993 resultados para 2003-2010
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A educação é o processo de inserção de homens e mulheres no mundo cultural. E a educação, dentro das sociedades mais complexas como as capitalistas industriais, é uma atividade planejada, que implica a elaboração de objetivos e a indicação de meios para atingi-los. A compreensão das tramas de construção de práticas formalizadas é ligada a agentes que determinam os objetivos da educação e suas intenções educativas sobre Relações Raciais no Brasil. Dediquei-me às atividades de levantamento acadêmico sobre a produção de teses de doutoramento, concluídas entre os anos 2005-2010, e a respeito de pesquisas e estudos sobre Educação e Relações Raciais nos Programas de Pós-Graduação em Educação. Investiguei sobre a circulação da temática relações raciais em espaços de elaboração de políticas educacionais, especificamente programas do Governo Federal que atendam à demanda de inclusão da temática no sistema de ensino no Brasil. Pois, a partir de 2003, a temática passa por uma fase de institucionalização, principalmente pelo conjunto jurídico que estabelece novo marco legal à educação. O objeto pesquisado incluiu a configuração de práticas formalizadas que desenvolvem quadros de agentes especializados sobre relações raciais. Analisar a relação intencional entre as práticas formalizadas sobre relações raciais que prescrevem a formulação de objetivos educacionais nos diferentes níveis e instâncias sociais. Identificar os objetivos do sistema de ensino descritos nos programas do Governo Federal destinados à promoção da educação para igualdade racial. Relacionar as práticas formalizadas no campo da pesquisa em educação às intenções descritas nos programas do Governo Federal. Explicar quais os interesses que movem essas práticas formalizadas a partir das demandas educacionais da temática relações raciais. A escrita da tese pauta-se na defesa de análise em que a obrigatoriedade da temática relações raciais é movida por duas forças antagônicas, uma direcionada à constituição de direito à cidadania movida por intenções de construir uma sociedade para a igualdade racial, de oportunidades de acesso a bens materiais e simbólicos e livre de práticas discriminatórias; outra relacionada aos interesses existentes dentro de um jogo de poder a ponto de converter a educação no centro de tão acerba disputa que desfavorece dissimuladamente a equidade racial no Brasil.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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SETTING: Respiratory mortality rates are declining in several countries, including Brazil; however, the effect of socio-economic indicators and sex is unclear. OBJECTIVE: To identify differences in mortality trends according to income and sex in the city of Sao Paulo, Brazil. DESIGN: We performed a time-trend analysis of all respiratory diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis, using Joinpoint regression comparing high, middle and low household income levels from 1996 to 2010. RESULTS: The annual per cent change (APC) and 95% confidence intervals (95%CIs) for death rates from all respiratory disease in men in high-income areas was -1.1 (95%CI -2.7 to 0.5) in 1996-2002 and -4.3 (95%CI -5.9 to -2.8) in 2003-2009. In middle- and low-income areas, the decline was respectively -1.5 (95%CI -2.2 to -0.7) and -1.4 (95%CI -1.9 to -0.8). For women, the APC declined in high-income (-1.0, 95%CI -1.9 to -0.2) and low-income areas (0.8, 95%CI -1.3 to -0.2), but not in middle-income areas (-0.5, 95%CI -1.4 to 0.3) from 1996 to 2010. CONCLUSION: Death rates due to COPD and all respiratory disease declined more consistently in men from high-income areas. Mortality due to lung cancer decreased in men, but increased in women in middle- and low-income areas.
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Anexos IV-VIII
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PURPOSE To develop a score predicting the risk of adverse events (AEs) in pediatric patients with cancer who experience fever and neutropenia (FN) and to evaluate its performance. PATIENTS AND METHODS Pediatric patients with cancer presenting with FN induced by nonmyeloablative chemotherapy were observed in a prospective multicenter study. A score predicting the risk of future AEs (ie, serious medical complication, microbiologically defined infection, radiologically confirmed pneumonia) was developed from a multivariate mixed logistic regression model. Its cross-validated predictive performance was compared with that of published risk prediction rules. Results An AE was reported in 122 (29%) of 423 FN episodes. In 57 episodes (13%), the first AE was known only after reassessment after 8 to 24 hours of inpatient management. Predicting AE at reassessment was better than prediction at presentation with FN. A differential leukocyte count did not increase the predictive performance. The score predicting future AE in 358 episodes without known AE at reassessment used the following four variables: preceding chemotherapy more intensive than acute lymphoblastic leukemia maintenance (weight = 4), hemoglobin > or = 90 g/L (weight = 5), leukocyte count less than 0.3 G/L (weight = 3), and platelet count less than 50 G/L (weight = 3). A score (sum of weights) > or = 9 predicted future AEs. The cross-validated performance of this score exceeded the performance of published risk prediction rules. At an overall sensitivity of 92%, 35% of the episodes were classified as low risk, with a specificity of 45% and a negative predictive value of 93%. CONCLUSION This score, based on four routinely accessible characteristics, accurately identifies pediatric patients with cancer with FN at risk for AEs after reassessment.
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Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is preceded by an episode of diarrhea mostly due to Shiga-toxin-producing Escherichia coli. There is important geographical variation of many aspects of this syndrome. Nationwide data on childhood HUS in Switzerland have not been available so far. In a prospective national study through the Swiss Pediatric Surveillance Unit 114 cases (median age 21 months, 50% boys) were reported between April 1997 and March 2003 by 38 pediatric units (annual incidence 1.42 per 10(5) children < or =16 years). Shiga-toxin-producing E. coli were isolated in 32 (60%) of tested stool samples, serotype O157:H7 in eight. Sixteen children presented with only minimal renal involvement, including three with underlying urinary tract infection. Six patients presented with atypical hemolytic-uremic syndrome, and six with HUS due to invasive Streptococcus pneumoniae infection. Mortality was 5.3%, including two out of six children with S. pneumoniae infection. The severity of thrombocytopenia and the presence of central nervous system involvement significantly correlated with mortality. In conclusion, childhood HUS is not rare in Switzerland. Contrasting other countries, E. coli O157:H7 play only a minor role in the etiology. Incomplete manifestation is not uncommon.
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Swiss ambulatory care is characterized by independent, and primarily practice-based, physicians, receiving fee for service reimbursement. This study analyses supply sensitive services using ambulatory care claims data from mandatory health insurance. A first research question was aimed at the hypothesis that physicians with large patient lists decrease their intensity of services and bill less per patient to health insurance, and vice versa: physicians with smaller patient lists compensate for the lack of patients with additional visits and services. A second research question relates to the fact that several cantons are allowing physicians to directly dispense drugs to patients ('self-dispensation') whereas other cantons restrict such direct sales to emergencies only. This second question was based on the assumption that patterns of rescheduling patients for consultations may differ across channels of dispensing prescription drugs and therefore the hypothesis of different consultation costs in this context was investigated.