The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03–1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 2.30–3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer

O devir-consciente em rodas de poesia On becoming aware in poetry reading

O texto discute o conceito de devir-consciente, proposto por Depraz, Varela e Vermersch (2003), à luz de uma experiência de rodas de poesia no contexto de um trabalho comunitário com mulheres de classes populares. Apresenta o ciclo básico e a intuição que caracterizam o devir-consciente, sugerindo que esta é uma prática de produção de subjetividade. Analisa o caso específico do devir-consciente de experiências de breakdown (VARELA, 1994), que acessam o plano pré-subjetivo da cognição e que se potencializam na situação grupal através de uma dinâmica de ressonâncias. A roda de poesia revela uma dimensão coletiva da cognição e é proposta uma modalidade de relato que busca dar expressão a ela. A partir desta experiência de cognição coletiva, são levantadas questões relativas aos métodos de primeira e segunda pessoas que se apresentam no campo das ciências cognitivas contemporâneas.<br>In this work we discuss the concept of "becoming-aware", as defined by Depraz, Varela, and Vermersch (2003), in the light of an experience of poetry reading in the context of a community work with lower class women. We present the basic cycle and the intuition that characterize the becoming-aware, suggesting that this is a practice of production of subjectivity. We also analyze a particular case of becoming-aware in experiences of breakdown (VARELA, 1994), which mobilize the pre-subjective level of cognition and empower group situation by means of a dynamics of resonances. Since the practice of poetry reading reveals a collective dimension of cognition, we propose a modality of writing which would be adequate to express it. Based on this experience of collective cognition, we bring up issues concerning the methods of first and second persons in the field of contemporary cognitive sciences

Crianças em trilhas na natureza: jogos de percurso e reencantamento Children in nature's trail: itinerary games and re-enchantment

O presente estudo analisa a atividade de caminhada por trilhas na floresta. Busca desvelar a estrutura dinâmica da atividade, seu universo simbólico e seu núcleo temático à luz dos estudos sobre o ato de brincar, os milenares jogos de percurso e as representações do meio ambiente. Inspirado no modelo da pesquisa etnográfica, teve na observação e registro suas principais ferramentas. As respostas emocionais aos diferentes apelos da paisagem, tais como as cavernas, a fenda, o mirante, a cachoeira que trouxeram a tona toda uma profusão de imagens que remetiam ao universo simbólico dos tradicionais jogos de percurso.<br>The present study analyses children's tracking activity at Forest. It aims at showing the dynamic structure of the activity, its symbolic universe as well as its thematic nucleus according to the act of playing studies, the millenarian itinerary games and the environment representations. Inspired on the ethnographic research model, the main tools were observation and recording. The emotional answers to different landscapes appeals such as caves, cracks, sightseeing sand waterfalls brought up lots of images that would remind the symbolic universe of the traditional itinerary games