Sonhar e brincar: o espaço psíquico a ser construído / Dream and play: the psychical space to be built / Soñar y jugar: el espacio psíquico a construir / Rêver et jouer: l'espace psychique à construire

Este trabalho examina o significado e a função do sonhar, como forma essencial de funcionamento psíquico. O objetivo do processo analítico é gerar condições para que a pessoa sonhe seus sonhos não sonhados e sonhos interrompidos. É apresentado um caso clínico que se caracterizava por extremo retraimento e pela sensação de pouca vivacidade. A paciente tinha pouco contato consigo mesma e parecia incapaz de dar vazão a seus sonhos. Ao lado da posição de inacessibilidade da paciente na análise, havia um pedido silencioso de ajuda. Foi ressaltada a necessidade da analista de levar em conta as condições possíveis da paciente para estabelecer com ela um canal de comunicação. Isso se deu por meio da série Friends, que trouxe um espaço transicional no qual a proximidade pôde ocorrer. O sonhar e o brincar foram considerados processos correspondentes, e foi discutido o trabalho clínico possível com pacientes que apresentam uma capacidade simbólica muito prejudicada.

This work examines the meaning and function of dreaming as an essential form of psychic functioning. The purpose of the analytical process is to create conditions for the person to dream of his/her undreamed dreams and interrupted dreams. We present a clinical case that was characterized by extreme withdrawal and by the sensation of poor alertness. The patient had little contact with herself and seemed unable to vent her dreams. Beside the position of patient inaccessibility in the analysis, there was a silent request for help. It was emphasized the need of the analyst to take into account the possible conditions of the patient to establish a communication channel with her. This was done through the Friends series, which established a transitional space in which proximity could occur. Dreaming and playing were considered as corresponding processes and the possible clinical work with patients with a very impaired symbolic capacity was discussed.

Este trabajo examina el significado y función del soñar, como forma esencial de funcionamiento psíquico. El objetivo del proceso analítico es generar condiciones para que la persona sueñe sus sueños no soñados y sueños interrumpidos. Se presenta un caso clínico que se caracterizaba por extremo retraimiento y por la sensación de poca vivacidad. La paciente tenía poco contacto consigo misma y parecía incapaz de dar flujo a sus sueños. Al lado de la posición de inaccesibilidad de la paciente en el análisis, había una petición silenciosa de ayuda. Se resalta la necesidad de la analista de tener en cuenta las condiciones posibles de la paciente para establecer con ella un canal de comunicación. Esto se dio a través de la serie Friends, que estableció un espacio transicional en el que la proximidad pudo ocurrir. El soñar y el juego fueron considerados procesos correspondientes y se discutió el trabajo clínico posible con pacientes que presentan una capacidad simbólica muy perjudicada.

Cet article examine le sens et la fonction du rêve en tant que forme essentielle du fonctionnement psychique. Le processus analytique a pour but de créer des conditions permettant à la personne de rêver ses rêves non atteints et ses rêves interrompus. Nous présentons un cas clinique caractérisé par un retrait extrême et un sentiment de faible vivacité. La patiente avait peu de contact avec elle-même et semblait incapable de donner libre cours à ses rêves. Cependant, à côté de la position inaccessible du patient dans l'analyse se trouvait une demande d'aide silencieuse. La nécessité pour l'analyste de prendre en compte les conditions possibles de la patiente pour établir un canal de communication avec elle a été soulignée. Cela s'est fait à travers la série Friends, qui a créé un espace transitionel dans lequel la proximité pouvait exister. Rêver et jouer ont été considérés comme des processus correspondants et le travail clinique possible avec des patients ayant une capacité symbolique très altérée a été discuté.

Factors influencing the acceptance of cervical cancer screening among civil servants in Delta State Secretariat

Background: Cervical cancer is one of the top two cancers affecting Nigerian women. This has created impetus to investigate the situation. This third of a four-part series seeks to evaluate perception, acceptance and psychosocial factors of cervical screening among women who are gainfully employed in the State’s civil service within Delta State Secretariat.Methods: Based on cross-sectional descriptive survey using a structured questionnaire and ‘N=285’ participants. Statistical analysis assessed percentage proportions of respondents; as well as absolute and relative frequencies of the factors associated with acceptance of screening. Chi-squared analysis was based on no/yes response to have done cervical screening.Results: About 10% of respondents have undergone cervical screening. 16% of the lowest income earners have done the screening, compared to 8% and 10% of the mid income and high income group, respectively. Nature of work implying time constraints was an absolute factor. Knowledge of what cervical cancer is; the causes; how to detect and prevent it are significantly associated (p <0.01), while accessibility, fear of adverse effect and attitude of healthcare workers were significant psychosocial factors (p 0.01).Conclusions: This report affirms nature of work and accessibility as two of four major factors influencing acceptance of cervical screening among working class women in Delta State secretariat. It is hereby suggested to expound sites of cervical service programs.

Factors influencing the acceptance of HPV vaccine among civil servants in Delta State Secretariat

Background: The importance of cervical screening and HPV vaccination cannot be overemphasized. Yet, the level of uptake of HPV vaccination has never been evaluated among Secretariat personnel in Delta State of Nigeria. This part-of-four piece of study aimed to identify the barriers to the acceptance of HPV vaccination in Delta State, Nigeria.Methods: A cross-sectional, descriptive survey method was adopted using a structured questionnaire. 285 participants were included. The structured questionnaire included questions on acceptance of HPV vaccination and the factors influencing acceptability. Statistical analysis included percentage proportions of respondents. Absolute and relative frequencies of the factors were also determined. Chi-squared analysis was performed based on dichotomy of participants based on yes/no response to being vaccinated.Results: Less than 8% of respondents have completed the HPV vaccination program. Low income earners have accepted the vaccination more than the high income group (p <0.003). Nature of work implying time constraints was an absolute factor. Accessibility is one of four factors that were significantly associated (p <0.002).Conclusions: Given the observation on nature of work and associated implication of time constraints and also inaccessibility as potentially major factors; it suffices to suggest that acceptance of HPV vaccination may be improved by expounding the days and sites of vaccination programs to be closer to the offices and scheduled around lunch-break times.