The Gentleman-Scholar at Home: Domesticity, Masculinity, and Civility in Dutch Seventeenth-Century Genre Painting

This dissertation examines the gentleman-scholar depicted at home in Dutch seventeenth-century genre paintings, focusing primarily on art created in the Northern Netherlands from the 1630s through the 1670s. The methodological approach is art historical but also pertains to history of architecture, history of dress, and gender studies. Employing the framework of the 'Ages of Man', this thesis investigates three related pictorial themes: the student, the scholar in his prime, and the aged scholar. Variations of male scholarly figures and the accoutrements of the study have a long history in Europe. Prototypical sources include religious history paintings of learned hermit-saints; artistic interest in the allegorical Saturnine persona; portraits of famous scholars; and the iconography of scholarly melancholy implied through vanitas allusions in portraiture and genre paintings. While the majority of Dutch genre paintings pertain to themes of women, male domestic routines form a small but important subset of this imagery and have not been studied. By the 1640s, this subject is readily identified by his setting, clothing, and actions. The ubiquity of scholarly attributes, such as books and globes, paired with the wearing of scholarly robes suggest the merits of intellectual curiosity and the privileges of studying as a pastime and designating a room as a study (studeerkamer). Distinct themes in genre also imply the challenges and rewards of scholarly activity pursued in concert with masculine civic and familial duty. Central to the development of this pictorial theme were: the innovative treatment of learned men by Rembrandt and his circle; the fijnschilder subjects of Dou; and the practice of amateur study by elite men, as suggested by the art of Vermeer. As this dissertation reveals, this convention did not grow to be consistent across the Northern Netherlands, nor was artistic interest limited to university towns. Rather, the larger relevance of scholars in Dutch society is evident in visual and literary sources. The domesticity of this figure in genre painting suggests that scholars mediated between an active and a contemplative life. Societal respect was garnered for scholars through their balance of familial and social duties with the honorable pastime of scholarly leisure.

Relaciones interétnicas en el Fuerte San José (Patagonia, siglo XVIII). Una aproximación comparativa

El presente trabajo tiene por objeto presentar la primera aproximación a las relaciones interétnicas en el escenario del Fuerte San José y el Puesto de la Fuente, desde una perspectiva histórica y arqueológica. En particular, presentaremos los primeros resultados de las investigaciones históricas respecto de la problemática mencionada, sobre la base de información inédita analizada hasta el momento. Para ello nos centraremos en los primeros diez años de vida en el Fuerte (1779-1789) y estableceremos una comparación con los otros dos asentamientos que formaron parte del plan de poblamiento español de las costa patagónica (siglo XVIII): el Fuerte Nuestra Señora del Carmen y la Nueva Colonia de Floridablanca, a los efectos de destacar la particularidad del Fuerte San José en el marco de la variabilidad de la estructuración de las relaciones interétnicas en las colonias patagónicas.

Cost-effectiveness of natriuretic peptide-based screening and collaborative care: a report from the STOP-HF (St Vincent's Screening TO Prevent Heart Failure) study

AIMS: Prevention of cardiovascular disease and heart failure (HF) in a cost-effective manner is a public health goal. This work aims to assess the cost-effectiveness of the St Vincent's Screening TO Prevent Heart Failure (STOP-HF) intervention.

METHODS AND RESULTS: This is a substudy of 1054 participants with cardiovascular risk factors [median age 65.8 years, interquartile range (IQR) 57.8:72.4, with 4.3 years, IQR 3.4:5.2, follow-up]. Annual natriuretic peptide-based screening was performed, with collaborative cardiovascular care between specialist physicians and general practitioners provided to patients with BNP levels >50 pg/mL. Analysis of cost per case prevented and cost-effectiveness per quality-adjusted life year (QALY) gained was performed. The primary clinical endpoint of LV dysfunction (LVD) with or without HF was reduced in intervention patients [odds ratio (OR) 0.60; 95% confidence interval (CI) 0.38-0.94; P = 0.026]. There were 157 deaths and/or emergency hospitalizations for major adverse cardiac events (MACE) in the control group vs. 102 in the intervention group (OR 0.68; 95% CI 0.49-0.93; P = 0.01). The cost per case of LVD/HF prevented was €9683 (sensitivity range -€843 to €20 210), whereas the cost per MACE prevented was €3471 (sensitivity range -€302 to €7245). Cardiovascular hospitalization savings offset increased outpatient and primary care costs. The cost per QALY gain was €1104 and the intervention has an 88% probability of being cost-effective at a willingness to pay threshold of €30 000.

CONCLUSION: Among patients with cardiovascular risk factors, natriuretic peptide-based screening and collaborative care reduced LVD, HF, and MACE, and has a high probability of being cost-effective.

TRIAL REGISTRATION: NCT00921960.

Natriuretic peptide-based screening and collaborative care for heart failure:the STOP-HF randomized trial

IMPORTANCE: Prevention strategies for heart failure are needed.

OBJECTIVE: To determine the efficacy of a screening program using brain-type natriuretic peptide (BNP) and collaborative care in an at-risk population in reducing newly diagnosed heart failure and prevalence of significant left ventricular (LV) systolic and/or diastolic dysfunction.

DESIGN, SETTING, AND PARTICIPANTS: The St Vincent's Screening to Prevent Heart Failure Study, a parallel-group randomized trial involving 1374 participants with cardiovascular risk factors (mean age, 64.8 [SD, 10.2] years) recruited from 39 primary care practices in Ireland between January 2005 and December 2009 and followed up until December 2011 (mean follow-up, 4.2 [SD, 1.2] years).

INTERVENTION: Patients were randomly assigned to receive usual primary care (control condition; n=677) or screening with BNP testing (n=697). Intervention-group participants with BNP levels of 50 pg/mL or higher underwent echocardiography and collaborative care between their primary care physician and specialist cardiovascular service.

MAIN OUTCOMES AND MEASURES: The primary end point was prevalence of asymptomatic LV dysfunction with or without newly diagnosed heart failure. Secondary end points included emergency hospitalization for arrhythmia, transient ischemic attack, stroke, myocardial infarction, peripheral or pulmonary thrombosis/embolus, or heart failure.

RESULTS: A total of 263 patients (41.6%) in the intervention group had at least 1 BNP reading of 50 pg/mL or higher. The intervention group underwent more cardiovascular investigations (control, 496 per 1000 patient-years vs intervention, 850 per 1000 patient-years; incidence rate ratio, 1.71; 95% CI, 1.61-1.83; P<.001) and received more renin-angiotensin-aldosterone system-based therapy at follow-up (control, 49.6%; intervention, 56.5%; P=.01). The primary end point of LV dysfunction with or without heart failure was met in 59 (8.7%) of 677 in the control group and 37 (5.3%) of 697 in the intervention group (odds ratio [OR], 0.55; 95% CI, 0.37-0.82; P = .003). Asymptomatic LV dysfunction was found in 45 (6.6%) of 677 control-group patients and 30 (4.3%) of 697 intervention-group patients (OR, 0.57; 95% CI, 0.37-0.88; P = .01). Heart failure occurred in 14 (2.1%) of 677 control-group patients and 7 (1.0%) of 697 intervention-group patients (OR, 0.48; 95% CI, 0.20-1.20; P = .12). The incidence rates of emergency hospitalization for major cardiovascular events were 40.4 per 1000 patient-years in the control group vs 22.3 per 1000 patient-years in the intervention group (incidence rate ratio, 0.60; 95% CI, 0.45-0.81; P = .002).

CONCLUSION AND RELEVANCE: Among patients at risk of heart failure, BNP-based screening and collaborative care reduced the combined rates of LV systolic dysfunction, diastolic dysfunction, and heart failure.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00921960.

Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada

Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have benefits such as improved caregiver health outcomes, and enhancing their ability to meet care-giving demands, thereby potentially allowing for longer patient care in the home setting.

Understanding the Patient Experience Through the Power of Film: a Mixed Method Qualitative Research Study

Background For decades film has proved to be a powerful form of communication. Whether produced as entertainment, art or documentary, films have the capacity to inform and move us. Films are a highly attractive teaching instrument and an appropriate teaching method in health education. It is a valuable tool for studying situations most transcendental to human beings such as pain, disease and death. Objectives The objectives were to determine how this helps students engage with their role as health care professionals; to determine how they view the personal experience of illness, disease, disability or death; and to determine how this may impact upon their provision of patient care. Design, Setting and Participants The project was underpinned by the film selection determined by considerate review, intensive scrutiny, contemplation and discourse by the research team. 7 films were selected, ranging from animation; foreign, documentary, biopic and Hollywood drama. Each film was shown discretely, in an acoustic lecture theatre projected onto a large screen to pre-registration student nurses (adult, child and mental health) across each year of study from different cohorts (n = 49). Method A mixed qualitative method approach consisted of audio-recorded 5-minute reactions post film screening; coded questionnaires; and focus group. Findings were drawn from the impact of the films through thematic analysis of data sets and subjective text condensation categorised as: new insights looking through patient eyes; evoking emotion in student nurses; spiritual care; going to the moves to learn about the patient experience; self discovery through films; using films to link theory to practice. Results Deeper learning through film as a powerful medium was identified in meeting the objectives of the study. Integration of film into pre registration curriculum, pedagogy, teaching and learning is recommended. Conclusion The teaching potential of film stems from the visual process linked to human emotion and experience. Its impact has the power to not only help in learning the values that underpin nursing, but also for respecting the patient experience of disease, disability, death and its reality.

Povoações, freguesias e vilas na Paraíba Colonial: Pombal e Sousa, 1697-1800

The towns presently named Pombal and Sousa, located in the hinterland of the State of Paraíba, Brazil, still keep vestiges of the colonization process they went through along the 18th and 19th centuries, when they both emerged as settlement nuclei in the extreme West of the then captaincy of Paraíba and attained the status of freguesia and vila in a later period. This research aims to comprehend the process of urban formation and development of the colonial urban nuclei of Pombal and Sousa as they became povoados (hamlets), freguesias (parishes) and vilas (small urban communities with a local government), according to territorial expansion policies implemented by the Portuguese government from 1697 to 1800. The choice of the two urban settlements for this survey lies in the fact that they were part of the great conquest and colonization program undertaken by the Portuguese Crown. Another aspect that was considered was the fact that those towns are the oldest urban nuclei of Paraíba s hinterland. They came into being as early as in the times of the colony, thus producing a favorable environment to the study of the changes that occurred in the captaincy s hinterland scenery resulting from the process of formation and development of the colonial urban space. Three fundamental categories of analysis were defined since they have a direct bearing upon the urban configuration of the two colonization nuclei: povoado, freguesia and vila. The three of them are related to civil and ecclesiastic jurisdictions. Field, documentation and bibliography surveys were undertaken in order to develop the study. They allowed for the finding of vestiges of the old, colonial urban structures and for the development of theoretical analysis based on present-day studies of issues relating to the colonial urban history. The study purposes were, therefore, to try to understand how the old urban nuclei of Pombal and Sousa fit in the territorial expansion policies undertaken by the Portuguese government; to relate the process of urban formation and development of such nuclei with the categories of analysis povoação-freguesia-vila by discussing the relations and influences they exert over one another and their territory, as well as to unveil, as much as possible, the configuration the urban spaces that were shaped along the 18th century

Economia na consulta de Endodontia

Introdução: Em Portugal a realidade actual, clínica e financeira do exercício da Medicina Dentária é bem distinta da do final do séc. XX devido à pletora de Médicos Dentistas e à baixa de honorários por acto Médico registada nos últimos anos. Objectivos: Este trabalho teve como objectivo perceber um pouco sobre os detalhes a ter em consideração aquando da abertura de uma clínica centrada na realização de tratamentos na área da Endodontia, e como publicitá-la de forma legal e apelativa. Pretende-se depois também estimar o custo mínimo para a realização de tratamentos Endodonticos com diferentes equipamentos e comparar a eficácia entre tratamentos usando ferramentas diferentes. Materiais e Métodos: Foram usadas como fontes de pesquisa para o presente trabalho bases de dados como a PubMed, B-On e Cochrane Library. Foi também usado o Google. Para pesquisa no PubMed foram usados vários descritores MeSH, como “Commerce”, “Dentistry”, “Endodontics”, “Management” e “Marketing”. Foram também usadas diversas palavras-chave no PubMed e nos outros motores de pesquisa, como “Anesthesia”, “Dental Office”, “Files”, “Irrigation”, “Magnification”, “Microscope”, “Obturation Systems” e “Rotatory Systems”. As pesquisas foram filtradas para serem apresentados apenas resultados entre 2011 e 2016, sendo este filtro retirado só quando não eram encontrados resultados satisfatórios ou relevantes para os temas discutidos no trabalho. Foram obtidos 3927 artigos e seleccionados 24. A inclusão destes artigos foi feita tendo em conta as suas fontes bibliográficas e a qualidade dos estudos a que se reportavam. Foram excluídos artigos que se reportavam a estudos muito antigos ou a tecnologias ultrapassadas, como sistemas de limas antigos. Conclusões: As novas tecnologias usadas para tratamento Endodontico, apesar de dispendiosas, melhoram muito o atendimento ao paciente.

"Secretary in Fashion" and "Love-Letters": a study of socio-cultural and pragmatic-linguistic features in the late 17th century English language

Epistolary manuals are conspicuous historical documents for the pedagogy of letter writing; however, their actual usage as manuals by letter writers is unknown. "Secretary in Fashion" by Serre (1668), an epistolary manual, and "Love-Letters between a Nobleman and his Sister" (1684), an epistolary novel attributed to Behn, both give insights into epistolary conventions. Their inception and nature is interesting, considering their historical context. Despite the Restoration of Charles II, 17th century England was in a confused political state; as a result, texts regarding social convention or politics interested contemporary readers (the novel is inspired by a scandal of Lord Grey, an ardent Whig opposing Charles II). Past epistolary studies focus on 18th rather than 17th century manuals; the latter is typically used as supplementary information. Similarly, past epistolary fiction studies focus on 18th century texts; moreover, linguistic studies on Behn and the novel are deficient. Thus, this study addresses the research questions: 1) What are the socio-cultural and pragmaticlinguistic features represented in "Secretary in Fashion"? 2) What are the socio-cultural and pragmatic-linguistic features represented in "Love-Letters between a Nobleman and his Sister", and do any of these features correlate with the features represented in "Secretary in Fashion"? How far do the characteristic linguistic features of "Love-Letters between a Nobleman and his Sister" correlate with the practices recommended by the manual? Both texts were qualitatively analysed from an historical pragmatic perspective, which observes the potential effects of the socio-cultural and historical context. Also, as the texts concern shared discourses, comparisons were made with Gricean and Politeness Theory. The results show that the manual is a typical 17th century epistolary manual, aligning particularly with the "Academies of Complements", as it concerns the social conventions of the gentry. The novel mainly upheld instructions on form and matter; deviations occurred due to the amatory nature of some letters, and the narrative force affecting the style. Unfortunately, neither research question elucidates the actual usage of manuals. However, this study does show the epistolary practices of two writers, within specific contexts. It reveals that their 17th century English language use is affected by socialisation, in terms of social conventions concerning social rank, age, and gender; therefore, context varies language use. Also, their popularity reveals the interests of the 17th century society. Interest in epistolary-related texts, surely piques the interest of the modern reader as to why such epistolary-related texts were interesting.

"Je ne vous dirai point, mon très cher fils" Correspondance de Catherine de Charrière de Sévery 1780-1783

This dissertation examines the principles of education imbued in a three year correspondence between an eighteenth century woman and her teenage son from the French speaking region of Vaud, current day Switzerland. Despite her great respect for the literature and ideas of the new pedagogues of the Enlightenment, especially J.J. Rousseau and Mme de Genlis, Catherine de Charrière de Sévery maintained the traditional perspective of education of the Ancien Régime. To explore the concepts of education and instruction through the epistolary practice, this research is based on the corpus of 107 letters that Mme de Sévery wrote to her son Vilhelm between 1780 and 1783. Additional documents - among them Mme de Sévery’s diaries - from the particularly rich archival holdings of this aristocratic family have been used to complement her correspondence. Most previous studies on family correspondence have dealt with mothers to daughters, or fathers to sons, whereas this research is centered on letters between a mother and her son. The location of this family – Lausanne and the Pays de Vaud – provides a particular regional perspective due to two factors: immersion into a region uniformly Protestant, and the dual-influence of Germanic and French cultures. The study analyzes the educational principles that appear throughout Mme de Sévery’s letters by comparison with three literary works of the 18th century: a familiar correspondence, the Lettres du Lord Chesterfield à son fils (1776); the fundamental education treatise by J.J. Rousseau, Émile, ou de l’Éducation (1762); and a pedagogical treatise written by Mme de Genlis as an epistolary novel, Adèle et Théodore, ou lettres sur l’éducation. Using letters as the main tool to guide her son’s upbringing, Mme de Sévery highlights the moral and family values that are most important to her and leads him to find his place in society.

A visão do ensino técnico-profissional português : evolução histórica das medidas e rupturas

Hermeneuticamente, e na perspectiva histórico-educativa, o texto aborda a evolução do ensino técnico-profissional em Portugal desde o fim do século 18. Analisa as medidas e decisões legislativas que visavam implementar o ensino profissional. Todo o percurso do ensino profissional caracterizou-se por uma série de avanços e recuos, ligados à evolução política do país. Ao seu início promissor, com Marquês de Pombal, seguiu-se um forte impulso no século 19, mas posto em xeque durante as convulsões liberais e a 1ª República. No Estado Novo, foi destinado às classes desfavorecidas, o que conduziu à sua estigmatização.

Exploration of portuguese-bengal cultural heritage throught museological studies

The Portuguese came to Bengal in the early 16th century for trading. Between 1575 and 1600, they established many colonies on the banks of river Ganga, like Chinsura, Hooghly (Porto Pequeno), Satagaon, Gopalpur and Bandel, covering the eastern part of India. During their stay, Portuguese built many churches, schools and charitable institutions. Churches of Augustinians and Jesuits became popular tourist destinations until today. Although by the 18th century, the Portuguese presence had almost disappeared from Bengal with the emergence of British imperialism, the 500 years old (approx.) Portuguese culture is still living in modern Bengal, in the form of tangible and intangible heritage. Traces of the Portuguese impact could be seen in Bengali language, literature, folk-tales, folksongs, cuisines, agriculture, religion, cinema and trade. Some of these are included in the academic curriculum of history at school, college and university levels. In this context, research has been undertaken in the past and is still ongoing in several universities. However, heritage studies under a museological point of view have not yet been initiated at the university level. Though Goa, Panaji, Calicut, Chennai and Nagapattanam were the Portuguese centers for long periods and research has been conducted there along with the establishment of some museums,

The symbolic, socio-economic and exchange value of Imperial German and National Socialist medals and badges, 1701 to the present

This thesis examines the manufacture, use, exchange (including gift exchange), collecting and commodification of German medals and badges from the early 18th century until the present-day, with particular attention being given to the symbols that were deployed by the National Socialist German Workers’ Party (NSDAP) between 1919 and 1945. It does so by focusing in particular on the construction of value through insignia, and how such badges and their symbolic and monetary value changed over time. In order to achieve this, the thesis adopts a chronological structure, which encompasses the creation of Prussia in 1701, the Napoleonic wars and the increased democratisation of military awards such as the Iron Cross during the Great War. The collapse of the Kaiserreich in 1918 was the major factor that led to the creation of the NSDAP under the eventual strangle-hold of Hitler, a fundamentally racist and anti-Semitic movement that continued the German tradition of awarding and wearing badges. The traditional symbols of Imperial Germany, such as the eagle, were then infused with the swastika, an emblem that was meant to signify anti-Semitism, thus creating a hybrid identity. This combination was then replicated en-masse, and eventually eclipsed all the symbols that had possessed symbolic significance in Germany’s past. After Hitler was appointed Chancellor in 1933, millions of medals and badges were produced in an effort to create a racially based “People’s Community”, but the steel and iron that were required for munitions eventually led to substitute materials being utilised and developed in order to manufacture millions of politically oriented badges. The Second World War unleashed Nazi terror across Europe, and the conscripts and volunteers who took part in this fight for living-space were rewarded with medals that were modelled on those that had been instituted during Imperial times. The colonial conquest and occupation of the East by the Wehrmacht, the Order Police and the Waffen-SS surpassed the brutality of former wars that finally culminated in the Holocaust, and some of these horrific crimes and the perpetrators of them were perversely rewarded with medals and badges. Despite Nazism being thoroughly discredited, many of the Allied soldiers who occupied Germany took part in the age-old practice of obtaining trophies of war, which reconfigured the meaning of Nazi badges as souvenirs, and began the process of their increased commodification on an emerging secondary collectors’ market. In order to analyse the dynamics of this market, a “basket” of badges is examined that enables a discussion of the role that aesthetics, scarcity and authenticity have in determining the price of the artefacts. In summary, this thesis demonstrates how the symbolic, socio-economic and exchange value of German military and political medals and badges has changed substantially over time, provides a stimulus for scholars to conduct research in this under-developed area, and encourages collectors to investigate the artefacts that they collect in a more historically contextualised manner.