IntroductionIn Portugal as in other countries, data on the epidemiology of asthma are mainly grounded in questionnaire studies. Additionally, the detailed characterisation of asthma in terms of disease severity, control and phenotypes remain scarce. Studies assessing the prevalence of asthma and its subgroups using accurate methods are needed. This study aims to determine the prevalence of asthma, difficult-to-treat asthma and severe asthma, and to evaluate sociodemographic and clinical characteristics of those patients, in mainland Portugal.Methods and analysisA population-based nationwide study with a multicentre stepwise approach will be conducted between 2021 and 2023 in 38 primary care centres of the Portuguese National Health Service. The stepwise approach will comprise four stages: Stage 0—telephone call invitation to adult subjects (≥18 years) randomly selected (n~15 000); stage 1—telephone screening interview assessing the participants’ respiratory symptoms (n~7500); stage 2—diagnostic visit, including physical examination, diagnostic tests (eg, spirometry, fraction of exhaled nitric oxide, blood eosinophil count) and patient-reported outcome measures for diagnostic confirmation of those identified with possible asthma at stage 1 (n~1800); stage 3—further evaluation of patients with asthma and of patients with difficult-to-treat asthma and severe asthma, after 3 months (n~460). At stage 3, data will be collected from a review of the patient’s electronic health records, a follow-up telephone call and the CARATm (Caracteristicas Auto-reportadas de Asma em Tecnologias Móveis) app database. The prevalence of asthma, difficult-to-treat asthma and severe asthma will be determined as the percentage of patients with asthma confirmed from the overall population (stage 1). For the analysis of factors associated with asthma, difficult-to-treat asthma and severe asthma, logistic regression models will be explored.Ethics and disseminationEthical approvals for the study were obtained from the ethics committee of the local health unit of Matosinhos, Porto (38/CES/JAS), Alto Minho (38/2021/CES) and the regional health administration of Lisbon-Vale do Tejo (035/CES/INV/2021). Results will be published in peer-reviewed journals.Trial registration numberNCT05169619.
Resumo: Com base nos pressupostos teóricos da Análise do Discurso, este trabalho discute, através de alguns questionamentos, a prática de leitura, numa perspectiva discursiva, na formação do professor que atua no Estado de Tocantins, ou seja, reflete sobre leitura como efeito de sentidos, conforme pressupostos teóricos da Análise do Discurso (AD) de linha francesa. O intuito no presente texto, mais que contribuir para o debate da questão, é apontar alguns obstáculos na formação inicial (FI) ou na formação continuada (FC) de professores do nível básico que podem estar causando entraves em seu entendimento dos Parâmetros Curriculares Nacionais (PCN) e, consequentemente, sua compreensão inadequada do Referencial Curricular do Estado de Tocantins (RC-TO) em relação ao ensino/aprendizagem de leitura em uma perspectiva mais flexível, que leve em conta as condições de produção num contexto mais abrangente. Palavras-chave: Discurso. Leitura e ensino. Formação docente. PCN e RC-TO.
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