2 resultados para Tyler, Imogen

em Duke University


Relevância:

10.00% 10.00%

Publicador:

Resumo:

The Carmelite friars were the last of the major mendicant orders to be established in Italy. Originally an eremitical order, they arrived from the Holy Land in the 1240s, decades after other mendicant orders, such as the Franciscans and Dominicans, had constructed churches and cultivated patrons in the burgeoning urban centers of central Italy. In a religious market already saturated with friars, the Carmelites distinguished themselves by promoting their Holy Land provenance, eremitical values, and by developing an institutional history claiming to be descendants of the Old Testament prophet Elijah. By the end of the 13th century the order had constructed thriving churches and convents and leveraged itself into a prominent position in the religious community. My dissertation analyzes these early Carmelite churches and convents, as well as the friars’ interactions with patrons, civic governments, and the urban space they occupied. Through three primary case studies – the churches and convents of Pisa, Siena and Florence – I examine the Carmelites’ approach to art, architecture, and urban space as the order transformed its mission from one of solitary prayer to one of active ministry.

My central questions are these: To what degree did the Carmelites’ Holy Land provenance inform the art and architecture they created for their central Italian churches? And to what degree was their visual culture instead a reflection of the mendicant norms of the time?

I have sought to analyze the Carmelites at the institutional level, to determine how the order viewed itself and how it wanted its legacy to develop. I then seek to determine how and if the institutional model was utilized in the artistic and architectural production of the individual convents. The understanding of Carmelite art as a promotional tool for the identity of the order is not a new one, however my work is the first to consider deeply the order’s architectural aspirations. I also consider the order’s relationships with its de facto founding saint, the prophet Elijah, and its patron, the Virgin Mary, in a more comprehensive manner that situates the resultant visual culture into the contemporary theological and historical contexts.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Aims: Measurement of glycated hemoglobin (HbA1c) is an important indicator of glucose control over time. Point-of-care (POC) devices allow for rapid and convenient measurement of HbA1c, greatly facilitating diabetes care. We assessed two POC analyzers in the Peruvian Amazon where laboratory-based HbA1c testing is not available.

Methods: Venous blood samples were collected from 203 individuals from six different Amazonian communities with a wide range of HbA1c, 4.4-9.0% (25-75 mmol/mol). The results of the Afinion AS100 and the DCA Vantage POC analyzers were compared to a central laboratory using the Premier Hb9210 high-performance liquid chromatography (HPLC) method. Imprecision was assessed by performing 14 successive tests of a single blood sample.

Results: The correlation coefficient r for POC and HPLC results was 0.92 for the Afinion and 0.93 for the DCA Vantage. The Afinion generated higher HbA1c results than the HPLC (mean difference = +0.56% [+6 mmol/mol]; p < 0.001), as did the DCA Vantage (mean difference = +0.32% [4 mmol/mol]). The bias observed between POC and HPLC did not vary by HbA1c level for the DCA Vantage (p = 0.190), but it did for the Afinion (p < 0.001). Imprecision results were: CV = 1.75% for the Afinion, CV = 4.01% for the DCA Vantage. Sensitivity was 100% for both devices, specificity was 48.3% for the Afinion and 85.1% for the DCA Vantage, positive predictive value (PPV) was 14.4% for the Afinion and 34.9% for the DCA Vantage, and negative predictive value (NPV) for both devices was 100%. The area under the receiver operating characteristic (ROC) curve was 0.966 for the Afinion and 0.982 for the DCA Vantage. Agreement between HPLC and POC in classifying diabetes and prediabetes status was slight for the Afinion (Kappa = 0.12) and significantly different (McNemar’s statistic = 89; p < 0.001), and moderate for the DCA Vantage (Kappa = 0.45) and significantly different (McNemar’s statistic = 28; p < 0.001).

Conclusions: Despite significant variation of HbA1c results between the Afinion and DCA Vantage analyzers compared to HPLC, we conclude that both analyzers should be considered in health clinics in the Peruvian Amazon for therapeutic adjustments if healthcare workers are aware of the differences relative to testing in a clinical laboratory. However, imprecision and bias were not low enough to recommend either device for screening purposes, and the local prevalence of anemia and malaria may interfere with diagnostic determinations for a substantial portion of the population.