RESUMEN
O processo de escolarização brasileiro, alicerçado pelo prisma da modernidade, fortaleceu no cotidiano escolar a predominância de práticas pedagógicas homogêneas e monoculturais que não dialogam com a diversidade cultural presente na escola. Argumentamos que esse cenário traz implicações para o processo educativo e para a formação do sujeito, além de provocar tensões ou conformidade diante da (in)adequação frente à cultura dominante. Diante disso, o presente artigo analisa as interseções entre cultura, escola e práticas corporais desenvolvidas na Amazônia para a valorização dos sujeitos e significação do processo de aprendizagens à luz da interculturalidade crítica e da educação física cultural. O diálogo com o campo teórico opõe-se aos modelos vigentes de pensar e construir a educação e tensiona em favor do reconhecimento dos diferentes conhecimentos, da valorização e do respeito à diversidade de sujeitos e culturas para a construção de uma sociedade mais democrática, plural e humana. (AU)
The Brazilian schooling process, based on the prism of modernity, has strengthened in everyday schools the predominance of homogeneous and monocultural pedagogical practices that do not dialogue with the cultural diversity present in schools. It is argued that this scenario has implications for the educational process and the formation of the subject, besides causing tensions or conformity in the face of (in)adequacy to the dominant culture. Therefore, this article analyzes the intersections between culture, school and body practices developed in the Amazon towards the valorization of subjects and the significance of the learning process in the light of critical interculturality and cultural physical education. The dialogue with the theoretical field opposes the current models of thinking and building education and tenses in favor of recognizing different knowledge, valuing and respecting the diversity of subjects and cultures for the construction of a more democratic, plural and human society. (AU)
El proceso de escolarización brasileño, basado en el prisma de la modernidad, fortaleció en el cotidiano escolar el predominio de prácticas pedagógicas homogéneas y monoculturales que no dialogan con la diversidad cultural presente en la escuela. Se argumenta que este escenario tiene implicaciones para el proceso educativo y para la formación del sujeto, además de provocar tensiones o conformismo delante de la (in)adecuación frente a la cultura dominante. Por lo tanto, este artículo analiza las intersecciones entre cultura, escuela y prácticas corporales desarrolladas en la Amazonía para la apreciación de los sujetos y el sentido del proceso de aprendizaje a la luz de la interculturalidad crítica y la educación física cultural. El diálogo con el campo teórico se contrapone a los modelos vigentes de pensar y construir la educación y se incide a favor del reconocimiento de los saberes diferentes, la valoración y el respeto a la diversidad de sujetos y culturas para la construcción de una sociedad más democrática, plural y humana. (AU)
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Humanos , Masculino , FemeninoRESUMEN
Importance: Most of the global morbidity and mortality in chronic obstructive pulmonary disease (COPD) occurs in low- and middle-income countries (LMICs), with significant economic effects. Objective: To assess the discriminative accuracy of 3 instruments using questionnaires and peak expiratory flow (PEF) to screen for COPD in 3 LMIC settings. Design, Setting, and Participants: A cross-sectional analysis of discriminative accuracy, conducted between January 2018 and March 2020 in semiurban Bhaktapur, Nepal; urban Lima, Peru; and rural Nakaseke, Uganda, using a random age- and sex-stratified sample of the population 40 years or older. Exposures: Three screening tools, the COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE; range, 0-6; high risk indicated by a score of 5 or more or score 2-5 with low PEF [<250 L/min for females and <350 L/min for males]), the COPD in LMICs Assessment questionnaire (COLA-6; range, 0-5; high risk indicated by a score of 4 or more), and the Lung Function Questionnaire (LFQ; range, 0-25; high risk indicated by a score of 18 or less) were assessed against a reference standard diagnosis of COPD using quality-assured postbronchodilator spirometry. CAPTURE and COLA-6 include a measure of PEF. Main Outcomes and Measures: The primary outcome was discriminative accuracy of the tools in identifying COPD as measured by area under receiver operating characteristic curves (AUCs) with 95% CIs. Secondary outcomes included sensitivity, specificity, positive predictive value, and negative predictive value. Results: Among 10â¯709 adults who consented to participate in the study (mean age, 56.3 years (SD, 11.7); 50% female), 35% had ever smoked, and 30% were currently exposed to biomass smoke. The unweighted prevalence of COPD at the 3 sites was 18.2% (642/3534 participants) in Nepal, 2.7% (97/3550) in Peru, and 7.4% (264/3580) in Uganda. Among 1000 COPD cases, 49.3% had clinically important disease (Global Initiative for Chronic Obstructive Lung Disease classification B-D), 16.4% had severe or very severe airflow obstruction (forced expiratory volume in 1 second <50% predicted), and 95.3% of cases were previously undiagnosed. The AUC for the screening instruments ranged from 0.717 (95% CI, 0.677-0.774) for LFQ in Peru to 0.791 (95% CI, 0.770-0.809) for COLA-6 in Nepal. The sensitivity ranged from 34.8% (95% CI, 25.3%-45.2%) for COLA-6 in Nepal to 64.2% (95% CI, 60.3%-67.9%) for CAPTURE in Nepal. The mean time to administer the instruments was 7.6 minutes (SD 1.11), and data completeness was 99.5%. Conclusions and Relevance: This study demonstrated that screening instruments for COPD were feasible to administer in 3 low- and middle-income settings. Further research is needed to assess instrument performance in other low- and middle-income settings and to determine whether implementation is associated with improved clinical outcomes.
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Países en Desarrollo , Ápice del Flujo Espiratorio , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Encuestas y Cuestionarios , Adulto , Obstrucción de las Vías Aéreas/epidemiología , Estudios Transversales , Estudios de Factibilidad , Femenino , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Nepal/epidemiología , Perú/epidemiología , Valor Predictivo de las Pruebas , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/clasificación , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Curva ROC , Estándares de Referencia , Sensibilidad y Especificidad , Fumar/epidemiología , Espirometría/métodos , Contaminación por Humo de Tabaco/estadística & datos numéricos , Uganda/epidemiologíaRESUMEN
Existem na Comunidade do Catu saberes, vivências e práticas culturais tradicionais que resistem e são ressignificadas pelos povos potiguaras do lugar. O estudo objetiva mapear as práticas corporais para perceber os saberes que as significam como identidade da Comunidade dos Indígenas do Catu. Usa o referencial dos estudos culturais e da abordagem etnográfica e adota o diário de campo e a iconografia que resultam no desenho prático-teórico da organização dos Catu. Conclui sobre a necessidade educativa de se assumir a co-responsabilidade diante do desafio de construir novos caminhos para a Educação Indígena Potiguar.
The Catu Community has traditional cultural knowledge, experiences and practices that resist and are re-signified by the local people. The study aims to map corporal practices to perceive the knowledge that signifies them as the identity of the Catu Indigenous Community. It uses cultural studies as a reference and the ethnographic approach. It adopts the field diary and iconography that result in the practical-theoretical design of the organization of the Catu Community. It concludes there's the educational need to assume co-responsibility in the face of the challenge of creating new paths for the Potiguar Indigenous Education.
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Características Culturales , Educación , Cultura Indígena , Pueblos IndígenasRESUMEN
Estradiol (17ß-estradiol, E2) is a crucial estrogen hormone that regulates sexual, cognitive, social and affective behaviors in various species. However, complex central nervous system (CNS) effects of E2, including its activity in males, remain poorly understood. The zebrafish (Danio rerio) is rapidly becoming a powerful novel model system in translational neuroscience research. Here, we evaluate the effects of a single 24-h exposure to 20 µg/L of E2 on behavioral and endocrine (cortisol) responses in adult male zebrafish. Overall, E2 exerted pro-social effect in the social preference test, reduced whole-body cortisol levels, elevated exploration in the novel tank test and increased the shoal size in the shoaling test, indicative of an anxiolytic-like profile of this hormone in male zebrafish. Supporting mounting human and rodent evidence on the role of E2 in behavioral regulation, the observed pro-social and anxiolytic-like effects of E2 in male zebrafish reinforce the use of this aquatic organism in studying steroid-mediated CNS mechanisms of complex affective and social behaviors.
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Ansiolíticos/farmacología , Conducta Animal/efectos de los fármacos , Sistema Endocrino/efectos de los fármacos , Estradiol/farmacología , Animales , Masculino , Actividad Motora/efectos de los fármacos , Conducta Social , Factores de Tiempo , Pez CebraRESUMEN
Zebrafish anxiety-like behavior was assessed in the novel tank test after the formation of dominant-subordinate hierarchies. Ten pairs of animals were subjected to dyadic interactions for 5 days, and compared with control animals. After this period, a clear dominance hierarchy was established across all dyads, irrespective of sex. Social status affected parameters of anxiety-like behavior in the novel tank test, with subordinate males and females displaying more bottom-dwelling, absolute turn angle, and freezing than dominant animals and controls. The results suggest that subordinate male and female zebrafish show higher anxiety-like behavior, which together with previous literature suggests that subordination stress is conserved across vertebrates.
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Este é um diagnóstico dos agentes culturais do esporte e do lazer na Rede Cedes-PA no Município de Belém. Faz mapeamento dos sujeitos, projetos e atividades desenvolvidas para instalar uma política de formação, acompanhamento e assessoramento. Objetiva reconhecer a organização e funcionamento do esporte e lazer desenvolvidos em projetos sócios educacionais coordenados por agentes culturais ou órgãos públicos. A pesquisa do tipo ação com abordagem quanti-qualitativa, aplica o questionário como instrumento de coleta de dados e analisa os dados coletados com o parâmetro das políticas públicas para o esporte e para o lazer e o referencial teórico da área. Conclui que o trabalho orgânico e coletivo entre pesquisadores da área e agentes culturais resiste às intempéries da conjuntura político-econômica e se materializa com a auto-organização e propósito comum entre esses sujeitos e a população.
This is a diagnosis of the cultural agents of sports and leisure in the Cedes-PA Network in the city of Belém.Makes mapping the subjects, projects and activities developed to implement the policy of training, follow-up and counseling. It aims to recognize the organization and functioning of sports and leisure developed in socio-educational projects coordinated by cultural agents or public agencies. Actiontype research with quantitative-qualitative approach applies the questionnaire as a data collection instrument and analyzes the data collected with the parameter of public policies for sports and leisure and the theoretical reference of the area. It concludes that the organic and collective work between researchers of the area and cultural agents resists the intemperies of the political-economic conjuncture and materializes with the self-organization and common purpose between these subjects and the population.
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Actividades RecreativasRESUMEN
Experimental animal models are a valuable tool to study the neurobiology of emotional behavior and mechanisms underlying human affective disorders. Mounting evidence suggests that various aquatic organisms, including both vertebrate (e.g., zebrafish) and invertebrate (e.g., crayfish) species, may be relevant to study animal emotional response and its deficits. Ideally, model organisms of disease should possess considerable genetic and physiological homology to mammals, display robust behavioral and physiological responses to stress, and should be sensitive to a wide range of drugs known to modulate stress and affective behaviors. Here, we summarize recent findings in the field of zebrafish- and crayfish-based tests of stress, anxiety, aggressiveness and social preference, and discuss further perspectives of using these novel model organisms in translational biological psychiatry. Outlining the remaining questions in this field, we also emphasize the need in further development and a wider use of crayfish and zebrafish models to study the pathogenesis of affective disorders.
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Astacoidea/fisiología , Conducta Animal/fisiología , Emociones/fisiología , Pez Cebra/fisiología , Agresión/psicología , Animales , Ansiedad/psicologíaRESUMEN
RESUMO O objetivo do presente texto é analisar a formação de professores, especialmente no campo da educação física. Problematiza o ordenamento legal para a formação de professores, que envida organização normativa para a formação em Educação Física. Metodologicamente realiza pesquisa bibliográfica e adota o método crítico-dialético para compreender a concepção de formação em Educação Física, frente às normativas curriculares, que orientam as agências formadoras no Brasil. Conclui que o ordenamento legal obstaculiza a formação ampla e única em educação física, pela separação entre os cursos, pela geração de um habitus produtivus, que busca a submissão do trabalho docente à lógica do capital, e o descompromisso com a profissionalidade docente.
ABSTRACT The aim of this paper is to analyze the training of teachers, especially in the field of physical education. It problematizes the legal ordering for the formation of teachers, which sends normative organization for the formation in Physical Education. Methodologically it conducts bibliographic research and adopts the critical-dialectical method to understand the conception of formation in Physical Education, in face of the curricular norms, that guide the formation agencies in Brazil. It concludes that the legal system hinders the broad and unique formation in physical education, by the separation between the courses, by the generation of a productive habitus, which seeks the submission of the teaching work to the logic of capital, and the lack of commitment to the teaching professionalism.
RESUMEN El objetivo de este trabajo es analizar la formación del profesorado, especialmente en el campo de la educación física. Problematiza el ordenamiento legal para la formación del profesorado, que envía una organización normativa para la formación en Educación Física. Metodológicamente realiza investigaciones bibliográficas y adopta el método crítico-dialéctico para comprender la concepción de la formación en Educación Física, frente a las normas curriculares, que guían a las agencias de formación en Brasil. Concluye que el sistema legal dificulta la formación amplia y única en educación física, por la separación entre los cursos, por la generación de un habitus productivo, que busca la sumisión del trabajo docente a la lógica del capital, y la falta de compromiso a la profesionalidad docente.
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INTRODUCTION AND AIM: The association between lysosomal acid lipase (LAL) activity and liver steatosis or fibrosis is poorly studied. The aim of our study was to determine the predictive power of LAL for cryptogenic liver steatosis and cryptogenic significant fibrosis/cirrhosis. MATERIAL AND METHODS: Cross-sectional observational study of 101 adult patients with unexplained elevated liver enzymes/hepatomegaly with or without dyslipidemia submitted to the determination of LAL activity and LIPA gene (E8SJM-C.894G^A) mutation. Seventy-one patients underwent liver biopsy or FibroScan®. Patients with an identifiable liver dysfunction cause and well-stablished NAFLD/NASH risk factors were excluded. Predictors for liver steatosis, significant fibrosis (> F2) or cirrhosis (F4) were evaluated. RESULTS: Liver steatosis and fibrosis were mainly assessed by liver biopsy (74.6%; n = 53). Steatosis was present in 62.0% (n = 44), significant fibrosis in 47.9% (n = 34) and cirrhosis in 39.4% (n = 28). The median LAL was 0.36 (0.21-0.46)nmol/spot/h (vs. 0.29 (0.20-0.47); p = 0.558) for liver steatosis, 0.22 (0.11-0.29) nmol/spot/h (vs. 0.40 (0.34-0.51); p <0.001) for significant fibrosis and 0.21 (0.11-0.27) nmol/spot/h (vs. 0.40 (0.32-0.52); p < 0.001) for cirrhosis. No LIPA gene mutations were found. LAL activity was the strongest predictor of significant fibrosis (AUROC: 0.833; p < 0.001) with a cut-off of 0.265 (sensitivity: 85.9%; specificity: 75.0%) and cirrhosis (AUROC: 0.859; p < 0.001) with a cut-off of 0.235 (sensitivity: 86.2%; specificity: 75.0%), being higher than FIB4, GUCI or APRI. However, LAL activity was not associated with liver steatosis (AUROC: 0.536; p =0.558). CONCLUSION: LAL activity can be considered a non-invasive new marker of cryptogenic liver fibrosis with higher accuracy than other known biomarkers. LAL activity < 0.265 nmol/spot/h was strongly associated with cryptogenic significant fibrosis and <0.235 nmol/spot/h with cryptogenic cirrhosis. LAL activity was not associated with cryptogenic liver steatosis.
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Cirrosis Hepática/congénito , Cirrosis Hepática/enzimología , Hígado/diagnóstico por imagen , Esterol Esterasa/sangre , Biomarcadores/sangre , Biopsia , Estudios Transversales , Diagnóstico por Imagen de Elasticidad , Femenino , Estudios de Seguimiento , Humanos , Cirrosis Hepática/diagnóstico , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de RiesgoRESUMEN
In guppies (Poecilia reticulata), a small number of individuals break away from a shoal and approach a potential predator, a behavior termed "predator inspection". These animals often employ a "conditional approach" strategy, in which an individual approaches the predator in the first move and subsequently approaches it only if a second individual swims even with it during inspection. This strategy is analogous to the "tit-for-tat" strategy of the Prisoner's Dilemma, suggesting that it could be used to study cooperation. Serotonin is thought to mediate cooperative behavior in other fish species. Exposure to the animated image of a predator in a tank that contained a parallel mirror - mimicking an equally cooperating conspecific - promoted inspection and decreased refuge use, but increased freezing, suggesting that conditional approach is also associated with fear. To understand whether serotonin participates in conditional approach in guppies, we treated animals with either vehicle (Cortland's salt solution), fluoxetine (2.5 mg/kg) or metergoline (1 mg/kg), and tested then in a predator inspection paradigm. Fluoxetine increased the time the animal spent inspecting the predator image, while metergoline decreased it. Fluoxetine also decreased time spent avoiding the predator and increased freezing, while metergoline decreased freezing. These results suggest that phasic increases in serotonin levels promote conditional approach, suggesting a role for this neurotransmitter in cooperation. Preprint: https://doi.org/10.1101/436345; Data and scripts: https://github.com/lanec-unifesspa/TFT.
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Conducta de Elección/fisiología , Conducta Cooperativa , Serotonina/metabolismo , Animales , Conducta Animal/efectos de los fármacos , Conducta Animal/fisiología , Fluoxetina/farmacología , Masculino , Metergolina/farmacología , Poecilia , Conducta Predatoria , Serotonina/fisiología , NataciónRESUMEN
The monoamines serotonin and dopamine are important neuromodulators present in the central nervous system, known to be active regulators of social behaviour in fish as in other vertebrates. Our aim was to investigate the region-specific brain monoaminergic differences arising when individual cleaners face a client (mutualistic context) compared to when they are introduced to another conspecific (conspecific context), and to understand the relevance of visual assessment compared to the impact of physical contact with any partner. We demonstrated that serotoninergic activity at the diencephalon responds mostly to the absence of physical contact with clients whereas cerebellar dopaminergic activity responds to actual cleaning engagement. We provide first insights on the brain's monoaminergic (region-specific) response variations, involved in the expression of cleaner fishes' mutualistic and conspecific behaviour. These results contribute to a better understanding of the monoaminergic activity in accordance to different socio-behavioural contexts.
RESUMEN
Social interactions are commonly found among fish as in mammals and birds. While most animals interact socially with conspecifics some however are also frequently and repeatedly observed to interact with other species (i.e. mutualistic interactions). This is the case of the (so-called) fish clients that seek to be cleaned by other fish (the cleaners). Clients face an interesting challenge: they raise enough motivation to suspend their daily activities as to selectively visit and engage in interactions with cleaners. Here we aimed, for the first time, to investigate the region-specific brain monoaminergic level differences arising from individual client fish when facing a cleaner (interspecific context) compared to those introduced to another conspecific (socio-conspecific context). We show that monoaminergic activity differences occurring at two main brain regions, the diencephalon and the forebrain, are associated with fish clients' social and mutualistic activities. Our results are the first demonstration that monoaminergic mechanisms underlie client fish mutualistic engagement with cleanerfish. These pathways should function as a pre-requisite for cleaning to occur, providing to clients the cognitive and physiological tools to seek to be cleaned.
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Diencéfalo/metabolismo , Prosencéfalo/metabolismo , Simbiosis/fisiología , Animales , Conducta Cooperativa , Arrecifes de Coral , Diencéfalo/fisiología , Dopamina/metabolismo , Dopamina/fisiología , Conducta Alimentaria/fisiología , Peces/fisiología , Motivación , Perciformes/metabolismo , Perciformes/fisiología , Prosencéfalo/fisiología , Serotonina/metabolismo , Serotonina/fisiología , Conducta SocialRESUMEN
The presence of endocrine-derived compounds in the environment occurs due to a myriad of human or industrial activity and can disrupt the endocrine system of animals, including fish. One important group of endocrine disruptors are the estrogens, such as 17-ß estradiol (E2, estradiol). Estrogens are gonadal steroid hormones, able to be influential even in small concentrations. Here, we demonstrate that E2 is linked to female' decisions made by an important coral reef species, the cleaner fish Labroides dimidiatus, during interactions with other reef fishes (known as clients). E2 treatment in natural conditions interfered directly in the cooperative relationships, by increasing cleaners' willingness to interact with clients, providing greater amounts of physical contact to their fish partners. We discuss the meaning of the observed behavioural disruption produced by E2, which by affecting a key species (cleaners) may produce a cascade impact in the aquatic ecosystem.
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Disruptores Endocrinos/toxicidad , Estradiol/toxicidad , Perciformes/fisiología , Simbiosis , Contaminantes Químicos del Agua/toxicidad , Animales , Ecosistema , Conducta Alimentaria/efectos de los fármacos , Femenino , Peces/fisiologíaRESUMEN
O presente artigo analisa o manuscrito da Base Nacional Comum Curricular e compreende a concepção de Educação Física por ele proposta. Identifica a concepção atribuída à educação física pela Base Nacional Comum Curricular. Metodologicamente, utiliza a análise bibliográfica e documental (Base Nacional Comum Curricular), a dialética como método e aplica a análise de conteúdo, para tratar os dados. Constata que a Base Nacional Comum Curricular localiza a educação física na área da linguagem e a filia a um ecletismo no que diz respeito a sua concepção e corpo de conhecimento específico, gerando dada incoerência nos conteúdos e nos processos formativos deste campo de conhecimento. Concluiu que o manuscrito concretiza uma aliança entre educação e capital, defendendo os interesses dos grupos hierárquicos centrais, transformando o direito à educação em serviço mercadológico.
El presente artículo analiza el manuscrito de la Base Nacional Común Curricular y entiende la concepción de la Educación Física propuso. Identifica la concepción atribuido a la Educación Física de Base Nacional Común Curricular. Metodológicamente, utiliza revisión de la biografia y el documento (Base Nacional Común Curricular), la dialéctica como método y aplica el análisis de contenido, para procesar los datos. Señala que la Base Nacional Común Curricular localiza la Educación Física en el área del lenguaje y filia a un eclecticismo en cuanto a su concepción y cuerpo del conocimiento especifico, generando dada incoherencia en el contenido y procesos en la formación de este campo del conocimiento. La conclusión de que el manuscrito concretado una alianza entre educación y el capital. La defensa de los intereses del grupos jerárquicos, el centro de torneado el derecho a la educación en el servicio mercadeo.
This article analyzes the manuscript of the National Common Curriculum Basis and it comprehends the conception of Physical Education. It identifies the concept attributed to physical education by the National Common Curriculum Basis. Methodologically, it uses a bibliographic and documentary analysis (National Common Curriculum Basis), the dialectic as method and applying content analysis to process data. It verifies that the National Common Curriculum Basis identifies the physical education in the language field and it affiliates to an eclecticism regarding to their conception and specific body of knowledge, generating inconsistency in content and the formative processes of this knowledge field. It concludes that the manuscript materializes an alliance between education and capital, defending the central hierarchical groups' interests, transforming the right to education in marketing service.
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Educación y Entrenamiento Físico/normas , Instituciones Académicas , Curriculum , Educación Primaria y SecundariaRESUMEN
OBJECTIVES: Validating an instrument to assess nurse knowledge related to preventing and treating individuals with venous ulcer (VU). METHODS: This is an exploratory study, conducted with 78 primary health care nurses. These professionals answered the questionnaire with twelve items pertaining to knowing and doing while addressing the person with VU. SPSS for Windows, version 21.0, with descriptive analyses and Pearson correlation was used for data analysis. RESULTS: The measurement of questionnaire reliability, from Cronbach's alpha, revealed in the Theoretical Knowledge Domain (TKD), 0.88 alpha, and in the Practical Knowledge Domain (PKD), 0.70 alpha, indicators that guaranteed reliability of such a measurement for the extracted sample. With regard to the correlation between TKD and PKD and Nursing Care to the Person with VU, those were significant and strong in almost all items. The bi-factorial model, with theoretical and practical domains, is what best explains the nurse assistance for the person with VU. The nurse that knows one or both domains in treating wounds, probably, will allow for greater dominance over VU and in assisting the person with VU. CONCLUSIONS: The validated version showed reliability, enabling thus the other professionals to tailor the same methodology to other topics, identifying the ramifications of knowing and doing and, thereby, strengthening gaps in the Nursing Education area.
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Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.
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Tecnología Biomédica/economía , Análisis Costo-Beneficio , Técnicas de Apoyo para la Decisión , Árboles de DecisiónRESUMEN
A maioria das avaliações econômicas que participam dos processos de decisão de incorporação e financiamento de tecnologias dos sistemas de saúde utiliza modelos de decisão para avaliar os custos e benefícios das estratégias comparadas. Apesar do grande número de avaliações econômicas conduzidas no Brasil, há necessidade de aprofundamento metodológico sobre os tipos de modelos de decisão e sua aplicabilidade no nosso meio. O objetivo desta revisão de literatura é contribuir para o conhecimento e o uso de modelos de decisão nos contextos nacionais das avaliações econômicas de tecnologias em saúde. Este artigo apresenta definições gerais sobre modelos e preocupações com o seu uso; descreve os principais modelos: árvore de decisão, Markov, microssimulação, simulação de eventos discretos e dinâmicos; discute os elementos envolvidos na escolha do modelo; e exemplifica os modelos abordados com estudos de avaliação econômica nacionais de tecnologias preventivas e de programas de saúde, diagnósticas e terapêuticas.
Most economic evaluations that participate in decision-making processes for incorporation and financing of technologies of health systems use decision models to assess the costs and benefits of the compared strategies. Despite the large number of economic evaluations conducted in Brazil, there is a pressing need to conduct an in-depth methodological study of the types of decision models and their applicability in our setting. The objective of this literature review is to contribute to the knowledge and use of decision models in the national context of economic evaluations of health technologies. This article presents general definitions about models and concerns with their use; it describes the main models: decision trees, Markov chains, micro-simulation, simulation of discrete and dynamic events; it discusses the elements involved in the choice of model; and exemplifies the models addressed in national economic evaluation studies of diagnostic and therapeutic preventive technologies and health programs.
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Tecnología Biomédica/economía , Análisis Costo-Beneficio , Técnicas de Apoyo para la Decisión , Árboles de DecisiónRESUMEN
As características, as causas, os cursos e os tratamentos dos vários tipos de convulsões serão aqui apresentados. Os tipos mais comuns de desordens convulsivas são: 1. grande mal, às vezes chamada tônico-clônica generalizada; 2. ausência ou pequeno mal; 3. psicomotora ou complexa parcial; 4. mioclônica ou espasmo convulsivo; e 5. febril, em crianças pequenas. Os tipos de convulsões mais raras são: status epilepticus; atônica; parcial; jacksoniana; e espasmo infantil.
The characteristics, causes, treatment and courses of various types of convulsive disorders are presented here. The most common types of convulsive disorders are: 1. great evil, sometimes called generalized tonic-clonic; 2. absence or petit mal; 3. psychomotor or complex partial; 4. myoclonic or convulsive spasm; and 5. febrile, illness in young children. The types of convulsions are rare: status epilepticus; atonic; partial; jacksonian; and infantile spasms.