Discapacidad, agencia y asistencia en dos cartas de Plinio el Joven: Corelio Rufo (Ep. 1.12) y Domicio Tulo (Ep. 8.18) / Deficiência, agência e assistência em duas cartas de Plínio o Jovem: Corélio Rufo (Ep. 1.12) e Domício Tulo (Ep. 8.18) / Disability, agency, and assistance in two letters of Pliny the Younger: Corelius Rufus (Ep. 1.12) and Domitius Tullus (Ep. 8.18)

This article discusses the experience of disability in ancient Rome through the letters Ep. 1.12 and Ep. 8.18 of Pliny the Younger (1st-2nd centuries CE). The main characters of these letters, Corellius Rufus and Domitius Tullus, were two senators with reduced mobility and assisted in their daily tasks by relatives and enslaved people. Based on the methodology provided by Disability Studies, we analyse the agency of the subjects of study as disabled people, as well as the role that assistance played in their lives and how their environment conditioned their life decisions. Finally, we address Pliny the Younger's personal perspective and the bias this may entail when interpreting the meaning of the letters.(AU)

Este artículo aborda la experiencia de la discapacidad en la antigua Roma a través de las cartas Ep. 1.12 y Ep. 8.18 de Plinio el Joven (ss. I-II n.e.). Los protagonistas de estas misivas, Corelio Rufo y Domicio Tulo, fueron dos senadores con movilidad limitada y asistidos en las tareas cotidianas por familiares y personas esclavizadas. Partiendo de la metodología proporcionada por los Estudios de Discapacidad, analizamos la agencia de los sujetos de estudio en cuanto que personas discapacitadas, así como el papel que la asistencia jugó en sus vidas y cómo su entorno condicionó sus decisiones vitales. Finalmente, abordamos la perspectiva personal de Plinio el Joven y el sesgo que ésta puede suponer a la hora de interpretar el significado de las cartas.(AU)

Este artigo aborda a experiência da deficiência na Roma antiga através das cartas Ep. 1.12 e Ep. 8.18 de Plínio o Jovem (1ª-2ª c. n.e.). Os protagonistas destas cartas, Corélio Rufo e Domício Tulo, foram dois senadores com mobilidade limitada e assistidos em tarefas diárias por familiares e pessoas escravizadas. Com base na metodologia fornecida pelos Estudos sobre Deficiência, analisamos a agência dos sujeitos de estudo como pessoas com deficiência, bem como o papel que a assistência desempenhou nas suas vidas e como o seu ambiente condicionou as suas decisões de vida. Finalmente, abordamos a perspectiva pessoal de Plínio o Jovem e o preconceito que isto pode implicar ao interpretar o significado das letras.(AU)

Historia cultural sobre el conocimiento de higiene y lavado de manos en las mujeres nahuas del México Antiguo / História cultural sobre os conhecimentos de higiene e lavagem das mãos das mulheres Nahua no México Antigo / Cultural history on the knowledge of hygiene and hand washing in the Nahua women of Ancient Mexico

Introducción. El trabajo de cuidados ha sido el núcleo fundamental de análisis y objeto de estudio tradicional de la Enfermería. Las investigaciones que durante mucho tiempo se han realizado se han centrado mayoritariamente en la producción de cuidados desde la mirada cientificista y hegemónica de la ciencia una ciencia de la enfermería llena de conocimientos técnicos y mecánicos desde una visión parcial de estos, una visión eurocentrista y anglosajona con "valor" académico, dejando al margen los trabajos que se realizan fuera de estos ámbitos y que no están plagados de números y cosas "tangibles". Metodología. Se trata de una investigación histórico cultural, que pretende deconstruir y cristalizar el conocimiento femenino en torno a la higiene y al lavado de manos, por medio de la transdisciplinariedad, haciendo uso de la heurística y la hermenéutica analógica. Hallazgos. Las mujeres nahuas del México Antiguo, dice Clementina Battcock en el Seminario de Historia de las Mujeres en el México Antiguo (Battcock, 2018, 2021), que la historia de las mujeres en el México Antiguo es una historia acallada, "bajita", por lo cual las historiadoras e historiadores han ido construyendo un debate profundo sobre las aportaciones de las mujeres. A través de la heurística seguida se logró encontrar la valiosa recopilación de libros, hecha por Andrés de Olmos denominada "Huehuetlatolli", también denominados la "antigua palabra", gracias a estos escritos se sabe la forma de educación que brindaban mujeres y hombres sabios (tlamatini, mujeres u hombres que saben algo, que conocen las cosas) Discusión. La higiene en la sociedad náhuatl era un método de cuidado para la salud individual y colectiva. Estudiar estos fenómenos como sustento de la la historia del cuidado en la sociedad mexicana gracias al pueblo nahua, es una fuente de información que robustece el cuerpo histórico académico de la profesión de enfermería en México y Latinoamérica Conclusiones. La participación de las mujeres en la educación y en otros ámbitos ha tenido un realce inconmensurable, equiparable con el conocimiento hegemónico proveniente de Europa, las mujeres histórica y universalmente son quienes se han encargado de ilustrar y enseñar desde el seno del hogar las normas básicas de convivencia y civilidad, y aunque ha sido un papel de cierta forma impuesto, no se debe dejar de lado que el conocimiento empírico de todas estas mujeres es valioso y digno de darse a conocer

Introduction. The work of care has been the fundamental nucleus of analysis and traditional object of study of nursing. The research that has been carried out for a long time has focused mainly on the production of care from the scientificist and hegemonic viewpoint of science, a nursing science full of technical and mechanical knowledge from a partial view of this, a Eurocentric and Anglo-Saxon view with academic "value", leaving aside the work that is carried out outside these fields and which is not full of numbers and "tangible" things. Methodology. This is cultural-historical research, which aims to deconstruct and crystallize feminine knowledge around hygiene and hand washing, by means of transdisciplinarity, making use of heuristics and analogical hermeneutics. Findings. Nahua women in Ancient Mexico, says Clementina Battcock in the Seminar on the History of Women in Ancient Mexico (Battcock, 2018, 2021), that the history of women in Ancient Mexico is a silenced history, "bajita", for which historians and historians have been building a deep debate on the contributions of women. Through the heuristics followed, it was possible to find the valuable compilation of books, made by Andrés de Olmos called "Huehuetlatolli", also called the "ancient word", thanks to these writings we know the form of education provided by wise women and men (tlamatini, women or men who know something, who know things). Discussion. Hygiene in the Nahuatl society was a method of care for individual and collective health. Studying these phenomena as a support for the history of care in Mexican society thanks to the Nahua people, is a source of information that strengthens the academic historical body of the nursing profession in Mexico and Latin America. Conclusions. The participation of women in education and in other fields has had an immeasurable enhancement, comparable to the hegemonic knowledge coming from Europe, women historically and universally have been in charge of illustrating and teaching from the bosom of the home the basic rules of coexistence and civility, and although it has been a role somewhat imposed, it should not be left aside that the empirical knowledge of all these women is valuable and worthy of being made known

Introdução. O trabalho de cuidar tem sido o núcleo fundamental de análise e o objeto tradicional de estudo da enfermagem. A investigação que se realizou durante muito tempo centrou-se principalmente na produção de cuidados a partir da visão cientificista e hegemónica da ciência, uma ciência de enfermagem cheia de conhecimentos técnicos e mecânicos a partir de uma visão parcial desta, uma visão eurocêntrica e anglo-saxónica com "valor" académico, deixando de lado o trabalho que se realiza fora destes campos e que não está cheio de números e coisas "tangíveis". Metodologia. Trata-se de uma investigação histórico-cultural, que tem como objetivo desconstruir e cristalizar o conhecimento feminino sobre higiene e lavagem das mãos através da transdisciplinaridade, utilizando a heurística e a hermenêutica analógica. Conclusões. No Seminário de Clementina Battcock sobre a História das Mulheres no México Antigo (Battcock, 2018, 2021), Clementina Battcock afirma que a história das mulheres no México Antigo é uma história silenciada, "baixa", razão pela qual os historiadores têm vindo a construir um debate aprofundado sobre os contributos das mulheres. Através da heurística seguida, foi possível encontrar a valiosa compilação de livros escritos por Andrés de Olmos chamada "Huehuetlatolli", também chamada de "palavra antiga", graças a estes escritos conhecemos a forma de educação fornecida por mulheres e homens sábios (tlamatini, mulheres ou homens que sabem algo, que sabem coisas). Discussão. A higiene na sociedade Nahuatl era um método de cuidado da saúde individual e colectiva. O estudo destes fenómenos como base para a história dos cuidados na sociedade mexicana graças ao povo Nahua é uma fonte de informação que reforça o corpo académico histórico da profissão de enfermeiro no México e na América Latina. Conclusões. A participação das mulheres na educação e em outros campos teve uma importância incomensurável, comparável ao conhecimento hegemónico proveniente da Europa. Histórica e universalmente, as mulheres foram encarregadas de ilustrar e ensinar as regras básicas de convivência e civilidade a partir do seio do lar, e embora tenha sido um papel um tanto imposto, não se deve esquecer que o conhecimento empírico de todas essas mulheres é valioso e digno de ser divulgado

Historia cultural sobre el conocimiento de higiene y lavado de manos en las mujeres nahuas del México Antiguo / História cultural sobre os conhecimentos de higiene e lavagem das mãos das mulheres Nahua no México Antigo / Cultural history on the knowledge of hygiene and hand washing in the Nahua women of Ancient Mexico

Introducción. El trabajo de cuidados ha sido el núcleo fundamental de análisis y objeto de estudio tradicional de la Enfermería. Las investigaciones que durante mucho tiempo se han realizado se han centrado mayoritariamente en la producción de cuidados desde la mirada cientificista y hegemónica de la ciencia una ciencia de la enfermería llena de conocimientos técnicos y mecánicos desde una visión parcial de estos, una visión eurocentrista y anglosajona con "valor" académico, dejando al margen los trabajos que se realizan fuera de estos ámbitos y que no están plagados de números y cosas "tangibles". Metodología. Se trata de una investigación histórico cultural, que pretende deconstruir y cristalizar el conocimiento femenino en torno a la higiene y al lavado de manos, por medio de la transdisciplinariedad, haciendo uso de la heurística y la hermenéutica analógica. Hallazgos. Las mujeres nahuas del México Antiguo, dice Clementina Battcock en el Seminario de Historia de las Mujeres en el México Antiguo (Battcock, 2018, 2021), que la historia de las mujeres en el México Antiguo es una historia acallada, "bajita", por lo cual las historiadoras e historiadores han ido construyendo un debate profundo sobre las aportaciones de las mujeres. A través de la heurística seguida se logró encontrar la valiosa recopilación de libros, hecha por Andrés de Olmos denominada "Huehuetlatolli", también denominados la "antigua palabra", gracias a estos escritos se sabe la forma de educación que brindaban mujeres y hombres sabios (tlamatini, mujeres u hombres que saben algo, que conocen las cosas) Discusión. La higiene en la sociedad náhuatl era un método de cuidado para la salud individual y colectiva. Estudiar estos fenómenos como sustento de la la historia del cuidado en la sociedad mexicana gracias al pueblo nahua, es una fuente de información que robustece el cuerpo histórico académico de la profesión de enfermería en México y Latinoamérica Conclusiones. La participación de las mujeres en la educación y en otros ámbitos ha tenido un realce inconmensurable, equiparable con el conocimiento hegemónico proveniente de Europa, las mujeres histórica y universalmente son quienes se han encargado de ilustrar y enseñar desde el seno del hogar las normas básicas de convivencia y civilidad, y aunque ha sido un papel de cierta forma impuesto, no se debe dejar de lado que el conocimiento empírico de todas estas mujeres es valioso y digno de darse a conocer.

Introduction. The work of care has been the fundamental nucleus of analysis and traditional object of study of nursing. The research that has been carried out for a long time has focused mainly on the production of care from the scientificist and hegemonic viewpoint of science, a nursing science full of technical and mechanical knowledge from a partial view of this, a Eurocentric and Anglo-Saxon view with academic "value", leaving aside the work that is carried out outside these fields and which is not full of numbers and "tangible" things. Methodology. This is cultural-historical research, which aims to deconstruct and crystallize feminine knowledge around hygiene and hand washing, by means of transdisciplinarity, making use of heuristics and analogical hermeneutics. Findings. Nahua women in Ancient Mexico, says Clementina Battcock in the Seminar on the History of Women in Ancient Mexico (Battcock, 2018, 2021), that the history of women in Ancient Mexico is a silenced history, "bajita", for which historians and historians have been building a deep debate on the contributions of women. Through the heuristics followed, it was possible to find the valuable compilation of books, made by Andrés de Olmos called "Huehuetlatolli", also called the "ancient word", thanks to these writings we know the form of education provided by wise women and men (tlamatini, women or men who know something, who know things). Discussion. Hygiene in the Nahuatl society was a method of care for individual and collective health. Studying these phenomena as a support for the history of care in Mexican society thanks to the Nahua people, is a source of information that strengthens the academic historical body of the nursing profession in Mexico and Latin America. Conclusions. The participation of women in education and in other fields has had an immeasurable enhancement, comparable to the hegemonic knowledge coming from Europe, women historically and universally have been in charge of illustrating and teaching from the bosom of the home the basic rules of coexistence and civility, and although it has been a role somewhat imposed, it should not be left aside that the empirical knowledge of all these women is valuable and worthy of being made known.

Introdução. O trabalho de cuidar tem sido o núcleo fundamental de análise e o objeto tradicional de estudo da enfermagem. A investigação que se realizou durante muito tempo centrou-se principalmente na produção de cuidados a partir da visão cientificista e hegemónica da ciência, uma ciência de enfermagem cheia de conhecimentos técnicos e mecânicos a partir de uma visão parcial desta, uma visão eurocêntrica e anglo-saxónica com "valor" académico, deixando de lado o trabalho que se realiza fora destes campos e que não está cheio de números e coisas "tangíveis". Metodologia. Trata-se de uma investigação histórico-cultural, que tem como objetivo desconstruir e cristalizar o conhecimento feminino sobre higiene e lavagem das mãos através da transdisciplinaridade, utilizando a heurística e a hermenêutica analógica. Conclusões. No Seminário de Clementina Battcock sobre a História das Mulheres no México Antigo (Battcock, 2018, 2021), Clementina Battcock afirma que a história das mulheres no México Antigo é uma história silenciada, "baixa", razão pela qual os historiadores têm vindo a construir um debate aprofundado sobre os contributos das mulheres. Através da heurística seguida, foi possível encontrar a valiosa compilação de livros escritos por Andrés de Olmos chamada "Huehuetlatolli", também chamada de "palavra antiga", graças a estes escritos conhecemos a forma de educação fornecida por mulheres e homens sábios (tlamatini, mulheres ou homens que sabem algo, que sabem coisas). Discussão. A higiene na sociedade Nahuatl era um método de cuidado da saúde individual e colectiva. O estudo destes fenómenos como base para a história dos cuidados na sociedade mexicana graças ao povo Nahua é uma fonte de informação que reforça o corpo académico histórico da profissão de enfermeiro no México e na América Latina. Conclusões. A participação das mulheres na educação e em outros campos teve uma importância incomensurável, comparável ao conhecimento hegemónico proveniente da Europa. Histórica e universalmente, as mulheres foram encarregadas de ilustrar e ensinar as regras básicas de convivência e civilidade a partir do seio do lar, e embora tenha sido um papel um tanto imposto, não se deve esquecer que o conhecimento empírico de todas essas mulheres é valioso e digno de ser divulgado.

Sacred Circle: Symbol of Wholeness in Traditional Persian Art and Architecture.

Jung wrote extensively about the archetypal mandala symbol as an expression in many cultures of the centrality and nature of the interplay between human consciousness and divine consciousness. This article investigates-how in Persia, for millennia-the archetypal symbol of the mandala has been widespread in many expressions of the sacred arts. My research outlines the importance of the archetypal mandala symbol in Persian religio-aesthetic history from the first unearthed stone carvings of Persia's ancient foundations until the more recent, breathtakingly marvellous ceilings of traditional Persian architecture today. From the artistic expressions of first religious beliefs of ancient Persia-Mithraism-and through the development of the Zoroastrian faith until the subsequent rise of Christianity and then Islam, Persian sacred art illustrates the Jungian idea that wholeness sought in the journey of individuation is often expressed through archetypal symbols of circles that articulate basic truths about the divine interplay with humanity.

Jung a beaucoup écrit sur le symbole archétypal du mandala en tant qu'expression dans de nombreuses cultures de la centralité de l'interaction entre la conscience humaine et la conscience divine. Cet article examine comment en Perse - depuis des millénaires - on trouve le symbole archétypal du mandala de manière très répandue dans de nombreuses expressions des arts sacrés. Ma recherche souligne l'importance du symbole archétypal du mandala dans l'histoire religieuse et esthétique persane depuis les premières sculptures en pierre qu'on a pu découvrir (qui font partie des fondations anciennes de la Perse) jusqu'aux magnifiques plafonds de l'architecture persane traditionnelle d'aujourd'hui. Depuis les expressions artistiques des premières croyances religieuses de la Perse antique - le mithraïsme - et tout au long du développement de la foi zoroastrienne jusqu'à l'essor ultérieur du christianisme puis de l'islam, l'art sacré persan illustre l'idée jungienne selon laquelle l'unité recherchée dans le chemin de l'individuation s'exprime souvent à travers des symboles archétypaux de cercles qui expriment des vérités fondamentales sur l'interaction divine avec l'humanité.

Jung escribió extensamente sobre el símbolo arquetípico del mandala como expresión en muchas culturas de la centralidad y naturaleza de la interacción entre la conciencia humana y la conciencia divina. Este artículo investiga cómo en Persia, durante milenios, el símbolo arquetípico del mandala se ha extendido en muchas expresiones de las artes sagradas. Mi investigación describe la importancia del símbolo arquetípico del mandala en la historia religiosa y estética persa, desde las primeras piedras talladas desenterradas de los antiguos cimientos de Persia hasta los más recientes e impresionantes techos de la arquitectura tradicional persa actual. Desde las expresiones artísticas de las primeras creencias religiosas de la antigua Persia -el mitraísmo- y pasando por el desarrollo de la fe zoroástrica hasta el posterior auge del cristianismo y luego del islam, el arte sagrado persa ilustra la idea junguiana de que la totalidad buscada en el viaje de individuación se expresa a menudo a través de símbolos arquetípicos de círculos que articulan verdades básicas sobre la interacción divina con la humanidad.

Cervical Cancer and Human Papillomavirus Awareness among Women in Antigua and Barbuda.

Background and objectives: Cervical cancer is the fourth leading cause of cancer-related deaths in women. Human papilloma virus (HPV) is known to cause cervical cancer. The incidence and mortality of cervical cancer has drastically reduced due to effective vaccination against HPV in developed countries. The projected rise in cervical cancer cases in Latin American and Caribbean countries necessitates a study to evaluate awareness about HPV, cervical cancer, the HPV vaccine, and prevention among women in Antigua and Barbuda. Materials and methods: This was an observational, cross-sectional study. The participants were women aged between 18 and 65 years, residing in Antigua and Barbuda. The study was conducted over the period of February to April 2023. After taking informed consent electronically, sociodemographic and behavioral data was collected through questionnaires sent out as links and QR-codes and were analyzed by QualtricsXM. The association between the demographic groups and awareness about HPV, cervical cancer, the HPV vaccine, and prevention was analyzed by a Chi-square test. Results: In total, 467 women were included in the study. The percentage of participants aware of HPV was 91.6% (n = 412). A total of 70.7% (n = 318) and 56.7% (n = 255) women were aware that cervical cancer is caused by HPV and is sexually transmitted, respectively. Although 70.6% (n = 315) of participants were aware that the vaccine protects against HPV, only 12.8% (n = 57) were vaccinated. Of the participants, 49.7% (n = 192) were willing to get vaccinated. The percentage of participants aware of the Papanicolaou (Pap) smear procedure was 98.9% (n = 435) and 87.8% (n = 382) had a Pap smear within the last 10 years while 12.2% (n = 53) never had a Pap smear screening. The willingness to know more information about HPV and the HPV vaccine among the participants was 77% (n = 335). Conclusions: The overall awareness among women in Antigua and Barbuda about HPV, cervical cancer, the HPV vaccine, and prevention was high. We recommend a national health education program and vaccine drive to complement our findings.

Sickle Cell Disease Newborn Screening-An Audit of a Twin Island State Pilot Program.

The prevalence of Sickle Cell Disease (SCD) within the Caribbean region remains second only to that of West Africa. The Newborn Screening (NBS) Program in Antigua and Barbuda remains heavily dependent on grants, therefore ultimately facing sustainability challenges. Early intervention and implementation of preventative measures post-NBS result in significant improvements in morbidity, quality of life, and survival. This audit reviewed the pilot SCD NBS Program in Antigua and Barbuda from September 2020 to December 2021. A conclusive result was received by 99% of babies eligible for screening, 84.3% of which were HbFA, whilst 9.6% and 4.6% were HbFAS and HbFAC, respectively. This was comparable to other Caribbean countries. Sickle Cell Disease was noted in 0.5% of babies screened, which translates to 1 in 222 live births. Eighty-two percent of mothers were aware of their sickle cell status, compared to 3% of fathers. The importance of instituting a quality improvement team post the initiation of a screening program and the need for a robust public education program have been demonstrated by this audit.

Introduction of the Hepatitis B Vaccine-Birth Dose: Methods of Improving Rates in a Milieu of Vaccine Hesitancy.

The hepatitis B virus is a public health threat, chronically infecting over 240 million persons worldwide. The hepatitis B vaccine is 90% effective in preventing perinatal transmission if the first dose is given within the first 24 h of life, followed by a minimum of two subsequent doses. Antigua and Barbuda instituted a hospital-based birth dose vaccination policy in October 2021. Data were extracted from hospital logbooks from November 2021 to October 2022, and a database was created. Frequency distributions of the hepatitis B birth dose, barriers to administration, and maternal and healthcare system factors were analyzed. The positive maternal HBsAg prevalence rate was 0.6%. The timely and total birth dose coverage was 72% and 81%, respectively. In total, 10.5% of parents refused the vaccine, of which 76% either felt uncomfortable or preferred to wait. Moreover, 100% of hepatitis B-exposed babies were vaccinated, with 83% of them receiving the Hepatitis B Immunoglobulin. Barriers to vaccine administration included vaccination hesitancy, gaps in knowledge of medical staff, and the inconsistent vaccination supply. Instituting a quality improvement team, health information system, robust educational efforts, and addressing barriers will make achieving the WHO programmatic targets of eliminating mother-to-child transmission of hepatitis B by 2030 possible.

Morphological evaluation of dental diseases in Parion chamber tomb (OM 5) Roman people / Evaluación morfológica de enfermedades dentales en la tumba de la cámara de Parion (OM 5) del pueblo romano

SUMMARY: Most of the dental diseases occur due to tooth or jaw morphology or nutritional habits. Anatomical differences in the teeth and jaws of men and women can cause different dental diseases between the sexes. In this study, 33 skeletons obtained from the excavation of the ancient city of Parion, which are dated to the late Roman period, were examined. Dental diseases and possible causes were investigated on a total of 33 skeletons. In the evaluations, it was evaluated that some diseases were caused by the difference between the sexes, while some were classified as nutritional diseases. The rates of tooth decay are different between men and women with Parion. It has been determined that the most important reason for this is the different morphological structure of the jaws and teeth, but the nutritional differences also cause this. Other dental and jaw diseases were also evaluated in the Parion population.

RESUMEN: La mayoría de las enfermedades dentales se deben a la morfología de los dientes o la mandíbula o a los hábitos nutricionales. Las diferencias anatómicas en los dientes y las mandíbulas de hombres y mujeres pueden causar diferentes enfermedades dentales entre los sexos. En este estudio, se examinaron 33 esqueletos obtenidos de la excavación de la antigua ciudad de Parion, que datan del período romano tardío. Se investigaron las enfermedades dentales y las posibles causas en un total de 33 esqueletos. En las evaluaciones, se determinó que algunas enfermedades fueron causadas por la diferencia entre los sexos, mientras que otras fueron clasificadas como enfermedades nutricionales. Además se encontraron diferentes estimaciones de caries entre hombres y mujeres. Se analizó que la razón más importante de esto es la diferencia de la estructura morfológica de los maxilares y los dientes, sin embargo las diferencias nutricionales también es un factor que se debe considerar. Se evaluaron además, otras enfermedades dentales y de la mandíbula en la población de Parion.

The current state of prostate cancer in Antigua & Barbuda-2021.

Antigua and Barbuda is a twin-island nation within the Caribbean where the men are predominantly of African descent. The burden of prostate cancer is therefore expected to be similar to regional counterparts. There has been very little research done on prostate cancer in this nation. Few published peer-reviewed and non-peer reviewed documents exist to guide prostate cancer management and policy. A review of the available literature and the author's experience managing prostate cancer in the country was used to provide a synopsis of prostate cancer management in the country. All aspects of the prostate cancer care pathway exist in Antigua and Barbuda from public awareness and screening campaigns to external beam radiotherapy, abiraterone acetate and hospice care. There are still limitations to accessing some aspects of the care pathway such as prostate biopsies, radical prostatectomies and newer imaging modalities for staging. Data collection and analysis will help to provide objective and quantitative evidence of the nation's prostate cancer management capabilities. Other developing nations will face many of the same challenges managing prostate and other cancers and this shared experience may be particularly useful for comparing and contrasting purposes. It also provides a documented milestone on which future plans can be made to improve care and shape national policy.

Morphometric analysis of accessory vessel grooves (AVG) in the skulls of the ancient spradon population: an anthropological approach / Análisis morfométrico de los surcos de vasos sanguíneos accesorios (SVA) en los cráneos de la antigua población de spradon: un enfoque antropológico

SUMMARY: Accessory vessel grooves (AVG), or accessory vessel sulcus, is the name given to grooves seen in the frontal region of the skull. In studies conducted by anthropologists on antiquity skeletons, it is seen that some variations are confused with traumas due to the unknown skeletal morphology. This situation leads to an incorrect evaluation of the socio-economic or health structure of the population. In this study, an accessory vessel grooves research was carried out on the skeletons of the late Roman-early Byzantine population. Studies were conducted on 69 adult human skeletons of known age and sex, and 3 human skeletal skulls whose sex could not be determined. Accessory vessel grooves rate was calculated as 10.54 % in the Spradon ancient population. While there is 10.52 % AVG in female individuals in the population, lower AVG levels have been detected in males compared to females with 9.67 %. There is no significant difference between male and female individuals in terms of AVG. Although the lengths of AVG differ in the right and left frontal, it can be said that there is no difference in direction. Although the relation of AVG variation with high blood pressure is included in the literature, the intense appearance of this structure in the Spradon Population, especially in young individuals, weakens this hypothesis. The literature on the existence of AVG will expand further with the studies to be carried out on ancient Anatolian populations in the following years.

RESUMEN: Surcos de los vasos accesorios (SVA), o canales de vasos accesorios, es el nombre que se les da a los surcos que se ven en la región frontal del cráneo. En los estudios realizados por antropólogos sobre esqueletos de la antigüedad, algunas variaciones se pueden confundir con traumas debido a la morfología esquelética desconocida. Esta situación conduce a una valoración incorrecta de la estructura socioeconómica o sanitaria de la población. En este estudio, se llevó a cabo una investigación de surcos de vasos sanguíneos accesorios en los esqueletos de la población romana tardía y bizantina temprana. Se realizaron estudios en 69 esqueletos humanos adultos de edad y sexo conocidos, y 3 cráneos esqueléticos humanos cuyo sexo no se pudo determinar. La tasa de surcos de vasos accesorios se calculó como 10,54 % en la población antigua de Spradon. Si bien hay un 10,52 % de SVA en las mujeres de la población, se han detectado niveles más bajos de SVA en los hombres en comparación con las mujeres en un 9,67 %. No existe una diferencia significativa entre hombres y mujeres en términos de SVA. Aunque la relación de la variación de SVA con la hipertensión arterial está incluida en la literatura, la importante advertencia de esta estructura en la población de Spradon, particularmente en sujetos jóvenes, debilita esta hipótesis. La literatura sobre la existencia de SVA se ampliará aún más con los estudios que se llevarán a cabo en las antiguas poblaciones de Anatolia en el futuro.

Population increase and changes in behavior and morphology in the Critically Endangered Redonda ground lizard (Pholidoscelis atratus) following the successful removal of alien rats and goats.

Redonda is a small volcanic Caribbean island that is home to at least 4 endemic lizard species, including the Critically Endangered ground lizard (Pholidoscelis atratus). Black rats (Rattus rattus) and domestic goats (Capra hircus) were introduced to the island at some time after its discovery by Europeans in the late 1500s. They had a devastating effect on the island, resulting in the loss of nearly all trees and most of the ground vegetation. Point count surveys of P. atratus in 2012 indicated low densities, and the invasive rats were observed hunting and preying on the lizards. Both populations of rats and goats were successfully removed in 2017 as part of an ecological restoration program, and native vegetation and invertebrate populations have increased rapidly since. Population surveys in 2017, 2018, and 2019 show the lizard population has increased by more than sixfold. In 2017, as rats and goats were being removed, we evaluated the morphology and escape behavior of this species and repeated these measurements 1 year later. We observed that P. atratus had become bolder, with a reduced flight distance. We also detected changes in limb morphology related to locomotion and suggest possible explanations that will need to be further investigated in the future. These results show how the removal of invasive species can rapidly affect lizard population recovery and behavior, potentially restoring island ecosystems to their pre-human interference dynamics.

Status of coral reefs in Antigua & Barbuda: using data to inform management.

The nation of Antigua and Barbuda has experienced major degradation of its coral reef ecosystems over the past 40+ years. The primary drivers of this degradation are multiple and are highly linked to anthropogenic influences, including over-exploitation and poor management of marine resources. The effectiveness of management actions in marine protected areas (MPAs) has often been hampered by a lack of data to inform management recommendations. This was emphasized by The Nature Conservancy's (TNC) Coral Reef Report Card which highlighted not only the lack of data collection in Antigua and Barbuda and other Caribbean nations, but also illustrated how spatially dispersed available datasets are. The government of Antigua and Barbuda recognized the need for a marine data collection program to better inform the designation and management of MPAs as a tool to improve the health of the marine ecosystems. The Atlantic Gulf Rapid Reef Assessment (AGRRA) protocol has been identified as a means to address planning and management for marine areas. Three AGRRA surveys have been conducted in the years following the TNC 2016 report, in previously established managed areas: North East Marine Management Area (NEMMA) in 2017 and Nelson Dockyard National Park (NDNP) in 2019 as well as areas outlined for future management (Redonda in 2018). Our surveys were conducted to provide updated datasets to inform management for the aforementioned areas. While the results of these surveys mirror the underlying poor coral reef-health conditions, which have been shown to exist within the Caribbean region, they also highlight intra-site variation that exists within each survey location. This knowledge can be crucial in guiding management decisions in these marine areas, through zoning and other management prescriptions. Additionally, the marine surveys conducted around Redonda established useful marine baselines to aid in monitoring the island's recovery following removal of terrestrial invasive species. This article provides an overview of data collected using the AGRRA methodology in marine zones across Antigua and Barbuda which have current or future management prescriptions and provides recommendations to demonstrate the data's future utilization for marine conservation and management.

Evaluation of the rapid, multi-country, parallel process, multi-tasking approach to startup of short-term technical assistance to improve service delivery in newborn and child health in the context of USAID's Zika response in four Eastern and Southern Caribbean countries.

Background: In 2018, the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started a new partnership with four Eastern and Southern Caribbean countries impacted by the Zika virus: Antigua and Barbuda, Dominica, St. Kitts and Nevis, and St. Vincent and the Grenadines.  The goal of the project was to provide short-term technical assistance (STTA) to strengthen the health systems' capacity to detect newborns and young children potentially affected by Zika and to address their health needs.  To meet these objectives, ASSIST developed an innovative approach based on its existing model for service delivery improvement. This novel approach is known as Rapid, Multi-country, Parallel Process, Multi-tasking Approach for a Project Startup (RMPP-MAPS).  An evaluation was conducted to document the STTA startup activities, to identify enabling and constraining factors, and to capture lessons learned. Methods: An external consultant conducted remote in-depth interviews with individuals involved in the startup using semi-structured interview guides and retrieved data from the review of project documents. Results: Using RMPP-MAPS, the ASSIST Project successfully implemented the startup for complex STTA in four countries within less than four months, spanning mid-May to early September 2018. Project milestones included achieving buy-in from stakeholders, co-developing the technical scope and materials, and rapidly executing critical operational functions.  Dedicated project teams, country leaderships, and local champions were essential to overcoming the main challenges, which included a condensed timeframe, lack of in-country offices, and country-level factors such as a shortage of health care workers and a weak health infrastructure.  Conclusions: The RMPP-MAPS is a feasible and resource-efficient mechanism of interest to implementers, donors, and low and middle-income countries facing temporal and financial limitations to rapidly addressing public health priorities.

Prevalence and Genetic Diversity of Toxoplasma gondii in Free-Ranging Chickens from the Caribbean.

PURPOSE: Toxoplasma gondii is a zoonotic parasite capable of infecting a wide range of hosts. Free-range chickens are important sentinels in the epidemiology of this parasite as they feed from the ground and are likely to ingest oocysts shed in the faeces of infected cats. Atypical strains of T. gondii are known to dominate in South America where they are associated with more severe disease in humans, yet relatively little is known about the strains circulating in neighbouring Caribbean islands. METHODS: In this study, hearts and brains were collected from free-range chickens in Antigua and Barbuda (n = 45), Dominica (n = 76) and Trinidad (n = 41), and DNA was extracted for nested ITS1 PCR and PCR-RFLP. Sera were collected and screened for antibodies using the modified agglutination test (MAT). RESULTS: Antibodies to T. gondii were detected in 20.5, 38.2 and 17.1% of chickens in Antigua and Barbuda, Dominica and Trinidad, respectively. Toxoplasma gondii DNA was also detected by PCR in 24.4, 17.1 and 17.1% of chickens, respectively, giving an overall prevalence of 31.1, 42.1, and 29.3% for each of the 3 island nations. Results of PCR-RFLP revealed 2 new atypical genotypes (designated ToxoDB #281 and #282) and one Type III (ToxoDB #2) in chickens from Antigua. Partial genotyping of a further 8 isolates (7 from Antigua and one from Trinidad) revealed different allele-types at five or more markers for 7 of the isolates, suggesting atypical genotypes. CONCLUSIONS: This is the first study to report the prevalence of T. gondii in free-range chickens in Antigua and Barbuda, Dominica and Trinidad and Tobago. It is also the first to report the presence of atypical genotypes in Antigua and Barbuda and Trinidad and Tobago.

O movimento na luta pela vida: sistema de organização e treinamento dos gladiadores / The movement in the fight for life: Gladiators' system of organization and training / El movimiento en la lucha por la vida: El sistema de organización y entrenamiento de los gladiadores

INTRODUÇÃO E OBJETIVO: Apresentar a origem dos gladiadores, seus sistemas de treinamento e vida cotidiana. PROCEDIMENTOS METODOLÓGICOS: Realizou-se revisão narrativa, a partir de recuperação de fatos históricos contidos em fontes iconográficas, eletrônicas e bibliográficas. DISCUSSÃO: Acredita-se que a origem dos jogos de gladiadores seja etrusca, inicialmente realizados como parte de ritos funerais. Após inserido na famiglia gladiatoria, os gladiadores seguiam as leis das escolas de formação (ludus). Gladiadores que haviam combatido durante muito tempo, e sobreviveram a todos os combates, recebiam uma espada de madeira como símbolo de sua aposentadoria, denominada rudis. CONCLUSÃO: Por um período de quase 600 anos, a arena foi um dos entretenimentos mais populares do mundo romano. Combates de gladiadores eram um elemento do paganismo que governou Roma até a conversão do imperador Constantino ao cristianismo no século IV, e ocupam um lugar central na percepção popular moderna de comportamento romano.

INTRODUCTION AND OBJECTIVE: Present the origin of gladiators, their training systems and daily life. METHODOLOGICAL PROCEDURES: A narrative review was carried out, based on the retrieval of historical facts contained in iconographic, electronic and bibliographical sources. DISCUSSION: It is believed that the origin of the gladiator's combat is Etruscan, initially realized as part of funeral rites. After entering the gladiatorial family, the gladiators followed laws from schools of formation (ludus). Gladiators who had fought for a long time, and survived all combats received a wooden sword as a symbol of their retirement, called rudis. CONCLUSION: For a period of almost 600 years, the arena was one of the most popular entertainments in the Roman world. Gladiator fights were an element of paganism that ruled Rome until the conversion of Emperor Constantine to Christianity in the fourth century, and occupy a central place in the modern popular perception of Roman behavior.

INTRODUCCIÓN Y OBJETIVO: Presentar el origen de los gladiadores, sus sistemas de entrenamiento y la vida cotidiana. PROCEDIMIENTOS METODOLÓGICOS: se realizó una revisión narrativa, basada en la recuperación de hechos históricos, contenidos en fuentes iconográficas, electrónicas y bibliográficas. DISCUSIÓN: Se cree que el origen del combate del gladiador es etrusco, inicialmente realizado como parte de los ritos funerarios. Después de entrar en la familia de gladiadores, los gladiadores siguieron las leyes de las escuelas de formación (ludus). Los gladiadores que habían luchado durante mucho tiempo y sobrevivieron a todos los combates recibieron una espada de madera como símbolo de su retiro, llamada rudis. CONCLUSIÓN: durante un período de casi 600 años, la arena fue uno de los entretenimientos más populares en el mundo romano. Las luchas de gladiadores fueron un elemento del paganismo que estaba en el Imperio Romano hasta la conversión del emperador Constantino al cristianismo en el siglo IV, y ocupan un lugar central en la percepción popular moderna del comportamiento romano.

¿Resulta posible que un pueblo se autogobierne? Una paradoja generada por la ambigüedad entre participación y representación en la libertad de los modernos en el contexto de la libertad de los antiguos / Is it possible for a people to govern themselves? A paradox generated by the equality between participation and representation in the freedom of the moderns in the context of the freedom of the ancients / Seria possível que um povo se autogoverne? Um paradoxo gerado pela ambigüidade entre participação e representação da liberdade dos modelos em contexto com a liberdade dos antigos

El propósito de este texto es exponer una relación sociológica obviada por muchos analistas políticos en la actualidad entre el concepto de pueblo, la crisis de representación del cuerpo de lo político que de aquel concepto se deriva y la ambigüedad que se patentiza con las crisis entre participación y representación de la libertad de los modernos en el contexto de la libertad de los antiguos. De esta manera, queremos realizar una comprensión sociológica sobre esa relación relegada, desplegando sobre ella una pregunta, la cual es concerniente de la posibilidad de que un pueblo se autogobierne y las consecuencias de anulación y destrucción de los ejercicios de deberes y derechos que toda ciudadanía democrática reporta, y el pasmo que esto supone con el concepto de habitante, como base de todo ciudadano, permitiendo la construcción ideológica y utópica de una ficción de un pueblo soberano. En definitiva: una ralentización, parálisis y anulación de la ciudadanía moderna.

The purpose of this text is to expose, a sociological relationship obviated by many political analysts at present between the concept of the people, the crisis of representation of the body of the political that derives from that concept and the ambiguity that is evident with the crises between participation and representation of the freedom of the moderns, in the context of the freedom of the ancients. In this way, we want to make a sociological understanding about this relationship, by displaying a question about the possibility of the people's self-government and the consequences of the annulment and destruction of the rights and rights exercises that all democratic citizenship reports and the shock that this implies in the concept of inhabitant, as the basis of this, allow the ideological and utopian construction of a fiction of a sovereign people: in short, slowdown, paralysis and cancellation of modern citizenship.

O propósito desse texto é expor uma relação socióloga observada por muitos analistas políticos na atualidade entre o conceito do povo, a crise de representação do corpo político de que aquele conceito se deriva e a ambigüidade se assemelha com a crise entre participação e representação da liberdade dos moldes no contexto da liberdade dos (antiguos). Dessa maneira queremos realizar uma compreensão socióloga sobre essa relação (relegada, al desplegar) sobre ela uma pergunta convincente a possibilidade de que um povo se autogoverne e as consequências de anulação e destruição dos exercícios e deveres e direitos que toda cidadania democrática denuncia e justamente isso que pressupõe que o conceito de habitante, como base de aquele permitindo a construção ideológica e utópica de uma ficção de um povo soberano: em definitiva (ralentización), paralisia e anulação da cidadania moderna.

Las lesiones traumato-ortopédicas de Jesucristo, según el Sudario de Turín / Traumato-orthopedic injuries of Jesus Christ according to the Shroud of Turin

Introducción: El Sudario de Turín es un paño de lino que supuestamente cubrió el cadáver de Jesucristo. Posee marcas de un hombre muerto, flagelado, coronado de espinas, al que le traspasaron un objeto cortante en el lado izquierdo del tórax y fue crucificado. Es uno de los objetos más estudiados de la historia. Objetivo: Describir las lesiones traumato-ortopédicas sufridas por el hombre del Sudario de Turín en su condenación y crucifixión. Métodos: Utilizamos doce artículos de las bases de datos: PubMed, EMBASE, Web of Science, Scopus, Lilacs, Scielo. En la búsqueda se emplearon las palabras en inglés: "injuries" y "Turin Shroud". Se añadieron siete artículos centinela y tres libros de estudios relacionados con el Sudario de Turín. Los materiales utilizados fueron publicados antes del 30 de junio de 2018. La búsqueda no tuvo restricciones en cuanto a contenidos, fechas e idiomas de publicación. Resultados: Los principales hallazgos fueron lesiones en la cabeza derivadas de una corona de espinas; miosis, enoftalmia y ptosis palpebral, causadas por lesión del plexo braquial; la luxación en el hombro derecho, debido a un trauma violento; perforación en el tórax, por la penetración de una lanza, y lesiones perforadas en puños y pies por la colocación de los clavos. Conclusiones: Se han descrito lesiones en la cabeza (corona de espinas, cartílago nasal y maxilofacial), en el cuello y en los miembros superiores (plexo braquial, luxación de hombro, lesión del nervio mediano y / o ulnar y perforación en los puños), en el tórax (perforación por lanza y las excoriaciones), en el abdomen (excoriaciones), en los miembros inferiores (articular, trauma de patela, luxación de tobillo y perforación en los pies). Algunas hipótesis sobre las lesiones descritas deben ser mejor elucidadas en futuros trabajos de investigación(AU)

Introduction: The Shroud of Turin is a linen cloth that is said to be the burial cloth of Jesus. This shroud has marks of a dead man, flagellated, crowned with thorns, who was pierced by a sharp object on the left side of his chest and was crucified. It is one of the most studied objects in history. Objective: To describe the traumatic-orthopedic injuries suffered by the man in Shroud of Turin in his condemnation and crucifixion. Methods: We used twelve articles from PubMed, EMBASE, Web of Science, Scopus, Lilacs, Scielo databases. We used keywords such as "Injuries" and "Turin Shroud". Seven sentinel articles and three study books related to the Shroud of Turin were added. The materials used were published before June 30, 2018. The search was not restricted in terms of content, dates or languages of publication. Results: The main findings were head injuries derived from a crown of thorns; miosis, enophthalmia and palpebral ptosis, caused by a brachial plexus injury; the dislocation in his right shoulder, due to violent trauma; perforation in the thorax, due to the penetration of a spear and perforated injuries in his fists and feet by the placement of the nails. Conclusions: Injuries to the head (crown of spines, nasal and maxillofacial cartilage), neck and upper limbs (brachial plexus, shoulder dislocation, median and / or ulnar nerve injury and puncture in the fists) have been described. The thorax (perforation by spear and excoriations), in the abdomen (excoriations), in the lower limbs (articular, patella trauma, ankle dislocation and perforation in the feet). Some hypotheses about the lesions described should be better elucidated in future research(AU)

La Tuberculosis a través de la Historia: un enemigo de la humanidad / Tuberculosis through history: an enemy of mankind

Introducción: La tuberculosis es una enfermedad infectocontagiosa causada por el Mycobacterium tuberculosis, la cual representa un serio problema de salud. Se evidencia, a través de la Historia, la lucha del hombre en su afán de contrarrestarla y los estragos que la enfermedad ha causado y provocado innumerables muertes sin importar razas, edad, clases sociales, aunque si afectando en mayor medida a los más desposeídos. Objetivo: Describir algunos aspectos generales que caracterizan la historia de la tuberculosis y su efecto negativo sobre la salud del hombre, precisar la lucha de las instituciones de salud a nivel mundial contra esta enfermedad y aspectos del programa de prevención y control utilizado en Cuba. Material y Métodos: Se realizó una revisión bibliográfica en el período comprendido entre mayo y junio de 2015. Se evaluaron revistas de impacto de Web of Sciencies (43 revistas) y revistas cubanas. Se consultaron las bases de datos de sistemas referativos, como MEDLINE, PubMed y Scielo con la utilización de descriptores como tuberculosis pulmonar tuberculosis Infection. Se incluyeron artículos en idioma inglés y español, y publicaciones de los últimos 5 años. Se obtuvieron 55 artículos, y se circunscribió el estudio a 27 que enfocaron estas temáticas de manera más integral. Conclusiones: La tuberculosis es una enfermedad muy antigua y a pesar del avance científico y social alcanzado, continúa siendo un inminente peligro para la salud. Constituye un compromiso político de todas las naciones mejorar y desarrollar programas y servicios de salud para el mejor desempeño en la lucha contra esta enfermedad(AU)

Introduction: Tuberculosis is an infectious-contagious disease caused by Mycobacterium tuberculosis, which represents a serious health problem. The man´s fight against this disease has been evidenced through history. He has demonstrated his desire to control it and the damage it has caused such as uncountable deaths regardless race, age, and social classes; mainly affecting the dispossessed. Objective: To describe some general aspects that characterize the history of tuberculosis and its negative effect on man´s health, specify the fight of health care centers worldwide against this disease, and present prevention and control measures used in Cuba. Material and methods: A bibliographic review was carried out during the period between May and June, 2015. Impact factor journals from the Web of Sciences (43 journals), and Cuban journals were evaluated. Reference databases such as MEDLINE, PubMed, and SciELO were consulted using some descriptors such as pulmonary tuberculosis, and tuberculosis infection. Articles in English and Spanish languages were included, as well as publications of the last 5 years. A total of 55 articles were obtained, and the study was limited to 27 ones that focused these topics in a more comprehensive way. Conclusions: Tuberculosis is a very old disease and, despite the scientific and social progress achieved, it continues being an imminent danger to health. The development of programs and health services for best actions in the fight against this disease is a political commitment of all nations(AU)

Chronic Kidney Disease in the Caribbean Island of Antigua: Causes, Morbidity and Mortality Factors / Enfermedad renal crónica en la isla caribeña de Antigua: causas, morbilidad y factores de mortalidad

ABSTRACT Background: Chronic kidney disease (CKD) and its associated high morbidity and mortality cause a significant economic burden and decreased quality of life in affected patients in Antigua, the rest of the Caribbean and globally. The causes of CKD in Antigua, morbidity and mortality factors affecting the sampled patients were evaluated with a view to formulating interventions to minimize the occurrence and the impact of these factors. Objective: To determine the causes of CKD over a nine-year period and the causes of morbidity and mortality among patients with CKD at the two main hospitals in Antigua. Methods: A retrospective review was done of the medical records of patients with CKD who were diagnosed between January 1, 2005 and December 1, 2013. Chronic kidney disease was defined as a glomerular filtration rate of less than 60 mL/minute/1.73 m2. The causes of CKD, the patients 'admission diagnoses, the causes of death and laboratory investigations were evaluated. Results: The documented causes of CKD in these patients were diabetes mellitus (51% of the patients), hypertension (26%), glomerulonephritis (5%) and lupus nephritis (4%). The causes of morbidity among the patients with CKD were myocardial infarction (5.1%), unstable angina (12.7%) and ischaemic stroke (12%). Contributing significantly to the patients 'morbidity were catheter-associated sepsis (8.1%, p < 0.001) and lower respiratory tract infections (5.4%). The main factors contributing to the patients 'mortality were myocardial infarction (16.7%) and catheter-associated sepsis (16.7%). Conclusion: This study documented that the most common causes of CKD among the sampled patients in Antigua were diabetes mellitus and hypertension. Ischaemic heart disease and infections were the major causes of morbidity and mortality among the patients. Early recognition and aggressive management of CKD and its risk factors and complications are important in reducing the clinical and economic burden associated with CKD.

RESUMEN Antecedentes: La enfermedad renal crónica (ERC) y su alta morbilidad y mortalidad asociadas, son causa de una importante carga económica y disminución de la calidad de vida entre los pacientes afectados en Antigua, el resto del Caribe y en todo el mundo. Se evaluaron las causas de la ERC en Antigua, así como los factores de morbilidad y mortalidad que afectan a los pacientes muestreados, con el fin de formular intervenciones encaminadas a minimizar la ocurrencia y el impacto de estos factores. Objetivo: Determinar las causas de la ERC durante un período de nueve años y las causas de morbilidad y mortalidad entre pacientes con ERC en los dos principales hospitales de Antigua. Métodos: Se realizó una revisión retrospectiva de las historias clínicas de los pacientes con ERC diagnosticados entre el 1 de enero de 2005 y el 1 de diciembre de 2013. La enfermedad renal crónica se definió como una tasa de filtración glomerular inferior a 60 ml/minuto/1.73 m2. Se evaluaron las causas de la ERC, los diagnósticos de admisión de los pacientes, así como las causas de muerte y las investigaciones de laboratorio. Resultados: Las causas documentadas de la ERC en estos pacientes fueron la diabetes mellitus (51% de los pacientes), la hipertensión (26%), la glomerulonefritis (5%), y la nefritis lúpica (4%). Las causas de morbilidad entre los pacientes con ERC fueron el infarto de miocardio (5.1%), la angina inestable (12.7%) y el accidente cerebrovascular isquémico (12%). La sepsis asociada con catéter (8.1%, p < 0.001) y las infecciones de las vías respiratorias inferiores (5.4%) contribuyeron significativamente a la morbilidad de los pacientes. Los principales factores que contribuyeron a la mortalidad de los pacientes fueron el infarto del miocardio (16.7%) y la sepsis asociada con catéter (16.7%). Conclusión: Este estudio documentó que las causas más comunes de ERC entre los pacientes incluidos en la muestra en Antigua fueron la diabetes mellitus y la hipertensión. La enfermedad cardíaca isquémica y las infecciones fueron las principales causas de morbilidad y mortalidad entre los pacientes. El diagnóstico temprano y el tratamiento agresivo de la ERC y sus factores y complicaciones de riesgo, son asuntos de importancia a la hora de reducir la carga clínica y económica asociadas con ERC.

¿Resulta posible que un pueblo se autogobierne? Una paradoja generada por la ambigüedad entre participación y representación en la libertad de los modernos en el contexto de la libertad de los antiguos / Is it possible for a people to govern themselves? A paradox generated by the equality between participation and representation in the freedom of the moderns in the context of the freedom of the ancients / Seria possível que um povo se autogoverne? Um paradoxo gerado pela ambigüidade entre participação e representação da liberdade dos modelos em contexto com a liberdade dos antigos

El propósito de este texto es exponer una relación sociológica obviada por muchos analistas políticos en la actualidad entre el concepto de pueblo, la crisis de representación del cuerpo de lo político que de aquel concepto se deriva y la ambigüedad que se patentiza con las crisis entre participación y representación de la libertad de los modernos en el contexto de la libertad de los antiguos. De esta manera, queremos realizar una comprensión sociológica sobre esa relación relegada, desplegando sobre ella una pregunta, la cual es concerniente de la posibilidad de que un pueblo se autogobierne y las consecuencias de anulación y destrucción de los ejercicios de deberes y derechos que toda ciudadanía democrática reporta, y el pasmo que esto supone con el concepto de habitante, como base de todo ciudadano, permitiendo la construcción ideológica y utópica de una ficción de un pueblo soberano. En definitiva: una ralentización, parálisis y anulación de la ciudadanía moderna.(AU)

The purpose of this text is to expose, a sociological relationship obviated by many political analysts at present between the concept of the people, the crisis of representation of the body of the political that derives from that concept and the ambiguity that is evident with the crises between participation and representation of the freedom of the moderns, in the context of the freedom of the ancients. In this way, we want to make a sociological understanding about this relationship, by displaying a question about the possibility of the people's self-government and the consequences of the annulment and destruction of the rights and rights exercises that all democratic citizenship reports and the shock that this implies in the concept of inhabitant, as the basis of this, allow the ideological and utopian construction of a fiction of a sovereign people: in short, slowdown, paralysis and cancellation of modern citizenship.(AU)

O propósito desse texto é expor uma relação socióloga observada por muitos analistas políticos na atualidade entre o conceito do povo, a crise de representação do corpo político de que aquele conceito se deriva e a ambigüidade se assemelha com a crise entre participação e representação da liberdade dos moldes no contexto da liberdade dos (antiguos). Dessa maneira queremos realizar uma compreensão socióloga sobre essa relação (relegada, al desplegar) sobre ela uma pergunta convincente a possibilidade de que um povo se autogoverne e as consequências de anulação e destruição dos exercícios e deveres e direitos que toda cidadania democrática denuncia e justamente isso que pressupõe que o conceito de habitante, como base de aquele permitindo a construção ideológica e utópica de uma ficção de um povo soberano: em definitiva (ralentización), paralisia e anulação da cidadania moderna.(AU)