Do universal ao singular: um tratamento possível do fracasso escolar

El presente artículo fue construido a través de dos prácticas de diálogo entre la Psicoanálisis y la Educaci ón. En el primer momento, el expone algunas consecuencias obtenidas de la conversación entre dos laboratorios de lo CIEN (Centre Interdisciplinaire sur Lenfant). En el según momento, los testimonios son extraídos de lo proyecto de investigación y intervención Aleph, sobre las Etiologías del Fracaso Escolar creado en el curso de pos grado de la Universidad del Rio de Janeiro.O presente artigo traz o testemunho de duas práticas de diálogo entre a psicanálise e a educa ção. No primeiro momento, expõe algumas conseqüências retiradas da conversação entre dois laboratórios do CIEN (Centre Interdisciplinaire sur Lenfant). No segundo, depoimentos são extraídos do projeto de pesquisa e intervenção Aleph, Sobre as Etiologias do Fracasso Escolar, desenvolvido no curso de Pós-graduação da Universidade Federal do Rio de Janeiro.The present article refers two practices and the dialogue between psychoanalysis and education. At a first moment, it introduces some consequences of the conversation between two laboratories of the CIEN (Centre Interdisciplinaire sur Lenfant). At a second time, the testimonies are drawn from the research project and intervention Aleph, about the Etiologies of the School Failure, developed in the postgraduation course of The Federal University of Rio De Janeiro

O fracasso escolar na clínica com crianças e adolescentes¹. Educação: entre o impossível e o necessário

O evento freudiano não deixou sem marcas o ato de educar, seja em sua vertente formal, que inclui n ação pedagógica, seja na educação da criança praticada peía família. O próprio fato de aceitarmos intervir, com a psicanálise, em transtornos dessa ordem indica que vislumbramos, de antemão, uma articulação entre o sujeito do conhecimento, descrito pela lógica aristotélica, e o sujeito do inconsciente, efeito da articulação significante do qual a psicanálise se ocupa. Neste texto, abordamos o fracasso escolar em suas relações com os processos psíquicos inconscientes, em sua vertente lógica de funcionamento. Para tanto, partimos da premissa de que as tensões que se originam nas articulações entre o impossível c o necessário podem, através cia inibição de funções cognitivas, traduzir-se em fracasso escolar.The freudian event left its marks in the education act, or in the formal orientation, which include pedagogic action, or in the family education. Our acceptance to take a part on that, with the psychoanalysis, shows that is possible an articulation between knowledge's subject, described on the aristotelic logical, and unconscious's subject that results from the significant articulation studied by psychoanalysis. In this text, we approach the student's school failure in its relations with the unconscious psychic processes, in its logical source of functioning. For that, we start from the premise that the tensions which are originate in the articulation between the impossible and the necessary can, through the inhibition of cognitives functions, be expressed by student's school failure

O brincar como modo de tratamento ao real da doença

Este artigo discute, a partir de uma perspectiva psicanalítica, como o brincar constitui-se como um modo de tratamento ao real da doença, em crianças acometidas de diversos tipos de câncer. Traça considerações sobre o brincar e o simbólico, a partir das idéias freudianas para, em seguida, discutir o modo como Lacan pensa o brincar e a sua função na clínica com crianças. A partir de um fragmento de caso clínico, este artigo tenta demonstrar o modo como os pressupostos teóricos assumidos servem de operadores lógicos, no que se refere aos casos de crianças em tratamento no Instituto de Pediatria e Puericultura Marzagão Gesteira

Entre o hospital e a escola: o cancer em crianças

In this paper we propose to raise some dilemmas of school children fell ill with cancer. When we realize their impediments to school we seek to bring into discussion issues related to barriers imposed by illness, social ties and the school institution itself. Our guided interventions by psychoanalysis have indicated that childhood, when entered in the hospital, undergoes changes that require a reorganization of libidinal investment of the child, parents and professionals involved in the process. Even though Brazilian law recognizes the right of children and adolescents admitted to the pedagogical-educational service, which choices are the subject child? What can a psychoanalyst, challenged in his city, to respond to these dilemmas without sacrificing their ethics in the bond established with the areas of health and education?En el presente artículo nos proponemos a investigar las difíciles situaciones de niños enfermos por cáncer. Al percibimos sus obstáculos a la vida escolar, buscamos discutir cuestiones inherentes a las barreras impuestas por la enfermedad, a los lazos sociales y la propia institución escolar. Nuestras intervenciones, basadas por el psicoanálisis, vienen apuntando que la infancia, cuando inscrita en un ambiente hospitalario, sufre cambios, que necesitan una reorganización de las inversiones libidinales del niño, de los padres y de los profesionales envueltos en el proceso. Aunque la legislación brasileña reconozca los derechos de los niños y adolescentes hospitalizados al atendimiento pedagógico-educativa, en este panorama, ¿qué elecciones tienen esos niños? ¿Qué puede un psicoanalista, provocado en su ciudad, contestar a esos obstáculos sin renunciar de su ética, en el enlace establecido entre las áreas de la salud y de la educación.No presente artigo propomo-nos levantar alguns impasses escolares de crianças adoecidas pelo câncer. Ao constatarmos seus impedimentos à vida escolar buscamos trazer à discussão questões inerentes às barreiras impostas pelo adoecimento, laços sociais e pela própria instituição escola. Nossas intervenções, orientadas pela psicanálise, vêm indicando que a infância, quando inscrita no ambiente hospitalar, sofre mudanças que necessitam uma reorganizacão dos investimentos libidinais da criança, dos pais e dos profissionais envolvidos no processo. Mesmo que a legislação brasileira reconheça o direito de crianças e adolescentes hospitalizados ao atendimento pedagógico-educacional, que escolhas têm esses sujeitos? O que pode um psicanalista, desafiado em sua cidade, responder a esses impasses sem abrir mão de sua ética no laço estabelecido com as áreas da saúde e da educação

Conversação com educadores: uma troca possível

O presente artigo pretende discutir, na interface entre psicanálise e educação, algumas consequências extraídas de dez encontros realizados em três escolas do município do Rio de Janeiro. O dispositivo implantado, sob a forma de rede interdisciplinar, busca refletir sobre alguns parâmetros que norteiam essas práticas, tendo como objeto de investigação e troca o desafio que o fracasso escolar impõe a psicanalistas e educadores. A ênfase recai sobre essa problemática, que incide como uma patologia na cultura contemporânea, e os novos paradigmas que regem as ações político-educacionais do Estado. Alguns testemunhos da prática de “conversação” são trazidos para elucidar os modos discursivos predominantes na fala dos educadore

O lugar do psicanalista na escola

In this work we analyze the tension inherent to the educative action in its formal aspect, practiced at school, and in its informal aspect, practiced by the family, raising some questions ot impossibility that give rise to impotence and as a consequence the miscarriage of education. The miscarriage of school, considered one of the pathologies of our time, is being associated to the manipulation of the promises of pleasure associated to the political actions of Education, supported by an ethic of globalization and by the loss of ideals. These are questions that are brought to the psychoanalyst in intersection of the psychoanalysis and education.Este trabalho busca pensar a tensão inerente à ação educativa em seu aspecto formal, praticada pela escola, e no informal, ministrada pela família, levantando alguns pontos de impossibilidade que vêm se transformando em impotência e conseqüente fracasso da educação. O fracasso escolar, considerado uma das patologias de nosso tempo, vem sendo associado à manipulação das promessas de gozo inerentes às ações políticas da educação amparadas por uma ética da globalização e da queda de ideais. Estas questões interrogam o psicanalista na interseção psicanálise e educação

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions