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

Arte e loucura como limiar para outra história

We intend to problematize art and madness. We begin by discussing the experience of the researcher in relation to images of the world, to witnessing and to the image of the insane, and then inevitably to the outside they evoke. Subsequently, we stand before a wall, a limit situation in which madness as catastrophe and art as poetics compose a threshold, an absence which Blanchot transposes to language to bring other possible constellations into view, both as words and as their unnamable others. Finally, with Walter Benjamin, we touch upon the grain of the history of madness - immersed in the Writing Workshop at the São Pedro Psychiatric Hospital, in Porto Alegre, Brazil, we reveal that, in relation to madness, art can become the essential language of the perilous passage towards experience, transposing the experience of this horrific state to bring another sense to the world, recognizing other modes of existence which may come to be other poetics of life.Nuestra intención es de problematizar el arte y la locura, inicialmente discutiendo la experiencia del investigador en relación con las imágenes del mundo, el testimonio y la figura del loco, y por lo tanto con el afuera que ella evoca. Seguidamente, nos ponemos delante de un muro, una situación extrema en la que la locura como catástrofe y el arte como vía poética componen un umbral, una ausencia que Blanchot transpone en lenguaje para revelar las otras constelaciones posibles tanto como palabras, tanto como innombrables otros. Por último, con Walter Benjamin, ponemos la historia de la locura a contra pelo, y sumergidos en el Taller de escritura del Hospital Psiquiátrico São Pedro de Porto Alegre, Brasil, desvelamos que, en relación con la locura, el arte puede convertirse en el lenguaje esencial de ese peligroso pasaje que nos conduce a la experiencia, que transpone lo vivido en este estado aterrador para dar otro sentido al mundo, reconociendo otros modos de existencia que pueden llegar a ser otras poéticas de vida.Pretendemos problematizar arte e loucura, inicialmente discutindo a experiência do pesquisador em relação às imagens do mundo, com o testemunho e a figura do louco e, consequentemente, com o fora que ela evoca. Em seguida nos colocamos diante do muro, situação-limite na qual a loucura enquanto catástrofe e a arte enquanto via poética vêm compor um limiar, ausência que Blanchot transpõe à linguagem para dar a ver outras constelações possíveis, tanto de palavras quanto de seus inomináveis. Por fim, com Walter Benjamin, pomos a história da loucura a contrapelo, e, mergulhados no Ateliê de Escrita do Hospital Psiquiátrico São Pedro, desvelamos que a arte pode, na relação com a loucura, tornar-se a linguagem essencial na perigosa travessia em direção à experiência, transpondo a vivência desse estado assustador para trazer ao mundo outro sentido, reconhecendo outros modos de existência que podem vir a ser outras poéticas de vida.Nous désirons problématiser l’art et la folie, initialement en discutant l’expérience du chercheur par rapport aux images du monde, avec le témoignage et l’image du fou, et, par conséquent, l’extérieur qu’elle évoque. Puis, on se pose devant le mur, situation extrême dans laquelle la folie comme catastrophe et l’art comme voie poétique composent un seuil viennent à construire un seuil, absence que Blanchot transpose en langage afin de révéler d’autres constellations possibles tant comme des mots, tant comme ses innombrables. Enfin, avec Walter Benjamin, nous prenons l’histoire de la folie à contre-poil, et plongés dans l’Atelier d’écriture de l’Hôpital psychiatrique de São Pedro, à Porto Alegre au Brésil, nous révélons que l’art, par rapport à la folie, peut devenir le langage essentiel de la traversée dangereuse vers l’expérience, en transposant le vécu de cet état terrifiant, afin de donner un autre sens au monde, tout en reconnaissant d’autres modes d’existence qui pourraient devenir d’autres poétiques de vie