Determinants of dental care use in patients with rare diseases: a qualitative exploration.

BACKGROUND: Oral health is an inherent part of overall health as an important physiological crossroad of functions such as mastication, swallowing or phonation; and plays a central role in the life of relationships facilitating social and emotional expression.Our hypothesis was that in patients with rare diseases, access to dental care could be difficult because of the lack of professionals who know the diseases and accept to treat the patients, but also because some patients with cognitive and intellectual disabilities could not find adequate infrastructure to assist in managing their oral health. METHODS: This study employed a qualitative descriptive design including semi-structured interviews using guiding themes. The transcripts were reviewed to identify key themes and interviews were performed until the data were saturated and no further themes emerged. RESULTS: Twenty-nine patients from 7 to 24 years old were included in the study of which 15 patients had an intellectual delay. The results show that access to care is complicated more by aspects concerning intellectual disability than by the fact that the disease is rare. Oral disorders are also an obstacle to the maintenance of their oral health. CONCLUSION: The oral health of patients with rare diseases, can be greatly enhanced by a pooling of knowledge between health professionals in the various sectors around the patient's care. It is essential that this becomes a focus of national public health action that promotes transdisciplinary care for the benefit of these patients.

Early Buddhist Texts: Their Composition and Transmission.

This article discusses the composition and transmission of early Buddhist texts with specific reference to sutras. After briefly summarizing the main reasons why it is likely that these oral compositions were designed to be memorized and transmitted verbatim, I will discuss the main types of changes that these texts underwent in the course of their transmission and the reasons such changes occurred, then attempt to give an account of the challenge that change, particularly intentional change, posed to the oral transmission of fixed, memorized texts.

Una escucha para el cuidado. Contribuciones desde el pensamiento de Bernard Stiegler / A listening for care. Contributions from the thought of Bernard Stiegler

Los planteamientos teóricos respecto de la técnica por parte de Bernard Stiegler pueden ser utilizados para comprender la oralidad como una tecnología, de las contribuciones de dicha tecnología para con el cuidado, y de la importancia del cuidado en la configuración de una economía política negantrópica. El presente artículo propone un soporte teórico para la investigación cualitativa en enfermería y otras ciencias de la salud. Para ello, se realiza un planteamiento general de las ideas de Stiegler, y a partir de allí se construye un diálogo que, utilizando distintas fuentes, identifica elementos de la oralidad en función del cuidado. Uno de los argumentos que se deriva, radica en que la posibilidad de estudios en esta perspectiva no se limita a estudios de caso, en cambio, pueden ser contribuyentes a epistemologías distantes del Antropoceno. Así, este trabajo abre caminos de diálogos teóricos y metodológicos a través del pensamiento de Bernard Stiegler, llamando la atención de investigaciones donde se comprenda la oralidad como una tecnología y su relevancia metodológica respecto de la escucha, contribuyendo tanto al cuidado, como a modelos económicos negantrópicos (AU)

Oficinas pedagógicas de enfrentamento ao trabalho infantil: memória, oralidade e expressão estética / Pedagogical workshops to coping child labor: memory, orality and aesthetic expression

Resumo: Este relato reporta a experiência em curso de formação acerca do trabalho infantil, no qual, por meio de oficinas pedagógicas que envolveram as memórias, a oralidade e as expressões estéticas dos participantes, buscava-se desnaturalizar o fenômeno, ressignificando-o, favorecendo assim a sua identificação e o seu enfrentamento. O curso foi ofertado a 333 técnicos da Assistência Social provenientes de 98 municípios mineiros.

Abstract: This article reports the experience in a training course about child labor, in which, through pedagogical workshops that involved the participants' memories, orality and aesthetic expressions, sought to denaturalize the phenomenon, giving it a new meaning, thus favoring their identification and coping. The course was offered to 333 Social Assistance technicians from 98 municipalities in Minas Gerais.

How can we improve perinatal care in isolated multiple intestinal atresia? A retrospective study with a 30-year literature review.

INTRODUCTION: Multiple intestinal atresia (MIA) is a rare cause of neonatal intestinal obstruction. To provide an overview of the current prenatal, surgical, and nutritional management of MIA, we report our experience and a literature review of papers published after 1990. METHODS: All cases of isolated MIA (non-hereditary, not associated with apple-peel syndrome or gastroschisis) treated at our institution between 2005 and 2016 were reviewed and compared with cases found in the literature. RESULTS: Seven patients were prenatally suspected of having intestinal obstruction and were postnatally diagnosed with MIA, with a mean 1.7 (1-2) resections-anastomoses (RA) and 6 (1-10) strictureplasties performed, resulting in a mean resected bowel length of 15.1cm (15-25 cm). Median time to full oral feed was 46 days (14-626 days). All patients were alive and none had orality disorder after a mean follow-up of 3.1 years (0.2-8.1 years). Three surgical strategies were found in the literature review: multiple RA (68%, 34/50) including Santulli's technique in four of 34 (12%) and anastomoses over a transanastomotic tube (32%, 16/50), with a 98% survival rate, and short-bowel syndrome for only two patients. CONCLUSION: Bowel-sparing surgery and appropriate medical management are key to ensuring a favorable nutritional and gastrointestinal outcome and a good prognosis. Prenatal assessment and standardization of the surgical course of treatment remain challenging.

Kleist para tempos de isolamento social: oralidade, corpo e pensamento / Kleist for isolation times: orality, body, and thought / Kleist para tiempos de aislamiento social: oralidad, cuerpo y pensamiento

O artigo apresenta e explora o texto de Heinrich von Kleist intitulado "Sobre a fabricação gradativa dos pensamentos enquanto se fala" (1805-1806). A tese central do ensaio articula oralidade, corpo e produção de pensamento: apartando-se da tradição metafísica, Kleist investiga a imbricação entre a fala, os estados atmosféricos do corpo e o ato de pensar, salientando as dimensões temporais necessárias à fabricação de ideias, não na mente, mas na prática viva dos falantes, em seus intercâmbios presenciais. O ensaio fornece pistas para que se vislumbrem possíveis efeitos sobre o pensamento no contexto de comunicações tecnologicamente mediadas por conta da pandemia da Covid-19, dissociando o falar da presença direta dos corpos. A metodologia adotada concerne à análise detalhada desse texto (pouco conhecido entre nós), remetendo a alguns conceitos de Deleuze e Guattari e visando a levantar possíveis problemas que o pensamento enfrenta na atual situação de distância entre os corpos.

The article presents and explores Heinrich von Kleist's essay "On the gradual construction of thoughts during speech" (1805-1806). Its main thesis articulates orality, body, and the gradual production of thought: against the metaphysical tradition, Kleist analyses the intertwining of speech, atmospherical states of the body and the act of thinking. He highlights the temporal dimensions necessary to the fabrication of ideas not inside the mind, but during the vivacious practice of speech. This text offers relevant clues to the discussion of possible effects on thinking caused by the social isolation due to the Covid-19 pandemic, which segregates speech from the presence of the bodies. The methodology employed concerns a close reading of Kleist's essay, relating the thesis presented to some concepts and perspectives developed by Deleuze and Guattari, as well as to the present context of social isolation and expansion of mediated communications.

El artículo explora el texto de Heinrich von Kleist titulado "Sobre la fabricación gradual de los pensamientos mientras se habla" (1805-1806). La tesis central del ensayo articula oralidad, cuerpo y producción de pensamiento: apartándose de la tradición metafísica, Kleist investiga la imbricación entre el habla, los estados atmosféricos del cuerpo y el acto de pensar, subrayando las dimensiones temporales necesarias a la fabricación de ideas, no en la mente, sino en la práctica viva de los hablantes, en sus intercambios presenciales. En ese sentido, provee pistas para comenzar a vislumbrar posibles efectos sobre el pensamiento en el contexto de expansión de comunicaciones tecnológicamente mediadas debido a la pandemia de la Covid-19. La metodología utilizada concierne al análisis detallado del texto (poco conocido entre nosotros), remitiendo a algunos conceptos de Deleuze e Guattari y apuntando a evaluar posibles problemas que el pensamiento enfrenta en la actual situación de distancia entre los cuerpos.

The cultural transmission of food habits, identity, and social cohesion: A case study in the rural zone of Cali-Colombia.

While the cooking-culture relationship is a biocultural phenomenon that gives meaning to gastronomic practices through signs and symbols shared within a community, in the 20th century, its transmission has been influenced by important processes of change, such as urban expansion and environmental pollution, which put the continuity of immaterial cultural patrimony at risk. These changes have altered the supply, conservation, and preparation of food and utensils, which are elements that demarcate the society-nature relationship and gender roles, among other things. The objective of this article is to demonstrate the role of the cultural transmission of food habits in identity formation and social cohesion, based upon an ethnographic case study in the Ancestral Community La Playa Renaciente, in Cali (Colombia). This study presents the cultural transmission of food habits, culinary practices, and their relationship with the inhabited environment. Likewise, this article presents a temporal-spatial contextualization of the locality and some oral testimonies that reveal how dietary practices constitute an important element in socialization, social cohesion, and the transmission of knowledge from generation to generation.

In conversation: Freud, Abraham and Ferenczi on "Mourning and Melancholia" (1915-1918).

This article concentrates on Freud's draft of "Mourning and Melancholia," written in 1915 and published in 1996. After presenting a summary of the main theses of Freud's draft, Abraham's and Ferenczi's reactions to the text are discussed as well as Freud's response to their comments. In addition to reviewing Freud's partial adoption of Ferenczi's introjection and his reluctance towards Abraham's "mouth eroticism and sadism," the article considers the question of whether and to what extent his disciples' interjections-particularly Abraham's approach-made their way into the final version of "Mourning and Melancholia." The article closes by integrating the notion of narcissistic identification, which forms the core of Freud's understanding of depression, and his study of the "preliminary stages of love," written the same year, into a conceptualization of the narcissistic relationship between subject and object. Special attention is paid to the clinical relevance of the difference between narcissistic and libidinal object cathexis, which Freud had introduced.

Developmental Trajectories of Hand Movements in Typical Infants and Those at Risk of Developmental Disorders: An Observational Study of Kinematics during the First Year of Life.

Highlights The kinematics of hand movements (spatial use, curvature, acceleration, and velocity) of infants with their mothers in an interactive setting are significantly associated with age in cohorts of typical and at-risk infantsdiffer significantly at 5-6 months of age, depending on the context: relating either with an object or a person.Environmental and developmental factors shape the developmental trajectories of hand movements in different cohorts: environment for infants with VIMs; stage of development for premature infants and those with West syndrome; and both factors for infants with orality disorders.The curvature of hand movements specifically reflects atypical development in infants with West syndrome when developmental age is considered. We aimed to discriminate between typical and atypical developmental trajectory patterns of at-risk infants in an interactive setting in this observational and longitudinal study, with the assumption that hand movements (HM) reflect preverbal communication and its disorders. We examined the developmental trajectories of HM in five cohorts of at-risk infants and one control cohort, followed from ages 2 to 10 months: 25 West syndrome (WS), 13 preterm birth (PB), 16 orality disorder (OD), 14 with visually impaired mothers (VIM), 7 early hospitalization (EH), and 19 typically developing infants (TD). Video-recorded data were collected in three different structured interactive contexts. Descriptors of the hand motion were used to examine the extent to which HM were associated with age and cohort. We obtained four principal results: (i) the kinematics of HM (spatial use, curvature, acceleration, and velocity) were significantly associated with age in all cohorts; (ii) HM significantly differed at 5-6 months of age in TD infants, depending on the context; (iii) environmental and developmental factors shaped the developmental trajectories of HM in different cohorts: environment for VIM, development for PB and WS, and both factors for OD and; (iv) the curvatures of HM showed atypical development in WS infants when developmental age was considered. These findings support the importance of using kinematics of HM to identify very early developmental disorders in an interactive context and would allow early prevention and intervention for at-risk infants.

Que boca grande você tem! Articulações sobre os distúrbios da oralidade no autismo / What a big mouth you have! On orality disorders in autism / Quelle grande bouche vous avez! Considérations sur les troubles de l’oralité dans l’autisme / Qué boca grande tienes! Articulaciones sobre los disturbios de oralidad en el autismo / Was hast du für ein entsetzlich großes Maul! Artikulationen der autistischen Sprachstörung

O texto apresenta algumas considerações sobre os distúrbios da oralidade no autismo, no viés da psicanálise, entrelaçando as questões da constituição do psiquismo infantil e a oralidade. Para enlaçar estas questões teóricas e clínicas dois casos são delineados no trabalho. As crianças retratadas apresentam funcionamento autistico onde a primazia oral apresenta-se e o surpreendente enigmático comparece no modo como a oralidade se revela, seja na voracidade ou na indiscriminação oral, instalando a boca exclusivamente no lugar de fenda, buraco que engloba tudo e não se satisfaz.

The text presents some considerations on orality disorders in autism, from the point of view of psychoanalysis, intertwining issues of the constitution of the infant psyche and orality. To approach these theoretical and clinical issues two clinical cases are presented. The portrayed children present autistic functioning, characterized by oral primacy, and the enigmatic appears in the way orality is revealed, either in voracity or oral indiscrimination, installing the mouth exclusively in place of a, hole that encompasses everything and is never satisfied.

Le texte présente des éléments sur les troubles de l’oralité dans l’autisme, du point de vue de la psychanalyse, en combinant des questions de la constitution du psychisme enfantile et de l’oralité. Pour combiner ces questions théoriques et cliniques, deux cas cliniques sont développés dans le texte. Les enfants dont les cas sont abordés présentent un fonctionnement autistique où l’oralité est primordiale. Cette oralité revêt un effet de surprise énigmatique, soit par la voracité, soit par l’indiscrimination orale. Celle-ci installe la bouche comme lieu exclusif de fente, trou qui englobe tout et ne satisfait jamais.

El texto presenta algunas consideraciones sobre los disturbios de la oralidad en el autismo, en el sesgo del psicoanálisis, combinando las cuestiones de la constitución del psiquismo infantil y la oralidad. Para enlazar estas cuestiones teóricas y clínicas, dos casos son delineados en el trabajo. Los niños retratados presentan funcionamiento autístico donde la primacía oral se presenta y el sorprendente enigmático comparece en el modo como la oralidad se revela, sea con la voracidad o en la indiscriminación oral instalando la boca exclusivamente en el lugar de la ranura, agujero que engloba todo y no se satisface.

Der Text stellt einige Überlegungen der autistischen Sprachstörung vor, durch psychoanalytische Theorie werden die Fragen nach kindlichen psychischen Konstitution und Mündlichkeit verflochten. Um die theoretischen und klinischen Fragen anzuschließen, werden zwei Fälle in diesem Artikel abgezeichnet. Die abbildenden Kinder weisen in der oralen Phase autistisches Funktionieren auf und das Symptom erscheint in der Art und Weise wie die Mündlichkeit sich offenbart, sowohl in der Gefräßigkeit als auch in der oralen Nichtdiskriminierung, sie bringen den Mund ausschließlich an der Stelle des Risses unter, ein Loch, der alles umfasst und nicht genügt.

Revisiting the crisis in Freud's libido theory and Abraham's concept of the oral-sadistic phase as a way out of it.

The now available unabridged correspondence between Freud and Abraham leads to a re-evaluation of the significance of Abraham's work. The author proposes the thesis that clinical observations by Karl Abraham of the ambivalence of object relations and the destructive-sadistic aspects of orality have an important influence on the advancement of psychoanalytical theory. The phantasy problem of the Wolf Man and the question of the pathogenic relevance of early actual, or merely imagined traumata led Freud to doubt the validity of his theory. He attempted repeatedly to solve this problem using libido theory, but failed because of his problematic conception of oral erotics. The pathogenic effect of presymbolic traumatizations cannot be demonstrated scientifically because of the still underdeveloped brain in the early stage of the child's development. Consequently, the important empirical evidence of a scientific neurosis theory could not be provided. A revision of the theory of the instincts thus became necessary. With Abraham's clinical contributions and other pathologic evidence, Freud was, with some reservation, forced to modify his idea of oral erotics by ascribing to it a status of a merely constructed and fictive phase of oral organization. A solution was eventually facilitated via recognition of non-erotic aggression and destruction, thereby opening libido theory to fundamental revisions. Driven by the desire to develop a scientific theory, Freud initially had, in his first theory of the instincts, assumed a strongly causal-deterministic view on Psychic Function. His third revision of theory of the instincts, Beyond the Pleasure Principle including the death instinct hypothesis, considered the hermeneutic aspect of psychoanalytic theory, which had previously existed only implicitly in his theory. Further development of the death instinct hypothesis by Melanie Klein and her successors abandoned quantitative-economic and causal-deterministic principles, and instead focused on the practical utility of the psychoanalytic theory.

Las pulsaciones canibalísticas de la oralidad / As pulsões canibalíticas da oralidade / Cannibalistic drives in orality / Les pulsations cannibaliques de l'oralité

El presente trabajo propone revisitar los fundamentos histórico- conceptuales del componente canibalístico asociado a la concepción freudiana de la oralidad, con el fin de interrogar sus hipótesis rectoras y analizar su posible aporte a la comprensión de los trastornos alimentarios. En primer lugar, se interrogará el origen histórico del término caníbal. Luego, se analizarán las vías de introducción del canibalismo en el campo psicoanalítico, para, finalmente, proponer que las paradójicas relaciones al deseo y la necesidad, que evidencian los trastornos de la conducta alimentaria, podrían ser redefinidas como pulsaciones canibalísticas de la oralidad.

O presente trabalho propõe revisitar os fundamentos histórico-conceituais do componente canibalesco associado à concepção freudiana da oralidade, com o fim de interrogar suas hipóteses regentes e analisar sua possível contribuição para a compreensão dos transtornos alimentares. Em primeiro lugar, se interrogará a origem histórica do termo canibal. Logo, analisar-se-ão as vias de introdução do canibalismo no campo psicanalítico, para, finalmente, propor que as relações paradoxais ao desejo e à necessidade, que põem em jogo os transtornos de conduta alimentar, poderiam ser redefinidas como pulsações canibalescas da oralidade.

This paper takes up the conceptual and historical foundations of the cannibalistic component associated with the Freudian conception of orality. The purpose is to examine the basic hypotheses of orality and to analyze its possible contributions to the understanding of eating disorders. First, the historical origin of the term cannibal will be discussed, followed by the ways that cannibalism can be introduced into the field of psychoanalysis. Finally, we discuss the paradoxical relations between desire and need, an approach which shows that eating disorders can be redefined as cannibalistic drives in orality.

Le travail suivant propose de revisiter les fondements historico-conceptuels de la composante cannibalique associés à la conception freudienne de l'oralité afin d'interroger leurs hypothèses directrices et d'analyser leur éventuelle contribution à la compréhension des troubles alimentaires. Tout d'abord, on s'interroge sur l'origine historique du terme cannibale. Ensuite, on analysera les voies d'introduction du cannibalisme dans le domaine psychanalytique pour proposer finalement que les relations paradoxales avec le désir et la nécessité impliquant les troubles de la conduite alimentaire peuvent être redéfinies en tant que pulsations cannibaliques de l'oralité.

Las pulsaciones canibalísticas de la oralidad / As pulsões canibalíticas da oralidade / Cannibalistic drives in orality / Les pulsations cannibaliques de l'oralité

El presente trabajo propone revisitar los fundamentos histórico- conceptuales del componente canibalístico asociado a la concepción freudiana de la oralidad, con el fin de interrogar sus hipótesis rectoras y analizar su posible aporte a la comprensión de los trastornos alimentarios. En primer lugar, se interrogará el origen histórico del término caníbal. Luego, se analizarán las vías de introducción del canibalismo en el campo psicoanalítico, para, finalmente, proponer que las paradójicas relaciones al deseo y la necesidad, que evidencian los trastornos de la conducta alimentaria, podrían ser redefinidas como pulsaciones canibalísticas de la oralidad.(AU)

O presente trabalho propõe revisitar os fundamentos histórico-conceituais do componente canibalesco associado à concepção freudiana da oralidade, com o fim de interrogar suas hipóteses regentes e analisar sua possível contribuição para a compreensão dos transtornos alimentares. Em primeiro lugar, se interrogará a origem histórica do termo canibal. Logo, analisar-se-ão as vias de introdução do canibalismo no campo psicanalítico, para, finalmente, propor que as relações paradoxais ao desejo e à necessidade, que põem em jogo os transtornos de conduta alimentar, poderiam ser redefinidas como pulsações canibalescas da oralidade.(AU)

This paper takes up the conceptual and historical foundations of the cannibalistic component associated with the Freudian conception of orality. The purpose is to examine the basic hypotheses of orality and to analyze its possible contributions to the understanding of eating disorders. First, the historical origin of the term cannibal will be discussed, followed by the ways that cannibalism can be introduced into the field of psychoanalysis. Finally, we discuss the paradoxical relations between desire and need, an approach which shows that eating disorders can be redefined as cannibalistic drives in orality.(AU)

Le travail suivant propose de revisiter les fondements historico-conceptuels de la composante cannibalique associés à la conception freudienne de l'oralité afin d'interroger leurs hypothèses directrices et d'analyser leur éventuelle contribution à la compréhension des troubles alimentaires. Tout d'abord, on s'interroge sur l'origine historique du terme cannibale. Ensuite, on analysera les voies d'introduction du cannibalisme dans le domaine psychanalytique pour proposer finalement que les relations paradoxales avec le désir et la nécessité impliquant les troubles de la conduite alimentaire peuvent être redéfinies en tant que pulsations cannibaliques de l'oralité.(AU)

A arte de contar histórias e o conto de tradição oral em práticas educativas / The art of storytelling and the tale of oral tradition in educational practices

Este trabalho é fruto da pesquisa que se iniciou com o estudo de especialização em literatura infanto-juvenil o-juvenil "sobre as histórias que se contam para as crianças" na Universidade de São Paulo - USP, talvez pelo fato de eu mesma ser uma contadora de histórias. Nessa condição, até onde me lembro, sempre estive na atmosfera que experimentei, desde a infância, quando as pessoas se reuniam em torno das histórias do contador. Convencida da importância de se contar e ouvir histórias, por experiência própria, realizei um aprofundamento nos estudos para o mestrado em Ciências das Religiões na PUC-SP, cuja dissertação versou sobre: "Contar histórias como um caminho para o sagrado" que culminou com a defesa da tese de doutorado em Psicologia Social pela PUC-SP, onde trabalhamos a identidade dos contadores de histórias contemporâneos e o impacto social e cultural da importância do contar e ouvir histórias nas cidades modernas. A metodologia de trabalho empregada foi o conto de tradição oral. A partir dessa experiência, traçaremos, neste texto, relatos da nossa compreensão e contribuição dos contos tradicionais para as sociedades modernas e seu emprego na educação e áreas afins(AU)

This work is the result of research that began with studies of specialization in children's literature "on the stories that count for children" at the University of São Paulo (USP), maybe because I myself be a storyteller. In this condition, as far as I can remember, I was always in the atmosphere I experienced, since childhood, when people gathered around the stories of counter. Convinced of the importance of telling and listening to stories from my own experience, I realised a deepening in the studies for a master's degree in Sciences of religions at PUC-SP, whose dissertation focussed on: "storytelling as a way for the sacred" that culminated in the defense of the doctoral thesis in Social Psychology from PUC-SP, where we work the identity of contemporary storytellers and the social and cultural impact of the importance of the tell and listen to stories in modern cities. The methodology employed was the tale of oral tradition. From this experience, in this text, we will draw up reports of our understanding and contribution of traditional tales to modern societies and their employment in education and related field(AU)

Orality disorders in melancholia: acedia as stagnation / Distúrbios da oralidade na melancolia: acidia como estagnação / Troubles de l'oralité dans la mélancolie: l'acédie comme stagnation / Distúrbios de la oralidad en la melancolía: acidia como estagnación / Orale störungen bei melancholie: skedia als stagnation

In this article valuable contributions by Lasègue, Freud and Abraham are discussed, as they are all indispensible to the understanding of orality disorders in melancholia. Although none of the above authors used the exact term "orality disorders," their understandings of both hysteria and melancholia are important in the debate surrounding the clinical treatment of these difficulties. Sadness is a common denominator for the authors, but contributions on acedia, the "noonday demon" mentioned by Agamben, are also important. Acedia is defined as stagnation, a desperate lack of vigor when faced with a wearying and demanding situation. Those who suffer from chronic acedia feel great inertia and are unable to envision a future. They see their creativity wane away, especially due to the painful isolation caused by what might be called anguished sadness - a denial of sadness through manic action.

Este trabalho apresenta as valiosas contribuições de Lasègue, Freud e Abraham, indispensáveis para a compreensão dos distúrbios da oralidade na melancolia. Apesar desses autores não utilizarem a terminologia "distúrbios da oralidade", sua compreensão tanto da histeria como da melancolia possibilita problematizar uma clínica desses distúrbios. A tristeza é um denominador comum entre esses autores. Juntam-se a eles as contribuições sobre a acídia, o "demônio meridiano", referidas por Agamben. Acídia significa estagnação, desesperada falta de ânimo diante de uma situação trabalhosa e desgastante. O acidioso, aquele que se encontra crônico em sua inércia e incapaz de dimensionar o futuro, apresenta uma estagnação da criatividade revelada por um doloroso isolamento provocado pelo que pode ser chamado de angustiada tristeza - negação da tristeza pela via da ação maníaca.

Cet article présente les précieuses contributions de Lasègue, Freud et Abraham, indispensable à la compréhension des troubles de l'oralité dans la mélancolie. Bien que ces auteurs n'ont pas utilisé le terme «troubles de l'oralité¼, leur compréhension de l'hystérie et de la mélancolie permet de problématiser une clinique de ces troubles. La tristesse est un dénominateur commun chez ces auteurs. On y additionne les contributions sur l'acédie, le «démon méridien¼ mentionnée par Agamben. Acédie signifie stagnation, manque désespéré de courage face à une situation pénible et épuisante. L'acédien, qui souffre de façon chronique d'inertie et qui est incapable de dimensionner l'avenir, manifeste une stagnation de la créativité révélée par un isolement douloureux causé par ce qu'on peut appeler la tristesse angoissante - le déni de la tristesse par voie d'action maniaque.

Este trabajo presenta las valiosas contribuciones de Lasègue, Freud y Abraham, indispensables para la comprensión de los disturbios de la oralidad en la melancolía. Aunque esos autores no utilizan la terminología "disturbios de la oralidad", su comprensión tanto de la histeria como de la melancolía posibilita problematizar una clínica de esos disturbios. La tristeza es un denominador común entre esos autores. Las contribuciones de Agamben sobre la acidia o el "demonio meridiano" se junta a de ellos. Acidia significa estagnación, falta desesperada de ánimo frente a una situación trabajosa y extenuante. El acidioso, aquel que está crónico en su inercia e incapaz de dimensionar el futuro, presenta una estagnación de la creatividad revelada por un aislamiento doloroso provocado por lo que puede ser llamado de tristeza angustiosa - negación de la tristeza por la vía de la acción maniaca.

In dieser Studie werden wertvolle Beiträge von Lasegue, Freud und Abraham besprochen, die für das Verständnis der oralen Störungen bei Melancholie unabdingbar sind. Obwohl diese Autoren nicht den Begriff "orale Störungen" verwenden, ermöglicht ihre Auffassung sowohl von Hysterie als auch von Melancholie die Problematisierung einer klinischen Behandlung dieser Störungen. Das Thema Traurigkeit ist ein gemeinsamer Nenner dieser Autoren. Dazu kommen die Beträge zu Akedia, dem "Dämonischen", von dem Agamben spricht. "Akedia" bedeutet Stagnation, verzweifelte Antriebslosigkeit gegenüber einer mühsamen und erschöpfenden Situation. Die "akedische" Person befindet sich in einer chronischen Tatenlosigkeit und ist unfähig, die Zukunft zu ermessen. Diese Person äuβert eine Stagnation der durch eine schmerzhafte Isolierung aufgedeckten Kreativität, infolge einer sogenannten verzweifelten Traurigkeit - der Verneinung der Traurigkeit durch ein manisches Handeln.

O jogo do morto no corpo: introjeção e mortificação / The game of the dead on the body: introjection and mortification

Os problemas em torno do alcoolismo questionam as ordenações de etiologia, diagnóstico e tratamento deste grave sintoma clínico. O álcool, para além de seu entorno histórico, mítico e prosaico, vem estabelecendo um conjunto de fenômenos evolutivos de estado mórbido oferecendo ao sujeito condições de sustentação imaginária de suas relações objetais circunscritas ao dever fálico ao mesmo tempo em que cobra seu preço com a instalação de uma cronificação corporal e psíquica ante esse estado. Percorremos um caminho que visa discutir as origens dessa relação interrogando as fundações e funções mais arcaicas dos objetos parentais, as vicissitudes decorrentes dessas relações e a impossibilidade do luto. Funções estas que, para além de seus encarnantes, ou seja, o paterno e o materno deverão constituir as bases de uma organização libidinal e suas dimensões de gozo, culpa e castigo. Estas vicissitudes se manifestam em estados de afetação através de um pathos que encontra nos distúrbios da oralidade alcoólica manifestações extremamente agressivas. Este trabalho revê e discute uma analogia entre duas conceitualizações fundamentais na constituição das relações de objeto a partir do discurso presente na clínica de alcoolistas internados em ambientes para tratamento de seu sintoma. O discurso do alcoolista, a princípio, não propõe o objeto álcool como objeto de troca. Em sua suposta dialética discursiva este mesmo objeto serve para uma anulação do sujeito. O ego se narra fora da condição de senhor neste processo e as palavras os conduzem a situações de disrupção e agressividade, imposição de um gozo que convoca estes sujeitos ao eterno retorno da recaída alcoólica. Os conceitos de Introjeção e Incorporação estabelecem uma conexão entre as primeiras relações de objeto e organização corporal e nos orientam sobre as condições de intervenções simbólicas que auxiliariam o sujeito alcoólico a constituir um sentido para seu sintoma e com isso conseguir controlar ou mesmo modificar o mesmo.

Problems related to alcoholism bring up questions as to the etiology, diagnosis and treatment of this very serious clinical symptom. Beyond its historical, mythical and prosaic aspects, alcohol causes a number of evolving phenomena related to the morbid state of alcoholism that provide the subject with imaginary props for his object relations related to phallic expectations. In the process, it results in serious chronic physical and mental consequences. Go through a way which discuss the origins of this relationship by questioning the earliest foundations and functions of the parental objects, problems resulting from these relationships and the impossibility of mourning. These functions that beyond the paternal and maternal must constitute the bases of a libidinal organization and its dimensions of jouissance, guilt and punishment. This problems manifest such states consist of affective pathos which results in extremely aggressive manifestations in disorders of alcoholic orality. This paper review and discusses an analogy between two fundamental conceptualizations in establishing object relations. The analysis was base on the speech of alcohol-addicted patients hospitalized in a clinic to treat their symptons. The alcoholic's discourse does not propose the object alcohol as an object of exchange. In its supposed discursive dialectic, this very object serves for an invalidation of the subject. The ego narrates itself outside of the condition of master in this process and the words conduce them towards disruptive and aggressive situations. It is the jouissances' imposition that summons these subjects to the eternal return of the alcoholic reinsidence. The concept of Introjection and Incorporation establish a connection between the first object relations and the body organization, and help us understand the conditions of symbolic interventions, which will help the alcoholic subject find a sense in their symptoms and with it monitor or even modify it.

O jogo do morto no corpo: introjeção e mortificação / The game of the dead on the body:introjection and mortification

Os problemas em torno do alcoolismo questionam as ordenações de etiologia, diagnóstico e tratamento deste grave sintoma clínico. O álcool, para além de seu entorno histórico, mítico e prosaico, vem estabelecendo um conjunto de fenômenos evolutivos de estado mórbido oferecendo ao sujeito condições de sustentação imaginária de suas relações objetais circunscritas ao dever fálico ao mesmo tempo em que cobra seu preço com a instalação de uma cronificação corporal e psíquica ante esse estado. Percorremos um caminho que visa discutir as origens dessa relação interrogando as fundações e funções mais arcaicas dos objetos parentais, as vicissitudes decorrentes dessas relações e a impossibilidade do luto. Funções estas que, para além de seus encarnantes, ou seja, o paterno e o materno deverão constituir as bases de uma organização libidinal e suas dimensões de gozo, culpa e castigo. Estas vicissitudes se manifestam em estados de afetação através de um pathos que encontra nos distúrbios da oralidade alcoólica manifestações extremamente agressivas. Este trabalho revê e discute uma analogia entre duas conceitualizações fundamentais na constituição das relações de objeto a partir do discurso presente na clínica de alcoolistas internados em ambientes para tratamento de seu sintoma. O discurso do alcoolista, a princípio, não propõe o objeto álcool como objeto de troca. Em sua suposta dialética discursiva este mesmo objeto serve para uma anulação do sujeito. O ego se narra fora da condição de senhor neste processo e as palavras os conduzem a situações de disrupção e agressividade, imposição de um gozo que convoca estes sujeitos ao eterno retorno da recaída alcoólica. Os conceitos de Introjeção e Incorporação estabelecem uma conexão entre as primeiras relações de objeto e organização corporal e nos orientam sobre as condições de intervenções simbólicas que auxiliariam o sujeito alcoólico a constituir um sentido para seu sintoma e com isso conseguir controlar ou mesmo modificar o mesmo.(AU)

Problems related to alcoholism bring up questions as to the etiology, diagnosis and treatment of this very serious clinical symptom. Beyond its historical, mythical and prosaic aspects, alcohol causes a number of evolving phenomena related to the morbid state of alcoholism that provide the subject with imaginary props for his object relations related to phallic expectations. In the process, it results in serious chronic physical and mental consequences. Go through a way which discuss the origins of this relationship by questioning the earliest foundations and functions of the parental objects, problems resulting from these relationships and the impossibility of mourning. These functions that beyond the paternal and maternal must constitute the bases of a libidinal organization and its dimensions of jouissance, guilt and punishment. This problems manifest such states consist of affective pathos which results in extremely aggressive manifestations in disorders of alcoholic orality. This paper review and discusses an analogy between two fundamental conceptualizations in establishing object relations. The analysis was base on the speech of alcohol-addicted patients hospitalized in a clinic to treat their symptons. The alcoholic's discourse does not propose the object alcohol as an object of exchange. In its supposed discursive dialectic, this very object serves for an invalidation of the subject. The ego narrates itself outside of the condition of master in this process and the words conduce them towards disruptive and aggressive situations. It is the jouissances' imposition that summons these subjects to the eternal return of the alcoholic reinsidence. The concept of Introjection and Incorporation establish a connection between the first object relations and the body organization, and help us understand the conditions of symbolic interventions, which will help the alcoholic subject find a sense in their symptoms and with it monitor or even modify it.(AU)

Literturas eróticas comparadas: a partir da moqueca de maridos. Mitos eróticos / Comparative erotic literature

Uma coletânea de contos recentemente publicada em língua francesa evoca de maneira muito agradável as culturas eróticas de seis populaçõesindígenas da Amazônia. Sua apresentação permite observarmos nossa cultura erótica de um ângulo inédito. Os índios da Amazônia atribuem aoerotismo oral uma importância análoga, assim nos parece, à que nós atribuímos ao erotismo sádico por eles negligenciado. Isso transforma toda a cultura (sexual). Assim, os contos mostram as singularidades da nossa própria cultura (sexual) e nossos modos particulares de elaboração, dentre outros, da diferença sexual, da posição fálica e do narcisismo.

A compilation of stories recently published in French reminds us in a very pleasant manner of the erotic cultures present in six Amazon indigenouspopulations. Its presentation allows us to observe our erotic culture from adifferent angle. We postulate that Amazonian Indians attribute oral eroticisma similar importance than the one we offer sadistic eroticism, neglected by their own culture. This transforms all of (sexual) culture. Therefore, these stories show the singularities of our own (sexual) culture, as well as our particular ways of elaborating sexual difference, phallic position and narcissism.

The [in]visibility of HIV/AIDS in the Malawi public sphere.

This paper argues that, far from being invisible, issues of sexuality are omnipresent in the African public sphere. However, this presence is not usually found in the medical nor overtly gender/sexual arenas but in general social contexts. Western derived research models have sought and continue to seek to situate gender and sexual discourse in overt forms, especially when emphasising public health aspects. Using qualitative and quantitative evidence from my PhD research of popular discourse in Malawi, and using some evidence from Zambia, Zimbabwe and South Africa, I argue that the perceived secrecy is allied to cultural, male/female and intra-female power relations. I found that significant issues of sexual and medical concerns were 'hidden' in the easy to decode public social sphere. Using a historical model of the colonial and postcolonial construction of this dominant social public sphere in Malawi I was able to demonstrate that key messages relating to sexuality and sexual behaviour can be easily found in social discourse, from where they can be exploited for health promotion purposes.