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A critical feminist discursive approach was used to explore how and to what ends women organized their talk about female genitals. Exploration and interpretation of how the eight women in this research used talk to orient their constructed positions for female genitals, within the dyad conversational sessions, was informed by the analytic concepts of interpretative repertoires, subject positioning and ideological dilemmas. Findings indicated that these women repeatedly drew on socially available information (e.g., fictional and non-fictional literature, media, family and friend, empirical research) regarding female genitals during their dyad discussions. Shared components in the womens accounts were organized into two opposing interpretative repertoires consistent with those identified in a selection of reviewed textual resources: powerful female genital repertoire and powerless female genital repertoire. The participants drew on both these repertoires when arguing and defending multiple, and often contradictory, subject positions on this topic. Although the women discursively demonstrated a strong pull toward a position that aligned with the powerful repertoire, their powerful subject positions were tenuous. This tenuousness may have been due to the sensitive nature of this topic, the rhetorical demands of the research conversations, and/or the untenability of an extremist position in either of the powerful or powerless female genital repertoires. Further, these women did not construct any new information in their talk regarding female genitals, thus suggesting that the female genital repertoires are discursively pervasive and constraining. This research contributes to our knowledge of talk regarding female genitals by illustrating how and to what ends women choose to organize, interpret and exclusively use existing discourses on this topic.

A critical feminist discursive approach was used to explore how and to what ends women organized their talk about female genitals. Exploration and interpretation of how the eight women in this research used talk to orient their constructed positions for female genitals, within the dyad conversational sessions, was informed by the analytic concepts of interpretative repertoires, subject positioning and ideological dilemmas. Findings indicated that these women repeatedly drew on socially available information (e.g., fictional and non-fictional literature, media, family and friend, empirical research) regarding female genitals during their dyad discussions. Shared components in the womens accounts were organized into two opposing interpretative repertoires consistent with those identified in a selection of reviewed textual resources: powerful female genital repertoire and powerless female genital repertoire. The participants drew on both these repertoires when arguing and defending multiple, and often contradictory, subject positions on this topic. Although the women discursively demonstrated a strong pull toward a position that aligned with the powerful repertoire, their powerful subject positions were tenuous. This tenuousness may have been due to the sensitive nature of this topic, the rhetorical demands of the research conversations, and/or the untenability of an extremist position in either of the powerful or powerless female genital repertoires. Further, these women did not construct any new information in their talk regarding female genitals, thus suggesting that the female genital repertoires are discursively pervasive and constraining. This research contributes to our knowledge of talk regarding female genitals by illustrating how and to what ends women choose to organize, interpret and exclusively use existing discourses on this topic.

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Den här studien handlar om olika diskurser kring genitala ingrepp på personer som upplever att de har en annan könsidentitet än den juridiska könstillhörigheten, och vill genomföra en juridisk könsändring. Syftet med uppsatsen var att genom analyser av dessa diskurser försöka förstå hur genitalierna är kopplade till den sociala konstruktionen av kön och genus. Intervjuer har gjorts med personer som finns med i utrednings- och beslutsprocess eller har verkställighetsfunktion som berör de genitala ingreppen. Det har inneburit psykiatriker, kirurger och jurister. Intervjuer har även gjorts med föreningsrepresentanter för transsexuella, före detta transsexuella och transpersoner. Flertalet inom professionen uttrycker att genitalierna har en avgörande betydelse för bestämmande av kön och genus. Även om de har en uppfattning om att könet ”sitter i huvudet” måste detta överensstämma med känslan för genitalierna. Det finns en skillnad i resonemanget för KtM (Kvinna-till-man-transsexuella) och MtK (Man-till-Kvinna-transsexuella). Penis ses som den mest avgörande könsmarkören och flertalet av de intervjuade inom professionen hade svårt att förstå att en person som vill behålla sin penis kan ha en könsidentitet som kvinna. Vaginan uttrycktes inte ha samma status som könsmarkör men livmoder och äggstockar och dess reproduktiva funktion uttrycktes nästan ha samma betydelse som könsmarkör som penis. De inom professionen hade därmed svårt att förstå hur en gravid person skulle kunna ha en könsidentitet som man.De som representerade transsexuella, före detta transsexuella och transpersoner uttryckte olika syn på kön och definition av kön. Det gavs både uttryck för att hela kroppen inklusive genitalierna skulle ha stor betydelse för kön men det gavs även uttryck för att kroppen och genitalierna inte i sig skulle ha betydelse för kön utan att ”könet i huvudet” var det viktigaste för bestämmande av kön. / The aim of this thesis was to, through the analyses of different discourses surrounding sex reassignment try to understand how the genitals are linked to the social construction of sex and gender. I have interviewed psychiatrists, surgeons and people dealing with the laws surrounding sex reassignment surgery. I also interviewed people from organizations who represent transgender persons, transsexuals and former transsexuals. Most of the professionals indicate in the interviews that the genitals have an essential meaning in the decision-making regarding sex and gender. Even if they have an idea that the gender is “in the head”, it has to match the feelings for the genitals. There is a difference between the reasoning for FtM (Female-to-male-transsexual) and MtF (Male-to-female-transsexual). The penis is seen as the most essential sex marker and most of the professionals that were interviewed had difficulties in understanding how a person who wanted to keep the penis could have a gender identity as a woman. The vagina did not have the same status as a sex marker but instead the reproductive function from the ovaries and the uterus had almost the same status as a sex marker as the penis. For this reason the professionals that where interviewed had difficulties in understanding that a pregnant person could have a gender identity as a man. People from organizations who represented transgender persons, transsexuals and former transsexuals had some differing views. One considered that the whole body including the genitals was important for the feeling about ones gender while the other person expressed that the gender “in the head” was more vital for the decision and feelings of sex and gender.

This thesis provides an interpretative study of Augustine of Hippo’s City of God, book 14. The introduction explains how the thesis demonstrates that Augustine only partially endorses a model of emotional control through reason, and asserts that the key to his emotions doctrine is not to be found in an affections-passions dichotomy. It also addresses Augustine’s engagement with Platonism in the text, and, using work by Volker Drecoll, explains how the commentary-style project is able to situate City 14 within the Pelagian controversy ca. A.D. 419. The following seven chapters proceed uninterruptedly through City 14, clarifying Augustine’s argumentative aims and making use of secondary scholarship and philological tools to investigate points of fine detail. Chapter 1 explores City 14.1, his recapitulation of City 11-13 and his setting out of the initial two-cities dichotomy. Chapter 2 explores City 14.2-5, in which Augustine critiques Manichean or Platonist positions that the body is bad or evil. Chapter 3 explores City 14.6-9, and Augustine’s explication of the Biblical doctrine of emotions. Chapter 4 explores City 14.10-15, and the theme of the primal Fall and the will being ‘spontaneous’. Chapter 5 explores City 14.16-20, and Augustine’s exploration of the disobedience of the genitals in all forms of sex, including married life. Chapter 6 explores City 14.21-25, in which Augustine discusses the workings of Adam and Eve’s hypothetical sexual experience in the Pre-Fall Paradise. Chapter 7 explores City 14.26-28, in which Augustine recapitulates City 14.10-25, and comments on the workings of Providence, before hurtling towards the final dichotomy about the two cities being separated by their ‘loves’. A conclusion reviews the main points of the thesis. The thesis makes extensive use of German and French scholarship, of the CCL 48 Latin text, and the tools of the CAG 3 Augustine database; it occasionally contests the chapter divisions found in modern editions.

Submitted by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:00Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Approved for entry into archive by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-09-29T15:37:08Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) / Made available in DSpace on 2017-09-29T15:37:08Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) DISSERTAÇAO LUCIANO MEIRELES.pdf: 1043230 bytes, checksum: 20c7f97cfba9488935ee9dcde38c164c (MD5) Previous issue date: 2013 / Instituto Nacional do Câncer / As infecções de corrente sanguínea (ICS) são complicações frequentes em pacientes com câncer. O objetivo deste estudo foi descrever as características epidemiológicas, clínicas e microbiológicas das ICS em pacientes com câncer ginecológico. Método: uma série de 311 episódios de ICS com comprovação microbiológica (ICS-CM) detectadas em 288 pacientes com câncer ginecológico assistidas no Hospital do Câncer II de janeiro/2002 a dezembro/2009. Para análise das variáveis categóricas, foram utilizados o teste do qui-quadrado ou o teste exato de Fisher e, para as variáveis contínuas, os testes t de Student, Mann-Whitney ou de regressão linear com cálculo do coeficiente de correlação (R2). P-valores ≤ 0,05 foram considerados estatisticamente significativos. Resultados: 205 (66%) episódios foram hospitalares; 85 (27%) comunitários, 13 (4%) relacionados à assistência à saúde e 8 (2,57%) corresponderam a neutropenia febril. As ICS secundárias foram mais frequentes (148; 47,58%) do que as primárias (141; 45,34%); dentre as secundárias, grande parte deveu-se a infecções urinárias (79; 53,4%). Dentre os 336 microrganismos isolados, os mais frequentes foram Escherichia coli (70; 20,83%), Staphylococcus aureus (66; 19,64%), staphylococcus coagulase negativo (SCN; 37; 11,01%), Klebsiella pneumoniae (33; 9,82%) e Pseudomonas aeruginosa (26; 7,74%). A prevalência global de microrganismos multirresistentes (MMR) foi 17,56% (59 MMR em 336 amostras): 11 (3,27%) amostras de S. aureus resistentes à oxacilina (MRSA), 14 (4,2%) amostras de gramnegativos entéricos resistentes às cefalosporinas de 3ª/4ª geração, 29 (8,63%) amostras de gramnegativos não fermentadores (GNNF) resistentes às cefalosporinas de 3ª/4ª geração, 5 (1,5%) amostras de GNNF resistentes aos carbapenemas. Em 224 (72%) episódios, o escore de Pitt foi ≥2. A mortalidade bruta foi 39,86% (114) com 57,89% (66) dos óbitos relacionados às ICS. Conclusão: as ICS são eventos associados a elevada mortalidade. Estes dados sugerem que as infecções urinárias, de evolução geralmente benigna na população geral, devem ser nas pacientes com câncer ginecológico, objeto de uma abordagem preventiva, diagnóstica e terapêutica mais cuidadosa. Estudos futuros, que avaliem os fatores determinantes para o óbito serão fundamentais para um melhor entendimento do prognóstico dessas pacientes / Bloodstream infections (BSI) are frequent complications in patients with cancer. The goal of this study was to describe the epidemiological, clinical and microbiological characteristics of these infections in patients with gynecological cancer. Method: a case-series of 311 episodes of laboratory-confirmed BSI detected in 288 patients with gynecological cancer assisted at Hospital do Cancer II from January 2002 to December 2009. Chi-squared test or Fisher's exact test were used for analysis of categorical variables and Student's t test, Mann-Whitney or linear regression with correlation coefficients (R2) were used with continuous variables. P-values ≤0.05 were considered statistically significant. Results: 205 (66%) BSI episodes were hospital-acquired; 85 (27%) community acquired; 13 (4%) healthcare-associated and 8 (2.57%) related to febrile neutropenia episodes. Secondary BSI episodes were more frequent (148; 47.58%) than primary cases (141; 45.34%); among the secondary BSI, many resulted from urinary tract infections (79; 53.4%). The most frequent agents among 336 microorganisms detected were Escherichia coli (70, 20.83%), Staphylococcus aureus (66, 19.64%), coagulase-negative Staphylococcus (CoNS; 37, 11.01%), Klebsiella pneumoniae (33, 9.82%) and Pseudomonas aeruginosa (26, 7.74%). The overall prevalence of multidrug resistant (MDR) agents were 17.56% (59 MDR in 336 isolates): 11 (3.27%) methicillin resistant S. aureus (MRSA) isolates, 14 (4.2%) enteric gram-negative isolates resistant to 3rd/4th generation cephalosporins, 29 (8.63%) non-fermentative gramnegative isolates resistant to 3rd/4th generation cephalosporins, 5 (1.5%) non-fermentative gramnegative isolates resistant to carbapenems. In 224 (72%) episodes had Pitt score ≥2. The crude mortality rate was 39.86% (114) with 57.89% (66) deaths were related to BSI. Conclusion: BSI are severe events associated with high mortality. These data suggest that urinary tract infection, mostly a nonthreatening illness in the general population, must have a special preventive, diagnostic and therapeutic approach in patients with gynecological cancer. Further studies assessing the factors predisposing to death will be necessary to a better understand of the prognosis in this population.

Made available in DSpace on 2014-10-09T12:42:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:59:41Z (GMT). No. of bitstreams: 0 / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Made available in DSpace on 2014-10-09T12:42:20Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:59:41Z (GMT). No. of bitstreams: 0 / A candidíase vaginal (CV) é uma doença causada por fungos do gênero Candida spp. que acomete milhares de mulheres no mundo. Estima-se que 75% das mulheres sofrerão CV pelo menos uma vez durante a vida fértil, 40 a 50% terão o segundo episódio e 5 a 8% sofrerão a forma recorrente, caracterizada pela ocorrência de quatro ou mais episódios durante um ano. O tratamento ainda permanece um desafio para as candidíases complicadas. A terapia fotodinâmica (TFD) é uma modalidade terapêutica que utiliza substâncias fotossensibilizadoras (FS) e uma fonte de luz, que juntas, produzem espécies reativas de oxigênio, tóxicas para micro-organismos e inofensivas para a célula animal hospedeira. O objetivo deste trabalho foi avaliar os efeitos antifúngicos e anti-inflamatórios da TFD mediada por azul de metileno (AM) e laser de emissao vermelha (LEV) no tratamento da CV em modelo animal. Fêmeas de camundongos BALB/c, com 6 a 10 semanas foram estrogenizadas e, 72h após, receberam via intravaginal 20μL de suspensão contendo 107 UFC/mL de C. albicans ATCC 90028. Cinco dias após, a TFD foi aplicada na vagina das fêmeas, utilizando AM 1000μM e laser (100mW, 660nm, energia de 36J por 6 min ou duas aplicações de 18J por 3min, com intervalo de 24h entre sessões). Após 0, 24 e 96h foram feitas lavagens vaginais para recuperação fúngica, cultivo microbiológico, eutanásia para remoção das vaginas e estudo histológico. Lâminas coradas por hematoxilina e eosina foram utilizadas para contagem da área de células inflamatórias (ACI), utilizando o programa ImageJ. Os resultados mostraram que TFD in vivo reduziu a carga fúngica em aproximadamente 1,6 log UFC/mL e, quando aplicada em duas sessões de 18J por 3min, diminuiu a ACI. A TFD mediada por LEV e AM 1000μM mostra-se como alternativa promissora para o desenvolvimento de novas modalidades terapêuticas para vaginites fúngicas. / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP