O estudo da relação médico-paciente vem ganhando novos contornos não só em razão dos avanços biotecnológicos e da massificação do serviço, mas, principalmente, pelos princípios que o norteiam, como o da dignidade da pessoa humana e o da autonomia, consagrados pela Constituição Federal de 1988. O enfoque do presente trabalho é o caráter predominantemente existencial da relação jurídica decorrente de contrato privado, regulado pelo Código Civil, pelo Código de Defesa do Consumidor, e por outras leis e normas deontológicas. Tal relação surge de um vínculo de confiança, intuitu personae, mediante remuneração entre o paciente e o médico. Isto porque o alvo do contrato de prestação de serviços médicos é a saúde, a dignidade e o bem-estar psicofísico e social do paciente, o que impõe uma releitura do tratamento jurídico da relação médico-paciente, de sua estrutura e função, não mais adstrita ao aspecto patrimonial vigente na ótica oitocentista. Passa-se de um vínculo de perfil lógico-autoritário para o perfil dialógico-consensual, em que predomina a liberdade de escolha do paciente. A autonomia do paciente é a mola propulsora dessa relação da qual decorrem diversos direitos e deveres extrapatrimoniais, com maior ênfase no dever do médico de informar. É a informação que permite ao paciente o exercício de sua autodeterminação, seu poder de decidir acerca da disposição de seu próprio corpo por meio da intervenção médica, que inclui serviços de diagnóstico, terapêuticos, cirúrgicos, preventivos e pesquisa em seres humanos. Só após o paciente ser devidamente esclarecido acerca de seu estado de saúde, do tratamento proposto, dos benefícios e riscos envolvidos, tempo de duração, custos e natureza do procedimento, dentre outros fatores, poderá dar ao médico seu consentimento informado para realização das ações médicas da qual será objeto. O consentimento livre e esclarecido do paciente constitui uma das dimensões mais importantes do princípio da autonomia e legitima o ato médico. A autonomia do paciente é tão relevante que sua inobservância pelo médico, independentemente da prática de erro médico, pode dar ensejo à sua responsabilização civil, por configurar por si só fato ou vício do serviço médico, o que lhe confere direito à reparação integral dos danos injustos sofridos, como vem sendo reconhecido pelos Tribunais brasileiros.

Introdução: Interrupção diária da sedação e sedação intermitente são efetivas na redução do tempo de ventilação mecânica. No entanto, a superioridade de uma em relação à outra não foi ainda determinada. Nosso objetivo foi comparar a interrupção diária da sedação e a sedação intermitente quanto à duração da ventilação mecânica em uma unidade de terapia intensiva (UTI) com baixa densidade de pessoal de enfermagem. Métodos: Pacientes adultos com expectativa de permanecerem por mais de 24h em ventilação mecânica foram randomizados, em um centro único, à interrupção diária da infusão de sedativos e opioides ou à sedação intermitente. Em ambos os casos, o objetivo era manter os pacientes em nível de SAS (Sedation Agitation Scale) 3 ou 4, ou seja, os pacientes deveriam estar calmos ou serem facilmente despertos com estímulo verbal ou leve sacudida. O desfecho primário foi número de dias livres da ventilação mecânica em 28 dias. Os desfechos secundários foram mortalidade na UTI e hospitalar, incidência de delirium, carga de trabalho da enfermagem, extubação acidental e stress psicológico seis meses após a alta da UTI. Resultados: Foram incluídos 60 pacientes. Não houve diferenças quanto ao número de dias livres em 28 dias entre interrupção diária da sedação e sedação intermitente (mediana: 24 vs. 25 dias, P = 0,160). Também não houve diferenças quanto à mortalidade na UTI (40 vs. 23,3%, P = 0,165) ou hospitalar (43,3 vs. 30%, P = 0,284), incidência de delirium (30 vs. 40%, p = 0,472), extubação acidental (3,3 vs. 6,7%, P = 0,514) e stress psicológico seis meses após a alta da UTI. A carga de trabalho de enfermagem não foi diferente entre os dois grupos, mas reduziu-se no quinto dia de internação na UTI em comparação com o primeiro dia [Nurse Activity Score (NAS) no grupo sedação intermitente foi 54 no dia 1vs. 39 no dia 5, P < 0.001; NAS no grupo interrupção diária da sedação foi 53 no dia 1 vs. 38 no dia 5, P < 0.001]. As dosagens de fentanil e midazolam por paciente foram maiores no grupo interrupção diária da sedação. O volume corrente foi maior no grupo sedação intermitente durante os primeiros cinco dias de internação na UTI. Conclusões: Não houve diferenças quanto ao número de dias livres de ventilação mecânica em 28 dias entre os grupos. Sedação intermitente associou-se a um menor uso de sedativos e opioides / Introduction: Daily sedative interruption and intermittent sedation are effective in abbreviating the time on mechanical ventilation. Whether one is superior to the other has not yet been determined. Our aim was to compare daily interruption and intermittent sedation during the mechanical ventilation period in a low nurse staffing intensive care unit (ICU). Methods: Adult patients expected to need mechanical ventilation for more than 24 hours were randomly assigned, in a single center, either to daily interruption of continuous sedative and opioid infusion or to intermittent sedation. In both cases, our goal was to maintain a Sedation Agitation Scale (SAS) level of 3 or 4; that is patients should be calm, easily arousable or awakened with verbal stimuli or gentle shaking. Primary outcome was ventilator-free days in 28 days. Secondary outcomes were ICU and hospital mortality, incidence of delirium, nurse workload, self-extubation and psychological distress six months after ICU discharge. Results: A total of 60 patients were included. There were no differences in the ventilator-free days in 28 days between daily interruption and intermittent sedation (median: 24 versus 25 days, P = 0.160). There were also no differences in ICU mortality (40 versus 23.3%, P = 0.165), hospital mortality (43.3 versus 30%, P = 0.284), incidence of delirium (30 versus 40%, P = 0.472), self-extubation (3.3 versus 6.7%, P = 0.514), and psychological stress six months after ICU discharge. Also, the nurse workload was not different between groups, but it was reduced on day 5 compared to day 1 in both groups (Nurse Activity Score (NAS) in the intermittent sedation group was 54 on day 1versus 39 on day 5, P < 0.001; NAS in daily interruption group was 53 on day 1 versus 38 on day 5, P < 0.001). Fentanyl and midazolam total dosages per patient were higher in the daily interruption group. The tidal volume was higher in the intermittent sedation group during the first five days of ICU stay. Conclusions: There was no difference in the number of ventilator-free days in 28 days between both groups. Intermittent sedation was associated with lower sedative and opioid doses

Esta pesquisa analisa a expressão artística dos alunos de uma escola Waldorf da cidade de São Paulo SP Brasil, com o objetivo de compreender a estreita ligação entre arte e sensibilidade que se apresenta enquanto caminho para a harmonização da alma humana e a contribuição da arte para o desenvolvimento da razão, da intuição, da emoção e do sentimento. Isto pode ser comprovado pela produção elaborada pelos alunos, interpretada e compreendida a partir das atividades especificas do cotidiano escolar com o aporte teórico de autores que buscam entender o ser humano através do equilíbrio entre sensibilidade e razão. A pesquisa apóia-se teoricamente na Antroposofia de Rudolf Steiner para o estudo da utilização pedagógica da arte; na cosmovisão cientifica e artística de Johann Wolfgang Goethe e na sua Doutrina das Cores; n A Educação Estética do Homem de Friedrich Schiller; na Psicologia Analítica de Carl Gustav Jung; na transformação alquímica através da imaginação ativa utilizada por Jung. O referencial teórico dos autores transita no eixo existente entre o consciente e o inconsciente, entre a razão e a sensibilidade, entre o sensível e o inteligível. A contribuição final é a reflexão sobre a utilização prática dos procedimentos artísticos e sua influência sobre o desenvolvimento cognitivo e a aquisição de conhecimento que conduz ao equilíbrio entre razão e sensibilidade. / This research analyses the artistic expression of students in a Waldorf school at the city of São Paulo SP Brazil, in order to comprehend the close connection between art and sensitivity that shows itself as a path to develop reason, intuition, emotion and feeling. This can be proof by the production elaborated by the students, interpreted and comprehended from the specific everyday school activities with the theory support of Rudolf Steiners Anthroposophy for the study of the pedagogical utilization of art; in the scientific and artistic cosmovision of Johann Wolfgang Goethe and his Doctrine of Colors; in the Aesthetic Education of Man of Friedrich Schiller; in the analytical psychology of Carl Gustav Jung; in the alchemy transformation by means of active imagination used by Jung. The theoretical references of the authors circulate in the axis existent between conscious and unconscious, between reason and sensitivity, between the sensitive and the intelligible. The final contribution is the reflection about practical utilization of artistic procedures and their influences on cognitive development and the knowledge acquirement that leads to balance between reason and sensitivity.

Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2017-05-10T20:18:04Z No. of bitstreams: 2 Tese - Heloisa de Sousa Gomes Rodrigues - 2016.pdf: 24514601 bytes, checksum: 5d8491e9be339376d5b3114ac0b8fd41 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-05-11T12:08:41Z (GMT) No. of bitstreams: 2 Tese - Heloisa de Sousa Gomes Rodrigues - 2016.pdf: 24514601 bytes, checksum: 5d8491e9be339376d5b3114ac0b8fd41 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-05-11T12:08:41Z (GMT). No. of bitstreams: 2 Tese - Heloisa de Sousa Gomes Rodrigues - 2016.pdf: 24514601 bytes, checksum: 5d8491e9be339376d5b3114ac0b8fd41 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-12-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Paediatric dental treatment may stress children and their parents influencing the child behaviour and the maternal dental anxiety. It is important to understand those behavioural and physiological alterations to aid using of adequate sedatives techniques during paediatric dental procedure. The aim of this study was to evaluate the stress of children and their mothers during the paediatric dental treatment using different sedation protocols. Also, the maternal dental anxiety, the child’s behaviour and age and its associations were evaluated. This observational study is a secondary analysis of two randomised controlled clinical trials. Children aged 2-6 years old received one tooth restoration under moderate sedation according to the groups: [A] 18 children received oral midazolam (1.0 mg/kg) and [B] 18 children received placebo in a crossover design [Clinical Trials database (NCT01795222)]; [C] 14 children received oral midazolam (0.5 mg/kg) and oral ketamine (3.0 mg/kg) plus sevoflurane inhalation (0.3% - 0.4%) and [D] 13 children had oral midazolam (0.5 mg/kg) and oral ketamine (3.0 mg/kg) plus oxygen inhalation in a parallel design (NCT02284204). The sessions were video recorded for evaluation of child behaviour using OSUBRS scale (Ohio State University Behavioural Rating Scale) and mothers answered the Brazilian version of Dental Anxiety Scale (DAS). The saliva samples were collected on children and on their mothers at 4 moments: waking up (T0), upon arrival at Dental School (T1), 25 minutes after the local anaesthesia injection on child (T2) and 25 minutes after the end of procedure (T3). Salivary cortisol was measured using an immunoassay kit (ELISA). As the data presented non normal distribution (Shapiro Wilk, p>0,05), Kruskal-Wallis and Mann-Whitney tests were used for non paired comparisons and Mann-Whitney for associations among the variables. For paired comparisons, Friedman and Wilcoxon tests were used (p<0,05). The increase of cortisol levels from T1 to T2 (reactivity to stressful stimulus – local anaesthesia) was higher in children of group [B] [median (interquartile)] – [0.53 (0.60)] following by groups [D] – [0.21 (0.35)], [C] – [0.11 (0.49)] and [A] – [0.02 (0.59)] (p=0.02). The decrease of cortisol levels from T2 to T3 (regulation to stress) was higher in children of group [B] – [0.08 (0.29)] following by groups [A] [-0.02 (0.40)], [C] – [-0.18 (0.41)] and [D] – [-0.19 (0.8)] (p=0.02). Majority of mothers were not stressed during their child’s local anaesthesia injection (67.9%) and presented low/moderate anxiety (69.6%), while 25.0% of them presented high/severe anxiety (DAS scale). Mothers who reacted to stress (increasing of cortisol at least 10% from T1 to T2) had higher cortisol levels at the moments T2 [0.15 (0.48)] and T3 [0.16 (0.50)] compared to T1 [0.09 (0.17)] (p<0.01 and p<0.006, respectively). On the other hand, mothers who did not react to stress had higher cortisol levels at the moments: T1 [0.36 (0.18)] compared to T2 [0.16 (0.18)] (p<0.01) and T3 [0.10 (0.12)] (p<0.01) and T2 compared to T3 (p=0.01). There was no statistically significant association between maternal stress (salivary cortisol levels) with child behaviour (p=0.56), child’s age (p=0.48) and maternal dental anxiety (DAS) (p=0.69). The findings of this study allow to conclude that sedation protocol using oral ketamine caused higher liberation of salivary cortisol at the moments of local anaesthesia and at the end of procedure (higher reactivity and lower regulation) indicating a prolonged response to physiological stress in children, which was not observed during the use of oral midazolam. Although, there was any maternal dental anxiety most of mothers were not stressed during the dental treatment under sedation of their children. Also, maternal dental anxiety, child’s age and child behaviour did not influence the maternal stress. / O tratamento odontopediátrico pode causar estresse em crianças e em seus acompanhantes prejudicando o comportamento infantil e a ansiedade odontológica materna. A compreensão dessas alterações fisiológicas e comportamentais é de suma importância a fim de auxiliar no uso de técnicas sedativas adequadas durante o atendimento odontológico infantil. O objetivo deste estudo foi avaliar o estresse de crianças e de suas respectivas mães durante o tratamento odontopediátrico sob diferentes protocolos de sedação. Além disso, objetivou-se avaliar a ansiedade odontológica materna e o comportamento infantil, bem como a associação destas características. Este estudo observacional é uma análise de dados de dois ensaios clínicos randomizados e controlados. Crianças de 2 a 6 anos de idade receberam tratamento odontológico restaurador padronizado sob sedação moderada de acordo com os grupos: [A] 18 crianças receberam midazolam oral 1,0 mg/kg e [B] 18 crianças receberam placebo, em um desenho cruzado [Clinical Trials database (NCT01795222)]; [C] 14 crianças receberam midazolam oral 0,5 mg/kg e cetamina oral 3,0 mg/kg mais inalação de sevoflurano (0,3% - 0,4%) e [D] 13 crianças tiveram midazolam oral 0,5 mg/kg e cetamina oral 3,0 mg/kg mais inalação de oxigênio, em um desenho paralelo (NCT02284204). As sessões foram filmadas para posterior avaliação do comportamento infantil usando a escala OSUBRS (Ohio State University Behavioural Rating Scale) e as mães responderam a versão Brasileira da Dental Anxiety Scale (DAS). As coletas de saliva foram realizadas concomitantemente nas crianças e mães em 4 momentos: ao acordar (T0), na chegada na clínica (T1), 25 minutos após a aplicação da anestesia local na criança (T2) e 25 minutos após o término do procedimento (T3). O cortisol salivar foi mensurado por meio de ensaio imunoenzimático (ELISA). Como os dados apresentaram distribuição não normal (Shapiro Wilk, p>0,05), o teste de KruskalWallis seguido de Mann-Whitney foram utilizados para comparações não pareadas e MannWhitney para associação entre as variáveis. Para análises pareadas, o teste de Friedman seguido de Wilcoxon foi utilizado adotando-se como nível de significância um valor de 5% (p<0,05). O aumento do cortisol de T1 para T2 (reatividade ao estímulo estressor – anestesia) foi maior em crianças do grupo [B] [mediana (interquartil)] – [0,53 (0,60)] seguido dos grupos [D] – [0,21 (0,35)], [C] – [0,11 (0,49)] e [A] – [0,02 (0,59)] (p=0,02). Já a redução do cortisol de T2 para T3 (regulação ao estresse) foi maior em crianças do grupo [B] – [0,08 (0,29)] seguido dos grupos [A] [-0,02 (0,40)], [C] – [-0,18 (0,41)] e [D] – [-0,19 (0,8)] (p=0,02). A maioria das mães não ficaram estressadas durante a aplicação da anestesia local em seus filhos (67,9%) e apresentaram ansiedade baixa/moderada (69,6%), enquanto 25,0% delas apresentaram alta/severa ansiedade (escala DAS). As mães que reagiram ao estresse (aumento de pelo menos 10% do nível de cortisol salivar do momento T1 ao T2) tiveram maiores níveis de cortisol nos momentos T2 [0,15 (0,48)] e T3 [0,16 (0,50)] comparado com T1 [0,09 (0,17)] (p<0,01 e p=0,006, respectivamente). Por outro lado, mães que não reagiram tiveram maior nível de cortisol nos momentos: T1 [0,36 (0,18)] comparado a T2 [0,16 (0,18)] (p<0,01) e T3 [0,10 (0,12)] (p<0,01); T2 comparado a T3 (p=0,01). Não houve associação estatisticamente significante entre o nível de cortisol salivar das mães com o comportamento infantil (p=0,56); idade das crianças (p=0,48) e ansiedade odontológica materna (DAS) (p=0,69). Os achados obtidos no presente estudo permitem concluir que o uso do protocolo de sedação com cetamina oral provocou aumento da liberação de cortisol salivar tanto no momento da anestesia quanto ao final do tratamento (maior reatividade e menor regulação) indicando uma resposta prolongada ao estresse fisiológico das crianças, o que não foi observado com o uso de midazolam oral. Embora algum grau de ansiedade odontológica materna tenha sido evidenciada, a maioria das mães não ficaram estressadas durante o tratamento odontológico sob sedação de seus filhos. Adicionalmente, a ansiedade odontológica das mães, bem como a idade e o comportamento infantil não influenciaram o estresse materno.

Wang Meng, an important figure of modern Chinese literature, is best known as an author experimenting with literary techniques at the turn of the 70s and the 80s. Our paper examines a relatively little-known part of his work inspired by the writer's many-year stay in Xinjiang. Examined proses originate primarily from two collections - In Yili and Hello, Xinjiang. In the analysis of Wang Meng's literary creation we take into account the historical context and we present particular features of the literary image of non-Han culture in the work of a Han writer. We also examine the use of narrative techniques, with particular focus on "stream of consciousness" technique.

Abstract The main objective of this research was to develop practical tools with which it is possible to improve the environment, micro-climate and energy economy of buildings and plans in different climate zones, and take the climate change into account. The parts of the study are: – State of art study into existing know-how about climate and planning. – Study of the effects of climate change on the built environment. – Development of simple micro-climate, nature and built environment analysis methods. – Defining the criteria of an acceptable micro-climatic environment. – Development of the wind test blower. – Presenting ways to interpret test results and draw conclusions. – Development of planning and design guidelines for different climate zones. An important part of the research is the development of the CASE wind test instrument, different wind simulation techniques, and the methods of observing the results. Bioclimatic planning and architectural design guidelines for different climate zones are produced. The analyse tools developed give a qualitative overall view, which can be deepened towards a quantitative analyse with wind testing measurements and roughness calculations. No mechanical rules are suggested, but complementary viewpoints and practices introduced to a normal planning process as well as improvement of consultative knowledge. The “method” is that there is no strict mechanical method, but a deeper understanding of bioclimatic matters. Climate-conscious planning with the developed CASE method, make it possible to design a better micro-climate for new or old built-up areas. Winds can be used in to ventilate exhaust fumes and other pollutants, which improves the quality of air and the healthiness of the urban environment. The analyses and scale-model tests make it possible to shield cold windy areas and to diminish the cooling effect of wind on facades. According to studies in Scandinavian countries this will bring energy savings of 5–15 per cent. The method can be used to: – Evaluation of the cooling effect of wind. Areas and facades exposed to wind. – Evaluation of the wind comfort at the pedestrian level. Windy areas, relative wind speeds. – Enhancing wind-forced ventilation. Positive and negative pressures at the inlets and outlets. – Analysis of the diffusion of pollutants. Ventilation of streets and areas. – Avoiding the damages caused by wind. Planning and designing wind protective solutions. – Characterisation of the wind loading of small and medium-size street architecture items. Designing wind resistant and protective items and plantings. – Analysing the drifting of snow. Placing of snow fences. / Tiivistelmä Tutkimuksen päätavoitteena oli kehittää käytännöllisiä suunnitteluvälineitä, joilla voidaan parantaa ympäristöä, mikroilmastoa sekä rakennusten ja kaavojen energiataloutta eri ilmastovyöhykkeissä, sekä varautua ilmaston muutokseen. Tutkimuksen osat ovat: – Selvitys tämän hetkisestä ilmastoon ja suunnitteluun liittyvästä osaamisesta. – Selvitys ilmaston muutoksen vaikutuksesta rakennetulle ympäristölle. – Yksinkertaisten mikroilmasto-, luonto- ja rakennetunympäristön analyysien kehittäminen. – Määritellä hyväksyttävän mikroilmaston kriteerit. – Kehittää pienoismallien tuulitestauslaite. – Kehittää metodit testitulosten analysoimiseksi ja johtopäätösten vetämiseksi. – Laatia kaavoitus- ja rakennussuunnitteluohjeet eri ilmastovyöhykkeille. Tärkeä osa tutkimusta oli CASE tuulitestauslaitteen, erilaisten tuulen simulointitekniikoiden ja testausten havainnointimenetelmien kehittäminen. Kehitettiin bioklimaattisen kaavoituksen ja arkkitehtisuunnittelun suunnitteluohjeet eri ilmastovyöhykkeisiin. Kehitetyt analyysimenetelmät antavat laadullisen yleiskuvan, jota voidaan syventää määrällisen analyysin suuntaan käyttämällä tuulitestausmittauksia ja karheuslaskelmia. Mitään mekaanisia metodeita ei ehdoteta, vaan halutaan lisätä tieto-taitoa sekä uusia näkökulmia ja työtapoja nykyisiin kaavoitus- ja konsultointikäytäntöihin. ”Metodi” on siinä, ettei ole mitään kaavamaista metodia, vaan bioklimaattisten tekijöiden syvempi ymmärtäminen. Kehitetyn CASE metodin mukaisella ilmastotietoisella suunnittelulla voidaan aikaansaada parempi mikroilmasto sekä uusilla että vanhoilla rakennetuilla alueilla. Tuulen avulla voidaan tuulettaa pakokaasut ja muut ilmansaasteet, ja näin parantaa rakennetun ympäristön ilmanlaatua ja terveellisyyttä. Analyysien ja pienoismallien tuulitestauksen avulla voidaan suojautua kylmiltä tuulilta ja vähentää tuulen julkisivuja jäähdyttävää vaikutusta. Skandinaavisten tutkimusten mukaan näin voidaan saavuttaa 5–25 prosentin energiansäästö. Metodia voidaan käyttää mm. seuraaviin tarkoituksiin: – Arvioida tuulen jäähdyttävää vaikutusta. Selvittää tuulelle alttiit alueet ja julkisivut. – Arvioida tuulen vaikutusta jalankulun mukavuuteen. Tuuliset alueet ja suhteelliset tuulennopeudet. – Tehostaa painovoimaista ilmanvaihtoa. Positiiviset ja negatiiviset paineet ilmastoinnin sisäänmeno- ja ulostuloaukoissa. – Analysoida saasteiden leviämistä. Katujen ja alueiden tuulettaminen. – Torjua tuulen aiheuttamia tuhoja. Kaavoittaa ja suunnitella tuulelta suojaavia ratkaisuita. – Luonnehtia pieniin ja keskikokoisiin ulkona oleviin rakenteisiin kohdistuvia tuulikuormia. Suunnitella tuulenkestäviä ja suojaavia rakennelmia ja istutuksia. – Analysoida lumen kinostumista. Lumiaitojen sijoittelu.

Magister Scientiae Dentium - MSc(Dent) / AIM:The aim of this study was to review the data available from the Department of Health(DOH), on pre-school paediatric patients treated under Dental General Anaesthesia(DGA), at public health facilities in the Western Cape (WC) in order to ascertain the type and nature of treatment provided.METHODOLOGY:This retrospective descriptive study reviewed the records on the Department of Health(DoH) Database of 16 732 pre-school patients treated under dental general anaesthesia in the period 1 January 2005 until 31 December 2007. A questionnaire was also completed telephonically with 22 dentists from the district dental health clinics.Summary descriptive statistics were calculated from data collected and comparisons were drawn between services available at the health districts and academic hospitals.RESULTS:Of the 58 255 procedures recorded for pre-school patients in the district health clinics in the Western Cape, 99.94% were for extractions provided and 0.5% for restorations.The average number of teeth extracted was 10.4 (SD ±3.9).The average rate of DGA per 1000 of the population was 1.06. Only 9% (2) of dentists at district clinics reported that pre-DGA prevention was provided and 5% (1) reported including post-DGA prevention. The Academic Hospital at Tygerberg Oral Health Centre was the only facility in the Western Cape that provided comprehensive dental treatment for pre-school patients which included restorations, extractions, pre and post DGA prevention. Red Cross Children’s Hospital provided treatment for pre-school patients under DGA that included extractions, pre- and post DGA, but no restorative treatment. CONCLUSION:The demand for DGA in pre-school patients in the WC was high. The lack of prevention associated with DGA in the public health service is the most likely reason the retreatment rate under DGA was reported by dentists as being 77%. There was an absence of protocol regarding DGA for pre-school patients in the public health service.RECOMMENDATIONS:Guidelines formulated were recommended for use in the public service for pre-school patients being treated under DGA and includes the provision of preventive interventions such as regular topical fluoride applications, oral hygiene instruction and dietary advice.

This study investigated the link between creative thought and intuition. These concepts were defined in terms of two psychometric tests used to measure personality and interest. The two tests used were the 19 Field Interest Inventory (19FII) and the Jung Personality Questionnaire (JPQ). Intuition was measured on a continuum in terms of Jung’s conceptualisation of intuition- sensation. Creative thought was conceived as both a cognitive and an unconscious process. The research was quantitative in nature. A comparison was done between the scores obtained on the personality questionnaire (JPQ) and the interest inventory (19FII) in order to determine if there was a link between intuition and creative thought. These results were inconclusive. Thereafter the study investigated whether the subjects enrolled for an engineering degree who used intuition as their dominant auxiliary function performed well in a course designed to promote creative thought. The results were inconclusive and this might be due to the small sample group and numerous variables that were not controlled. / Dissertation (MA (Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

Thesis Abstract The present thesis investigates correlations between a selection of metafictional texts and narrative theory. The selection consists in two sets of self-reflexive texts. The first one explores metafictional tendencies in the 17th and 18th century novels. To achieve this, the selection largely ignores their provenience. In addition to Henry Fielding's Tom Jones and Laurence Sterne's Tristram Shandy, it also examines Cervantes's Don Quixote. The latter set of texts focuses on post-War American metafictions (John Barth's Lost in the Funhouse, Donald Barthelme's Snow White, Kurt Vonnegut's Slaughterhouse-Five). These represent a coherent body of works from a particular period. Metafiction is generally understood as fiction about fiction. The present thesis challenges those assumptions and suggests interpreting metafiction within the framework of Michel Foucault's epistemes. Metafiction is not conceived of as a separate genre of literature but in the context of broader cultural tendencies in the understanding of representation. Representation is a key concept in metafiction and the increasing degree of narrative self-awareness is viewed in this light. The thesis emphasizes this contrastive and interdisciplinary approach. The text is divided into five chapters. Chapter one is a theoretical...

Dans l'environnement naturel, les signaux émotionnels sont transmis via différentes modalités sensorielles. Pourtant, l'effet d'évènements affectifs multisensoriels sur l'expérience émotionnelle consciente (le ressenti) reste relativement peu connu. Ce travail de recherche a exploité les avantages de la réalité virtuelle pour étudier le ressenti négatif induit par des évènements aversifs visuo-auditifs présentés dans un contexte écologique. Un tel contexte permet de prendre en compte un facteur important qui est la distance entre le sujet et le stimulus affectif. Par conséquent, ce travail a impliqué l'étude des liens entre l'affect, la présentation multisensorielle et l'espace. Une première étude a exploré l'influence de stimuli aversifs visuo-auditifs sur le ressenti. Une deuxième étude a examiné l'effet de la peur excessive sur la représentation de l'espace péri-personnel. Une troisième étude a testé l'effet de stimuli aversifs visuo-auditifs sur le ressenti en fonction de leur position plus ou moins proche du sujet. En conclusion, il a été constaté que le ressenti émotionnel est modulé par les caractéristiques sensorielles et spatiales des évènements aversifs. Les stimuli aversifs visuo-auditifs amplifient le ressenti négatif. Cependant, cet effet n'existe que si ces stimuli sont dans l'espace proche du sujet. Enfin, la peur excessive d'un stimulus spécifique provoque une extension de l'espace péri-personnel. L'ensemble de ces travaux fournit de nouvelles informations sur le traitement de l'information affective et met en évidence l'utilité et la pertinence de la réalité virtuelle pour l'étude de l'affect. / In a natural environment, affective events often convey emotional cues through multiple sensory modalities. Yet, the effect of multisensory affective events on the conscious emotional experience (feelings) they induce remains relatively undiscovered. The present research exploited the unique advantages of virtual reality techniques to examine the negative emotional experience induced by auditory-visual aversive events embedded in a natural context. In natural contexts, the spatial distance between the perceiver and the affective stimuli is an important factor. Consequently, this research investigated the relationship between affect, multisensory presentation and space. A first study using virtual reality tested the influence of auditory-visual aversive stimuli on negative emotional experience. A second study explored the effect of excessive fear on the representation of close space. A third study examined the effect of auditory-visual stimuli on negative emotional experience as a function of their location at close or far distances from the perceiver. Overall, it was found that negative emotional experience is modulated by the sensory and spatial characteristics of aversive events. Multisensory aversive events amplify negative feelings only when they are located at close distances from the perceiver. Moreover, excessive fear related to an event extends the space, wherein the event is represented as close. Taken together, the present research provides new information about affective processing and exposes virtual reality as a relevant tool for the study of human affect.