Carpal tunnel syndrome (CTS) is one of the most common injuries responsible for lost time claims to the Workplace Safety and Insurance Board (WSIB). The main purpose of this study was to determine whether measurable sensorimotor changes exist in asymptomatic individuals who are at risk for CTS such that sensory impairment and/or functional tests may be used in the early detection and intervention to reduce the impact of CTS on individuals, industry and the health care system. Participants were recruited into three strata: (1) individuals diagnosed with mild CTS, (2) asymptomatic individuals who were deemed to be at risk of developing CTS due to exposure to etiological risk factors and (3) asymptomatic individuals who were deemed to be at minimal risk of developing CTS based on non-exposure to risk factors. The main outcome measures included two-point discrimination ability, pressure acuity, vibration sense, Purdue Pegboard Test performance and tracking error and tracking variance on a manual tracking task performed at two different speeds. Seven individuals with CTS, fourteen individuals at risk of developing CTS and nine control individuals with minimal risk participated. The CTS group was significantly different from the at-risk and control groups on the main and work sections of the DASH questionnaire, and the symptom severity scale and functional status scale of the Boston Carpal Tunnel Questionnaire. The only outcome measure that showed a significant difference between the at-risk and the minimal risk group was the assembly task of the Purdue Pegboard Test (p = 0.044), however other measures including median nerve conduction latencies, and manual tracking abilities showed promise that with further recruitment, a significant difference may be seen. The sensory impairment tests did not demonstrate degradation in sensory function in individuals at risk of developing CTS, however analysis of sensory nerve conduction latencies and some aspects of fine motor skills testing did show some promise in their ability to detect individuals at risk of developing CTS. A future prospective study that follows individuals at risk of developing CTS may determine that it is possible to implement a screening tool for the early identification and treatment of CTS. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2009-09-15 12:15:45.208

The general objective of this dissertation is to study breast cancer screening and specifically social inequalities by social class and country of origin and its relationship with decreasing mortality. Therefore, four different studies have been done: three with quantitative methodology and one with qualitative. According to the quasi-experimental study, breast cancer mortality decreased in Barcelona before the introduction of the population screening program, but this reduction is more marked after its introduction. According to data from the Spanish National Health Survey in 2006, there are inequalities in the rate of breast cancer screening according to country of origin and social class. According to two studies conducted in Barcelona, immigrant women from low-income countries are less aware, and hence do less, early detection practices, as they have other priorities and perceive more barriers and taboos. Chinese women are the immigrants who present more differences with native women, followed by Maghribian and Philippine women. Place of origin, social class and migration process are key factors in preventive practices. In conclusion, it is necessary to encourage access to preventive screening practices for all women and also to undertake specific actions directed at the most vulnerable groups, taking into account any socio-cultural factors that influence the use of preventive practices. / L’objectiu general d’aquesta tesi és estudiar el cribratge de càncer de mama i en concret les desigualtats socials per classe social i país d’origen, així com la seva relació amb la disminució de la mortalitat. En conseqüència, s’han realitzat quatre estudis diferents: tres de metodologia quantitativa i un de qualitativa. Segons l’estudi quasi-experimental, la mortalitat per càncer de mama a Barcelona disminueix des d’abans de la introducció del programa poblacional de cribatge, però aquesta reducció és més accentuada desprès de la seva introducció. En base a l’Enquesta Nacional de Salut de l’Estat Espanyol de l’any 2006, existeixen desigualtats en la realització de mamografies periòdiques segons país d’origen i classe social. Segons els dos estudis realitzats a Barcelona, les dones immigrades procedents de països de renda baixa coneixen i realitzen menys les pràctiques de detecció precoç, ja que tenen altres prioritats i perceben més barreres i tabús. Les dones xineses són les que presenten més diferències amb les dones autòctones, seguides de les magribines i les filipines. El lloc d’origen, la classe social i el procés migratori són factors claus en les practiques preventives. En conclusió, és necessari afavorir l’accés a les pràctiques preventives a totes les dones i també realitzar accions específiques dirigides als grups més vulnerables sense deixar de tenir en compte els factors socioculturals que influeixen en les pràctiques preventives de les dones.

The invasion of natural environments by alien species is a significant threat to the ecological integrity of these systems. Senna obtusifolia is an aggressive invasive weed recently introduced to Australia that is having significant impacts on grassland ecosystems on the Cape York Peninsula. Currently the species is inadequately managed and so range expansion continues. The invasion potential of S. obtusifolia in Australia remains unknown, as does much about its behaviour and management in natural systems. This project undertakes extensive mapping and modelling of the current and future distributions and the invasion dynamics of S. obtusifolia in Australia to facilitate early detection of outbreak populations and the development of appropriate management strategies. The mapping and modelling of S. obtusifolia was conducted at three different scales: continental, landscape and local (population). To address these spatial scales, eco-climatic modelling, remote sensing analysis, field experimentation and creation of a model of seed fate was undertaken. Using the climatic preferences of S. obtusifolia displayed internationally, an eco-climatic model (using CLIMEX software) ascertained that S. obtusifolia has a very large invasive potential in Australia. The predicted geographic distribution comprised the entire eastern and northern Australian coastlines, with spread further inland being largely restricted by a lack of moisture. The regional distribution of S. obtusifolia was not successfully delineated using remote sensing technology. Despite possessing favourable traits for detection by remote sensors, poor data quality and inappropriate image scales prevented the weed from being distinguished from other vegetation by multi-spectral satellite imagery and aerial photography. However, the results indicated that refining the data and the techniques used, single S. obtusifolia populations may be detectable in the future. Investigation of the invasion dynamics of S. obtusifolia at the local scale involved multiple field surveys and manipulative experiments during 2002-2005. Field work indicated that little variation in population characteristics (e.g. stem density, soil seed reserve, seed production) existed within populations, but there was variability across populations and between years: the variation between years was very significant. The vegetation type adjacent to the weed population did not affect population attributes; however less competitive, more open and disturbed environments may better facilitate the invasion. The compartment model of seed fate reflecting S. obtusifolia population dynamics demonstrated that change in annual rainfall was unlikely to explain the variation evident between populations and years. Instead, the rate at which dormancy is broken in seeds and the intensity and regularity of fire provided a better explanation of the weed's population dynamics. Early detection of invaders and the prediction of likely sites of invasion provide the most effective means of preventing future invasions. How best to achieve these goals still remains largely unknown. The process undertaken in this study was a relatively quick and reliable method for assessing the seriousness of S. obtusifolia, predicting future outbreaks and for providing clues to long term management. The appropriate use of fire, maintaining high interspecific competition and shade, as well reducing the rate at which dormancy is broken in seeds are all possible methods of managing S. obtusifolia.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2018-05-11T13:03:15Z No. of bitstreams: 1 PDF - Aline Ferreira de Araújo Jerônimo.pdf: 26670711 bytes, checksum: 92864afd3e086a9cb19dbb47d53bcc6a (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2018-05-22T20:48:51Z (GMT) No. of bitstreams: 1 PDF - Aline Ferreira de Araújo Jerônimo.pdf: 26670711 bytes, checksum: 92864afd3e086a9cb19dbb47d53bcc6a (MD5) / Made available in DSpace on 2018-05-22T20:48:51Z (GMT). No. of bitstreams: 1 PDF - Aline Ferreira de Araújo Jerônimo.pdf: 26670711 bytes, checksum: 92864afd3e086a9cb19dbb47d53bcc6a (MD5) Previous issue date: 2017-03-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Background: Breast cancer is the type of cancer that most causes deaths among women in developing countries. In Brazil, an incidence of the disease increases and the number of new cases of breast cancer can be attributed to the increase in life expectation of women and changes related to reproductive factors and lifestyle. Objectives: The aim of this study was to analyze the literature on breast cancer risk factors and knowledge about the disease and to identify associations between risk factors and triple-negative breast cancer. Methods: Two scientific articles were developed for publication. The first article deals with an integrative review on the knowledge of breast cancer and its risk factors in Latin American studies. The second article deals with a cross-sectional study on lifestyle risk factors and triple-negative breast cancer, performed with 236 women diagnosed with invasive breast cancer in the state of Paraiba. Results: In the integrative review, of 47 studies selected, 27 were about risk of breast cancer and 20 were about knowledge or awareness. The main risk factors identified by the authors were obesity and overweight, old age, family history of breast cancer, nulliparity and menopause. The articles on knowledge focused in early diagnosis of breast cancer and breast self-examination was the most investigated method of detection. The cross - sectional study showed that smoking and obesity had associations with the triple- negative subtype of breast cancer. Women who smoked sometime in their lives had 3.70 (OR = 0.270, 95% CI: 0.10-0.68, p = 0.006) times less likely to have a triple-negative subtype. Patients with obesity had 3,514 (95% CI: 1.23 - 10.03; p = 0.019) more likely to have the triple-negative subtype when compared to the Luminal A subtype. Conclusions: The literature on breast cancer risk factors presents a better methodological outline and theoretical basis than the literature on the knowledge of the disease. Smoking is associated with lower chances of having triple-negative breast cancer, while obesity is associated with a higher chance of developing this type of breast cancer. / Introdução: O câncer de mama é o tipo de neoplasia que mais causa mortes entre as mulheres nos países em desenvolvimento. No Brasil, a incidência da doença é elevada no Nordeste do país e o aumento no número de casos novos pode ser atribuído às mudanças relacionadas aos fatores reprodutivos e do estilo de vida. Objetivos: Esta dissertação teve como objetivo analisar a literatura sobre os fatores de risco do câncer de mama e o conhecimento sobre a doença e identificar associações entre fatores de risco e o câncer de mama do tipo triplo-negativo. Métodos: Foram desenvolvidos dois artigos científicos para publicação. O primeiro artigo trata-se de uma revisão integrativa sobre o conhecimento da neoplasia mamária e seus fatores de risco em estudos Latino americanos. O segundo artigo trata-se de um estudo transversal sobre fatores de risco do estilo de vida e o câncer de mama triplo-negativo, realizado com 236 mulheres diagnosticadas com câncer de mama invasivo no estado da Paraíba. Resultados: Na revisão integrativa da literatura foram selecionados 47 artigos, dos quais 27 eram sobre fatores de risco do câncer de mama e 20 eram sobre conhecimento ou consciência sobre a doença. Os principais fatores de risco identificados pelos autores foram obesidade e sobrepeso, idade avançada, historia familiar de câncer de mama, nuliparidade e menopausa. Os artigos sobre conhecimento destacaram o diagnóstico precoce da neoplasia mamária e o autoexame foi o método de detecção mais investigado. O estudo transversal mostrou que tabagismo e obesidade tiveram associações com o subtipo triplo-negativo do câncer de mama. As mulheres que já fumaram alguma vez na vida tiveram 3.70 (OR= 0.270; 95% CI: 0.10-0.68; p= 0.006) vezes menos chances de ter o subtipo triplo-negativo. Pacientes com obesidade tiveram 3.514 (95% CI: 1.23- 10.03; p= 0.019) mais chances de ter o subtipo triplo-negativo quando comparadas com o subtipo Luminal A. Conclusões: A literatura sobre fatores de risco do câncer de mama apresenta melhor delineamento metodológico e fundamentação teórica do que a literatura sobre o conhecimento da doença. O tabagismo está associado a menores chances de ter o câncer de mama triplo-negativo, enquanto que a obesidade está associada a maiores chances de desenvolver esse tipo de câncer de mama.

O rastreamento para o cÃncer do colo uterino e o planejamento familiar sÃo prÃticas preventivas de relevÃncia em saÃde da mulher em idade fÃrtil. A atenÃÃo bÃsica ainda privilegia o ciclo gravÃdico-puerperal e a prevenÃÃo da neoplasia maligna do colo, ficando o planejamento familiar em segundo plano. Contudo, a despeito da melhor cobertura na realizaÃÃo da citologia cervicovaginal, as taxas de mortalidade pela neoplasia persistem elevadas. Persistem, tambÃm, taxas altas de gestaÃÃo na adolescÃncia, de abortamentos e iniquidades em saÃde. O objetivo do projeto foi caracterizar a situaÃÃo de saÃde reprodutiva de mulheres em idade fÃrtil de uma comunidade urbana de baixa renda em Fortaleza, priorizando a realizaÃÃo da citologia e o uso de mÃtodos contraceptivos. Tratou-se de estudo transversal por entrevistas domiciliares com 244 mulheres de 13 a 52 anos. A anÃlise exploratÃria inicial permitiu estabelecer correlaÃÃes atravÃs do teste do qui-quadrado de Pearson para as variÃveis nominais e ANOVA para mÃdias e desvios padrÃes. Para expressar a magnitude das associaÃÃes foram calculadas razÃes de chance (odds ratio) como expressÃes das razÃes de prevalÃncia utilizando regressÃo logÃstica simples e mÃltipla. Dentre as entrevistadas com atividade sexual e 25 anos ou mais, 90,3% realizaram citologia no mÃximo a cada trÃs anos, 59,3% anualmente. Correlacionaram-se positivamente à periodicidade anual o trabalho remunerado (OR=2,63; IC95%: 1,49-4,64) e a condiÃÃo de ter tido no mÃximo uma gestaÃÃo (OR=2,60; IC95%: 1,11-6,08). Quanto ao planejamento familiar, pouco mais da metade das mulheres (51,9%) usava algum mÃtodo e 39,5% delas nÃo foram orientadas por mÃdico ou enfermeiro. Predominou utilizaÃÃo de anticoncepcionais orais (40,4%) e condom (28,7%). A renda familiar de R$ 800,00 ou superior associou-se à maior chance de contracepÃÃo orientada por profissional adequado (OR=3,3, IC95%: 1,28-8,54), contrariamente à histÃria de abortamento (OR=0,32, IC95%: 0,13-0,82). Observou-se alta frequÃncia de realizaÃÃo da citologia cervicovaginal, inclusive anualmente e fora da faixa etÃria recomendada pelo MinistÃrio da SaÃde. Houve baixa prevalÃncia de anticoncepÃÃo, oferta insuficiente quanto à variedade e elevada proporÃÃo de mulheres que nÃo recebeu orientaÃÃo adequada para o uso de mÃtodos contraceptivos. Renda familiar e abortamento prÃvio foram fatores associados ao planejamento familiar orientado por profissional adequado, enquanto o trabalho remunerado e o fato de ter tido no mÃximo uma gestaÃÃo foram associados à coleta anual de citologia para prevenÃÃo do cÃncer do colo uterino. / Cervical cancer screening and family planning are relevant preventive health practices for women of childbearing age. Primary care still privileges gestational period and cervical neoplasia prevention over family planning. Nevertheless, despite improvements on the coverage for cervicovaginal cytology, cervical neoplasia mortality rates show only slight decrease. High rates of teenage pregnancy, abortions and health iniquities persist. The project aimed to portrait the reproductive health situation of childbearing aged women from a low income urban community in Fortaleza, prioritizing cytology procedures and the use of contraceptive methods. This was a cross-sectional study carried out through home interviews with 244 women from the age of 13 to 52 years old. The initial exploratory analysis allowed establishing correlations through the chi-square test for nominal variables and ANOVA for means and standard deviations. Odds ratios as expressions of prevalence ratios were obtained to express the magnitude of the associations using simple and multiple logistic regression. Amongst sexually active women and aged 25 years or more, 90.3% underwent cytology at least every 3 years, and 59.3% did it annually. Cytology annual frequency positively correlated to remunerated employment (OR=2.63; IC95%: 1.49-4.64) and to the condition of having had the maximum of one pregnancy (OR=2.60; IC95%: 1.11-6.08). Regarding family planning, just over half of women (51.9%) used any contraception and 39.5% of them were not guided by doctors or nurses. Oral contraceptives (40.4%) and condom (28.7%) predominated as current contraceptive methods. Family income of R$ 800.00 or above positively correlated with contraception guided by an appropriate professional (OR=3.3, IC95%: 1.28-8.54) and negatively correlated to a history of previous abortion (OR=0.32, IC95%: 0.13-0.82). High rates of cervicovaginal cytology were observed, even annually and out of the age group suggested by the Health Ministry. There was a low rate of contraception, insufficient offer as to methods variety and a high proportion of women who did not received adequate guidance on the use of contraceptive methods. Family income and previous abortion were associated to family planning guided by a qualified professional, whilst remunerated employment and having had the maximum of one pregnancy were associated to annual cytology screening to prevent cervix neoplasia.

Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-04-11T17:51:30Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO PPGGES MARIANA FRAGOSO - BIBLIOT. (1).pdf: 1525984 bytes, checksum: 4b14ff8ab52533beac252ef888d0461a (MD5) / Made available in DSpace on 2017-04-11T17:51:30Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO PPGGES MARIANA FRAGOSO - BIBLIOT. (1).pdf: 1525984 bytes, checksum: 4b14ff8ab52533beac252ef888d0461a (MD5) Previous issue date: 2016-09-22 / O Programa Nacional de Melhoria do Acesso e da Qualidade é um programa de âmbito nacional que traz a proposta de promover a melhoria da qualidade assistencial nos serviços públicos de saúde e o acesso oportuno, representa um novo paradigma na qualificação assistencial da principal porta de entrada do Sistema Único de Saúde. Este programa é formado por 47 indicadores de saúde, contudo, impulsionou-se a avaliação do impacto da política a um dos indicadores de desempenho da área da saúde da mulher, o qual referencia ao rastreamento precoce do Câncer de Colo do Útero. Pois, sabe-se que a maioria dos estudos realizados sobre a temática da cobertura do exame citopatológico focaliza-se nas grandes cidades das Regiões Sul e Sudeste. Assim, justificou-se que a incorporação de práticas avaliativas de impacto de programas nacionais aos serviços de saúde pública é uma necessidade que se afigura nas políticas públicas. Para tal, o estudo teve o objetivo de avaliar o impacto desta política sobre o indicador de rastreamento precoce do câncer do colo do útero no estado de Alagoas, no período de 2011 a 2014. Para mensurar este efeito utilizou o método estatístico chamado Diferenças em Diferenças e as análises estatísticas foram realizadas através do Software STATA versão 12.0 Special Edition. Aos resultados encontrados mediante as estimações das equações divididas em três modelos de regressão linear, o Modelo (1) apresentou um impacto positivo e estatisticamente significante a 1%, esse sinal positivo mostra o efeito entre o quantitativo de exames realizados pelas mulheres dos municípios participantes do programa foi de 5.410 exames a mais que as não participantes, um aumento médio percentual de 52% da Razão. Ao Modelo (2), a este foram incluídas as variáveis de controle socioeconômicas e demográficas, o efeito do programa captado no coeficiente estimador foi de 5.227 e a despeito da significância estatística mostrou-se a 1%, apresentando um aumento de 51% da Razão. Por fim, o Modelo (3), este foram incluídos os principais desfechos como variáveis independentes, o efeito encontrado foi de 5.049 e estatisticamente significante a 1%, verificou-se que o programa conseguiu assegurar aos usuários a garantia da melhoria do acesso oportuno ao rastreamento precoce e manteve o aumento médio percentual em media dos 50% da Razão. Neste sentido, o estudo apontou boas perspectivas para o fortalecimento da atenção básica através desta nova estratégia consolidadora e atribuiu ao programa os movimentos quantitativos positivos identificados, de forma que o programa potencializou as mudanças no processo de rastreio precoce e que puderam contribuir para a melhoria do acesso e da assistência. Com isso, o Ministério da Saúde espera que as taxas de incidência e mortalidade desta patologia venham diminuir, ocorrendo uma queda das estimativas local, regional e até mesmo nacional para o biênio 2016/2017. / The National Program of access improvement and health basic attention has as the purpose promoting the enhancement of access and care quality in the public health services. Also, this Program represents a new model in providing the better care of the main entrance of health unique system. It is formed by 47 health indicators, although, Although, boosted to assess the impact of policy to one of the performance indicators in the area of women's health, which it refers to early screening of cervical cancer. Therefore, it is known that the majority of studies on the issue of coverage of cervical cancer screening focuses in large cities of the South and Southeast. Thus, it is appropriate that the incorporation of assessment practices impact of national programs for public health services is a necessity which appears in public policy. For such, this research aimed to evaluate the impact of this policy about the early detection of cervical cancer in Alagoas, since 2011 to 2014. To measure this effect, the research used the statistical method called ‘Differences in Differences’ and the statistical analysis were made through the Software ‘STATA version 12.0 Special Edition’. The results found by the estimates of equations divided into three linear regression models, the model (1) had a positive impact and statistically significant at 1%, the positive sign shows the effect of the quantitative tests performed by the women of the participating municipalities program was 5,410 tests more than non-participants, increase average percentage of 52% of Reason. The model (2), this was included socioeconomic and demographic control variables, the effect of the captured program in estimator coefficient was 5.227 and despite the statistical significance was found to be 1%, with a 51% increase of Reason. While the model (3), this the main outcomes as independent variables were included, the effect of the program was found to be 5.049 and statistically significant at 1%, it was found that the program could provide users with the assurance of improving timely access to early screening and kept the average percentage increase in average 50% of Reason. Based on this, the study reveals important perspectives to the improvement of health basic attention through this new strategy in health unique system and gives the program the positive quantitative movements identified, so that the program leveraged changes in the early screening process and that could contribute to the improvement of access and assistance. Thus, the Ministry of Health expects incidence rates and mortality of this disease will decrease, causing a drop in place estimates, regional and even national for the biennium 2016/2017.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The following research is circumscribed to three subjects who suffer from language disorder. It approaches the process of early detection of risks to development and identification of the language disorder by the family and/or health professionals, as well as discussing aspects of how language works for these subjects. The body of this research is the analysis of how the process between detection of risk by health professionals and establishment of therapeutic demand by the family happens. To make this analysis possible, three babies were selected all three in risk of development. The first subject: a baby with obvious biological risk (prematurity) and had an early intervention; the other two babies don t had biological risk (not premature, nor lesions or syndromes) for language. The last two babies were not subjected to an early intervention and had late speech-language therapy. For this study, interviews were conducted with the aim of gathering general data on the subjects health, with the main focus on matters of communication and language. Footage of the subjects was also taken, in which a scenario was created and organized with the babies favorite toys, with themes related to child contemporary world, with the objective of analyzing how the subjects language worked. The episodes were used to analyzing how the subject s language worked. The footage was transcribed orthographically and language data presented in tables that identify the shifts of the interlocutors involved. The cases were analyzed as they unfolded, in a singular manner in what concerns symptom detection and language functionality, as well as the demand for speech-language therapy. In all cases, it s important to notice the baby-adult intersubjectivity, specially of mothers in the process of language acquirement, as early as the first protoconversations. Moreover, it s important to raise awareness of the effects of early intervention, particularly the process of symptom detection, as well as stabilizing the child s language with the aim of reducing symptoms. / Esta pesquisa circunscreve-se a três sujeitos com distúrbio de linguagem. Aborda como se deu o processo de detecção precoce de risco ao desenvolvimento infantil, e a identificação do distúrbio de linguagem pelos familiares e /ou profissionais da saúde, além de discutir os aspectos do funcionamento da linguagem desses sujeitos. Analisou-se, portanto, como transcorreu o processo entre a detecção de risco por profissionais da saúde e o estabelecimento de demanda terapêutica por parte da família e/ou profissionais. Para fazer tais reflexões, foram selecionados bebês identificados com risco ao desenvolvimento: um bebê com risco biológico evidente (prematuridade) e que teve a intervenção precoce antes dos 24 meses, e dois bebês sem risco biológico evidente (não prematuros, nem com lesões ou síndromes) para a linguagem. Os dois últimos sem intervenção precoce e com inserção mais tardia em terapia fonoaudiológica. Neste estudo, entrevistas com as mães foram realizadas, na busca de dados gerais de saúde das crianças, e dos históricos clínicos incluindo aspectos do funcionamento de linguagem das mesmas. Também, foram realizadas filmagens de aproximadamente 30 minutos, nas quais a situação de interação deu-se a partir dos brinquedos prediletos da criança, relacionados com o mundo infantil contemporâneo. Os episódios foram usados para analisar o funcionamento de linguagem dos sujeitos. As filmagens foram transcritas ortograficamente e os dados de linguagem apresentados em tabelas que identificam os turnos dos interlocutores envolvidos. Os casos foram analisados, tal como se apresentaram, de forma singular no que se refere à escuta do sintoma e ao funcionamento de linguagem, bem como à demanda para a terapia fonoaudiológica. Percebeu-se a importância de considerar a intersubjetividade bebê-adulto, nos casos em questão: das mães, no processo de aquisição de linguagem e os efeitos da intervenção precoce, tanto na sensibilização da escuta de um sintoma, quanto na sustentação da criança na linguagem, a partir da amenização de seu sintoma.

The aim of my thesis is to summarize all the information regarding newborn and infant hearing screening programmes, to find out about the awareness of mothers-to-be and to give account on the possibilites of the further professional development of the infant hearing screening. The theoretical part consists of the definitions of terminology relating to this topic, the historical development of the hearing screening and the latest findings and current level of knowledge of the issue both in the Czech Republic and abroad. The practical part of my master's thesis aspires to detect the awareness of expecting mothers and non-professionals through a questionnaire survey. Apart from the results of the survey the practical part also contains an interview with a specialist. Besides the research analysis, I have also focused on informing the target group about the prospects and significance of the newborn and infant hearing screening tests as this is a current issue now. KEYWORDS: Newborn Otoacoustic emissions Hearing screening Hearing loss Early detection

The current issue of Visceral Medicine focuses on colorectal cancer. Despite intense screening efforts, colorectal cancer still belongs to the most frequent cancers in both males and females in the EU. Particularly in rectal cancer there have been major developments in the surgical techniques over the last years that have led to a substantial reduction in local disease recurrence.

Exosomen aus Zellen nehmen eine immer größere Rolle in aktuellen Erkenntnissen zu Tumorwachstum und Metastasierung ein. Die Funktionen dieser circa 40-100 nm großen, aktiv sezernierten Vesikel sind bisher noch weitesgehend ungeklärt. Für die Untersuchung von Exosomen sind optimierte und schonende Isolierungsmethoden notwendig. Zur Zeit gibt es jedoch weder eine standardisierte Methode zur routinemäßigen Isolation von Exosomen noch zur Isolation von funktionell intakten Exosomen für die anschließende Funktionsanalyse. Ziel dieser Arbeit war es, eine vereinfachte, größenbasierte und standardisierbare Methode zur Isolation von funktionell intakten Exosomen zu entwickeln und die isolierten Exosomen qualitativ und quantitativ zu charakterisieren. Die Ergebnisse dieser Arbeit konnten in einer internationalen Fachzeitschrift publiziert werden. Die Publikation liegt dieser Arbeit bei (Heinemann et al. 2014).