Prostate cancer treatment as an embodied rite of passage: impotence and incontinence as challenges to status reversal and reintegration

Introduction and Rationale: A central argument in the thesis is that performative acts of control, sexual potency and spontaneity are central to the continuous construction of embodied masculine identities. The acts of control, and particularly issues of spontaneity, are central to understandings and addressing the difficulties men face at varying levels of embodied identity. Using Watson’s (2000) ‘Male body schema’, I will explore the challenges and opportunities men face when negotiating normative, pragmatic, and experiential embodiment. I will later then explore the importance of these levels of embodiment to achieving visceral embodiment; or what I would define as a renewed unconscious satisfaction and ability to achieve and maintain normative, pragmatic and experiential forms of embodiment. Purpose and Objectives: Using the concept of liminality, and permanent liminality, the thesis explores how we can interpret and understand men’s experience of prostate cancer diagnosis and treatment, and their struggle to regain power and control in the context of diagnosis, and also the side effects to treatment. The strategies men adopt in seeking out personalised medical programmes of treatment with their doctors are explored in detail. The power and control that can be exercised over medical professionals and treatment options is demonstrated. Method: Collecting responses online from prostate specific discussion boards via gatekeepers, and from interviews on the ‘health talk’ online database, three intersecting conceptual categories - liminality, masculinity and the body/embodiment - are combined in this research. Liminality and ‘time’ are directly linked to notions of ‘success’ and ‘outcome’ during the treatment process, and mark distinct points at which men, and their families, expect measures or limits to have been reached. Exploring liminality within the context of Turner’s ‘rites of passage’, I explore the difficulty men face in concluding the third stage of the rites; reintegration. Results: Prostate cancer diagnosis and treatment, impotence and incontinence, in particular, have profound implications for the continuous construction of embodied masculine identities, and thus identity in general, making the construction of hegemonic ideals in the context of a highly ‘performative’ society highly troublesome. The issue of ‘spontaneity’ in the construction of various forms of embodied identities is of particular concern for men who contributed to this study.

Du mal vertébral ou de l'impotence des extrémités inférieures, que reconnoît pour cause un vice de la colonne épinière, avec la moyen pour la guérir /

Mode of access: Internet.

“My people seem to be falling to bits”: impotence, memory, and the co-possibility of body and mind in Samuel Beckett’s works

The present thesis examines the representation of the impotent body and mind in a selection of Samuel Beckett’s dramatic and prose works. Aiming to show that the body-mind relation is represented as one of co-implication and co-constitution, this thesis also takes the representation of memory in Beckett’s work as a key site for examining this relation. The thesis seeks to address the centrality of the body and embodied subjectivity in the experience of memory and indeed in signification and experience more generally. In these terms, Chapter 1 analyzes the representation of the figure of the couple in Beckett’s drama of the 1950s – as a metaphor of the body-mind relation – and, in light of Jacques Derrida’s theory of the supplement and Bernard Stiegler’s theory of technics, it discusses how the relationship between physical body and mind is defined by an essential supplementarity that is revealed even (or especially) in their apparent separation. Furthermore, the impotence that marks both elements in Beckett’s writings, when it is seen to lay bare this intrication, can be viewed, in important respects, as enabling rather than merely privative. Chapter 2 discusses the somatic structure of memory as represented in four of Beckett’s later dramatic works composed in the 1970s and 1980s. Similarly to Chapter 1, the second chapter focuses on the more “extreme” representation of bodily impotence in Beckett and demonstrates that rather than a merely “mental” recollection, memory in the work of Beckett is presented as necessarily experienced through, and shaped by, the body itself. In this light, then, it is shown that despite the impotence that marks the body in Beckett’s work of the 1970s and 1980s, the body is a necessary site of memory and retains or discovers a kind of activity in this impotence. Finally, Chapter 3 shifts its attention to Beckett’s prose works in order to explore how such works, reliant on language rather than the physical performance of actors onstage, sustain questions of embodied subjectivity at their heart. Specifically, the chapter argues that, on closer inspection, Beckett’s “literature of the unword” is not an abstention from meaning and its materialization, but one that paradoxically foregrounds that “something” which remains an essential part of it, that is, an embodied subjectivity.

Party 25

Party 25 involved the conception and public launch of a radically new form of political party during that year’s Australian general election. The entire project was also intentioned as a conceptual artwork. Party 25 avoided conventional party-political approaches and was neither a protest group nor an advocacy organisation, but rather a new form of political association that confronted what we understood as the debilitating limits and impotence of contemporary parliamentary democracies in transitioning our societies towards ecological sustainability.----- Party 25 was based on responding to one fundamental question which all of its policies served - “how does humanity get to the 25th century?” By basing itself on a dramatically long-term approach uncommon within conventional politics it raised the proposition that humanity does not have an assured future. Party25 therefore shaped its agendas around the idea that any future now lies in human hands and so how humanity treats the ecologies on which it depends innately determines the quality of the inseparable relationship between its being, and the being of the biophysical world.----- The project was conceived through a number of discussion papers, workshops and creative works and was launched publicly at the Judith Wright Centre Brisbane accompanied by a full length showing of evocative imagery, text and sound, a series of speeches and the launch of a succinct web presence. Through the website and this party launch a community of interested participants and creative practitioners was sought who then would form the basis of a nascent community of change.

11:59

At first glance, the gallery seems to be empty. Upon entering however, 11:59 reveals itself to be masking tape placed lackadaisically in seemingly geometric forms. Enter the gallery at 11:59 and you would witness the light and shadows correlate with the gestural marks that have been made. Exploring ideas of time, space, gesture, value and mark-making, this work can be interpreted to be overflowing with confidence and/or impotence. It whispers about site and encounters, over-complication and simplicity, and boldness and hesitancy.

The GAF Domain of the cGMP-Binding, cGMP-Specific Phosphodiesterase (PDE5) Is a Sensor and a Sink for cGMP

We describe here a novel sensor for cGMP based on the GAF domain of the cGMP-binding, cGMP-specific phosphodiesterase 5 (PDE5) using bioluminescence resonance energy transfer (BRET). The wild type GAFa domain, capable of binding cGMP with high affinity, and a mutant (GAFaF163A) unable to bind cGMP were cloned as fusions between GFP and Rluc for BRET2 assays. BRET2 ratios of the wild type GAFa fusion protein, but not GAFaF163A, increased in the presence of cGMP but not cAMP. Higher basal BRET2 ratios were observed in cells expressing the wild type GAFa domain than in cells expressing GAFaF163A. This was correlated with elevated basal intracellular levels of cGMP, indicating that the GAF domain could act as a sink for cGMP. The tandem GAF domains in full length PDE5 could also sequester cGMP when the catalytic activity of PDE5 was inhibited. Therefore, these results describe a cGMP sensor utilizing BRET2 technology and experimentally demonstrate the reservoir of cGMP that can be present in cells that express cGMP-binding GAF domain-containing proteins. PDE5 is the target for the anti-impotence drug sildenafil citrate; therefore, this GAF-BRET2 sensor could be used for the identification of novel compounds that inhibit cGMP binding to the GAF domain, thereby regulating PDE5 catalytic activity.

El significado de la prosopopeya de las Leyes en el "Critón" de Platon

El objeto de este trabajo es realizar un estudio iusfilosófico sobre la aparición de las Leyes (nómoi) personificadas de Atenas en el Critón de Platón. La prosopopeya de las Leyes resulta ser un aspecto central para poder comprender la obra, ya que éstas entablan un diálogo imaginario con Sócrates en el cual instalan diversos argumentos filosóficos para fundamentar la autoridad de la pólis. A los fines de identificar el valor argumentativo de este recurso en la obra, analizaré el significado del nómos en la Atenas del siglo V a. C. y la naturaleza de las Leyes en el contexto general del diálogo. Se busca demostrar la importancia que tienen aquéllas para explicar la decisión de Sócrates de beber la cicuta.

Sildenafil (Viagra)-induced spontaneous intracerebral haemorrhage

Sildenafil (Viagra) has been developed as a drug to help male impotence. It has a direct effect on the vasculature of the corpus cavernosum. A case of spontaneous intracerebral haemorrhage (ICH) following the illicit use of Viagra is reported. A discussion of drug-induced ICH is included.

A population-based study of adverse physical effects following prostate cancer treatments: Results from the PiCTure (Prostate cancer treatment – your experience) study

Background:

Men and clinicians need reliable population based information when making decisions about investigation and treatment of prostate cancer. In the absence of clearly preferred treatments, differences in outcomes become more important.

Aim:

To investigate rates of adverse physical effects among prostate cancer survivors 2-15 years post diagnosis by treatment, and estimate population burden.

Methods:

A cross sectional, postal survey to 6,559 survivors (all ages) diagnosed with primary, invasive prostate cancer (ICD10-C61), identified in Northern Ireland and the Republic of Ireland via cancer registries. Questions included symptoms at diagnosis, treatments received and adverse physical effects (impotence, urinary incontinence, bowel problems, breast changes, libido loss, hot flashes, fatigue) experienced ‘ever’ and ‘current’ i.e. at questionnaire completion. Physical effect levels were weighted by age, country and time since diagnosis for all prostate cancer survivors. Bonferroni corrections were applied to account for multiple comparisons.

Results:

Adjusted response rate 54%, (n=3,348). 75% reported at least one current physical effect (90% ever), with 29% reporting at least three. These varied by treatment. Current impotence was reported by 76% post-prostatectomy, 64% post-external beam radiotherapy with hormone therapy, with average for all survivors of 57%. Urinary incontinence (overall current level: 16%) was highest post-prostatectomy (current 28%, ever 70%). 42% of brachytherapy patients reported no current adverse physical effects; however 43% reported current impotence and 8% current incontinence. Current hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more commonly by patients on hormone therapy.

Conclusions:

This study provides evidence that adverse physical effects following prostate cancer represent a significant public health burden; an estimated 1.6% of men over 45 is a prostate cancer survivor with a current adverse physical effect. This information should facilitate investigation and treatment decision-making and follow-up care of patients.

Patient-reported 'ever had' and 'current' long term physical symptoms following prostate cancer treatments

OBJECTIVE: To document prostate cancer patient reported 'ever experienced' and 'current' prevalence of disease specific physical symptoms stratified by primary treatment received.
PATIENTS: 3,348 prostate cancer survivors 2-15 years post diagnosis.
METHODS: Cross-sectional, postal survey of 6,559 survivors diagnosed 2-15 years ago with primary, invasive PCa (ICD10-C61) identified via national, population based cancer registries in Northern Ireland and Republic of Ireland. Questions included symptoms at diagnosis, primary treatments and physical symptoms (impotence/urinary incontinence/bowel problems/breast changes/loss of libido/hot flashes/fatigue) experienced 'ever' and at questionnaire completion ("current"). Symptom proportions were weighted by age, country and time since diagnosis. Bonferroni corrections were applied for multiple comparisons.
RESULTS: Adjusted response rate 54%; 75% reported at least one 'current' physical symptom ('ever':90%), with 29% reporting at least three. Prevalence varied by treatment; overall 57% reported current impotence; this was highest following radical prostatectomy (RP)76% followed by external beam radiotherapy with concurrent hormone therapy (HT); 64%. Urinary incontinence (overall 'current' 16%) was highest following RP ('current'28%, 'ever'70%). While 42% of brachytherapy patients reported no 'current' symptoms; 43% reported 'current' impotence and 8% 'current' incontinence. 'Current' hot flashes (41%), breast changes (18%) and fatigue (28%) were reported more often by patients on HT.
CONCLUSION: Symptoms following prostate cancer are common, often multiple, persist long-term and vary by treatment. They represent a significant health burden. An estimated 1.6% of men over 45 is a prostate cancer survivor currently experiencing an adverse physical symptom. Recognition and treatment of physical symptoms should be prioritised in patient follow-up. This information should facilitate men and clinicians when deciding about treatment as differences in survival between radical treatments is minimal.

Estudo sobre o consumo de tabaco entre os adolescentes da Ilha Terceira

RESUMO - O objetivo deste estudo foi conhecer o comportamento face ao consumo de tabaco reportado pelos adolescentes escolarizados da ilha Terceira e caracterizar alguns fatores associados. O estudo realizado assumiu uma metodologia de investigação observacional, descritiva, quantitativa e de carácter transversal. Os dados foram recolhidos no ano letivo 2012/2013, nos alunos do 9.º ano de escolaridade, através da aplicação de um questionário de autopreenchimento, anónimo e voluntário, em contexto de sala de aula. A amostra foi constituída por 323 adolescentes, 142 do sexo masculino e 181 do sexo feminino, com idade média de 14,71 anos. Verificou-se que cerca de 16,9% dos adolescentes consome tabaco regularmente, 6,6% ocasionalmente e 76,6% não fuma. Mais de metade dos adolescentes já experimentou fumar tabaco (56%), sendo a idade média de experimentação de 12,49 anos. A maioria dos adolescentes que experimentaram fumar referiram tê-lo feito por curiosidade (84,7%) e, sobretudo, na companhia dos amigos (83,1%). As variáveis associadas ao comportamento tabágico foram: o desempenho escolar, os hábitos tabágicos dos amigos, a permissividade dos pais para se fumar em casa, a frequência à exposição ao tabaco em casa, os conhecimentos da “impotência sexual” como consequência do consumo de tabaco, conhecimento dos danos na saúde em frequentar ambientes com fumo e a crença de que os jovens fumadores são mais atraentes. Os resultados mostram a elevada necessidade de serem desenvolvidas estratégias de prevenção e controlo do tabagismo entre os adolescentes da ilha Terceira.

Les axes prioritaires face à l'émergence de phénomènes criminels en banlieue québécoise : l'exemple d'un quartier de laval.

Les médias renforcent l’image négative de l’émergence de zones criminelles dans certaines banlieues, mettant en avant l’impuissance des interventions policières et de la stratégie étatique. Les citoyens vivant au quotidien dans ces quartiers expriment un sentiment d’insécurité. L’impression d’un cercle vicieux entre insécurité réelle et sentiment d’insécurité persiste alors au travers de tels discours et perdure au travers des époques et des lieux, que ce soit en France, aux États-Unis ou même au Canada. Bon nombre d’études ont déjà posé la question à savoir si ces discours se fondent sur une réelle situation d’insécurité ou sur le sentiment d’insécurité des citoyens mais peu ont pris l’axe d’approfondir la réflexion et l’étude sur ces nouveaux phénomènes de désordres urbains et d’incivilités émergents dans les banlieues du Québec. Cette recherche a pour but d’approfondir cette réflexion en prenant un exemple d’un quartier de Laval au Québec. Il s’agit d’établir s’il y a réelle problématique d’incivilités et de désordres urbains ou s’il s’agit davantage d’un sentiment d’insécurité, le but étant ainsi de pouvoir établir un guide de résolutions de problèmes dans les banlieues et d’apporter une réflexion sur les interventions potentielles dans des zones sensibles. Se basant sur une méthodologique mixte, reliant une comparaison des statistiques de criminalité par quartiers à la perception d’acteurs clés de terrain de Laval, cette recherche apporte un nouveau regard sur ces résolutions de problèmes. Les résultats apportent une analyse intéressante sur cette interaction en soulignant l’importance du quartier et des caractéristiques sociodémographiques, du contrôle social informel, du tissu social mais aussi de la nécessité du cadre de l’autorité institutionnelle telle que la police, l’école ou encore le tissu associatif. Ces premiers éléments permettent d’ouvrir la discussion sur un plan partenarial d’interventions établissant une stratégie de lutte contre l’insécurité et le sentiment d’insécurité, cassant ainsi ce cercle vicieux par la mise en place d’une nouvelle gouvernance locale de sécurité et de bien-vivre ensemble.

A comunicação da equipe de enfermagem com o paciente em cuidados paliativos

The article consists of a contextualized reflection on the communication in palliative care with the purpose of explaining strategies used for effective communication among the nursing, terminally ill and his family. In that sense, it was observed that for the nurse to assist the terminally ill is a difficult task, which raises sensation of sadness, frustration, impotence and even failure in the rendered attendance. This way, many professionals use denial, escaping, and the apparent coldness as defense mechanisms to cope with situation. Throughout this discussion are exposed some aspects that enable developing empathic communication skills, perceived as a task that requires nursing staff a shift in focus and attitude. Apart from careful listening, truthfulness, good humor and therapeutic touch, forming strategies for effective communication in the terminally ill life.