Políticas de ação afirmativa no Brasil: reflexões históricas / Affirmative action policies in Brazil: historical reflections

O artigo trata sobre o desenvolvimento histórico das políticas de ação afirmativa no Brasil. Dessa forma, primeiramente é feita uma retrospectiva histórica das principais ações afirmativas de modo geral e especificamente para a população negra. Em seguida, na nossa conclusão retomamos alguns dados indicados na primeira parte, e acrescentamos dados novos para articularmos com nossas reflexões sobre a necessidade de o Estado desenvolver políticas de ações afirmativas para a população negra brasileira. O estudo constitui uma investigação pura ou básica, a qual não consiste em dados empíricos. Constituiu-se, apenas por meio de fontes bibliográficas. Assim, utilizamos, principalmente, as seguintes fontes: Barbosa (1999), Guimarães (1999), Nunes (2004), Oliveira (2003), Silva (2002), Skidmore (1999), dentre outras. O estudo concluiu que a população negra é que a detém maior desvantagem no usufruto das benesses da cidadania brasileira

As mestiçagens da arte e os cruzamentos experienciais das linguagens artísticas das atividades cotidianas na escola / Art mixtures and experiential crossings of artistic languages of daily activities in school

Este artigo é uma reflexão sobre as atividades experienciais do cotidiano da escola e da sala de aula. Utilizou-se como tema discutir a interdisciplinaridade da música com as outras linguagens artísticas e com outras áreas de conhecimento que permeiam o currículo escolar, objetivando introduzir o cotidiano da escola como conteúdo a ser explorado e estudado cientificamente como apontam (NÓVOA, 1995; COUTINHO, 2012; FAZENDA, 2012), retirando destas vivências no espaço escolar, a característica de trivialidade do fazer. O fazer na sala de aula é sistematizado, baseado em um currículo geralmente fechado, rígido, no entanto, esse fazer na escola é carente da visão e representação científica. Utilizou-se duas imagens para representar o fazer da educação, uma representando a culminância das atividades relacionadas aos festejos juninos na escola e outra imagem (a fotografia de uma pintura/tela/quadro) realizada num espaço informal (Ong) de ensino de arte. A abordagem é a da mestiçagem da/na arte, a interdisciplinaridade (FAZENDA, 1993; 2012), que por vezes está ligada às atividades realizadas na sala de aula. A Arte na escola (Artes Visuais, Teatro, Música, Dança) está definida enquanto componente curricular, mas no seu fazer, as linguagens desse componente se entrelaçam, se utilizam umas das outras – é a interdisciplinaridade. Do resultado desse entrelaçamento, surgem a mestiçagem e o hibridismo na arte. Como manter a identidade na/da arte diante disso? Objetiva-se problematizar o cotidiano escolar e tecer algumas considerações acerca de conceitos relacionados à prática artística como a mestiçagem, a interdisciplinaridade e o hibridismo na/da arte e a polivalência.  

Statement of Second Brazilian Congress of Mechanical Ventilarion : part I

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Goal-directed therapy in patients with early acute kidney injury: a multicenter randomized controlled trial

OBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course

Health-related quality of life outcomes in head and neck cancer : results from a prospective, real-world data study with Brazilian patients treated with intensity modulated radiation therapy, conformal and conventional radiation techniques

Purpose: To compare global health-related quality of life (HRQoL) and overall survival (OS) in patients with head and neck cancer treated with intensity modulated radiation therapy (IMRT), conformal radiation therapy (3DCRT) or conventional ra- diation therapy (2DRT). Methods and Materials: In this real-world, multi-institutional and prospective study, HRQoL outcomes were assessed using the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Head and Neck 43 (H&N43) questionnaires. Item response theory was used to generate a global HRQoL score, based on the 71 questions from both forms. The effect of treatment modality on HRQoL was studied using multivariate regression analyses. Survival was estimated using the Kaplan-Meyer method, and groups were compared by the log-rank test. Results: Five hundred and seventy patients from 13 institutions were included. Median follow-up was 12.2 months. Concern- ing the radiation technique, 29.5% of the patients were treated with 2DRT, 43.7% received 3DCRT, and 26.8% were treated with IMRT. A higher proportion of patients receiving 2DRT had a treatment interruption of more than 5 days (69% vs 50.2% for 3DCRT and 42.5% for IMRT). IMRT had a statistically significant positive effect on HRQoL compared with 3DCRT (bZ 2.627, standard error Z 0.804, P Z .001) and 2DRT had a statistically significant negative effect compared with 3DCRT (bZ 5.075, standard error Z 0.926, P < .001). Patients receiving 2DRT presented a worse OS (P Z .01). There were no differences in OS when IMRT was compared with 3DCRT. Conclusions: IMRT provided better HRQoL than 3DCRT, which provided better HRQoL than 2DRT. Patients receiving 2DRT presented a worse OS, which might be related to more frequent treatment interruptions. Ó 2020 Elsevier Inc. All rights reserved

Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from BrazilResearch in context

Summary: Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30–39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz)

Characteristics of women diagnosed with mpox infection compared to men: A case series from Brazil

Background: Cisgender men were mostly affected during the 2022 mpox multinational outbreak, with few cases reported in women. This study compares the characteristics of individuals diagnosed with mpox infection according to gender in Rio de Janeiro. Methods: We obtained surveillance data of mpox cases notified to Rio de Janeiro State Health Department (June 12 to December 15, 2022). We compared women (cisgender or transgender) to men (cisgender or transgender) using chi-squared, Fisher's exact, and Mood's median tests. Results: A total of 1306 mpox cases were reported; 1188 (91.0%) men (99.8% cisgender, 0.2% transgender), 108 (8.3%) women (87.0% cisgender, 13.0% transgender), and 10 (0.8%) non-binary persons. Compared to men, women were more frequently older (40+years: 34.3% vs. 25.1%; p < 0.001), reported more frequent non-sexual contact with a potential mpox case (21.4% vs. 9.8%; p = 0.004), fewer sexual partnerships (10.9 vs. 54.8%; p < 0.001), less sexual contact with a potential mpox case (18.5% vs. 43.0%; p < 0.001), fewer genital lesions (31.8% vs. 57.9%; p < 0.001), fewer systemic mpox signs/symptoms (38.0% vs. 50.1%; p = 0.015) and had a lower HIV prevalence (8.3% vs. 46.3%; p < 0.001), with all cases among transgender women. Eight women were hospitalized; no deaths occurred. The highest number of cases among women were notified in epidemiological week 34, when the number of cases among men started to decrease. Conclusions: Women diagnosed with mpox presented differences in epidemiological, behavioral, and clinical characteristics compared to men. Health services should provide a comprehensive assessment that accounts for gender diversity