Índio ou cidadão : uma discussão sobre os desafios da promoção e proteção social no âmbito da política indigenista brasileira

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Serviço Social, Programa de Pós-Graduação em Política Social, 2012.O presente estudo tem como tema a política social indigenista brasileira, e por objeto, o atual projeto político do Estado brasileiro para os povos indígenas, suas formas de concretização, desafios e contradições. Procuramos caracterizar esse atual projeto político a partir uma análise da recente política social indigenista e de um recorte analítico em uma das ações do Programa 0150 – Proteção e Promoção dos Povos Indígenas, constante do Plano Plurianual 2008 – 2011 (PPA), a saber, a Ação 2384 - Proteção Social dos Povos Indígenas, também conhecida como Agenda Social dos Povos Indígenas, ou PAC Indígena. No escopo dessa Ação, o Governo Federal propõe para os povos indígenas a articulação de ações inseridas no campo das políticas sociais universais. Baseamo-nos na teoria da Política Social em associação à Antropologia da Política para estabelecer nexos que ajudassem a compreender o atual momento da relação entre o Estado e os povos indígenas no território nacional. Referenciamo-nos no método marxista de investigação de um objeto de pesquisa, procurando estabelecer-lhe suas múltiplas determinações históricas, causalidades e características para, depois, reproduzir-lhe como produto do pensamento. Apoiando esse processo, valemo-nos de técnicas de pesquisa tradicionalmente utilizadas pela etnografia, como observação participante, análise documental e realização de entrevistas com atores-chave do campo do indigenismo. As análises desenvolvidas nos apontaram a tendência de que, em vista da dificuldade de se equacionar a questão indígena a partir do reconhecimento e da demarcação das terras indígenas, principal demanda dos movimentos indígenas, a política indigenista estatal brasileira tem buscado saídas no campo das políticas sociais universais como “medidas compensatórias” para os povos indígenas. É sobre esse assunto que a presente dissertação de mestrado vai tratar. _______________________________________________________________________________________ ABSTRACTThe subject of this study is the Brazilian indigenous social policy, and its object is the Brazilian State's political citizenship project for indigenous peoples and its implementation means, challenges and contradictions. We made an effort to understand and characterize this political project based on an analysis of Budget Action 2384 - Social Protection for Indigenous Peoples, known as the Social Agenda of Indigenous Peoples or the Growth Acceleration Program for Indigenous People, contained in Program 0150 – Protection and Promotion of Indigenous Peoples – of Brazil's Multi-Year Plan (PPA) for the 2008-2011 period. With the aim of implementing this proposal, the Federal Government combines actions in the field of universal social policies to improve the access of indigenous peoples to food security and cash transfer policies and social security benefits, among others. To carry out this analysis, we used the Social Policy theory combined with studies on the Anthropology of Politics as a means to establish theoretical links that could help us understand the current historical moment of the relationship between the State and indigenous peoples. Using the Marxian method of investigation as reference, we sought to establish multiple historical determinations of the object and then reproduce it as a product of thought. In support of this investigation process, we relied on research procedures and techniques traditionally used for ethnographic purposes, such as participatory observation, analysis of documents, and interviews with actors dealing with indigenist issues. Our analyses tend to confirm the trend that, given the difficulties involved in addressing the indigenous social issue based on the recognition and demarcation of lands traditionally occupied by indigenous people, which is the main claim of indigenous movements, the Brazilian State has been resorting to universal social policies and to a political citizenship project as “compensatory measures” in favor of these people. These are the topics that this Master's dissertation will focus on. _______________________________________________________________________________________ RESÚMENEl tema del presente estudio es la política social indigenista brasileña y su objeto es el proyecto político de ciudadanía actual del Estado brasileño para los pueblos indígenas, sus formas de concretización, desafios y contradicciones. Tratamos de entender y caracterizar este proyecto político a través de un enfoque analítico en la Acción de Presupuesto 2384 - Protección Social de los Pueblos Indígenas, conocida como Agenda Social de los Pueblos Indígenas o PAC Indígena que consta en el Programa 0150 - Protección y Promoción de los Pueblos Indígenas, del plan plurianual (PPA) 2008 - 2011. Para la implementación de esta propuesta, el Gobierno Federal articula acciones en el ámbito de las políticas sociales universales destinadas a ampliar el acceso de los pueblos indígenas a las políticas de seguridad alimentaria, transferencia de ingresos y beneficios de seguridad social, entre otros. Para realizar este análisis, nos basamos en la teoría de la Política Social relacionada con la Antropología Política para tratar de establecer vínculos que ayuden a entender el momento histórico actual sobre la relación entre el Estado y los pueblos indígenas. Con la referencia al método de investigación marxiano, tratamos de establecer las múltiplas determinaciones históricas del objeto para reproducirlo como un producto del pensamiento. Para apoyar este proceso de investigación, hacemos uso de los procedimientos y técnicas de investigación de la etnografía, tales como la observación participante, análisis de documentos y entrevistas con los actores del campo de indigenización. Los análisis desarrollados nos han confirmado una tendencia en el sentido de que, dada la dificultad de ecuacionar el tema social indígena a partir del reconocimiento y la demarcación de tierras indígenas tradicionalmente ocupadas, que es la principal reivindicación de los movimientos indígenas, el Estado brasileño ha buscado soluciones en el ámbito de las políticas sociales universales y el proyecto político de la ciudadanía como las "medidas compensatorias" para esos pueblos. Es sobre este tema que esta disertación abordará

Still not reconciled yet! : reparation indigenism and the attempt to settle the historical debt with the Marãiwatsédé Xavante in Brazil and the Anishinaabeg of lac seul in Canada

Tese (doutorado)—Universidade de Brasília, Instituto de Ciências Sociais, Centro de Pesquisa e Pós-Graduação sobre as Américas, Programa de Pós-Graduação em Estudos Comparados sobre as Américas, 2021.A história das políticas coloniais no Brasil e no Canadá tem gerado desvantagens para os povos indígenas em todos os campos, evidenciadas pela disparidade entre essas populações e outros segmentos sociais em uma ampla gama de indicadores socioeconômicos. O presente estudo propõe uma comparação entre o Brasil e o Canadá sobre como esses países apresentam e negociam políticas para pagar as dívidas geradas ao longo dos projetos de desenvolvimento colonial e econômico. Dois casos de dívida histórica foram trazidos para a comparação: a transferência dos Xavante de Marãiwatsédé, da região central do Brazil, e o alagamento dos Anishinaabeg de Lac Seul First Nation, região Noroeste da Província de Ontário, no Canadá. No Canadá, as conseqüências do colonialismo para os povos indígenas foram e ainda são muito semelhantes às do Brasil; entretanto, como o processo de (a)pagamento da dívida histórica tem sido realizado neste país abre novas chaves de interpretação para pensar as relações interétnicas no contexto do capitalismo neoliberal global e do multiculturalismo. Em ambos os países, os processos políticos de reconciliação e reparação para os povos indígenas estão diretamente associados aos contextos econômicos e ideológicos de cada país. Entretanto, muito do Canadá se projetou mundialmente como referência no campo da política de reparação aos povos indígenas, a lógica capitalista global e neoliberal prevalece neste país, embora de natureza multicultural, que busca a inclusão econômica de segmentos excluídos da população sob os paradigmas de uma idéia de cidadania alinhada com estes valores e princípios. Neste ponto, no entanto, o Brasil e o Canadá estão totalmente alinhados.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) e Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).Colonialism in Brazil and Canada has generated disadvantages for Indigenous Peoples in every aspect of their lives, evidenced by the disparity between these populations and other social segments in a wide range of socioeconomic indicators. The present study proposes a comparison between Brazil and Canada on how these countries present and negotiate policies to settle the debts generated throughout the colonization process, past and present, and as a result of economic development projects. Two cases of historical debt were brought for comparison: the transfer of the Xavante people from Marãiwatsédé in central Brazil, and the flooding of the Anishinaabeg people from Lac Seul First Nation, Northwestern Ontario, Canada. In Canada, the consequences of colonialism for Indigenous Peoples were and still are very similar to those in Brazil; however, how the process of (un)payment of the historical debt has been carried out in this country opens new keys of interpretation for thinking about interethnic relations in the context of global neoliberal capitalism and multiculturalism. In both countries, the political processes of reconciliation and reparation for Indigenous Peoples are directly associated with each country's economic and ideological contexts. However, much Canada has projected itself worldwide as a reference in the field of the policy of reparations towards Indigenous Peoples, the global and neo-liberal capitalist logic prevails in this country, albeit of a multicultural nature, which seeks the economic inclusion of excluded segments of the population under the paradigms of an idea of citizenship aligned with these values and principles. At this point, however, Brazil and Canada are entirely aligned.La historia de las políticas coloniales en Brasil y Canadá ha generado desventajas a los pueblos indígenas en todos los ámbitos, evidenciadas por la disparidad entre estas poblaciones y otros segmentos sociales en una amplia gama de indicadores socioeconómicos. El presente estudio propone una comparación entre Brasil y Canadá sobre cómo estos países presentan y negocian las políticas para pagar las deudas generadas a lo largo de los proyectos de desarrollo colonial y económico. Se trajeron dos casos de deuda histórica para comparar: el traslado de los Xavante de Marãiwatsédé, en la región central de Brasil, y la inundación de los Anishinaabeg de la Primera Nación de Lac Seul, en el noroeste de Ontario, Canadá. En Canadá, las consecuencias del colonialismo para los pueblos indígenas fueron y siguen siendo muy similares a las de Brasil; con todo, la forma en que se ha llevado a cabo el proceso de (a)pagar la deuda histórica en este país abre nuevas claves de interpretación para pensar las relaciones interétnicas en el contexto del capitalismo neoliberal global y el multiculturalismo. En ambos países, los procesos políticos de reconciliación y reparación de los pueblos indígenas están directamente asociados a los contextos económicos e ideológicos de cada país. Sin embargo, por mucho que Canadá se haya proyectado mundialmente como un referente en el campo de la política de reparaciones a los pueblos indígenas, en este país prevalece la lógica capitalista global y neoliberal, aunque de carácter multicultural, que busca la inclusión económica de los segmentos excluidos de la población bajo los paradigmas de una idea de ciudadanía alineada con estos valores y principios. En este punto, al fin y al cabo, Brasil y Canadá están totalmente alineados

Epidemiologia das doenças tropicais negligenciadas em receptores de transplantes: revisão da literatura e experiência de um centro brasileiro

O sucesso crescente dos transplantes de órgãos sólidos (TOS) e de células tronco-hematopoiéticas (TCTH) e as novas drogas imunossupressoras fizeram dos transplantes a primeira opção terapêutica para muitas doenças que afetam milhares de pessoas em todo o mundo. Também os populosos países em desenvolvimento investiram no crescimento de seus programas de transplante e desde então começaram a vivenciar o impacto das doenças tropicais negligenciadas (DTNs) nestes pacientes. Revisamos os dados da literatura sobre a epidemiologia das DTNs de maior impacto clinico e social que afetam receptores de transplante de países em desenvolvimento, ou que podem representar um risco para receptores de transplante vivendo em outras regiões não afetadas por estas doenças. Tuberculose, hanseníase, doença de Chagas, malaria, leishmaniose, dengue, febre amarela e sarampo são os tópicos incluídos nesta revisão. Além disso, revisamos retrospectivamente a experiência referente ao manejo das DTNs do Serviço de Transplante de Medula Óssea da Fundação Amaral Carvalho, atualmente o maior centro de TCTH alogênico do Brasil.The rising success rate of solid organ (SOT) and haematopoietic stem cell transplantation (HSCT) and modern immunosuppression make transplants the first therapeutic option for many diseases affecting a considerable number of people worldwide. Consequently, developing countries have also grown their transplant programs and have started to face the impact of neglected tropical diseases (NTDs) in transplant recipients. We reviewed the literature data on the epidemiology of NTDs with greatest disease burden, which have affected transplant recipients in developing countries or may represent a threat to transplant recipients living in other regions. Tuberculosis, Leprosy, Chagas disease, Malaria, Leishmaniasis, Dengue, Yellow fever and Measles are the topics included in this review. In addition, we retrospectively revised the experience concerning the management of NTDs at the HSCT program of Amaral Carvalho Foundation, a public transplant program of the state of São Paulo, Brazil

Identificação de vírus respiratórios em crianças com cardiopatia congênita por comparação de diferentes métodos

Respiratory virus infections are the main cause of infant hospitalization and are potentially severe in children with congenital heart disease (CHD). Rapid and sensitive diagnosis is very important to early introduction of antiviral treatment and implementation of precautions to control transmission, reducing the risk of nosocomial infections. In the present study we compare different techniques in the diagnosis of respiratory viruses in CHD infants. Thirty-nine samples of nasopharyngeal aspirate were obtained from CHD infants with symptoms of respiratory infection. The Multiplex PCR (Seeplex® RV 12 ACE Detection) driven to the detection of 12 respiratory viruses was compared with the direct immunofluorescence assay (DFA) and PCR, both targeting seven respiratory viruses. The positivity found by DFA, Multiplex and PCR was 33.3%, 51.3% and 48.7%, respectively. Kappa index comparing DFA and Multiplex, DFA and PCR and PCR and Multiplex PCR was 0.542, 0.483 and 0.539, respectively. The concordance between techniques was considered moderate. Both Multiplex PCR (p = 0.001) and PCR (p = 0.002) detected significantly more respiratory virus than DFA. As the performance of the tests may vary, the combination of two or more techniques may increase diagnostic sensitivity favoring the diagnosis of co-infections, early introduction of antiviral therapy and implementation of appropriate measures.Infecções respiratórias virais são a principal causa de hospitalização infantil e podem ser extremamente graves em crianças com cardiopatia congênita. O diagnóstico rápido e sensível é importante para a introdução precoce de tratamento antiviral e implantação de precauções para controle da transmissão, reduzindo o risco de infecções nosocomiais. Neste estudo, comparamos o desempenho de diferentes técnicas no diagnóstico de vírus respiratórios em crianças com cardiopatia congênita e sintomas respiratórios. Trinta e nove amostras de aspirado de nasofaringe foram obtidas de crianças com sintomas de infecção respiratória. Ensaio de PCR Multiplex que detecta 12 vírus respiratórios (Seeplex® RV 12 ACE Detection) foi comparado à Imunofluorescência Direta (IFD) e à PCR específica, ambas direcionadas a sete vírus. A positividade da IFD foi 33,3%, do Multiplex foi 51,3% e da PCR 48,7%. O índice kappa comparando IFD e Multiplex, IFD e PCR, e PCR e Multiplex foi, respectivamente, 0,542, 0,483 e 0,539, sendo a concordância considerada moderada. O Multiplex e a PCR detectaram significantemente mais vírus que a IFD (p < 0,0001 e 0,002, respectivamente). Como o desempenho dos testes varia o uso de mais de uma técnica pode aumentar a sensibilidade diagnóstica favorecendo a introdução precoce de terapia antiviral e implantação de medidas profilática

Difficulties in the revaccination program of hematopoietic stem cell transplantation recipients

Hematopoietic stem cell transplant (HSCT) recipients should be routinely revaccinated after transplantation. We evaluated the difficulties met in the revaccination program and how a prospective and tailored follow-up could help to overcome these obstacles. HSCT recipients (n=122) were prospectively followed up and categorized into Group 1 (n=72), recipients who had already started the revaccination program, and Group 2 (n=50), recipients starting their vaccines. Whenever a difficulty was reported, interventions and subsequent evaluations were performed. Reported problems were related to patient compliance, HSCT center and/or vaccination center. Problems related to patient compliance were less frequent than those related to HSCT center modifications of previous recommendations, or to errors made by the vaccination center. The main gap found was vaccination delays (81.9%). Advisory intervention was needed in 64% and 46% of Group 1 and Group 2, respectively (p=0.05), and was partially successful in around 70% of the cases. Total resolution was achieved in more than 35% in both groups. Improvements are needed in the Brazilian vaccination program for HSCT recipients to assure a complete and updated revaccination schedule. HSCT centers should assign nurses and transplant infectious disease specialist physicians to organize the revaccination schedule and to monitor the program development

Monitoramento de doadores e receptores provenientes de áreas endêmicas para malária em transplante de células-tronco hematopoiéticas

Malaria is an unusual complication after hematopoietic stem cell transplantation in non-endemic countries. However, transplant candidates, recipients and donors living in endemic regions frequently report previous episodes of malaria. This fact could represent an important risk for immunosuppressed recipients that could develop severe malaria cases. We report a case of hematopoietic stem cell transplant (HSCT) in which the donor had a history of previous malaria, and close monitoring was performed before and after procedure by parasitological and molecular tests. The donor presented Plasmodium vivax in thick blood smears one month after transplant and was treated according to Brazilian Health Ministry guidelines. The polymerase chain reaction (PCR) was able to detect malaria infection in the donor one week earlier than thick blood film. Even without positive results, the recipient was pre-emptively treated with chloroquine in order to prevent the disease. We highlight the importance of monitoring recipients and donors in transplant procedures with the aim of reducing the risk of malaria transmission.A malária é complicação incomum após o transplante de células-tronco hematopoiéticas em países endêmicos. No entanto, candidatos a transplantes, receptores e doadores que vivem em regiões endêmicas frequentemente relatam episódios anteriores de malária. Este fato pode representar um risco importante para receptores imunossuprimidos, que podem desenvolver casos de malária grave. Relatamos um caso de transplante de células-tronco hematopoiéticas (TCTH) em que o doador teve história de malária anterior e um monitoramento por meio de exames parasitológicos e moleculares foi realizado antes e após o procedimento. O doador apresentou Plasmodium vivax na gota espessa um mês após o transplante e foi tratado de acordo com as orientações do Ministério da Saúde brasileiro. A reação em cadeia da polimerase (PCR) foi capaz de detectar a infecção por malária no doador uma semana mais cedo do que a gota espessa. Mesmo sem resultados positivos, o receptor foi preventivamente tratado com cloroquina, a fim de prevenir as formas sanguíneas assexuadas. Destacamos a importância do monitoramento de receptores e doadores em procedimentos de transplante, com o objetivo de reduzir o risco de transmissão da malária

Impact of Cytomegalovirus and Grafts versus Host Disease on the Dynamics of CD57+CD28−CD8+ T Cells After Bone Marrow Transplant

OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05). A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94%, p<0.01) and an increase in CD57+ lymphocytes (5.60%, p<0.01). This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant), also had an impact on the CD57+ subset, triggering an increase of 4.9% in CD57+ lymphocytes (p<0.05). CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia

A conceptual social media tool for supporting collaborative university-industry R&D programs

This paper aims to help professionals and academics involved in collaborative university-industry RD programs and projects, by presenting a conceptual social media tool that can be used to improve communication and collaboration between internal stakeholders. The social media tool conceptualization was developed based on a case study research strategy. The case selected was a large publicly funded RD collaborative program that covers 30 RD projects carried out by a university and an industry partner. During the case study analysis three research methods were applied: participant observation, document analysis, and focus groups. The social media tool is conceptualized in seven functional building blocks: identity, relationships, sharing, presence conversations, reputation and groups. For each building block, its main objectives and requirements are detailed, within this particular context of collaborative university-industry RD programs and projects.This research is sponsored by the Fundação para a Ciência e a Tecnologia FCT (SFRH/BPD/111033/2015), and by the Portugal Incentive System for Research and Technological Development. Project in co-promotion nº 36265/2013 (Project HMIExcel - 2013-2015)

Difficulties in the revaccination program of hematopoietic stem cell transplantation recipients

ABSTRACT Hematopoietic stem cell transplant (HSCT) recipients should be routinely revaccinated after transplantation. We evaluated the difficulties met in the revaccination program and how a prospective and tailored follow-up could help to overcome these obstacles. HSCT recipients (n=122) were prospectively followed up and categorized into Group 1 (n=72), recipients who had already started the revaccination program, and Group 2 (n=50), recipients starting their vaccines. Whenever a difficulty was reported, interventions and subsequent evaluations were performed. Reported problems were related to patient compliance, HSCT center and/or vaccination center. Problems related to patient compliance were less frequent than those related to HSCT center modifications of previous recommendations, or to errors made by the vaccination center. The main gap found was vaccination delays (81.9%). Advisory intervention was needed in 64% and 46% of Group 1 and Group 2, respectively (p=0.05), and was partially successful in around 70% of the cases. Total resolution was achieved in more than 35% in both groups. Improvements are needed in the Brazilian vaccination program for HSCT recipients to assure a complete and updated revaccination schedule. HSCT centers should assign nurses and transplant infectious disease specialist physicians to organize the revaccination schedule and to monitor the program development

Community-acquired pneumonia in Chile: the clinical relevance in the detection of viruses and atypical bacteria

Background Adult community-acquired pneumonia (CAP) is a relevant worldwide cause of morbidity and mortality, however the aetiology often remains uncertain and the therapy is empirical. We applied conventional and molecular diagnostics to identify viruses and atypical bacteria associated with CAP in Chile.\ud \ud Methods We used sputum and blood cultures, IgG/IgM serology and molecular diagnostic techniques (PCR, reverse transcriptase PCR) for detection of classical and atypical bacteria (Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumoniae) and respiratory viruses (adenovirus, respiratory syncytial virus (RSV), human metapneumovirus, influenza virus, parainfluenzavirus, rhinovirus, coronavirus) in adults >18 years old presenting with CAP in Santiago from February 2005 to September 2007. Severity was qualified at admission by Fine's pneumonia severity index.\ud \ud Results Overall detection in 356 enrolled adults were 92 (26%) cases of a single bacterial pathogen, 80 (22%) cases of a single viral pathogen, 60 (17%) cases with mixed bacterial and viral infection and 124 (35%) cases with no identified pathogen. Streptococcus pneumoniae and RSV were the most common bacterial and viral pathogens identified. Infectious agent detection by PCR provided greater sensitivity than conventional techniques. To our surprise, no relationship was observed between clinical severity and sole or coinfections.\ud \ud Conclusions The use of molecular diagnostics expanded the detection of viruses and atypical bacteria in adults with CAP, as unique or coinfections. Clinical severity and outcome were independent of the aetiological agents detected.This work was supported by the Fondo Nacional de Ciencia y Tecnología (FONDECYT) (grant number 1050734); and the Fondo Nacional de Investigación en Salud (FONIS) (grant number SA04 I 2084)