A BUSCA PELA ESCRITA ATRAVÉS DA ESCOLA: ESTRATÉGIA INTERÉTNICA E TRANSFORMAÇÃO SOCIAL ENTRE OS YANOMAMI DE MATURACÁ/AM

Este artigo analisa alguns pontos da situação de escolarização de um subgrupo Yanomami que atualmente vive às margens do canal de Maturacá, no noroeste da Amazônia, junto à fronteira com a Venezuela. Através de um panorama da relação mantida entre estes Yanomami e a missão católica salesiana, vemos o sentido “destruidor” do contato existe, mas é melhor compreendido através das ideias de “transformação social” e “estratégia interétnica”, uma vez que o processo de contato é também caracterizado por uma busca mútua (ainda que assimétrica) de acomodação e de entendimento comum entre as partes

A BUSCA PELA ESCRITA ATRAVÉS DA ESCOLA: ESTRATÉGIA INTERÉTNICA E TRANSFORMAÇÃO SOCIAL ENTRE OS YANOMAMI DE MATURACÁ/AM

Este artigo analisa alguns pontos da situação de escolarização de um subgrupo Yanomami que atualmente vive às margens do canal de Maturacá, no noroeste da Amazônia, junto à fronteira com a Venezuela. Através de um panorama da relação mantida entre estes Yanomami e a missão católica salesiana, vemos o sentido “destruidor” do contato existe, mas é melhor compreendido através das ideias de “transformação social” e “estratégia interétnica”, uma vez que o processo de contato é também caracterizado por uma busca mútua (ainda que assimétrica) de acomodação e de entendimento comum entre as partes

Filhos da imigração : sobre a segunda geração de imigrantes brasileiros nos EUA

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Sociais, Programa de Pós-Graduação em Antropologia Social, 2002.Neste trabalho, procuro examinar os processos de socialização e as dinâmicas de construção de identidades dos filhos dos imigrantes brasileiros habitantes da cidade de Danbury, em Connecticut, no nordeste dos Estados Unidos. Observo e procuro demonstrar as diferentes influencias que os jovens da segunda geração recebem dentro e fora do grupo domestico, isto e, quando em casa, com seus familiares brasileiros ou quando fora dela, na escola ou entre os amigos. Empenho-me em analisar os dilemas identitarios desses jovens, em destacar a maneira pela qual eles percebem a si mesmos e aos seus pais, assim como em apreender a sua concepção sobre o Brasil e sobre os Estados Unidos. A pesquisa de campo na qual se baseia este estudo foi realizada em Danbury, entre os meses de janeiro e marco 2000 e os meses de setembro e novembro de 2001. Em Danbury, procurei aprender mais sobre os brasileiros que ali vivem, visitando-os em suas casas, trabalhos, nas escolas e nas igrejas, e assim realizando entrevistas, aplicando questionários e tomando parte em longas conversas. As visitas ao Centro de Recepção ISL - Inglês como Segunda Língua - (onde os alunos estrangeiros sem proficiência em inglês sao testados e matriculados) foram muitas e de grande importância. Durante dois meses, uma vez por semana, trabalhei como voluntario neste centro, organizando arquivos e atuando como interprete para brasileiros recém-chegados. Jornais e periódicos da comunidade brasileira nos EUA, impressos e on-line, também foram fontes de preciosas informações para essa pesquisa

A busca pela escrita através da escola : estratégia interétnica e transformação social entre os Yanomami de Maturacá/AM

Este artigo analisa alguns pontos da situação de escolarização de um subgrupo Yanomami que atualmente vive às margens do canal de Maturacá, no noroeste da Amazônia, junto à fronteira com a Venezuela. Através de um panorama da relação mantida entre estes Yanomami e a missão católica salesiana, vemos o sentido “destruidor” do contato existe, mas é melhor compreendido através das ideias de “transformação social” e “estratégia interétnica”, uma vez que o processo de contato é também caracterizado por uma busca mútua (ainda que assimétrica) de acomodação e de entendimento comum entre as partes

Yanomami na encruzilhada da conquista : contato e transformação na fronteira amazônia

Tese (doutorado)—Universidade de Brasília, Instituto de Ciências Sociais, Departamento de Antropologia, 2010.Esta tese descreve e analisa alguns pontos na trajetória de um subgrupo Yanomami que atualmente vive às margens do canal de Maturacá, no noroeste da Amazônia. Nessa localidade, a presença por cinco décadas de uma missão católica e, mais recentemente, de posto da FUNAI, pelotão de fronteira do Exército e posto de saúde, acrescida do acirramento nas relações com o município de São Gabriel da Cachoeira, desencadeou uma série de transformações na comunidade, que passou a lidar com distintos (e muitas vezes incompatíveis) sistemas simbólicos. Pretendo apresentar um panorama da relação mantida entre os Yanomami da região de Maturacá com os agentes externos, na perspectiva política das relações de poder entre minorias étnicas e movimentos coloniais. Para isso, faço um apanhado histórico que culmina no encontro do processo de expansão dos territórios Yanomami com aquele de colonização e domínio da Amazônia pela sociedade nacional. Nas investigações sobre o contato e os processos de transformação, equilibro exemplos etnográficos específicos com análises mais amplas sobre os discursos externos em relação aos Yanomami

Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial

BackgroundSparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis.MethodsPROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin–angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850.FindingsBetween Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (−42·8%, 95% CI −49·8 to −35·0, with sparsentan versus −4·4%, −15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals.InterpretationOver 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial

Background: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein-creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein-creatinine ratio was statistically significantly greater in the sparsentan group (-49·8%) than the irbesartan group (-15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51-0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial

Background Sparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis. Methods PROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin–angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850. Findings Between Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6–110) was −2·7 mL/min per 1·73 m2 per year versus −3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1–week 110) was −2·9 mL/min per 1·73 m2 per year versus −3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI −0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (−42·8%, 95% CI −49·8 to −35·0, with sparsentan versus −4·4%, −15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals. Interpretation Over 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function.</p