Spring into summer : a novel

Spring into Summer is a novel based on my experiences as a student living in London for a year. The central character, an American under-graduate student studying history, attempts to complete a piece of work by his older brother who is killed in a car accident several months prior to his brother's departure for England. The narrative traces the younger brother's efforts and eventual failure to work on the history; in so doing, he also fails to become more like his older brother whom he greatly loved and admired. Thus, a doppelganger, or "Double" of sorts is used. Most of the action of the novel is set in London. However, the main character also travels to Dublin, York, and several other places in the British Isles, thereby giving a more complete picture of the experiences an American student undergoes while living abroad. During a year which many people might see as an escape from the problems and pressures of everyday life, the central character is forced to undergo a painful process of self-examination, resulting in his reevaluation of himself, his priorities, and his ambitions.

Dwelling in possibility: aestheticizing identity in African American women's fiction

African American women writers define aesthetics through their negotiation of identity in the politicized loci of space, place and voice. In the balkanization of such issues of voice and space, we can see the ways that the emergent selfis embodied and aestheticized in literature. To do so creates a more tactile and "artfull" representation of the self rather than a representation of identity as a mere abstract concept. To use written language to express the self is to carry processes of selfdefinition for black women into the realm of creative production. For women, especially black women, who are a politically and socially compromised element of society, the written word is a way of expressing the politically and the socially critical voice that is suppressed in other forums of expression. Using theories on "writing in difference" as a skeleton key, this project seeks to outline some of the ways that black women writers use aesthetic elements in their art to express the potential for self-examination, discovery, and emancipation.

Simulador radiográfico antropomórfico de mama humana

Mammography is a diagnostic imaging method in which interpretation depends on knowledge of radiological aspects as well as the clinical exam and pathophysiology of breast diseases. In this work a mammography phantom was developed to be used for training in the operation of mammographic x-ray equipment, image quality evaluation, self-examination and clinical examination of palpation. Polyurethane was used for the production of the phantoms for its physical and chemical properties and because it is one of the components normally used in prostheses. According to the range of flexibility of the polyurethane, it was possible to simulate breasts with higher or lower amount of adipose tissue. Pathologies such as areolar necrosis and tissue rejection due to surgery reconstruction after partial mastectomy were also simulated. Calcifications and nodules were simulated using the following materials: polyethylene, poly (methyl methacrylate), polyamide, polyurethane and poly (dimethyl silicone). Among these, polyethylene was able to simulate characteristics of calcification as well as breast nodules. The results from mammographic techniques used in this paper for the evaluation of the phantoms are in agreement with data found in the literature. The image analyses of four phantoms indicated significant similarities with the human skin texture and the female breast parenchyma. It was possible to detect in the radiographic images produced regions of high and low radiographic optical density, which are characteristic of breasts with regions of different amount of adipose tissue. The stiffnesses of breast phantoms were adjusted according to the formulation of the polyurethane which enabled the production of phantoms with distinct radiographic features and texture similar to human female breast parenchyma. Clinical palpation exam of the phantoms developed in this work indicated characteristics similar to human breast in skin texture, areolar region and parenchyma

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Actinic keratosis: a clinical and epidemiological revision

Queratoses actínicas são neoplasias benignas intraepiteliais formadas por proliferações atípicas de queratinócitos com potencial de transformação em carcinoma espinocelular. Desenvolvem-se em áreas fotoexpostas da pele, são induzidas principalmente pela radiação ultravioleta e constituem marcadores de exposição solar crônica. Acometem indivíduos adultos e idosos, de fototipos claros, representando o quarto diagnóstico dermatológico mais comum no Brasil. Danos nas vias de apoptose do epitélio fotoexposto favorecem a proliferação celular e manutenção das lesões. Nesta revisão os autores reúnem os principais dados epidemiológicos sobre a doença e defendem que estratégias de identificação de fenótipos de risco, diagnóstico precoce, tratamento adequado, seguimento clínico, incentivo ao autoexame da pele, fotoeducação e fotoproteção devem ser promovidas, a fim de evitar a evolução das lesões, e também prevenir e diagnosticar neoplasias concomitantes também induzidas pela radiação solar.

Study of denture-induced fibrous hyperplasia cases diagnosed from 1979 to 2001

Objective: the purpose of this research was to study the cases of inflammatory fibrous hyperplasia (IFH) at the Clinic of Semiology, Department of Bioscience and Oral Diagnosis, Sao Jose dos Campos Dental School, State University of São Paulo, Brazil. Methods and materials: A total of 141 clinical file cards indicating a final diagnosis of IFH, from the archives of the Department of Bioscience and Oral Diagnosis and dated from 1979 to 2001, were included in the study. of these files, 50 indicated a diagnosis of denture-induced fibrous hyperplasia. Sex, age, race, duration, and clinical features that confirm their classification in the non-neoplastic proliferating process were analyzed statistically. Results: of the 50 analyzed cases of denture-induced lesion, 22% occurred in men and 78% in women. Patients in the age group of 41 to 50 years presented the highest frequency of the lesion. Conclusions: Inflammatory fibrous hyperplasia occurs more frequently in women (71.63%), and denture-induced lesions appear mainly in patients over 40 years of age (70% of cases). Patients with denture-induced hyperplasia reported pain associated with the lesion (70%).

Maximal clenching effort influence on the electromyographic activity of the trapezius muscle in healthy subjects

Alteration of the occlusion and the position of the jaw can affect the muscles of the neck, due to a relationship between the masticatory and cervical systems. Thus, the objective of this study was to verify whether the bite in maximal clenching effort, in centric occlusion, in individuals with clinically normal occlusion, and without a history of dysfunction in the masticatory system, influences the electromyographic activity of the upper trapezius muscle. A total of 19 normal individuals participated in the study, 14 of which were women (average age of 25.4 ± 4.14 years), and 5 were men (average age of 24.11 ± 3.28 years). The root mean square (RMS) amplitude and median frequency (MF) of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction were analyzed under pre- and post-maximal clenching effort conditions in centric occlusion. The electromyographic signal was collected with a sampling frequency of 2. kHz and the value in RMS was obtained by a moving window of 200. ms. The paired Student's t-test was used to compare RMS amplitude and MF under pre- and post-maximal clenching effort conditions. The level of significance for each comparison was set to p<0.05. This study concluded that in individuals without a history of dysfunction of the masticatory system, maximum clenching effort in centric occlusion does not alter the electromyographic signal of the upper trapezius. © 2009 Elsevier Ltd.

A constituição do sujeito em Foucault e sua relação com a aquisição de linguagem

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Monitoramento por entrevistas telefônicas de fatores de risco para doenças crônicas: experiência de Goiânia, Goiás, Brasil

Este estudo descreve alguns resultados do sistema de monitoramento de fatores de risco para doenças crônicas por entrevistas telefônicas no Município de Goiânia, Goiás, Brasil, 2005. Foi estudada amostra probabilística (n = 2.002) da população adulta servida por linhas telefônicas residenciais fixas. Foram analisadas variáveis comportamentais (consumo alimentar, atividade física, tabagismo e consumo de bebida alcoólica), peso e altura referidos e referência a diagnóstico médico de doenças crônicas. Foram calculadas estimativas de prevalência e valores de qui-quadrado. Observou-se baixo consumo de frutas e hortaliças (47,1%), alta freqüência de inatividade física ocupacional (86,6%), no deslocamento para o trabalho (92,6%) e lazer (61,9%), consumo excessivo de bebidas alcoólicas (23,2%), excesso de peso (36,5%), obesidade (10,6%), hipertensão arterial (22,4%), dislipidemias (18,4%) e diabetes (4,4%). A maioria dos fatores de risco apresentou associação inversa com escolaridade e direta com idade, com diferenças significativas entre sexos (p < 0,05). Observou-se alta prevalência dos fatores de risco de doenças crônicas não transmissíveis e de auto-referidas. Aspectos positivos do sistema: baixo custo operacional, possibilidade de monitorar a carga e a tendência das doenças crônicas não transmissíveis no nível local.

Representações sociais de mulheres mastectomizadas e suas implicações para o autocuidado

Esta pesquisa teve como objetivos identificar as representações sociais de mulheres mastectomizadas sobre a mama e analisar as implicações dessas representações sociais no autocuidado. Tratou-se de um estudo qualitativo segundo o referencial Teoria das Representações Sociais. Para coleta de dados empregou-se duas técnicas: a associação livre de idéias e a observação livre. Para a análise das informações empregou-se a técnica de análise temática. A pesquisa teve como resultado duas unidades temáticas: a mama e suas representações sociais de mudança no corpo e representações sociais de mulheres mastectomizadas: implicações sobre o cuidado de si. No estudo, observou-se que as mulheres objetivaram o cuidado das mamas por meio da realização do autoexame.

Programa de diagnóstico e prevenção de câncer da boca: uma estratégia simples e eficaz

The program of diagnosis and prevention of oral cancer of Univag - University Center aims to increase preventive and early oral diseases with emphasis on oral cancer, aiming to reduce the morbidity and mortality through educative actions, spreading of the auto-examination, performed by dental students of UNIVAG since the second half of 2005 to the present day. The dental students of 1st, 2nd, 3rd and 4th semesters were trained using practice-theoretical classes, for realization the exams preventives and diagnostics, such as self-examination, exfoliative cytology and biopsy of oral mucosa, and even present educative actions. Analyzing the preliminary results were observed increase in the number of diagnoses and referral of diagnosed with oral cancer for treatment in referral services. It was concluded that the program of diagnosis and prevention of oral cancer can make possible early diagnosis and adoption of preventive measures, consequently improving survival rates and life quality in population.

Anemia and dementia among the elderly: the Sao Paulo Ageing & Health Study

Background: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the Sao Paulo Ageing & Health Study to address the relationship between anemia and dementia. Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, Sao Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively. Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17-3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76-2.33, p = 0.32). Further multivariate adjustment did not change the results. Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from Sao Paulo.

Broschüren zur Früherkennung von Hautkrebs

In der vorliegenden Studie wurde überprüft, ob Broschüren, die negative Konsequenzen unzureichender Hautselbstuntersuchung (HSU) betonen (Verlustrahmung), besser geeignet sind, die Früherkennung von Hautkrebs zu fördern als Broschüren, die positive Konsequenzen bei richtig durchgeführter HSU schildern (Gewinnrahmung). Geschlecht und die Bewältigungsdispositionen Vigilanz und kognitive Vermeidung wurden als mögliche Moderatorvariablen untersucht. Nach Erfassung von Baseline- und Hintergrundvariablen lasen 180 Teilnehmer jeweils eine der Broschüren, die ihnen per Zufall zugeteilt wurde. Diese variierten in Rahmung (Gewinn/Verlust) und Bedrohungsgrad (gering/hoch), so dass vier unterschiedliche Versionen vorlagen. Rahmung und Bedrohungsgrad wirkten sich in Abhängigkeit von Vigilanz, d.h. der Disposition, bedrohungsbezogene Informationen systematisch zu verarbeiten, auf die Intention aus. Deutlicher war die Wirkung der Rahmung auf die berichtete Häufigkeit von HSU, die zwei Monate nach dem Lesen erneut erfragt worden war. In der Verlustbedingung stieg die berichtete Häufigkeit von HSU bei Personen mit hoher Vigilanz, bei Personen mit niedriger Vigilanz dagegen sank sie. In der Gewinnbedingung profitierten Personen mit niedriger Vigilanz, während Personen mit hoher Vigilanz weniger HSU berichteten als zuvor. Diese Effekte korrespondierten zwar mit Änderungen der eigenen Risikowahrnehmung, der Erinnerungsleistung und der Beschäftigung mit dem Studienthema, jedoch ließ sich für keine dieser Variablen eine vermittelnde Wirkung nachweisen. Einstellung und Anforderung von Informationsmaterialien blieben unbeeinflusst.

Clinical evaluation of the CRIF 4.5/5.5 system for long-bone fracture repair in cattle

OBJECTIVE: To report clinical evaluation of the clamp rod internal fixator 4.5/5.5 (CRIF 4.5/5.5) in bovine long-bone fracture repair. STUDY DESIGN: Retrospective study. ANIMALS: Cattle (n=22) with long-bone fractures. METHODS: Records for cattle with long-bone fractures repaired between 1999 and 2004 with CRIF 4.5/5.5 were reviewed. Quality of fracture repair, fracture healing, and clinical outcome were investigated by means of clinical examination, medical records, radiographs, and telephone questionnaire. RESULTS: Successful long-term outcome was achieved in 18 cattle (82%); 4 were euthanatized 2-14 days postoperatively because of fracture breakdowns. Two cattle had movement of clamps on the rod. Moderate to severe callus formation was evident in 11 cattle 6 months postoperatively. CONCLUSIONS: Movement of clamps on the rod was recognized as implant failure unique to the CRIF. This occurred in cattle with poor fracture stability because of an extensive cortical defect. The CRIF system may not be ideal to treat metacarpal/metatarsal fractures because its voluminous size makes skin closure difficult, thereby increasing the risk of postoperative infections. CLINICAL RELEVANCE: CRIF cannot be recommended for repair of complicated long-bone fractures in cattle.

Comparability of skin screening histories obtained by telephone interviews and mailed questionnaires: A randomized crossover study

The comparability of information collected through telephone interviews and information collected through mailed questionnaires has not been well studied. As part of the first phase of a randomized controlled trial of population screening for melanoma in Queensland, Australia, the authors compared histories of skin examination reported in telephone interviews and self-administered mailed questionnaires. A total of 1,270 subjects each completed a telephone interview and a mailed questionnaire 1 month apart in 1999; 564 subjects received the interview first, and 706 received the mailed questionnaire first. Agreement between the two methods was 91.2% and 88.6% for whole-body skin examination by a physician in the last 12 months and the last 3 years, respectively, and 81.9% for whole-body skin self-examination in the last 12 months. Agreement was lower for any skin self-examination. Agreement between the two methods was similar regardless of whether the interview or the questionnaire was administered first. Missing data were less frequent for interviews (0.5%) than for mailed questionnaires (3.8%). Costs were estimated at A$9.55 (US$6.21) per completed interview and A$3.01 (US$1.96) per questionnaire. The similarity of results obtained using telephone interviews and mailed questionnaires, coupled with the substantially higher cost of telephone interviews, suggests that self-administered mailed questionnaires are an appropriate method of assessing this health behavior.