DETRIMENTO DA EDUCAÇÃO NO BRASIL: UM ENSAIO FILOSÓFICO PARA UMA PEDAGOGIA DA PLURIDIVERSIDADE

In the context of Brazilian education, the pursuit of a pluriversal approach emerges as a crucial path. Reflection on tensions between equality and difference highlights the need to overcome marginalizing practices, in harmony with exclusion and "denigration" of education. Critique of "banking education" underscores the importance of active student participation and critical thinking, while decolonial philosophy suggests a profound reevaluation of power and knowledge structures. In this context, pluriversity in education not only celebrates diversity but propels an authentic transformation, valuing diverse voices and promoting inclusion. In Brazil, a nation rich in cultures and inequalities, pluriversity stands as a response to build a fairer, more equitable, and interconnected education aligned with the complexities of Brazilian society.No cenário da educação brasileira, a busca por uma abordagem pluriversal emerge como um caminho crucial. A reflexão sobre as tensões entre igualdade e diferença destaca a necessidade de superar práticas marginalizadoras, em sintonia com a exclusão e "denigração" educacional. A crítica à "educação bancária" ressalta a importância da participação ativa e do pensamento crítico dos alunos, enquanto a filosofia decolonial propõe uma reavaliação profunda das estruturas de poder e conhecimento. Nesse contexto, a pluriversalidade na educação não apenas celebra a diversidade, mas impulsiona uma transformação autêntica, valorizando vozes diversas e promovendo a inclusão. No Brasil, um país rico em culturas e desigualdades, a pluriversalidade é uma resposta para construir uma educação mais justa, equitativa e conectada às complexidades da sociedade brasileira

ATIVIDADE FÍSICA, PROCESSO SAÚDE-DOENÇA E CONDIÇÕES SÓCIO-ECONÔMICAS: UMA REVISÃO DE LITERATURA

The intricate interplay between physical activity, the health-disease process, and socio-economic conditions has been a subject of profound scientific inquiry over recent decades. Understanding the complex connections among these elements holds a pivotal role in health promotion and the formulation of effective strategies for disease prevention and intervention in public health. Physical activity, as an essential component of the human lifestyle, plays a multifaceted role in maintaining health and reducing the risk of chronic diseases. However, engagement in physical activities can be profoundly influenced by socioeconomic factors that shape access to resources, opportunities, and pertinent information. This literature review aims to critically examine the extensive array of studies exploring the relationship between physical activity, the health-disease process, and socio-economic conditions. Our analysis delves into both the health benefits of physical activity and how socio-economic conditions can act as social determinants of health, affecting participation in physical activities and influencing the health-disease process. Furthermore, this review seeks to highlight potential interventions and avenues for future research that may contribute to a more equitable and comprehensive approach to health promotion and disease prevention. As we delve into the available evidence, our review underscores significant findings that substantiate the positive association between regular physical activity and various aspects of human health. Additionally, we distinctly identify how socio-economic conditions can shape patterns of physical activity and subsequently impact the health of different population segments. The critical analysis of these findings allows us to comprehend the intricacies of the interactions between physical activity, socio-economic conditions, and health, providing valuable insights for intervention strategies and health policies aimed at addressing existing health disparities. Throughout this article, we will meticulously explore the available evidence, discuss the implications of these findings, and provide a comprehensive view of potential approaches to promoting physical activity and improving health across diverse populations.A relação entre atividade física, processo saúde-doença e condições sócio-econômicas tem sido objeto de intensa investigação científica nas últimas décadas. A compreensão das interconexões complexas entre esses elementos desempenha um papel fundamental na promoção da saúde e na formulação de estratégias eficazes de prevenção e intervenção em saúde pública. A atividade física, como componente essencial do estilo de vida humano, desempenha um papel multifacetado na manutenção da saúde e na redução do risco de doenças crônicas. Porém, a participação em atividades físicas pode ser profundamente influenciada por fatores sócio-econômicos, que moldam o acesso a recursos, oportunidades e informações relevantes. Esta revisão de literatura tem como objetivo examinar criticamente a vasta gama de estudos que exploram a relação entre atividade física, processo saúde-doença e condições sócio-econômicas. Nossa análise aborda tanto os benefícios da atividade física para a saúde quanto as formas pelas quais as condições sócio-econômicas podem atuar como determinantes sociais da saúde, afetando a participação em atividades físicas e influenciando o processo saúde-doença. Além disso, esta revisão busca destacar intervenções potenciais e áreas de pesquisa futura que podem ajudar a promover uma abordagem mais equitativa e abrangente para a promoção da saúde e prevenção de doenças. Ao explorar as evidências disponíveis, nossa revisão aponta para resultados significativos que sustentam a associação positiva entre atividade física regular e diversos aspectos da saúde humana. Além disso, identificamos claramente como as condições sócio-econômicas podem moldar padrões de atividade física e, subsequentemente, impactar a saúde de diferentes segmentos da população. A análise crítica desses resultados nos permite compreender a complexidade das interações entre atividade física, condições sócio-econômicas e saúde, fornecendo insights valiosos para estratégias de intervenção e políticas de saúde que buscam abordar as disparidades de saúde existentes. No decorrer deste artigo, exploraremos detalhadamente as evidências disponíveis, discutiremos as implicações desses achados e ofereceremos uma visão abrangente das possíveis abordagens para promover a atividade física e melhorar a saúde em diversas populações

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen