Volume 1. How to be someone: A formula to Conquer the world is the misunderstanding by a Latin-American of what success means in the First World. / <p>Volume 1 is the first edition of a following publication to be released every April.</p><p></p>

Rwanda has made significant progress in decreasing the number of maternal deaths and increasing the number of antenatal care visits and childbirths at health facilities. This thesis seeks to illuminate potential barriers for Rwanda’s goal for maternal survival. The studies explore the bottom-up perspective of policies and practices in regards to maternal care in Kigali. Semi-structured interviews were conducted between 2013 and 2016 with women who nearly died (‘near-miss’) during pregnancy, their partners, and with other recent fathers and community members, as well as healthcare providers who work within abortion care. The framework of naturalistic inquiry guided the study design and data collection. Analysis was conducted using framework analysis, thematic analysis and naturalistic inquiry. The findings identify paradoxical outcomes in the implementation of maternal care policies. Despite recent amendments of the abortion law, safe abortion was identified as being non-accessible. Abortion-related symptoms continue to carry a criminalized and stigmatized label, which encourages risk-taking and clandestine solutions to unwanted pregnancies, and causes care-seeking delays for women with obstetric complications in early pregnancy. Healthcare providers had limited awareness of the current abortion law, and described tensions in exercising their profession due to fear of litigation. The first antenatal care visit appeared to require the accompaniment of a male partner, which underpinned women’s reliance on men in their care-seeking. Men expressed interest in taking part in maternal care, but faced resistance for further engagement from healthcare providers. Giving birth at a health facility was identified as mandatory, yet care was experienced as suboptimal. Disrespect during counseling and care was identified, leading to repeated care-seeking and may underpin the uptake of traditional medicine. An enhanced implementation of the current abortion law is recommended. Reconsideration of policy is recommended to ensure equitable and complete access to antenatal care: women should be able to seek care accompanied by their person of choice. These findings further recommend action for improved policy to better address men’s preferred inclusion in maternal health matters. The findings of this thesis promote continued attention to implementing changes to strengthen quality, and trust, in public maternal care.

OBJETIVOS: Verificar o índice de erros geográficos no planejamento radioterápico convencional de pacientes com carcinoma de colo uterino por meio da ressonância magnética (RM); comparar os dados de estadiamento da FIGO pelos exames físico e de RM e avaliar o estudo do Raio-X contrastado de reto na previsão do erro geográfico. MATERIAIS E MÉTODOS: Oitenta pacientes com diagnóstico histológico de carcinoma espinocelular de colo uterino, com indicação de radioterapia, foram analisadas. Após o estadiamento clínico (FIGO), foi realizada ressonância magnética da pelve e estas imagens comparadas aos campos clássicos de radioterapia, técnica de 4 campos em tijolo. Considerou-se erro geográfico, quando o volume alvo não foi englobado pelos campos, com margens mínimas de 1cm. Os dados de exame físico e RM foram comparados. RESULTADOS: Entre as 80 pacientes analisadas, os limites clássicos dos campos não foram adequados em 45 (56%). Os limites críticos foram as bordas anterior (1/3 anterior da sínfise púbica) ou posterior (limite em S2-S3) dos campos laterais de irradiação. Evidenciou-se grande discrepância entre o exame físico e a RM no que se refere à análise de informações para o estadiamento. Na maioria das vezes, o exame físico sub-estadiou as lesões, principalmente na detecção de doença vaginal e parametrial. Lesões com diâmetro antero-posterior maior que 6cm e volume acima de 100cm3 apresentaram correlação estatisticamente significante com o erro geográfico. O posicionamento da parede anterior do reto fora do limite posterior dos campos laterais, no raio-X contrastado mostrou correlação estatisticamente significante com o erro geográfico. CONCLUSÕES: Em relação aos limites dos campos de irradiação a RM foi decisória para adequação dos campos de radioterapia, na maioria das pacientes. O estadiamento por RM, comparado ao exame físico, mostrou-se preciso na avaliação de volume tumoral e extensão da doença. No presente estudo, a avaliação do deslocamento da parede anterior do reto na radiografia dos campos laterais de irradiação mostrou associação com o risco de erro geográfico. / OBJECTIVES The purposes of this study were to verify the chances of geographic miss in conventional 2-dimensional radiotherapy planning in patients with uterine cervix cancer, by means of magnetic resonance imaging (MRI); to compare the data from FIGO staging system with MRI findings; and to evaluate the influence of contrasted rectum X-ray in predicting geographic miss. MATERIAL AND METHODS: Eighty patients with uterine cervical carcinoma were analyzed. After clinical staging (FIGO), magnetic resonance imaging of the pelvis was performed. The images were compared to the classic 4-field technique (box) of radiotherapy. Geographic miss was considered when the tumor volume was not included in the irradiation fields with at least 1cm margins. Data of physical examination and RM were compared. RESULTS: In 45 (56,2%) of the 80 studied patients, fields? limits were not adequate. The anterior (anterior 1/3 of pubis) and posterior limits (S2-S3) of the lateral fields of irradiation were critical. Great discrepancy was observed when physical exam was compared to MRI findings. In most cases, physical exam tended to under-stage the tumors, mainly due to vaginal and parametrial extension. Tumors with antero-posterior diameter larger than 6cm and volume above 100cm3 presented statistically significant correlation with geographical miss. Displacement of the anterior rectal wall outside the posterior limit of the lateral fields in the contrasted X-ray was also significantly correlated with geographical miss. CONCLUSIONS: MRI findings detected and prevented geographic misses in the majority of the patients. When compared to physical examination, tumor volume and extension were better defined by MRI. In the present study, the evaluation of the anterior rectal wall displacement in the lateral x-ray of the irradiation fields was associated with the risk of geographical miss.

Made available in DSpace on 2015-04-14T13:47:24Z (GMT). No. of bitstreams: 1 430715.pdf: 1474491 bytes, checksum: ab9ecc1554a68667530e65fad737ee76 (MD5) Previous issue date: 2011-03-11 / Este estudo tem como objetivo estabelecer os condicionantes ?tnicos que dificultaram e/ou facilitaram a instala??o das Miss?es de Chiquitos na Bol?via. A partir do contato inter?tnico, surgiram alian?as e conflitos entre ind?genas/ind?genas e entre ind?genas/europeus, que possibilitaram o estabelecimento da sociedade europeia em seus territ?rios, a implanta??o do sistema de encomiendas em Assun??o e Santa Cruz de la Sierra e, finalmente, a funda??o das miss?es jesu?ticas entre os ind?genas da Chiquitania. O recorte temporal inicia em meados do s?culo XVI, quando os conquistadores europeus entram na regi?o do Pantanal e da Chiquitania na tentativa de alcan?ar as riquezas minerais do Peru e de Potosi na Bol?via. Nesse contexto, ocorrem v?rios epis?dios de intensos conflitos entre ind?genas e espanh?is encomenderos at? que, a partir de 1609, os mission?rios jesu?tas aparecem como uma possibilidade de salva??o dos ind?genas e de inser??o em um novo contexto colonial por meio das redu??es religiosas, primeiro, junto aos Guarani, nas margens do rio Paranapanema (no atual estado do Paran?) e, posteriormente, em 1691, na Chiquitania, junto aos ind?genas conhecidos como Chiquito. Assim, surgem conflitos e alian?as entre os europeus que almejavam conquistar riquezas e territ?rios para a Coroa espanhola, ocorre o genoc?dio e a explora??o de muitos ind?genas, a migra??o de ind?genas para regi?es mais seguras, como a das pr?prias Miss?es de Chiquitos e a miscigena??o de grupos ind?genas com culturas e l?nguas distintas. Para a interpreta??o dos epis?dios gerados pelo contato inter?tnico entre ind?genas e europeus, a an?lise de discurso foi utilizada na compreens?o de como a sociedade europeia construiu a imagem do ind?gena como um ser sem f?, sem lei e sem Rei.

Made available in DSpace on 2015-04-14T13:47:49Z (GMT). No. of bitstreams: 1 444645.pdf: 5390282 bytes, checksum: 337156087e50fae4e00695c8da51cd3d (MD5) Previous issue date: 2012-11-30 / Among the numerous remainders of the sculptural production of the jesuiticas doctrines of the Paraguayan Province, this study contemplates the miniatures and the medium port images. Under historical, anthropological and aesthetic perspectives of analysis, these statues present in the day-to-day of the missional villages, amalgamating the European and Indigenous contributions - , are understood as material culture of a long duration historical phenomenon, expression of the development of the religious and aesthetic autonomy of the missionary. From the second half of the century XVIII on , they constituted themselves as a reminiscence through the presence in the religious praxis of the human groups that dispersed and incorporated in the Spanish and Portuguese colonial states, compounding, afterwards, collections of the independent countries of huge area of the Southern America. / Dentre os numerosos remanescentes da produ??o escult?rica das doutrinas jesu?ticas da Prov?ncia paraguaia, este estudo contempla as miniaturas e imagens de m?dio porte. Sob perspectivas hist?ricas, antropol?gicas e est?ticas de an?lise, estas estatuetas presentes no cotidiano dos povoados missionais, amalgamando as contribui??es europeia e ind?gena, s?o compreendidas como cultura material de um fen?meno hist?rico de longa dura??o, express?o do desenvolvimento da autonomia religiosa e est?tica dos missioneiros. A partir da segunda metade do s?culo XVIII, constitu?ram-se como remanesc?ncia mediante a presen?a na pr?xis religiosa dos grupos humanos que se dispersaram e se incorporaram nos Estados coloniais espanhol e portugu?s, compondo, posteriormente, acervos dos pa?ses independentes de imensa ?rea da Am?rica meridional.

OBJETIVOS: Verificar o índice de erros geográficos no planejamento radioterápico convencional de pacientes com carcinoma de colo uterino por meio da ressonância magnética (RM); comparar os dados de estadiamento da FIGO pelos exames físico e de RM e avaliar o estudo do Raio-X contrastado de reto na previsão do erro geográfico. MATERIAIS E MÉTODOS: Oitenta pacientes com diagnóstico histológico de carcinoma espinocelular de colo uterino, com indicação de radioterapia, foram analisadas. Após o estadiamento clínico (FIGO), foi realizada ressonância magnética da pelve e estas imagens comparadas aos campos clássicos de radioterapia, técnica de 4 campos em tijolo. Considerou-se erro geográfico, quando o volume alvo não foi englobado pelos campos, com margens mínimas de 1cm. Os dados de exame físico e RM foram comparados. RESULTADOS: Entre as 80 pacientes analisadas, os limites clássicos dos campos não foram adequados em 45 (56%). Os limites críticos foram as bordas anterior (1/3 anterior da sínfise púbica) ou posterior (limite em S2-S3) dos campos laterais de irradiação. Evidenciou-se grande discrepância entre o exame físico e a RM no que se refere à análise de informações para o estadiamento. Na maioria das vezes, o exame físico sub-estadiou as lesões, principalmente na detecção de doença vaginal e parametrial. Lesões com diâmetro antero-posterior maior que 6cm e volume acima de 100cm3 apresentaram correlação estatisticamente significante com o erro geográfico. O posicionamento da parede anterior do reto fora do limite posterior dos campos laterais, no raio-X contrastado mostrou correlação estatisticamente significante com o erro geográfico. CONCLUSÕES: Em relação aos limites dos campos de irradiação a RM foi decisória para adequação dos campos de radioterapia, na maioria das pacientes. O estadiamento por RM, comparado ao exame físico, mostrou-se preciso na avaliação de volume tumoral e extensão da doença. No presente estudo, a avaliação do deslocamento da parede anterior do reto na radiografia dos campos laterais de irradiação mostrou associação com o risco de erro geográfico. / OBJECTIVES The purposes of this study were to verify the chances of geographic miss in conventional 2-dimensional radiotherapy planning in patients with uterine cervix cancer, by means of magnetic resonance imaging (MRI); to compare the data from FIGO staging system with MRI findings; and to evaluate the influence of contrasted rectum X-ray in predicting geographic miss. MATERIAL AND METHODS: Eighty patients with uterine cervical carcinoma were analyzed. After clinical staging (FIGO), magnetic resonance imaging of the pelvis was performed. The images were compared to the classic 4-field technique (box) of radiotherapy. Geographic miss was considered when the tumor volume was not included in the irradiation fields with at least 1cm margins. Data of physical examination and RM were compared. RESULTS: In 45 (56,2%) of the 80 studied patients, fields? limits were not adequate. The anterior (anterior 1/3 of pubis) and posterior limits (S2-S3) of the lateral fields of irradiation were critical. Great discrepancy was observed when physical exam was compared to MRI findings. In most cases, physical exam tended to under-stage the tumors, mainly due to vaginal and parametrial extension. Tumors with antero-posterior diameter larger than 6cm and volume above 100cm3 presented statistically significant correlation with geographical miss. Displacement of the anterior rectal wall outside the posterior limit of the lateral fields in the contrasted X-ray was also significantly correlated with geographical miss. CONCLUSIONS: MRI findings detected and prevented geographic misses in the majority of the patients. When compared to physical examination, tumor volume and extension were better defined by MRI. In the present study, the evaluation of the anterior rectal wall displacement in the lateral x-ray of the irradiation fields was associated with the risk of geographical miss.

Made available in DSpace on 2015-04-15T12:50:18Z (GMT). No. of bitstreams: 1 425176.pdf: 853310 bytes, checksum: 12ba60dc72894dc37958e161102d43a6 (MD5) Previous issue date: 2010-05-24 / A miss?o da Igreja tem alcan?ado uma dimens?o de import?ncia maior nos ?ltimos tempos, em vista das mudan?as de contexto que a interrogam a renovar-se e ao mesmo tempo a ser fiel ? sua ess?ncia e tradi??o eclesiais nas novas exig?ncias do tempo presente. A Miss?o da Igreja - do Conc?lio Vaticano II a Confer?ncia de Aparecida: um aggiornamento necess?rio ? o tema desta disserta??o visando expor o conte?do pesquisado a partir de sua fundamenta??o teol?gico-sistem?tica. A rela??o fundante da Igreja com Jesus Cristo ? o ponto de partida para uma correta compreens?o de sua ess?ncia e consequentemente de sua miss?o. ? a partir desta reflex?o de base que procuramos sintetizar o caminho mission?rio da Igreja no per?odo compreendido entre o Conc?lio Vaticano II - e sua inspira??o renovadora da vida e da miss?o da Igreja at? a Confer?ncia de Aparecida, com seus novos indicativos para o discipulado e esfor?o mission?rio. As Confer?ncias Episcopais Latino-Americanas Medell?n, Puebla e Santo Domingo s?o como que o elo de liga??o e o fio condutor por onde o aggiornamento desejado pelo Conc?lio vai gerando a vida e renovando o impulso origin?rio para que o Evangelho de Jesus Cristo v? fecundando o cora??o das comunidades e da sociedade numa perspectiva encarnat?ria, onde o advento do Eterno no tempo pode sempre abrir novas perspectivas de salva??o e liberta??o. Uma leitura de contexto em vista de uma evangeliza??o renovada dever? ter sempre como chave de compreens?o a reden??o conquistada por Cristo em seu mist?rio pascal, tendo como fatores de media??o as exig?ncias atuais do an?ncio, do di?logo, do servi?o e do testemunho de comunh?o.

Thesis (D.Min.)--Reformed Theological Seminary, Charlotte, NC, 2005. / Abstract and vita. Includes bibliographical references (leaves 313-323).

Project (D. Min.)--New Orleans Baptist Theological Seminary, 2008. / Abstract and vita. Includes final project proposal. Includes bibliographical references (leaves 137-144, 40-47).

Background: Little is known about the experience and psychological outcomes for women who experience emergency peripartum hysterectomy (EPH). The objective of this study was to explore women's experiences of EPH and to determine if women who experience EPH were more likely to experience mental health sequelae. Methods: This mixed method design involved a quantitative and a qualitative phase. The quantitative phase used a retrospective cohort design. Women were sampled through on-line communities, including an EPH support group, and a larger website for mothers. Women completed on-line surveys covering sociodemographic, obstetric/gynecological/ and psychiatric information, including screens for depression and Post-Traumatic Stress Disorder (PTSD). Logistic regression was used to calculate the independent risk that exposure to EPH has on screening positive for PTSD. Participants from the EPH support group who completed the on-line interview were then selected to participate in the second phase. In-depth telephone interviews were conducted and analyzed using Constant Comparative Analysis. Results: 74 exposed women and 355 non-exposed women completed the survey. In the adjusted logistic regression model, women who experienced EPH were over 6 times more likely to screen positive for current PTSD compared to women who did not experience EPH (adjusted Relative Risk (aRR): 6.76; 95% CI: 4.24, 8.88). When women recalled their psychological state at 6 months postpartum, exposed women were 11 times more likely to screen positive for current PTSD (aRR: 11.35; 95% CI: 8.43, 12.95). In the qualitative phase, 15 women participated and 7 major themes were identified: fear, pain, death and dying, numbness or delay in emotional reaction, bonding with baby, communication and the need for information. A major finding is the need for additional follow-up visits to address the emotional after-effects and to fill in gaps in women's understanding and memory of what had occurred. Conclusion: Understanding women's experiences and sequelae can help providers address not only women's initial complications but provide needed long-term support.