Review of the missed opportunities for the prevention of vertical transmission of HIV in Brazil

OBJECTIVE: The present literature review aims to highlight gaps in the treatment of preventative motherto-child HIV transmission and the risk factors in Brazil. METHODS: Among the 425 articles identified in SciELO and PubMed searches, 59 articles published between 1994 and 2016 were selected for reading and data extraction, and 33 articles were included in the present review. RESULTS: The rates of vertical HIV transmission described in the studies varied widely, from 1.8% to 27.8%, with a significant reduction over the years. However, recent rates were also found to be variable in different regions of Brazil, and despite the significant reduction in mother-to-child transmission, many gaps remain in prevention services. A failure to attend prenatal care is the main factor associated with the increased risk of vertical transmission of HIV, hindering early maternal diagnosis and the completion of preventative measures during the prenatal period and, often, the peripartum and postnatal periods. A small number of studies discussed the sociodemographic factors, including a low level of education for pregnant women and the inadequacies of health services, such as difficulties scheduling appointments and undertrained staff, associated with vertical transmission. As such, the current challenge is to better define the sociodemographic and infrastructural factors that increase the risk of mother-to-child transmission of HIV to provide the necessary investments to promote an earlier inclusion of these populations in prevention services. CONCLUSIONS: This review may serve as a guide for future programs to focus efforts on the prevention of vertical HIV transmission

Putting it together: o pós-modernismo e os musicais de Stephen Sondheim

Dissertação de mestrado em Língua, Literatura e Cultura InglesasMusical theatre has long been a popular form of theater and part of the culture of the English-speaking countries, with a rich history of over a hundred and fifty years. As a form that has adapted throughout this period, musicals present a tendency to showcase the social and cultural transformations that surround them. This includes the postmodern movement, which affected artistic and cultural forms from the 1960s onwards. As such, it becomes relevant to understand whether postmodernism influenced the musical theater of this and the following decades, which were a particularly hectic period for the genre. With a tendency towards experimentation, the musicals of the second half of the twentieth-century present an innovative tendency that separates them from the musicals of the past. The work of composer and lyricist Stephen Sondheim and his collaborators exhibit particular changes in both themes and narrative features that highlight the transformation of the American musical of the time. Their musicals thus appear as worthy candidates to explore the postmodern influence on musicals of the 1960s, 1970s and 1980s. With a careful comparative analysis of both cultural elements, it will be possible to determine whether there is an exchange between them. Since the musicals give great relevance to the elements of character and unconventional structures, this thesis will focus on how postmodernism views the issues of identity and time and how those perspectives coincide with the features of each musical. The many components of the musical will be considered within an interdisciplinary approach to their textual and performative qualities, a requirement to find the postmodern in the theatrical field.O teatro musical é uma forma popular de teatro que forma parte das culturas de língua inglesa, com uma rica história de mais de cento e cinquenta anos. Como um género que se tem adaptado ao longo deste período, o musical apresenta a tendência para demonstrar as transformações sociais e culturais que o envolvem. Isto inclui o movimento pós-moderno, que afetou as formas artísticas e culturais a partir da década de 1960. Dado isto, torna-se relevante entender se o pós-modernismo influenciou o teatro musical de esta década e das sucessivas, uma época particularmente agitada para o género teatral. Com tendências para a experimentação, os musicais da segunda metade do século XX apresentam esforços de inovação que os separam dos musicais do passado. O trabalho do compositor e letrista Stephen Sondheim e dos seus colaboradores exibem mudanças particulares nos seus temas e nos seus elementos de narrativa que sublinham a transformação do musical estado-unidense do período em questão. Os seus musicais então aparentam ser bons candidatos para a exploração da influência pós-moderna nos musicais dos anos 1960, 1970 e 1980. Através de uma análise comparativa entre ambos elementos culturais será possível determinar se existe uma intercâmbio entre eles. Dado que os musicais em questão dão grande importância aos elementos de personagem e de estruturas não convencionais, esta tese irá focar-se em como o pós-modernismo encara questões de identidade e de tempo e de como essas perspetivas coincidem com as características de cada musical. Os diversos componentes de um musical serão considerados assim como também se realizará uma abordagem multidisciplinar aos seus elementos textuais e performativos, um requerimento para encontrar o pós-moderno num âmbito do teatro