A REPRESENTAÇÃO INDÍGENA GUARANI EM LIVROS MEMORIALISTAS

RESUMO: As obras de autores memorialistas, pesquisadas neste trabalho, retratam o modo de vida guarani e os conflitos envolvendo disputas territoriais, entre o século XVIII e meados do século XX. Relatam experiências e buscam opinar sobre a relação entre indígenas e migrantes, como os próprios autores, que vieram para o sul do então Mato Grosso por motivos de trabalho e à procura de terras produtivas. A partir destas obras entende-se como conseguiram ocultar os indígenas da história regional e justificar seus juízos sobre essa população, considerando-a sem cultura e sem organização social. A pesquisa permite compreender o fenômeno da invisibilidade a que estão sujeitos, não somente os Guarani, mas os demais povos indígenas que habitam hoje o Estado do Mato Grosso do Sul.ABSTRACT: The works of authors memoir, researched this, depict the lifestyles Guarani and conflicts involving territorial disputes between the eighteenth and mid-twentieth century. They report experiences and seek their opinion about the relationship between indigenous people and migrants, as the authors themselves, who came to southern Ontario then on business and looking for productive land. From these works it is understood as the Indians managed to hide the regional history and justify their judgments about this population without considering the culture and without social organization. The research is to understand the phenomenon ofinvisibility to which they are subject, not only the Guarani, but the other indigenous peoples today the state of Mato Grosso do Sul

To integrate or not to integrate? Future considerations for chronic disease self-management programs in the health care system

Objective: The growing burden of chronic disease and the increasing realisation that the current health system is ill equipped to deal with this trend has resulted in a health policy shift away from the traditional medical model to a more patient centred approach. As such, chronic disease self-management programs (CDSMP) have emerged as a potentially important component within this approach. Policy and program trends at the international level highlight several critical factors that need to be considered by governments and health care providers alike if CDSMP are to be integrated within the broader health system. This study reviewed international and local policy literature and sought perspectives from key stakeholders to determine the value and potential for integrating a generic group-based CDSMP into the care continuum.Method: Prominent self-management policies were identified through a comprehensive literature search. Interviews were conducted with policy makers across Australia (n=20), health practitioners (n=20) and consumers (n=42) purposefully recruited from metropolitan and rural Victoria, representing key demographics of interest including low socioeconomic areas.Results: Whilst CDSMP were viewed as having significant potential to be integrated into the health sector it was identified that the delivery and content of CDSMP needs to be flexible in order to address the needs of people across the disease, age and care continuums. Critical issues to be addressed if CDSMP are to be successfully integrated include increasing the profile of self-management; actively engaging and training health practitioners in self-management and overcoming system barriers such as lack of integrated referral pathways and networks.Discussion: Policy directions at the national level suggest that self-management will be a centrepiece in forthcoming chronic disease initiatives. International evidence has highlighted the requirement for a &lsquo;suite&rsquo; of programs to adequately cater to different stages of the disease continuum, age groups, ethnic backgrounds and sociogeographical areas. Furthermore engagement with key stakeholders (particularly GPs) is identified as critical to ensure the successful integration of CDSMP into the health system.Conclusion: Evidence suggests that CDSMP is an important facet in improving care of people with chronic conditions. Findings from this study suggest that current infrastructure and policy direction, which have been found to be critical factors in facilitating integration of CDSMP into the health sector, are either absent or inadequate in Victoria. CDSMPs are currently lacking a sustainable workforce, referral infrastructure and specific policy. Such factors need to be addressed before the integration of CDSMP can be considered across the healthcare continuum in Victoria.<br /

Chronic disease self-management programs : perspectives on enablers and barriers to GP and patient engagement

Aims &amp; rationale/Objectives : Chronic disease self-management programs (CDSMP) are increasingly being integrated into the health system to improve the care of people with chronic conditions. Despite activity at both policy and program levels, GPs as the \u27gatekeepers\u27 to the health system have generally not been well informed or engaged in this process. This study, in collaboration with 3 Victorian Divisions of General Practice, sought both GP and patient perspectives on enablers and barriers to engagement in self-management programs.Methods : Interviews were conducted with GPs (n=20) and consumers (n=45) purposefully recruited from metropolitan and rural Victoria, representing key demographics of interest including low socioeconomic areas.Principal findings : Lack of education/information and uncertainty about the effectiveness of self-management programs were key barriers for both GP and patient engagement. Programs that were sustainable and utilised existing community resources were viewed as enablers to increase uptake. GP and patient preferences for disease specific or generic CDSMP differed.Discussion : Outcomes from the recent Council of Australian Governments\u27 meeting suggest that self-management will be a centerpiece in forthcoming chronic disease initiatives. International evidence has highlighted the need for GP and patient engagement as critical in ensuring the recruitment of a critical mass of individuals to participate in CDSMP to ensure the sustainability of such initiatives. Insight from this study indicates that GPs and patients are not well informed about self-management, have different preferences to current policy trends and identifies several other barriers which need to be addressed if CDSMP are to be successful.Implications : Identification of barriers and enablers of GP and patient engagement in self-management is essential in shaping current policy initiatives and delivery of future programs. This is supported by international evidence which indicates strongly that GP engagement in particular is crucial to the success of these programs.Presentation type : Paper <br /

Pilot implementation of ICoPE: An innovative model to support patients with glioma and their carers across key care transitions

The current study aims to conduct a pilot implementation and evaluation of an innovative model designed to support patients and their carers through transitions of care. The model involves the provision of Information, Coordination, Preparation and Emotional support (I-CoPE) over 3 key identified care transitions, for people newly diagnosed with primary malignant glioma (PMG) and their carers. I-CoPE is based on prior research conducted by our team which identified gaps in the early disease stages associated around times of care transition, when support was inadaquete. From these gaps in care, I-CoPE was defined which specifically aims to: 1) Provide remote monitoring and management for PMG patients who are likely to resort to acute hospital services for ongoing support; 2) Effectively institute a key care worker who can appropriately support the transition of the patient through acute hospital, ambulatory care and primary care settings; and 3) Focus and tailor support, information and education for patients’ carers to ensure they are able to engage in the primary health care process, enabling patients to remain in the community. The study will collect key patient/carer outcome and health service utilisation data to assess the effectiveness of this innovative model which targets care transitions. If successful, the model has important implications for broader implementation into other patient groups with end stage diseases who also have complex care needs. Indeed general practitioners in primary care settings face the difficult challenge of supporting complex care needs of palliative care patients and their families, often with minimal support and sometimes nil prior exposure to rare disease trajectories such as in the case of PMG. Having strategic and focused communication with a care transition manager throughout the patients' care process, including individualised patient screening results which identify unmet care needs, is likely to enhance primary care management.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Myocardial infarction and mortality following joint surgery in patients with rheumatoid arthritis: a retrospective cohort study

Summary of patient level comparing those with rheumatoid arthritis to those without rheumatoid arthritis. (DOCX 14 kb

Investigating well-being, work limitations and preferences for self-management education and peer support among younger people with hip and knee osteoarthritis: protocol for a cross-sectional study

Introduction:&nbsp;Osteoarthritis (OA) has traditionally&nbsp;been considered a condition of older age. However,&nbsp;younger people are also affected by hip and knee OA,&nbsp;often as a result of sporting and work-related injuries.&nbsp;As OA studies have generally focused on older&nbsp;individuals, little is known about the experience of&nbsp;younger adults with hip or knee OA who can face a&nbsp;distinct set of pressures including work responsibilities&nbsp;and parenting roles. This study aims to investigate&nbsp;well-being and work participation among younger&nbsp;people with hip or knee OA, as well as preferences for&nbsp;OA education and support.Methods and analysis: 200 people aged 20&ndash;55 years with a diagnosis of hip and/or knee OA will be&nbsp;recruited for this cross-sectional study. Participants will&nbsp;be recruited from three major public hospitals in the&nbsp;state of Victoria, Australia following screening of&nbsp;orthopaedic outpatient clinic lists and referrals, and&nbsp;through community-based advertisements. A study&nbsp;questionnaire will be mailed to all participants and&nbsp;written informed consent obtained. Validated measures&nbsp;of Health-Related Quality of Life (HRQoL), health status,&nbsp;psychological distress and work limitations will be used. Information on health services use will be collected,&nbsp;in addition to information on the perceived utility and&nbsp;accessibility of a range of existing and proposed&nbsp;education and peer support models. HRQoL data will be&nbsp;compared with Australian population norms using&nbsp;independent t tests, and associations between HRQoL,&nbsp;health status, psychological distress, work limitations&nbsp;and demographic factors will be evaluated using&nbsp;univariate and multivariate analyses. Data on the&nbsp;perceived utility and accessibility of education and peer&nbsp;support models will be analysed descriptively.&nbsp;Ethics and dissemination: Ethics approval for the&nbsp;study has been obtained. The study findings will be&nbsp;submitted to peer-reviewed journals and arthritis&nbsp;consumer organisations for broader dissemination, and&nbsp;presented at national and international scientific meetings.</div

Mountains and Food: Current Trends and Challenges in Europe’s Mountain Regions

1. The Context of this Special Issue This special issue originates in the (re)emergence of the food question in urban contexts in North America and Europe over the first two decades of the twenty-first century (Pothukuchi and Kaufman, 2000; Steel, 2009; Morgan, 2009; Perrin and Soulard, 2014; Brand, 2015; among others). Previously neglected as a planning issue, food has been put firmly back on the territorial agenda by urban movements and the issues raised by urbanisation (including sustainab..

Montagne et Alimentation : dynamiques et enjeux actuels dans les montagnes européennes

1. Le positionnement de ce numéro spécial Ce numéro spécial trouve son origine dans la (re)naissance de la question alimentaire dans les contextes urbains en Amérique du Nord et en Europe au cours des deux premières décennies du xxie siècle (Pothukuchi & Kaufman, 2000 ; Steel, 2009 ; Morgan, 2009 ; Perrin & Soulard, 2014 ; Brand, 2015 ; etc.). Oubliée des territoires en tant que problématique d’aménagement, l’alimentation est revenue à l’agenda de ceux-ci à partir de mouvements urbains et des..

Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) a framework for referral

Aims &amp; rationale/Objectives : The objective of the project was to specify the information required in referrals to public hospital orthopaedic outpatient departments in order to streamline the care and prioritisation of individuals who may require JRS. It was envisaged that an evidence-based GP-Orthopaedic derived referral system would assist in ensuring that the right person accessed the right care at the right time.Methods : In collaboration with the RACGP and the Commonwealth Department of Health and Ageing, a national stakeholder working group was convened. A scoping document was prepared with input from key stakeholders. A review of primary research was undertaken as well as a review of relevant guidelines. Information on the implementation and evaluation of similar programs in Australia and overseas also informed the referral specification.Principal findings : The initial scoping processes with key stakeholders provided clear information on core components of the referral. These were the use of standardised and respected assessment tools to determine the severity of arthritis, fitness for surgery and willingness of affected individuals to undergo surgery.Discussion : About 20,000 JRS occur each year in public hospitals which emanate from 5 to 10 fold number of referrals. Arthritis and musculoskeletal diseases are a national health priority area reflecting the high burden of disease associated with these conditions. Various initiatives are being undertaken to address the quality of life of affected individuals. This project has revealed areas of potential improvement in the communication between care providers of individuals who may need JRS.Implications : The project will result in the development of a standard referral form and guidelines to assist referring practitioners to communicate more effectively with the multidisciplinary care team, in particular orthopaedic care providers. The guidelines will be piloted in a large rural setting.<br /