Sexualidade e identidade no espaço escolar: notas de uma atividade em um curso de educação a distância

O artigo discute a construção das identidades docentes e discentes no âmbito escolar articulada às questões de gênero e sexualidade. Ele parte da análise de uma experiência de um curso de educação a distância – EaD em que, por meio de uma disciplina específica, buscou-se mapear cenas e ações que foram propostas na escola no sentido de se produzir um debate na área da diversidade. Compreende-se que as identidades constituídas por gêneros, por orientação sexual, por raça/etnia, por classe social, por geração, entre outros marcadores sociais, implicam em diferenças, em distinções vividas por vezes de forma harmônica, e vividas, não raras vezes, de forma conflitiva e/ou violenta. A instabilidade, a incerteza e a transitoriedade atribuídas ao jovem são aspectos que caracterizam também o nosso mundo contemporâneo. Essas novas condições juvenis geram tensões entre os sujeitos envolvidos nas instituições escolares (professoras/es, familiares, e entre as/os próprias/os alunos/as). A análise também permitiu verificar que nas situações de conflitualidade há uma tendência de um culpar o outro revelando: inabilidade dos/das professoras/es, famílias desestruturadas, alunos/as descomprometidos/as, entre outros. Argumenta-se que a temática relacionada à diversidade e especificamente à sexualidade e ao gênero compõe fortemente esse cenário de conflitos, apesar das discussões e avanços na compreensão desses temas existentes na sociedade brasileira como um todo.The article discusses the construction of teachers’ and students’ identities in the school system, articulating it with gender and sexuality issues. It presents an analysis of an experience in a distance education course in which, by means of a specific discipline, it was sought to map scenes and actions that were proposed in the school in order to produce a debate in the area of diversity. Identities consisted of genres, sexual orientation, race/ethnicity, social class, generations, among other social markers, imply differences in living distinctions which are sometimes experienced harmoniously and sometimes in a rather conflicting and/or violent way. The instability, uncertainty and transience attributed to youngsters are also aspects that characterize our contemporary world. These new youth conditions generate tensions between the subjects involved in educational institutions (teachers, families, and among the students themselves). The analysis has also shown that in situations of conflicts there is a tendency to blame each other revealing: the inability of teachers, broken families, uncompromising students, among other factors. It is argued that the themes related to diversity and specifically related to sexuality and gender sharply constitute this scenario of conflicts, despite the discussions and advances in the understanding of these existing topics in the Brazilian society as a whole

Expert consensus document: A 'diamond' approach to personalized treatment of angina.

In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for traditional first-choice drugs. Considering some drugs, but not others, to be first choice is, therefore, difficult. Moreover, double or triple therapy is often needed to control angina. Patients with angina can have several comorbidities, and symptoms can result from various underlying pathophysiologies. Some agents, in addition to having antianginal effects, have properties that could be useful depending on the comorbidities present and the mechanisms of angina, but the guidelines do not provide recommendations on the optimal combinations of drugs. In this Consensus Statement, we propose an individualized approach to angina treatment, which takes into consideration the patient, their comorbidities, and the underlying mechanism of disease

Inequality and the composition of taxes

This paper analyzes the political economics of the composition of taxes. Taxes may be levied on income, or on expenditure, with the median voter pivotal in the theoretical framework analyzed. As in Meltzer and Richard (1981) income taxes increase with inequality. Conversely expenditure taxes first increase and then decrease with increasing inequality. The extent to which taxes are levied on income relative to expenditure unambiguously rises with inequality. In contrast to government size evidence, cross-country data exhibit a robust positive correlation between the extent to which taxes are levied on income relative to expenditure, and inequality. Consistent with the theory this relationship holds most significantly in stronger democracies

Screening for glucose intolerance and development of a lifestyle education programme for prevention of Type 2 diabetes in a population with intellectual disabilities

Background: The prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited. Objectives: The objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD). Setting: Leicestershire, UK. Participants: Adults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2 and/or IGR were invited to take part in the education programme. Main outcome measures: The primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed. Data sources: Participants were recruited from general practices, specialist ID services and clinics, and through direct contact. Results: A total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals, n = 14; people with ID, n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity. Limitations: We were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work. Conclusions: The results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population. Future work: Further work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation