Uma rapariga do liceu: o legado de um percurso

Do cruzamento da leitura de Telling Women´s Lives, de Linda Wagner-Martin, e de In a Differente Voice, de Carol Gilligan, surgiu a ideia de dar conta de um legado escolar deixado por uma aluna do Liceu de Évora, da década de 60. Destaca-se a vivência experiencial, ingénua, conservadora e trágica, que vai do reconhecimento da singularidade e da compreensão da realidade, à confrontação com a morte

O estoicismo no pensamento de Luísa Sigea: a diotomia entre vida pùblica e vida privada

O presente texto pretende analisar o modo como Sigea se posiciona em face da questão prática de viver na corte, tópico central do Colloquium (Dialogue de deux jeunes filles sur la vie de cour et la vie de retraite), publicado em Lisboa no ano de 1552. O texto desenvolve-se através da explicitação de alguns aspectos como os do humanismo renascentista português, para depois analisar o modo como Sigea interpreta a formação necessária para se alcançar a vida feliz (beata uita). This paper aims to examine Sigea’s position to the question of life at court, the central topic of the Colloquium (Dialogue between two young women on courtly and private life), published in 1552 in Lisbon. The development of the text starts with the explanation of some aspects such as the princes’ mirror (specula principum) and the palace circle of the Princess D. Maria, during the Portuguese Renaissance Humanism. Further on the text, it is analyzed how Sigea interprets the training needed to achieve happy life (beata uita)

A ferramenta que faz os contos

O texto faz uma leitura crítica do livro, inserindo-o na bibliografia portuguesa de Filosofia para Crianças

Diversity and acceptance: views of children and youngsters

Comunicação apresentada no ISEC2010 – Inclusive and Supportive Education Congress "Promoting Diversity and Inclusive Practice", 2-5 Agosto 2010, Queen’s University Belfast"Modern societies are becoming more heterogeneous, multiethnic, multicultural, and schools have to deal with an increasing number of children whose characteristics are distinct in a multiplicity of aspects. Reflecting then the social reality, the public school is challenged to answer with quality in order to promote the full potential of its population (Ainscow, 1997; Morgado, 2004; Rodrigues, 2006). Human history is full of examples of segregation and humiliation of individuals and groups whose characteristics did not fit the social patterns and rules. This mechanism of categorizing some as different and deviant, upon which many prejudices were built, are still present in contemporary societies, though in more subtle and covered ways than in the past (França & Monteiro, 2004; Vala & Lima, 2003). School is the ideal context to provide the opportunity to contact with diversity. Young people realize this and are aware of school meaning for social development. But when diversity comes in very salient features, how they see it and react to it? Inscribed in the field of inclusive education, this study focuses on children and youngsters’ perceptions of different aspects of diversity in people (e.g., skin colour, handicap, ethnicity, violent behaviour, social-economic status) on their experience of contact with individuals of the referred groups and on the way they see and conceive relationships with them. The theoretical framework puts into perspective various approaches concerning education and difference, the self and others perception, the interpersonal and group relationships, stereotypes and prejudice and also the strategies to promote positive attitudes towards others. A group of 85 children and youngsters (10, 13 and 16 year-olds) of Beja (Portugal) elementary and secondary schools were interviewed. The data analysis was centred not only on the qualitative aspects of the content but also submitted to statistical procedures. As supported by the literature, it was expected that age, gender and parents’ academic level (independent variables) would influence children’s and youngsters’ perceptions, therefore bringing to light distinct patterns of thought and behaviour. However, in this study, there was no statistic evidence of such differences. As a whole, the results show a group whose perceptions of others, who belong to usually stereotyped and discriminated social categories, are mainly positive and so are the relationships established or foreseen with members of those groups. If skin colour, handicap and social-economic status are consider by the great majority as not offering any problem to relationships, the same is not so unanimous regarding the gipsy ethnic group and here the prejudice is more evident, with many stating how difficult they find to relate with members of this group. In fact, when we look into the various studies, the gipsy ethnic group is the minority group most rejected by the Portuguese Society (Dias et al., 2006; Fonseca et al., 2005; Mendes, 2005). Therefore, this presentation will analyse some of the results and discuss the role of school to promote the acceptance of diversity.

The artistic activities in the curriculum of children with special educational needs

This study stresses the importance of artistic activities (visual arts, music, drama, movement and dance) for the educational process of children with special educational needs. Having as a reference the recent legislation and the context of the Educational Reform in Portugal, it aims to understand the meaning attributed to those activities in the curriculum of a group of children with special educational needs who were integrated in regular primary schools during 1993/94 in Beja. For this purpose the analysis focuses on their educational programmes and on the perspectives of their support teachers who were responsible for both the design and implement of those programmes. Even though one cannot generalize on the basis of such study, there are some reflections that can be raised about the educational proposals that are usually made for this group of children and how educational practice can improve through adequate models of teacher training

Progress in systemic therapy of advanced melanoma between 2011 and 2019

RESUMO: Contexto prévio: Há cerca de dez anos, os doentes diagnosticados com melanoma em estadio IV tinham um prognóstico reservado e uma sobrevivência muito curta. As terapêuticas então disponíveis, nomeadamente dacarbazina, temozolomida e outros citotóxicos, isoladamente ou em combinação com cirurgia e/ou radioterapia, não proporcionavam benefícios clínicos significativos. Na última década, a comunidade médica e científica testemunhou uma revolução no tratamento do melanoma em estadio IV com a introdução da imunoterapia, particularmente dos inibidores de checkpoint, e das terapêuticas alvo, nomeadamente dos inibidores da via da mitogen-activated protein cinase (MAPKi). Ambas as terapêuticas demonstraram benefícios sustentados em termos de sobrevivência global em doentes com melanoma metastizado. Nesta análise, pretendemos investigar se o aumento de sobrevivência global observado nos ensaios clínicos de fase II e III que levaram à aprovação destas terapêuticas, podem ou não ser reproduzidos em contexto de prática clínica diária. População incluída: Nesta análise retrospectiva, multicêntrica, incluímos doentes diagnosticados com melanoma estadio IV entre 2011 e 2018, e tratados no centro oncológico de Tuebingen, ou noutros centros da Alemanha, e documentados prospectivamente no Registo Central de Melanoma Maligno (CMMR) alemão. Os seguintes dados foram obtidos através do CMMR: ano de nascimento, sexo, data de diagnóstico do tumor primário, tipo histológico, localização anatómica, espessura, nível de clark, presença de ulceração, presença de regressão, data da biópsia do gânglio sentinela (se aplicável), presença de metástases no gânglio sentinela, estadio à data do primeiro diagnóstico, e data e localização da recidiva. Outros dados foram posteriormente recolhidos através da consulta do processo clínico: tipo de terapêutica local e sistémica em estadio IV e respectivas datas de início e fim, melhor resposta à terapêutica e respectiva data, de acordo com os critérios RECIST 1.1, data de progressão da doença, data do último contacto, e causa e data da morte. Todos os doentes incluídos foram seguidos durante, pelo menos, três meses. Análise estatística: A sobrevivência livre de progressão (PFS) foi definida como o tempo entre a data de diagnóstico em estadio IV, data de início da terapia sistémica, ou data do diagnóstico de metástases cerebrais, dependendo do tipo de população avaliada, e data de progressão da doença, data do último contacto ou data de óbito no caso dos doentes que não tiveram progressão. A sobrevivência global (OS) foi definida como o tempo entre a data do diagnóstico em estadio IV, data de início da terapia sistémica, ou data do diagnóstico de metástases cerebrais, dependendo do tipo de população avaliada, e data do último contacto ou data de óbito. Usámos estimativas de Kaplan-Meier para o cálculo da PFS e OS. As diferenças entre grupos foram avaliadas utilizando o teste de log-rank. Quando aplicável, foram calculados hazard ratios (HR) com intervalos de confiança de 95% (95% IC) para quantificar o impacto na sobrevivência. Quando aplicável, foram também utilizados modelos de regressão logística multivariada para avaliar associações entre variáveis. As associações entre variáveis foram consideradas estatisticamente significativas para valores de p < 0.05. Para a comparação indirecta entre os MAPKi, foi usado o método de Bucher. Todas as análises foram submetidas e aprovadas pelas Comissões de Ética locais. Resultados: Seis publicações incluindo dados de 3143 doentes diagnosticados com melanoma em estadio IV foram compiladas para a elaboração da presente tese. A taxa de OS aos 3 anos (3-y OS rate) para doentes tratados com quimioterapia em primeira linha, a terapêutica sistémica mais utilizada em 2011-2014 foi de 15.9% (95% CI: 8.8-23); para doentes tratados com imunoterapia em primeira linha no mesmo período, a 3- y OS rate foi de 37.4% (95% CI: 16.6-58.2). No período entre 2015-2018, a 3-y OS rate para doentes tratados com imunoterapia em primeira linha, quase que duplicou em comparação com o período de 2011-2014, e foi de 64.6% (95% CI: 53.2-76) para doentes com resposta completa, resposta parcial ou doença estável. Para doentes com resposta completa, a 3-y OS rate foi de 87.7% (95%CI: 70.8-100). Em doentes com mutação BRAFV600 e presença de factores de pior prognóstico, nomeadamente valores elevados de LDH à data de início de tratamento, ECOG PS reduzido e maior volume tumoral, a combinação vemurafenib/cobimetinib demostrou uma redução não significativa do risco de progressão ou morte em comparação com dabrafenib/trametinib, e encorafenib/binimetinib. Em comparação com o melanoma cutâneo, os doentes com melanoma ocular beneficiaram menos da terapia sistémica, mesmo quando tratados com nivolumab/ipilimumab. A sobrevivência global média (mOS) foi de apenas 16.1 meses (95% CI: 12.9-19.3), ainda assim mais elevada do que a reportada em doentes tratados com quimioterapia ou monoterapia com anti-PD-1. Em termos de sobrevivência global, o benefício da imunoterapia e das terapêuticas alvo na doença intracerebral foi semelhante ao observado na doença extracerebral. Isto foi particularmente verdade em doentes tratados com nivolumab/ipilimumab. A mOS foi de 19 meses (95% CI: 15.9-22.0) e a 3-y OS rate foi de 30.1% (95% CI: 22.2-37.9) Para os doentes com resposta completa, a 2-y OS rate foi de 85.6% (95% CI: 69.3-100), muito semelhante às taxas de sobrevivência observadas em outros doentes em estadio IV, sem metastização cerebral. Os doentes que receberam nivolumab/ipilimumab e terapêutica local (radiocirugia ou cirurgia) beneficiaram mais em comparação com os doentes que não receberam terapêutica local - a 2-y OS rate foi de 49.5% versus 40.9% (95% CI: 40.9-58.1 e 26.6-55.2). Este benefício foi observado independentemente do timing em que os doentes receberam terapêutica local, i.e., antes ou depois de iniciar nivolumab/ipilimumab. Conclusões: Os nossos dados da prática clínica diária confirmam uma melhoria em termos de sobrevivência global em doentes com melanoma em estadio IV, diagnosticados e tratados entre 2011-2019. Estes benefícios deveram-se à introdução de novas opções terapêuticas, nomeadamente imunoterapia com inibidores de checkpoint e terapêuticas alvo com MAKi. Os nossos resultados mostraram que actualmente, a imunoterapia com inibidores de checkpoint, deve ser oferecida em primeira linha em todos os doentes com melanoma em estadio IV. Em doentes com mutação BRAFV600 e com presença de factores de pior prognóstico, terapêutica com MAPKi pode igualmente ser considerada em primeira linha metastática. Em doentes com metastização cerebral, a combinação de terapia sistémica e local deve ser discutida e ponderada, em primeira linha ou posteriormente, sempre que viável.ABSTRACT: Background: Ten years ago, stage IV melanoma carried a dismal prognosis, with very short survival. The therapies available then, namely dacarbazine, temozolomide, and other chemotherapies, alone or in combination with surgery and/or radiotherapy, were unable to provide clinically significant benefit. In the last decade, the medical community testified a revolution in the treatment of advanced melanoma with the introduction of immune checkpoint inhibitors, and targeted therapy with mitogen-activated protein kinase inhibitors (MAPKi). Both therapies were able to provide sustainable overall survival benefits in stage IV melanoma. Here, we aimed to investigate whether the survival advantages seen in phase II, and III clinical trials investigating the afore mentioned therapies, were reproducible or not in a real-world setting. Patients and methods: In this retrospective, multicentric analysis, we included stage IV melanoma patients, diagnosed between 2011 and 2018, treated in the skin cancer center in Tuebingen, or in other German centers, and prospectively documented in the German Central Malignant Melanoma Registry (CMMR). The following patients’ and tumor data were collected from the CMMR: year of birth, gender, date of primary tumor diagnosis, type of melanoma, localization, tumor thickness, Clark level, presence of ulceration, presence of regression, date of sentinel lymph node biopsy (if applicable), presence of lymph node metastases, stage at first diagnosis and date and localization of recurrence. The following variables were further included, based on patients’ clinical chart review: date and type of local and systemic therapy in stage IV, date and type of best overall response, according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), date of progressive disease, date of last contact, cause of death, and death date. Patients included had a minimum follow-up of three months. Progression free survival (PFS) was defined as the time between date of stage IV diagnosis, start date of systemic therapy, or date of melanoma brain metastases (MBM) diagnosis, depending on the type of population evaluated, and date of progressive disease, or last contact or death, for the patients that didn’t progress. Overall survival (OS) was defined as the time between stage IV diagnosis, start date of systemic therapy, or date of MBM diagnosis, depending on the type of population evaluated, and date of last contact or death. Kaplan-Meier estimates were used for the calculation of PFS and OS. Differences between groups were assessed using the log-rank test. When applicable, hazard ratios (HR) with 95% confidence intervals (CI) were calculated to quantify the impact on survival. Multivariate logistic regression models were used to examine associations between variables, when appropriate. Results were reported as two-sided p values with 95% CIs. All p-values presented are two-sided tests of statistical significance at 0.05. For the indirect comparison between MAPKi, the Bucher method was used. All analyses were submitted to and approved by the local Ethics Committee. Results: Six publications reporting data from 3143 stage IV melanoma patients were included in this thesis. The 3-years (3-y) OS rate for patients treated with first-line chemotherapy, the most used systemic therapy in 2011-2014 was 15.9% (95% CI: 8.8-23). For patients treated with first-line immunotherapy in the same period, the 3-y OS rate was 37.4% (95% CI: 16.6-58.2). In the period of 2015-2018, the 3-y OS rate for patients treated with first-line immunotherapy almost duplicated compared to the 2011-2014 period, and was 64.6% (95% CI: 53.2–76) for patients achieving a complete response (CR), partial response (PR) or stable disease (SD). For patients achieving a CR, the 3-y OS rate was 87.7% (95% CI: 70.8–100). In patients harboring a BRAFV600 mutation, and with presence of worse prognostic factors, namely elevated baseline lactate dehydrogenase (LDH), worse Eastern Cooperative Oncology Group Performance Status (ECOG PS) and higher tumor volume, the combination of vemurafenib plus cobimetinib showed a non-significant lower risk for progression or death, compared to dabrafenib plus trametinib, and encorafenib plus binimetinib. Compared to cutaneous melanoma, patients with uveal melanoma derived less benefit from systemic therapy, even when treated with combined immunotherapy. The median OS (mOS) was only 16.1 months (95% CI: 12.9–19.3), but still higher than those reported for both chemotherapy and programmed cell death protein 1 (PD-1) monotherapy in this sub-group. The benefit observed in intracerebral disease was similar to the benefit in extracerebral disease, when combined immunotherapy (nivolumab plus ipilimumab) was used. The mOS in patients with MBM was 19 months (95% CI: 15.9-22.0). For the whole collective of patients receiving nivolumab plus ipilimumab, the 3-y OS rate was 30.1% (95% CI: 22.2-37.9). For patients achieving a CR, the 2-y OS rate was 85.6% (95%CI: 69.3-100), very similar to other stage IV patients. Patients receiving combined immunotherapy and local therapy (surgery or stereotactic radiotherapy) had a better outcome when compared to patients that didn’t receive local therapy – the 2-y OS rate was 49.5% versus 40.9 % (95%CI: 40.9-58.1 and 26.6-55.2). This benefit was observed regardless the timing of local therapy, i.e., before or after starting nivolumab plus ipilimumab. Conclusions: Our real-world data confirmed the improvement of survival outcomes in stage IV melanoma patients with the introduction of immune checkpoint inhibitors, and MAPKi in the last decade. Results show that, currently, PD-1 based immunotherapy should be offered as first-line therapy in stage IV melanoma. In patients with BRAFV600 mutation and worse prognostic features, first-line systemic therapy with MAPKi could be considered. In patients with MBM, combination of systemic immunotherapy and local therapy should be offered, when feasible

Looking for a break in Spanish Inflation Data in the early eighties and assessing persistence

Using the Bai-Perron test, we look for a shift in the conditional mean of an AR representation of Spanish CPI inflation over the period: 1978-2006. It is clear that Spain, as most OECD economies, experienced an inflation slowdown in the early eithgties, which can be related to some policy measures undertook by the government coming out of the 1982 elections. It is shown, that when the break is accounted for, there are no signs of persistence in Spanish CPI inflation.inflation persistence; structural breaks; monetary policy

Who is the one I find different from me?

Comunicação apresentada no Congresso internacional "Inclusive and Supportive Education", na Universidade de Strathclyde (Glasgow), em Agosto de 2005.Difference and Diversity are concepts upon which inclusive school development should be rooted. However, when one talks about difference, the meaning attributed to that concept assumes a great spectrum of possible explanations, certainly based on individual experience and one’s framework of analysis, expressed through a particular world view. The main goal of this research project is to understand how school children and youngsters conceive difference, in other words, what kind of characteristics are stressed when they describe someone they find much different from them and what kind of relationships they think possible to establish with that person. The population was chosen among children and youngsters of all the public schools of Beja (Portugal), constituting three age groups of 9, 12 and 15 years old. In this research we used the written narrative as a method of analysis. What is proposed in this paper is to discuss some of the preliminary results and reflect upon some questions raised, which may bring a different perspective on inclusive education

Creativity in pre-school teachers’ education

«When addressing the issue of creativity in pre-school education it is of utmost importance to consider the role of the professionals and their own education. Studies on the lives of many creative people in different areas of expression point out that school (even high school) had little effect on their creative potential and in many cases the academic failure was evident (e.g., Einstein, Picasso) (Csikszentmihalyi, 1996). This raises the question of the possibility to educate for creativity at the formal systems of education and represent a challenge for those dedicated to teachers’ training.(...)» Retirado da introduçã