A Conservação da Mata Atlântica e a “Permanência da Terra” no Cenário Atual do Território Guarani

Between the last decade of the 20th century and the first of the 21st century, the implementation of economic projects, which have an impact on Indigenous lands, has accelerated with unpredictable implications and unfolding, continuing today. In the case of the traditionally inhabited lands of the Guarani people, on which plunder is a historical constant, its conflicts not only have their origins in the field of territorialization of spaces, but also reflect an unequal confrontation of rights that culminates in the paralysis of most of the demarcation processes of the Guarani lands. Such conflicts also become visible when comparing the Guarani theories about the sustainability of the Earth and those underlying within policies of environmental “management”, molded and subordinated to fit a model of civilization and economic growth that does not take into consideration diversities and increase inequalities. This paper collects current formulations, concepts and categories, with emphasis on the environmental context of lands and Guarani territory located in the Atlantic Rainforest of South and Southeastern Brazil.En el periodo que comprende la última década del siglo XX y la primera del XXI, la implementación de proyectos económicos que impactan sobre las Tierras Indígenas se acelera, con derivaciones e implicaciones imprevisibles, aún en curso. En el caso de las tierras tradicionalmente ocupadas por los Guaraní, cuya expropiación resulta una constante histórica, los conflictos no se traducen únicamente en el ámbito de la territorialización de espacios, sino que reflejan una confrontación desigual de derechos que culmina en la paralización de la gran mayoría de procedimientos de demarcación de tierras guaraní. Tales conflictos se manifiestan también en el contraste existente entre las teorías guaraní sobre la sostenibilidad de la Tierra y las que subyacen en las políticas de “gestión” ambiental moldeadas y subordinadas a un modelo de civilización y de crecimiento económico que no considera diversidades, además de aumentar desigualdades. Este artículo reúne formulaciones, conceptos y categorías vigentes enfocadas al contexto ambiental de tierras y territorio guaraní situados en la Mata Atlántica del Sur y Sudeste de Brasil.No período que compreende a última década do século XX e a primeira do XXI, a implementação de projetos econômicos que impactam as Terras Indígenas é acelerada, com desdobramentos e implicações imprevisíveis, ainda em curso. No caso das terras tradicionalmente ocupadas pelos Guarani, cujo esbulho é uma constante histórica, os conflitos não se traduzem apenas no âmbito da territorialização dos espaços, mas reproduzem um confronto desigual de direitos que culmina na paralisação da grande maioria dos procedimentos de demarcação das terras guarani. Tais conflitos transparecem também no contraste entre as teorias guarani sobre a sustentação da Terra e as que subjazem nas políticas de “gestão” ambiental moldadas e subordinadas a um modelo de civilização e de crescimento econômico que não leva em consideração diversidades, além de incrementar desigualdades. Este artigo reúne formulações, conceitos e categorias vigentes, com foco no contexto ambiental das terras e do território guarani situadas na Mata Atlântica do Sul e Sudeste do Brasil

Chronic kidney disease among adult participants of the ELSA-Brasil cohort: association with race and socioeconomic position

Submitted by sandra infurna ([email protected]) on 2016-05-31T11:08:04Z No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 736940 bytes, checksum: 9afa88f70aad384defddf130e462a777 (MD5)Approved for entry into archive by sandra infurna ([email protected]) on 2016-06-02T12:51:34Z (GMT) No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 736940 bytes, checksum: 9afa88f70aad384defddf130e462a777 (MD5)Made available in DSpace on 2016-06-02T12:51:34Z (GMT). No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 736940 bytes, checksum: 9afa88f70aad384defddf130e462a777 (MD5) Previous issue date: 2016Made available in DSpace on 2016-06-03T12:34:13Z (GMT). No. of bitstreams: 2 rosane_griep_etal_IOC_2016.pdf: 736940 bytes, checksum: 9afa88f70aad384defddf130e462a777 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) Previous issue date: 2016Universidade Federal de Minas Gerais. Escola de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Escola de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brasil / Departamento de Saúde. Belo Horizonte, MG, Brasil.Universidade Federal do Rio Grande do Sul. Escola de Medicina. Porto Alegre, RS, Brasil.Universidade Federal do Rio Grande do Sul. Escola de Medicina. Porto Alegre, RS, Brasil.Universidade Federal da Bahia. Departamento de Medicina Interna. Salvador, BA, Brasil.Universidade de São Paulo. Centro de Pesquisa Clínica e Epidemiológica. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Universidade Federal de Minas Gerais. Escola de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brasil.Universidade Federal de Minas Gerais. Escola de Medicina. Hospital das Clínicas. Belo Horizonte, MG, Brasil.Universidade de São Paulo. Centro de Pesquisa Clínica e Epidemiológica. São Paulo, SP, Brasil.Universidade Federal do Espírito Santo. Departamento de Ciências Fisiológicas. Vitória, ES, Brasil.BACKGROUND: There is increased interest in understanding why chronic kidney disease (CKD) rates vary across races and socioeconomic groups. We investigated the distribution of estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (ACR) and CKD according to these factors in Brazilian adults. METHODS: Using baseline data (2008-2010) of 14 636 public sector employees (35-74 years) enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA)-Brasil multicentre cohort, we estimated the prevalence of CKD by sex, age, race and socioeconomic factors. CKD was defined as ACR≥30 mg/g and/or eGFR<60 mL/min/1.73 m(2). GFR was estimated by CKD epidemiology collaboration without correction for race. We used logistic regression to estimate the association of race and socioeconomic position (education, income, social class and occupational nature) with CKD after adjusting for sex, age and several health-related factors. RESULTS: The prevalence of high ACR or low eGFR, in isolation and combined, increased with age, and was higher in individuals with lower socioeconomic position and among black individuals and indigenous individuals. The overall prevalence of CKD was 8.9%. After full adjustments, it was similar in men and women (OR=0.90; 95% CI 0.79 to 1.02) and increased with age (OR=1.07; 95% CI 1.06 to 1.08). Compared to white individuals, black individuals (OR=1.23; 95% CI 1.03 to 1.47), 'pardos' (OR=1.16; 95% CI 1.00 to 1.35) and Indigenous (OR=1.72; 95% CI 1.07 to 2.76) people had higher odds for CKD. Having high school (OR=1.15; 95% CI 1.00 to 1.34) or elementary education (OR=1.23; 95% CI 1.03 to 1.47) increased the odds for CKD compared to those having a university degree. CONCLUSIONS: There were marked discrepancies in the increases in reduced eGFR and high ACR with age and race. The higher prevalences of CKD in individuals with lower educational status and in non-whites were not explained by differences in health-related factors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing

Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease

Background: Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference. Methods: After a computerized search, data from 41 cohorts and whose authors agreed to provide data were pooled. COPD studies were eligible for analyses if they included, at least age, sex, post-bronchodilator spirometry, modified Medical Research Council, and COPD Assessment Test (CAT) total scores. Main outcomes: Receiver operating characteristic curves and the Youden index were used to determine the best calibration threshold for CAT, COPD Clinical Questionnaire, and St. Georges Respiratory Questionnaire total scores. Following, GOLD A/B/C/D frequencies were calculated based on current cut-points and the newly derived cut-points. Findings: A total of 18,577 patients with COPD [72.0% male; mean age: 66.3 years (standard deviation 9.6)] were analyzed. Most patients had a moderate or severe degree of airflow limitation (GOLD spirometric grade 1, 10.9%; grade 2, 46.6%; grade 3, 32.4%; and grade 4, 10.3%). The best calibration threshold for CAT total score was 18 points, for COPD Clinical Questionnaire total score 1.9 points, and for St. Georges Respiratory Questionnaire total score 46.0 points. Conclusions: The application of these new cut-points would reclassify about one-third of the patients with COPD and, thus, would impact on individual disease management. Further validation in prospective studies of these new values are needed. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine