198 resultados para prudence


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Foreword by Alicia Bárcena

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Includes bibliography

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Document prepared on the occasion of the visit of President Barack Obama to Brazil, Chile and El Salvador in March 2011

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Beekeeping is recognized as promoter of assumptions and dimensions of sustainable development, supported by the triple bottle line – economic viability, social relevance and environmental prudence. Historically, it is strongly related with the central state of São Paulo. This work has as main objective to identify the profile of beekeeping in the this region, based on four municipalities (Araraquara, Descalvado, Rio Claro and São Carlos) in order to determine the main difficulties faced by beekeepersfor the sustainable development, pointing alternative interventions able to soften the effects of difficulties. It was used two different and complementary methodological strategies. The first one was a search with the databases (SEADE and IBGE) to obtain secondary data and quantitative regarding beekeeping in the region. The second one, it wasthrough field research with the beekeepers. The survey found that beekeeping in the region, presents an essentially familial and hereditary. Was also noticed the damage caused in the production, by limiting access to the region’s bee pastures and use of pesticides. In processing, it was found the extremely precarious conditions. At the institutional level, it was found the relative weakness of the beekeepers cooperatives, and the lack of support from local governments to consolidate activity.

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OBJECTIVES In 2003 the International Breast Cancer Study Group (IBCSG) initiated the TEXT and SOFT randomized phase III trials to answer two questions concerning adjuvant treatment for premenopausal women with endocrine-responsive early breast cancer: 1-What is the role of aromatase inhibitors (AI) for women treated with ovarian function suppression (OFS)? 2-What is the role of OFS for women who remain premenopausal and are treated with tamoxifen? METHODS TEXT randomized patients to receive exemestane or tamoxifen with OFS. SOFT randomized patients to receive exemestane with OFS, tamoxifen with OFS, or tamoxifen alone. Treatment was for 5 years from randomization. RESULTS TEXT and SOFT successfully met their enrollment goals in 2011. The 5738 enrolled women had lower-risk disease and lower observed disease-free survival (DFS) event rates than anticipated. Consequently, 7 and 13 additional years of follow-up for TEXT and SOFT, respectively, were required to reach the targeted DFS events (median follow-up about 10.5 and 15 years). To provide timely answers, protocol amendments in 2011 specified analyses based on chronological time and median follow-up. To assess the AI question, exemestane + OFS versus tamoxifen + OFS, a combined analysis of TEXT and SOFT became the primary analysis (n = 4717). The OFS question became the primary analysis from SOFT, assessing the unique comparison of tamoxifen + OFS versus tamoxifen alone (n = 2045). The first reports are anticipated in mid- and late-2014. CONCLUSIONS We present the original designs of TEXT and SOFT and adaptations to ensure timely answers to two questions concerning optimal adjuvant endocrine treatment for premenopausal women with endocrine-responsive breast cancer. Trial Registration TEXT: Clinicaltrials.govNCT00066703 SOFT: Clinicaltrials.govNCT00066690.

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BACKGROUND Suppression of ovarian estrogen production reduces the recurrence of hormone-receptor-positive early breast cancer in premenopausal women, but its value when added to tamoxifen is uncertain. METHODS We randomly assigned 3066 premenopausal women, stratified according to prior receipt or nonreceipt of chemotherapy, to receive 5 years of tamoxifen, tamoxifen plus ovarian suppression, or exemestane plus ovarian suppression. The primary analysis tested the hypothesis that tamoxifen plus ovarian suppression would improve disease-free survival, as compared with tamoxifen alone. In the primary analysis, 46.7% of the patients had not received chemotherapy previously, and 53.3% had received chemotherapy and remained premenopausal. RESULTS After a median follow-up of 67 months, the estimated disease-free survival rate at 5 years was 86.6% in the tamoxifen-ovarian suppression group and 84.7% in the tamoxifen group (hazard ratio for disease recurrence, second invasive cancer, or death, 0.83; 95% confidence interval [CI], 0.66 to 1.04; P=0.10). Multivariable allowance for prognostic factors suggested a greater treatment effect with tamoxifen plus ovarian suppression than with tamoxifen alone (hazard ratio, 0.78; 95% CI, 0.62 to 0.98). Most recurrences occurred in patients who had received prior chemotherapy, among whom the rate of freedom from breast cancer at 5 years was 82.5% in the tamoxifen-ovarian suppression group and 78.0% in the tamoxifen group (hazard ratio for recurrence, 0.78; 95% CI, 0.60 to 1.02). At 5 years, the rate of freedom from breast cancer was 85.7% in the exemestane-ovarian suppression group (hazard ratio for recurrence vs. tamoxifen, 0.65; 95% CI, 0.49 to 0.87). CONCLUSIONS Adding ovarian suppression to tamoxifen did not provide a significant benefit in the overall study population. However, for women who were at sufficient risk for recurrence to warrant adjuvant chemotherapy and who remained premenopausal, the addition of ovarian suppression improved disease outcomes. Further improvement was seen with the use of exemestane plus ovarian suppression. (Funded by Pfizer and others; SOFT ClinicalTrials.gov number, NCT00066690.).

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BACKGROUND Adjuvant therapy with an aromatase inhibitor improves outcomes, as compared with tamoxifen, in postmenopausal women with hormone-receptor-positive breast cancer. METHODS In two phase 3 trials, we randomly assigned premenopausal women with hormone-receptor-positive early breast cancer to the aromatase inhibitor exemestane plus ovarian suppression or tamoxifen plus ovarian suppression for a period of 5 years. Suppression of ovarian estrogen production was achieved with the use of the gonadotropin-releasing-hormone agonist triptorelin, oophorectomy, or ovarian irradiation. The primary analysis combined data from 4690 patients in the two trials. RESULTS After a median follow-up of 68 months, disease-free survival at 5 years was 91.1% in the exemestane-ovarian suppression group and 87.3% in the tamoxifen-ovarian suppression group (hazard ratio for disease recurrence, second invasive cancer, or death, 0.72; 95% confidence interval [CI], 0.60 to 0.85; P<0.001). The rate of freedom from breast cancer at 5 years was 92.8% in the exemestane-ovarian suppression group, as compared with 88.8% in the tamoxifen-ovarian suppression group (hazard ratio for recurrence, 0.66; 95% CI, 0.55 to 0.80; P<0.001). With 194 deaths (4.1% of the patients), overall survival did not differ significantly between the two groups (hazard ratio for death in the exemestane-ovarian suppression group, 1.14; 95% CI, 0.86 to 1.51; P=0.37). Selected adverse events of grade 3 or 4 were reported for 30.6% of the patients in the exemestane-ovarian suppression group and 29.4% of those in the tamoxifen-ovarian suppression group, with profiles similar to those for postmenopausal women. CONCLUSIONS In premenopausal women with hormone-receptor-positive early breast cancer, adjuvant treatment with exemestane plus ovarian suppression, as compared with tamoxifen plus ovarian suppression, significantly reduced recurrence. (Funded by Pfizer and others; TEXT and SOFT ClinicalTrials.gov numbers, NCT00066703 and NCT00066690, respectively.).

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Good policy making is an art. It involves a substantial element of personal judgement about risks and consequences of alternative courses of actions and decisions. It is also a science because it requires systematic gathering and analysis of evidence about a policy issue, and rational assessment of costs and benefits of various ways of addressing the issue. However, in a crisis, there is little time to gather evidence or to search for imaginative solutions to a problem. There is a tendency, in such a situation, to act under pressure rather than on the basis of evidence, analysis or informed judgement. Furthermore, a crisis often creates a situation in which policy makers receive all sorts of advice. This note discusses a set of concepts, originating mainly from economics, that can be used to assess soundness of policy and advice, particularly during a crisis. These are concepts of rationality, sustainability, inclusiveness, feasibility, practicality and tipping, which can be used in decision making in normal and crisis times to reduce risks of disastrous advice or policy.

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"Art and Mass Culture" (GS 4, S. 419-438); 1. Aufsatz, veröffentlicht in: SPSS IX, 1941, S. 290-304; 2. Exzerpt aus: Mortimer Adler, "Art and Prudence", Part II und VI. Typoskript mit handschriftlichen Korrekturen. 18 Blatt;

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El proyecto del presente trabajo consiste en reflexionar sobre la constitución del sujeto ético-político en los Erga de Hesíodo. Trabajaremos desde una propuesta de matriz antropológica, en torno a los consejos de administración familiar que el poeta propone, recurriendo a Jenofonte cuando la comparación sea oportuna. Siguiendo el horizonte semántico del término chresis, indagaremos dos cuestiones fundamentales, la gestión del hogar, a partir de la problematización del matrimonio como cuestión afín, y la gestión de los vínculos personales, que van más allá del oikos, para convocar a otros actores, el hermano, el huésped, el amigo. En ambos niveles, el estrictamente familiar con la presencia del marido y la esposa en el centro de la escena, y el familiar, en sentido más amplio, los tópicos devuelven ciertas preocupaciones y reflexiones en torno a cuestiones que se repiten, el trabajo, la riqueza, la productividad, la prudencia, el honor, la convivencia, la tolerancia. Se plasma un universo antropológico que nos permite relevar, desde los topoi recortados, la pequeña familia intramuros y la gran familia extramuros, la preocupación habitual de la constitución de un sujeto temperante que en Hesíodo cobra distintas aristas. El modelo discursivo obedece a las reglas de formación que reconocemos en los Erga como matriz de discurso: recomendaciones, consejos, exhortaciones, que delinean dos topoi reconocibles, dos categorías de sujetos, dos registros de conductas, dos modelos de instalación en la vida. Hesíodo nos tiene acostumbrados a esos sistemas binarios que, a nuestro juicio, se inscriben en la lógica del linaje. Hombres, valores, conductas de matriz diurna o nocturna, positiva o negativa, luminosa o tenebrosa. La vida familiar y la comunitaria no parece escapar a esta lógica binaria y el corpus de consejos no hace otra cosa que vigorizar con su logos el aspecto diurno de la tensión

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No resulta fácil desentrañar el pensamiento de un escéptico acerca de temas sobre los que prefiere abstenerse de formular juicios. Es el caso de David Hume y la religión.El filósofo escocés nacido en 1711 dejó varios escritos aludiendo al fenómeno, es decir, a la religión tal como existe de hecho, y manifestó su opinión crítica acerca de las distintas posturas intelectuales de su tiempo en torno a cuestiones religiosas. Pero siempre fue ambiguo e irónico cuando le tocó dejar asentado su propio juicio con respecto a este tema. La dificultad principal reside en que, para Hume, a quien podríamos considerar un ?escéptico mitigado?, los juicios correctos son aquellos que se ajustan a la estrecha capacidad del entendimiento humano, que no va más allá de los límites de la experiencia de la vida cotidiana. Muchos aspectos vinculados a la religión ?tales como la posibilidad de conocer de la esencia y los atributos divinos- exceden nuestras limitadas facultades y, si nos aventuramos a argumentar en ese ámbito, corremos el riesgo de caer en el error y la irracionalidad. Nuestra propuesta consiste en examinar cuál es la postura de Hume sobre los distintos problemas que presentan el conocimiento y la práctica vinculados con la religión. Respecto del conocimiento, las dificultades se plantean a la hora de determinar qué estatuto otorgarle a las creencias religiosas, cuál es el origen en nuestra mente de la religiosidad y cómo justificar por medio de argumentos la existencia y atributos de la divinidad. En cuanto a la práctica, Hume formula una serie de críticas a las actitudes e instituciones religiosas tal como se han dado históricamente a partir del análisis de las consecuencias que observa en la sociedad, de las que surge una contradicción entre un conjunto de principios respetables y un sinnúmero de acciones deplorables. Para examinar estas cuestiones es necesario tener en cuenta el punto de vista desde el que efectúa su análisis, que se vincula, como acabamos de mencionar, con el escepticismo mitigado. Finalmente, evaluaremos si es posible proponer alguna forma de religión que tenga el visto bueno de Hume y, en ese caso, qué características debería revestir. Para lograrlo, deberemos abrirnos paso entre su inteligente ironía y su excesiva prudencia.