Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Ink Under the Fingernails: Making Print in Nineteenth-Century Mexico City

This dissertation examines Mexico City’s material politics of print—the central actors engaged in making print, their activities and relationships, and the legal, business, and social dimensions of production—across the nineteenth century. Inside urban printshops, a socially diverse group of men ranging from manual laborers to educated editors collaborated to make the printed items that fueled political debates and partisan struggles in the new republic. By investigating how print was produced, regulated, and consumed, this dissertation argues that printers shaped some of the most pressing conflicts that marked Mexico’s first formative century: over freedom of expression, the role of religion in government, and the emergence of liberalism. Printers shaped debates not only because they issued texts that fueled elite politics but precisely because they operated at the nexus where new liberal guarantees like freedom of the press and intellectual property intersected with politics and patronage, the regulatory efforts of the emerging state, and the harsh realities of a post-colonial economy.

Historians of Mexico have typically approached print as a vehicle for texts written by elites, which they argue contributed to the development of a national public sphere or print culture in spite of low literacy levels. By shifting the focus to print’s production, my work instead reveals that a range of urban residents—from prominent printshop owners to government ministers to street vendors—produced, engaged, and deployed printed items in contests unfolding in the urban environment. As print increasingly functioned as a political weapon in the decades after independence, print production itself became an arena in struggles over the emerging contours of politics and state formation, even as printing technologies remained relatively unchanged over time.

This work examines previously unexplored archival documents, including official correspondence, legal cases, business transactions, and printshop labor records, to shed new light on Mexico City printers’ interactions with the emerging national government, and reveal the degree to which heated ideological debates emerged intertwined with the most basic concerns over the tangible practices of print. By delving into the rich social and cultural world of printing—described by intellectuals and workers alike in memoirs, fiction, caricatures and periodicals— it also considers how printers’ particular status straddling elite and working worlds led them to challenge boundaries drawn by elites that separated manual and intellectual labors. Finally, this study engages the full range of printed documents made in Mexico City printshops not just as texts but also as objects with particular visual and material qualities whose uses and meanings were shaped not only by emergent republicanism but also by powerful colonial legacies that generated ambivalent attitudes towards print’s transformative power.

Beyond the Convent Walls: The Local and Japan-wide Activities of Daihongan’s Nuns in the Early Modern Period (c. 1550–1868)

This dissertation examines the social and financial activities of Buddhist nuns to demonstrate how and why they deployed Buddhist doctrines, rituals, legends, and material culture to interact with society outside the convent. By examining the activities of the nuns of the Daihongan convent (one of the two administrative heads of the popular pilgrimage temple, Zenkōji) in Japan’s early modern period (roughly 1550 to 1868) as documented in the convent’s rich archival sources, I shed further light on the oft-overlooked political and financial activities of nuns, illustrate how Buddhist institutions interacted with the laity, provide further nuance to the discussion of how Buddhist women navigated patriarchal sectarian and secular hierarchies, and, within the field of Japanese history, give voice to women who were active outside of the household unit around which early modern Japanese society was organized.

Zenkōji temple, surrounded by the mountains of Nagano, has been one of Japan’s most popular pilgrimage sites since the medieval period. The abbesses of Daihongan, one Zenkōji’s main sub-temples, traveled widely to maintain connections with elite and common laypeople, participated in frequent country-wide displays of Zenkōji’s icon, and oversaw the creation of branch temples in Edo (now Tokyo), Osaka, Echigo (now Niigata), and Shinano (now Nagano). The abbesses of Daihongan were one of only a few women to hold the imperially sanctioned title of eminent person (shōnin 上人) and to wear purple robes. While this means that this Pure Land convent was in some ways not representative of all convents in early modern Japan, Daihongan’s position is particularly instructive because the existence of nuns and monks in a single temple complex allows us to see in detail how monastics of both genders interacted in close quarters.

This work draws heavily from the convent’s archival materials, which I used as a guide in framing my dissertation chapters. In the Introduction I discuss previous works on women in Buddhism. In Chapter 1, I briefly discuss the convent’s history and its place within the Zenkōji temple complex. In Chapter 2, I examine the convent’s regular economic bases and its expenditures. In Chapter 3, I highlight Daihongan’s branch temples and discuss the ways that they acted as nodes in a network connecting people in various areas to Daihongan and Zenkōji, thus demonstrating how a rural religious center extended its sphere of influence in urban settings. In Chapter 4, I discuss the nuns’ travels throughout the country to generate new and maintain old connections with the imperial court in Kyoto, confraternities in Osaka, influential women in the shogun’s castle, and commoners in Edo. In Chapter 5, I examine the convent’s reliance upon irregular means of income such as patronage, temple lotteries, loans, and displays of treasures, and how these were needed to balance irregular expenditures such as travel and the maintenance or reconstruction of temple buildings. Throughout the dissertation I describe Daihongan’s inner social structure comprised of abbesses, nuns, and administrators, and its local emplacement within Zenkōji and Zenkōji’s temple lands.

Exploring these themes sheds light on the lives of Japanese Buddhist nuns in this period. While the tensions between freedom and agency on the one hand and obligations to patrons, subordination to monks, or gender- and status-based restrictions on the other are important, and I discuss them in my work, my primary focus is on the nuns’ activities and lives. Doing so demonstrates that nuns were central figures in ever-changing economic and social networks as they made and maintained connections with the outside world through Buddhist practices and through precedents set centuries before. This research contributes to our understanding of nuns in Japan’s early modern period and will participate in and shape debates on the roles of women in patriarchal religious hierarchies.

An archaeology of female monasticism in medieval Ireland

This thesis considers the archaeological evidence for female monasticism in medieval Ireland, with a particular emphasis on the later medieval period. Female monasticism has been considered from an archaeological perspective in several countries, most notably Britain, but has yet to be considered in any detail in Ireland. The study aims to bring together all the currently available evidence on female monasticism and consider it through an engendered archaeological approach. The data gathering for this research has been deliberately wide, and where gaps have been identified in the Irish evidence, comparative material from elsewhere has been considered. Nunneries should not be expected to conform to what has become the male monastic template of a claustrally-planned monastery. The research conducted shows a distinct and varied archaeology and architecture for medieval nunneries in Ireland which suggests that a claustral plan was not considered an essential part of a nunnery scheme. Nunneries provided an enclosed environment where women, for a variety of motives could become brides of Christ. Through the performance and celebration of the daily Divine Office, the Mass and seasonal liturgy, spaces used by the nunnery community were negotiated and transformed into a sacred Paradise on earth. However, rather than being isolated in the landscape nunneries in later medieval Ireland were located either within or close to walled towns, larger unenclosed settlements and settlement clusters and would have been well known throughout their hinterlands. This research concludes that nunneries were an intrinsic part of the medieval monastic landscape in Ireland and an essential component of patrons’ portfolios of patronage, at a particularly local level, and where they interacted closely with their local community.

Beyond Black and White: The grisaille exterior of the Netherlandish triptych

This thesis is a study of fifteenth- to mid sixteenth-century Netherlandish triptych exteriors, focusing on the so-called ‘grisaille’ technique. During this period, altarpieces produced in the Low Countries were typically constructed in a tripartite format with folding wings. This arrangement created the opportunity for pictorial representations on both sides of the hinged panels. Painters emphasized the distinction between the triptych’s two faces by executing the exteriors in a strikingly more subdued palette than the interiors. Particular iconographic subject matter was favoured for grisailles, which often depict the Annunciation or saints that reflect the triptych’s patronage or intended location. Jan van Eyck was notable for his emphasis on imitating stone statuary and created three important grisailles, one of which would influence triptych exteriors for years to come. Hieronymus Bosch, an artist working at the turn of the sixteenth century, also brought innovation to his grisailles, further expanding the potential of these reduced-palette paintings. This thesis examines the creative process involved in the production of grisailles and compares the underdrawings of triptych exteriors to those of the corresponding polychromatic interiors. In this study, grisailles are situated in their context as part of multifaceted artworks as well as within the broader church environment. New infrared reflectograms were generated using Queen’s OSIRIS infrared camera to document works in Belgium and the Netherlands. While some aspects of underdrawings could indicate that the figure was meant to imitate statuary, this distinction was not directly linked to triptych exteriors and was related instead to efforts at a trompe-l’oeil effect. Such attempts at mimicry can also be found on triptych interiors. Through a close examination of the underdrawing stage of these paintings it appears that this part of the creative process was not distinguished in any significant way from the underdrawings of triptych interiors.

Alonso de Burgos y la fundación y primeros estatutos del colegio de San Gregorio de Valladolid. La regulación de la vida religiosa y académica de los dominicos observantes en la Castilla del siglo XV

En el presente trabajo se analiza primeramente el proceso de fundación, a fines del siglo XV, del colegio de San Gregorio de Valladolid por parte del obispo dominico, consejero y confesor real Alonso de Burgos; el colegio, de patronato real y centrado en los estudios de teología, estaba reservado exclusivamente para frailes predicadores observantes. A continuación, y como parte más amplia y fundamental del estudio, se analizan los primeros estatutos que tuvo el colegio, otorgados por su fundador, ofreciéndose finalmente, en apéndice documental, su transcripción completa.

Fadrique Álvarez de Toledo, II Duque de Alba y su inventario de libros (1531): Una biblioteca patrimonial

Fadrique Álvarez de Toledo, que nació hacia 1460 y murió en 1531, lidera en Castilla el linaje de la casa de Alba en el tránsito de la Edad Media al Renacimiento. Primo carnal de Fernando el Católico, y colaborador íntimo de los Reyes, desarrolla una amplia labor de mecenazgo artístico y literario, de la cual son ejemplos relevantes los apoyos a poetas como Juan del Encina, Juan Boscán o Garcilaso de la Vega. A pesar de esta actividad, la crítica no se ha ocupado con detalle de este personaje por haberle eclipsado un tanto su nieto, el Gran Duque de Alba. Este artículo reproduce el inventario de la biblioteca de Don Fadrique (formado por los libros que fueron catalogados a su muerte), inédito hasta ahora y que nos muestra una rica biblioteca patrimonial de ciento ochenta y seis obras. Entre los libros religiosos encontramos biblias, tratados de oración y libros de horas; se hallan también algunos títulos indispensables de las tradiciones franciscana y dominica, que nos muestran a un personaje interesado en las nuevas corrientes devocionales de finales del siglo XV, en el escolasticismo y en las mujeres santas y visionarias del Medievo.

Patronazgo nobiliario e individuo. Los Macanaz y la “hora” del XVIII

Desde la fecunda obra de Caro Baroja, la renovación de las élites de gobierno localizada a comienzos del setecientos ha llamado la atención de una parte de la historiografía preocupada en proponer diversos enfoques con los que interpretar este proceso de enormes consecuencias sociales y políticas. El caso de los Macanaz presenta una serie de peculiaridades que lo hacen propicio para un análisis detallado de su proceso de promoción familiar en el que sobresale la trascendencia de ciertos factores escasamente subrayados hasta el momento. El importante papel desempeñado por la casa aristocrática de Villena y el escaso peso de lo local o regnícola en su proyección posterior, nos servirá para cuestionar la dimensión de los Macanaz como iniciadores de una hipotética “hora murciana”, destacando en su caso la importancia de otros elementos complementarios como el patrocinio nobiliario, el mérito, la formación y la capacidad e iniciativa individual, vías también de acceso al servicio del rey.

Noble States Managed by Women. Doña Teresa de Saavedra y Zúñiga, Countess of Villalonso: an Aristocrat during Philip II and Philip III’s Reign

This work intends to analyze the letters exchanged between doña Teresa de Saavedra y Zúñiga, countess of Villalonso, and Bartolomé de Cartagena, a merchant who lived in Seville. Those letters are a very detailed account of their financial relationship during two decades; but they also give us important information about the countess’ life. In her letters the countess discussed her domestic familial life but also made reference to her social position at Court, so we can reconstruct the strategies used by doña Teresa in order to accomplish all her objectives and the ways she used to present these goals to the others.

The value of military oath in civil wars in Rome: The example of conflict 49-45 BC

During the civil war between Caesar and Pompey, the military oath which binds the soldier to his army is often openly violated. Yet despite this offense, commanders of armed struggle require recursively the oath to their men. Admittedly, this ritual act seems ineffective given the many desertions and mutinies identified, but military leaders use its symbolic and sacred meaning to legitimize one hand their “anti-republican” actions, on the other armies fighting in a context deemed impius.

Interventions to Promote Follow-up After Trabeculectomy Surgery in Rural Southern China: A Randomized Clinical Trial.

Importance:

Follow-up after trabeculectomy surgery is important to surgical success, but little is known about the effect of interventions on improving follow-up in low-resource areas.

Objective:

To examine whether text message reminders and free eye medications improve follow-up after trabeculectomy in rural southern China.

Design, Setting, and Participants:

This randomized clinical trial studied 222 consecutive patients undergoing trabeculectomy from October 1, 2014, through November 31, 2015, at 4 rural hospitals in Guangdong and Guangxi Provinces, China. Data from the intention-to-treat population were analyzed.

Interventions:

Patients undergoing trabeculectomy were randomized (1:1) to receive text message reminders 3 days before appointments at 1 and 2 weeks and 1 month after surgery and free topical corticosteroid medication (US$5.30) at each visit or to standard follow-up without reminders or free medication.

Main Outcomes and Measure:

Follow-up at 1 month postoperatively.

Results:

Among 222 eligible patients, 13 (5.9%) refused and 209 (94.1%) were enrolled, with 106 (50.7%) randomized to the intervention group (mean [SD] age, 64.4 [12.7] years; 56 women [52.8%]) and 103 (49.3%) to the control group (mean [SD] age, 63.0 [12.7] years; 53 women [51.5%]). A total of 6 patients (2.9%) were unavailable for follow-up. Attendance at 1 month for the intervention group (59 of 102 [57.8%]) was significantly higher than for the control group (34 of 101 [33.7%]) (unadjusted relative risk [RR], 1.72; 95% CI, 1.13-2.63; P = .01). Factors associated with 1-month attendance in multiple regression models included intervention group membership (RR, 1.65; 95% CI, 1.08-2.53; P = .02) and being told to return for suture removal (RR, 1.80; 95% CI, 1.06-3.06; P = .03). One-month attendance among controls not told about suture removal was 3 of 31 (9.7%), whereas it was 44 of 68 (64.7%) among the intervention group with suture removal (unadjusted RR, 6.69; 95% CI, 2.08-21.6; P = .001).

Conclusions and Relevance:

In this setting, low-cost interventions may significantly improve postoperative follow-up after glaucoma surgery, a potential opportunity for interventions known to improve surgical success.

Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006

NORO, Luiz Roberto Augusto et al. Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006, Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 4, p. 783-790, abr. 2009.

Avaliação da sensibilidade médica para o risco de gravidez não planeada

Prémio em Contraceção 2012 da Sociedade Portuguesa de Contraceção