index were decreased by 0.13, the most important subcriteria would be suppliers and partners. The results demonstrated that the AHP is adequate to evaluate organizational performances. Both organizations presented similar performance levels.
Entrevista cedida a Fernando Augusto , por ocasião da Semana de arte de Londrina-PR em 11/11/2003. Esta entrevista, agora publicada, foi revista pelo artista em 2 de setembro de 2016. Marco Giannotti: é a pintura que me ensina No início dos anos 90, o Departamento de Artes Visuais da Universidade Estadual de Londrina-PR começou um programa denominado Semana de arte que, se desdobrou em várias exposições, encontros e debates significativos para o ensino e aprendizado da arte e também para o enriquecimento dos sistemas de arte no país. Numa dessas Semana de arte, em 2003, aproveitando a oportunidade, comecei a entrevistar artistas e teóricos que participavam do evento. A ideia era bater um papo com esses pensadores (professores e artistas), a fim de ampliar o debate sobre arte brasileira de forma coloquial, com perguntas e respostas surgidas entrevistas ¹Marco Giannotti é pintor, professor Associado da Escola de Comunicação e Artes da USP. Formou-se em Ciências Sociais na USP, e realizou suas exposições individuais nas principais galerias e museus de São Paulo e Rio de Janeiro. Defendeu seu mestrado em filosofia com a tradução e introdução crítica da Doutrina das Cores, de Goethe (1749-1832). Participou de duas versões da Bienal do Mercosul e do Arte Cidade, e de algumas exposições coletivas internacionais. Defendeu sua tese de livre-docência intitulada A sombra da Imagem. Forma o grupo de pesquisa sobre a cor no departamento de artes plásticas da USP. Convidado em 2011 para ser professor visitante durante o ano letivo na Universidade de Estudos Estrangeiros de Kioto, publica o livro Diário de Kioto pela Martins Fontes com apoio da embaixada do Brasil em Tóquio. Recentemente realizou uma exposição no Instituto Tomie Ohtake e na Galeria Raquel Arnaud.
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