Mammographic screening: measurement of the cost in a population based programme in Victoria, Australia

STUDY OBJECTIVES: To estimate the cost per woman participating in a mammographic screening programme, and to describe methods for measuring costs. DESIGN: Expenditure, resource usage, and throughput were monitored over a 12 month period. Unit costs for each phase of the screening process were estimated and linked with the probabilities of each screening outcome to obtain the cost per woman screened and the cost per breast cancer detected. SETTING: A pilot, population based Australian programme offering free two-view mammographic screening. PARTICIPANTS: A total of 5986 women aged 50-69 years who lived in the target area, were listed on the electoral roll, had no previous breast cancer, and attended the programme. RESULTS: Unit costs for recruitment, screening, and recall mammography were $17.54, $60.04, and $175.54, respectively. The costs of clinical assessment for women with subsequent clear, benign, malignant (palpable), and malignant (impalpable) diagnoses were $173.71, $527.29, $436.62, and $567.22, respectively. The cost per woman screened was $117.70, and the cost per breast cancer detected was $11,550. CONCLUSIONS: The cost per woman screened is a key variable in assessment of the cost effectiveness of mammographic screening, and is likely to vary between health care settings. Its measurement is justified if decisions about health care services are to be based on cost effectiveness criteria.

Screening for diabetic retinopathy using a non-mydriatic retinal camera in rural Victoria

PURPOSE: To develop a screening programme for the early detection of diabetic retinopathy using non-mydriatic retinal photography. METHODS: A community based screening service was offered to all people with known diabetes mellitus in selected townships in the LaTrobe and Goulburn Valleys in Victoria. At the local examination centre, basic sociodemographic information was collected as well as details of previous use of eye care services for the early detection of diabetic retinopathy. The examination included visual acuity (VA), glycosylated haemoglobin level and Polaroid photographs of each fundus using a Canon CR5-45NM non-mydriatic retinal camera (Canon, Tochigiken, Japan). Dilating drops were not used. Photographs were subsequently reviewed and letters were sent to all participants (with copies to their general practitioners) with recommendations for appropriate follow up. RESULTS: A total of 1177 people with diabetes attended the screening service, which is estimated to be 40% of the total population with known diabetes in the study area. The mean age was 65 years (range 20-94 years); 559 (48%) people reported not having a dilated fundus examination within the past 2 years; 345 (29%) people had never had a dilated fundus examination. Of the 2354 eyes, 2126 (90%) of the photographs were gradable. A total of 704 people (60%) had normal VA and no evidence of diabetic retinopathy, 209 people (18%) had diabetic retinopathy, 101 people (9%) had evidence of other fundus pathology, 42 people (3%) had reduced acuity (< 6/18) in one or both eyes (with no fundus pathology evident) and 121 people (10%) had ungradable photographs in one or both eyes. CONCLUSIONS: The present study demonstrates the usefulness of a screening programme with non-mydriatic retinal photography as an adjunct to current eye care services for the early detection of diabetic retinopathy.

Patterns of surgical treatment of breast cancer in Victoria

We analysed data on admissions to Victorian public hospitals for surgical treatment of breast cancer over the period July 1985 to December 1988. Of the 2993 women admitted, 28.7% received breast-preserving surgery. The probability of a woman being treated conservatively was dependent on age, with women aged less than 50 or more than 70 years more likely to receive breast-preserving surgery than women aged 50-69. There was an age-specific change, of marginal statistical significance, in the proportion of women receiving breast-preserving surgery over the period. The public hospitals admissions database is a potentially useful means of monitoring patterns of surgical treatment.

Healthy together Victoria and childhood obesity-a methodology for measuring changes in childhood obesity in response to a community-based, whole of system cluster randomized control trial

BACKGROUND: Healthy Together Victoria (HTV) - a complex 'whole of system' intervention, including an embedded cluster randomized control trial, to reduce chronic disease by addressing risk factors (physical inactivity, poor diet quality, smoking and harmful alcohol use) among children and adults in selected communities in Victoria, Australia (Healthy Together Communities).

OBJECTIVES: To describe the methodology for: 1) assessing changes in the prevalence of measured childhood obesity and associated risks between primary and secondary school students in HTV communities, compared with comparison communities; and 2) assessing community-level system changes that influence childhood obesity in HTC and comparison communities.

METHODS: Twenty-four geographically bounded areas were randomized to either prevention or comparison (2012). A repeat cross-sectional study utilising opt-out consent will collect objectively measured height, weight, waist and self-reported behavioral data among primary [Grade 4 (aged 9-10y) and Grade 6 (aged 11-12y)] and secondary [Grade 8 (aged 13-14y) and Grade 10 (aged 15-16y)] school students (2014 to 2018). Relationships between measured childhood obesity and system causes, as defined in the Foresight obesity systems map, will be assessed using a range of routine and customised data.

CONCLUSION: This research methodology describes the beginnings of a state-wide childhood obesity monitoring system that can evolve to regularly inform progress on reducing obesity, and situate these changes in the context of broader community-level system change.

Um (in)visible College na América Latina: Cecília Meireles, Gabriela Mistral e Victoria Ocampo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Um (in)visible college na América Latina: Cecília Meireles, Gabriela Mistral e Victoria Ocampo

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Formação em sexualidade, diversidade e relações de gênero no Centro de Habilitação Infantil Princesa Victoria - CHIPV: os seus desdobramentos

A pesquisa atuou no Centro de Habilitação Princesa Victoria- CHIPV, que é uma unidade de saúde cujo objetivo é atender crianças e adolescentes de 0 a 18 anos que possuem alguma deficiência física e ou sensorial. A pesquisa teve o objetivo de acompanhar as práticas vivenciadas pelos profissionais, a partir de uma formação que tratou a temática de sexualidade e relações de gênero, ministrada por pesquisadores da UNESP. A pesquisa se debruça em observar, acompanhar, perceber, problematizar e avaliar o quanto à formação continuada dentro do CHIPV (Centro de Habilitação Princesa Victoria), pode transformar as práticas dos adolescentes, o foco desta pesquisa, gerando mais possibilidades de vivencias, entendimento e outros olhares sobre a questão da sexualidade e deficiência, e como esta se desdobrará no cotidiano

Evaluation of genotoxicity and oxidative damage in painters exposed to low levels of toluene

Toluene is an organic solvent used in numerous processes and products, including industrial paints. Toluene neurotoxicity and reproductive toxicity are well recognized: however, its genotoxicity is still under discussion, and toluene is not classified as a carcinogenic solvent. Using the comet assay and the micronucleus test for detection of possible genotoxic effects of toluene, we monitored industrial painters from Rio Grande do Sul, Brazil. The putative involvement of oxidative stress in genetic damage and the influences of age, smoking, alcohol consumption, and exposure time were also assessed. Although all biomarkers of toluene exposure were below the biological exposure limits, painters presented significantly higher DNA damage (comet assay) than the control group; however, in the micronucleus assay, no significant difference was observed. Painters also showed alterations in hepatic enzymes and albumin levels, as well as oxidative damage, suggesting the involvement of oxidative stress. According to multiple linear regression analysis, blood toluene levels may account for the increased DNA damage in painters. In summary, this study showed that low levels of toluene exposure can cause genetic damage, and this is related to oxidative stress, age, and time of exposure. (C) 2012 Elsevier B.V. All rights reserved.

Un paso de América: Alfonso Reyes, Victoria Ocampo y el cosmopolitismo en la década de 1930

[ES] El artículo trata de las construcciones americanistas del cosmopolitismo (entendido en relación a la geopolítica imperial) en los textos de Victoria Ocampo y Alfonso Reyes de los años treinta. Al analizar su relación con los movimientos de inmigración y la subsiguiente revalorización de la nación, el artículo postula que en Alfonso Reyes la mediación cosmopolita es «des-jerarquizada», ubicada casi siempre en una «periferia», a diferencia de Victoria Ocampo cuyas visiones cosmopolitas son mediadas desde un «centro» —ya sea París o Buenos Aires— y relacionadas con una jerarquía de valores estéticos y políticos.

Monitoring Ice Velocity Field in Victoria Land (Antarctica) Using Cross-Correlation Techniques on Satellite Images

Perfluorinated compounds in environmental matrices of Lake Victoria Gulf

ABSTRACT One of the major ecological challenges on Lake Victoria resources is the existence of “hot spots”, caused by human waste, urban runoff, and industrial effluents. The lake is tending towards eutrophication which is attributed to the increasing human population in its watershed. A report of the levels of perfluorooctane sulfonate and perfluorooctanoic acid in environmental matrices of Lake Victoria is presented, and the management implication of perfluorinated compounds and similar potential organic pollutants examined. Two widely consumed and economically important fish species namely Lates niloticus (Nile perch) and Oreochromis niloticus (Nile tilapia) were obtained from Winam gulf of Lake Victoria, Kenya, and analysed for perfluorooctane sulfonate and perfluorooctanoic acid in muscles and liver using liquid chromatography coupled with mass spectroscopy. Variability in the concentrations of perfluorooctanoic acid or perfluorooctane sulfonate in river waters (range perfluorooctanoic acid 0.4 – 96.4 ng/L and perfluorooctane sulfonate < 0.4 – 13.2 ng/L) was higher than for Lake waters (range perfluorooctanoic acid 0.4 – 11.7 ng/L and perfluorooctane sulfonate < 0.4 – 2.5 ng/L respectively). Significant correlations were tested between perfluorinated compounds levels in sediments, fish and water. Wastewater treatment plants and other anthropogenic sources have been identified as significant sources or pathways for the introduction of perfluoroalkyl compounds into Lake Victoria ecosystem. In this study, elevated concentrations of perfluorooctanoic acid and perfluorooctane sulfonate was found in two wastewater treatment plants (WWTPs) in Kisumu, City of Kenya. An alternative analytical method to liquid chromatography/ mass spectroscopy for analysis of perfluorocarboxylic acids in abiotic and biotic matrices where high concentrations are expected is also presented. Derivatisation of the acid group to form a suitable alkyl ester provided a suitable compound for mass spectroscopy detection coupled to gas chromatography instrumental analysis. The acid is esterified by an alkyl halide i.e benzyl bromide as the alkylating agent for Perfluorocarboxylic acids quantification. The study also involved degradability measurements of emerging perfluorinated surfactants substitutes. The stability of the substitutes of perfluorinated surfactants was tested by employing advanced oxidation processes, followed by conventional tests, among them an automated method based on the manometric respirometry test and standardized fix bed bioreactor [FBBR] on perfluorobutane sulfonate (PFBS), a fluoroethylene polymer, fluorosurfactant (Zonyl), two fluoraliphaticesters (NOVEC ™ FC4430 and NOVEC ™ FC4432) and 10-(trifluoromethoxy) decane-sulfonate. Most of these emmerging surfactants are well-established in the market and have been used in several applications as alternatives to PFOS and PFOA based surfactants. The results of this study can be used as pioneer information for further studies on the sources, behaviour and fate of PFOA and PFOS and other related compounds in both abiotic and biota compartments of Lake Victoria and other lakes. Further an overview in degradation of emerging perfluorinated compounds substitutes is presented. Contribution in method development especially for acid group based fluorosurfactants is presented. The data obtained in this study can particularly be considered when formulating policies and management measures for preservation and sustainability of Lake Victoria resources.

Proposta di traduzione e commento di alcuni racconti tratti da "Antes, cuando Venecia no existía" di Victoria Pérez Escrivá

Il documento contiene la traduzione di alcuni racconti brevi del libro per bambini "Antes, cuando Venecia no existía" della scrittrice e illustratrice Victoria Pérez Escrivá. La proposta di traduzione è preceduta da una panoramica su genere letterario, struttura, stile e temi presenti nei testi. I sei racconti tradotti sono poi seguiti da un commento con analisi degli elementi più significativi che si presentano al traduttore nell'ambito della traduzione di letteratura per l'infanzia; rapporto con le illustrazioni e con il font, musicalità, aspetti inerenti alla cultura e difficoltà traduttive affrontate con relative soluzioni. Ognuno di essi è stato analizzato in un’ottica sia generale che rapportata specificamente ai racconti tradotti. Vi è infine una riflessione sul ruolo del traduttore di narrativa per bambini e ragazzi.