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O esquema operatório da moeda: corpo, imagem e transindividual / The operative scheme of money: body, image and transindividualOliveira, Diego Soares Viana de 24 August 2018 (has links)
Esta pesquisa investiga o conceito de moeda para além de sua determinação como dinheiro. Apoiada em conceitos oriundos da filosofia de Gilbert Simondon, busca deduzir um esquema operatório geral da moeda, do qual o dinheiro é uma dimensão. Os recursos para entender as demais dimensões da moeda, como imagem de poder e prestígio e como instrumento liberatório, são encontrados no exame de teorias não econômicas da moeda, na antropologia e na sociologia. A filosofia de Simondon fornece noções como a operação transdutiva, a alagmática, o transindividual e o ciclo genético da imagem, que permitem pensar a moeda não como substância, mas como rede de significações mediadas por imagens e objetos, cuja estrutura é correlata das operações que ela mantém. A tese busca demonstrar que o conceito de moeda se refere a uma operação de tomada de forma que marca o campo social, determinando atividades e relações. Essa marcação parte de uma esfera articuladora, que, com um modo de operação rítmico, se desdobra em dois eixos, um deles (vertical) tratando da remissão a uma temporalidade que transcende o ritmo da vida no campo social, e o outro (horizontal) ordenando as atividades da temporalidade interna ao ritmo da vida no campo social. Este esquema é válido tanto para a moeda enquanto dinheiro quanto para suas outras dimensões, como veículo de prestígio e como instrumento liberatório (paleomoeda). A moeda enquanto dinheiro é estudada a partir da escola francesa do \"institucionalismo monetário\", que integram reflexões sobre o papel da moeda na economia, na sociedade e na política. As teses do institucionalismo monetário são completadas pelas análises marxianas da relação entre a atividade somática do trabalho, as determinações sociais e o movimento do capital. Em seguida, o conceito de esquema operatório da moeda é empregado para investigar como o dinheiro, com as múltiplas dimensões em que opera, é deixado de lado na tradição da análise econômica, demonstrando que a teoria econômica garante sua autonomia como campo de estudo por meio da expulsão da moeda e, por isso, tem dificuldade de reintegrá-la. Como conclusão, o texto aborda iniciativas contemporâneas a partir da maneira como modificam o esquema operatório da moeda. / This thesis investigates the concept of money beyond its determination as currency. By resorting to concepts from the philosophy of Gilbert Simondon, it seeks to elicit the general operative scheme of money, of which currency is a dimension. The resources needed to understand the other dimensions of money, as as image of power and prestige, and as release instrument, are found by examining non-economic theories of money, in anthropology and sociology. Simondon\'s philosophy provides notions such as transductive operation, allagmatics, transindividual, and the genetic cycle of the image, which help to think money not as substance, but as a network of meanings, mediated by images and objects, with a structure that is relative to the operations it sustains. The thesis seeks to demonstrate that the concept of money refers to an operation of form giving, which marks the social field, determining activities and relations. This marking emerges from an articulating sphere, which, having a rhythmic mode of operation, doubles itself in two axes, one of which (vertical) deals with the remission to a temporality that transcends the rhythm of life in the social field, and the other (horizontal) ordaining the activities in the internal temporality of the social field\'s rhythm of life. This scheme is valid both for money as currency and for its other dimensions, as a vehicle of prestige and as a release instrument. Money as currency is studied in relation to the \"monetary institutional\" French school, which integrates analyses of the role of money in the economy, society and politics. The monetary institutional theses are completed with Marx\'s analyses of the relation between work as a somatic activity, social determinations and the movement of capital. The concept of operative scheme is then employed in the investigation of how money, with the several dimensions in which it operates, is left aside in the tradition of economic analysis, demonstrating that economic theory maintains its autonomy as a field of study only through the expulsion of money, and for that reason fails to reintegrate the concept of money. As a conclusion, the text deals with monetary invention initiatives from the angle of how they modify the operative scheme.
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Security techniques for dronesJongho Won (5930405) 10 June 2019 (has links)
<div>Unmanned Aerial Vehicles (UAVs), commonly known as drones, are aircrafts without a human pilot aboard. The flight of drones can be controlled with a remote control by an operator located at the ground station, or fully autonomously by onboard computers. Drones are mostly found in the military. However, over the recent years, they have attracted the interest of industry and civilian sectors. <br></div><div>With the recent advance of sensor and embedded device technologies, various sensors will be embedded in city infrastructure to monitor various city-related information. In this context, drones can be effectively utilized in many safety-critical applications for collecting data from sensors on the ground and transmitting configuration instructions or task requests to these sensors.</div><div> <br></div><div>However, drones, like many networked devices, are vulnerable to cyber and physical attacks.<br></div><div>Challenges for secure drone applications can be divided in four aspects: 1) securing communication between drones and sensors, 2) securing sensor localization when drones locate sensors, 3) providing secure drone platforms to protect sensitive data against physical capture attacks and detect modifications to drone software, and 4) protecting secret keys in drones under white-box attack environments.<br></div><div> <br></div><div>To address the first challenge, a suite of cryptographic protocols is proposed. The protocols are based on certificateless cryptography and support authenticated key agreement, non-repudiation and user revocation. To minimize the energy required by a drone, a dual channel strategy is introduced.<br></div><div>To address the second challenge, a drone positioning strategy and a technique that can filter out malicious location references are proposed.<br></div><div>The third challenge is addressed by a solution integrating techniques for software-based attestation and data encryption.<br></div><div>For attestation, free memory spaces are filled with pseudo-random numbers, which are also utilized to encrypt data collected by the drone like a stream cipher.<br></div>A dynamic white-box encryption scheme is proposed to address the fourth challenge. Short secret key are converted into large look-up tables and the tables are periodically shuffled by a shuffling mechanism which is secure against white-box attackers.
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Esquema terapêutico de dose fixa combinada (RHZE) e o controle da tuberculose em área de elevada carga da doença: Município de Santos (SP) / Treatment regimen of four drug fixed dose combination (RHZE) and the control of tuberculosis in high burden of disease area: City of Santos (SP)Nascimento, Ana Carolina Chiou 23 June 2017 (has links)
Introdução: A carga da tuberculose (TB) no Brasil ainda é expressiva e a proporção de desfechos de tratamento desfavoráveis é elevada. Para tornar mais efetivas as atividades de controle da TB, implantou-se, em 2010, o esquema terapêutico de dose fixa combinada (RHZE). Contrastando com bons indicadores socioeconômicos, o município de Santos (SP) ainda apresenta elevadas taxas de incidência de TB e de abandono de tratamento. Objetivos: Descrever a tuberculose pulmonar (TBP), os principais desfechos de tratamento em período prévio e posterior a introdução do esquema terapêutico de dose fixa combinada (RHZE), no município de Santos. Métodos: Estudo descritivo, abrangendo pacientes com TBP diagnosticados por critérios clínico-radiológicos ou bacteriológicos, com 15 anos ou mais, residentes, e cujo primeiro tratamento com esquema RHZ ou RHZE ocorreu no município de Santos entre 01/01/2008 a 31/12/2014. As definições de caso são as adotadas pelo Programa Nacional de Controle da Tuberculose (PNCT). As variáveis estudadas foram características sociodemográficas, aspectos relativos ao diagnóstico e tratamento, comorbidades e características do serviço de saúde. A análise descritiva se fez por coortes de pacientes definidas segundo o ano do primeiro tratamento. Para as análises comparativas de proporções aplicaram-se os testes qui-quadrado de Pearson, Exato de Fisher e qui-quadrado de tendência e para variáveis contínuas o de Kruskal - Wallis. Resultados: Dos 1603 pacientes estudados, 67,2 % eram do sexo masculino, a mediana de idade foi de 39 anos, 44,4% com escolaridade entre 8 e 11 anos de estudo, 53,6% de etnia branca, 11,5% coinfectados TB/HIV; 55,0% descoberto por demanda ambulatorial, 60,9% submetidos ao tratamento supervisionado e 17,8% hospitalizados durante o tratamento. Comparando a coorte de pacientes com início de tratamento em 2008 com a de 2014, verificamos a elevação da escolaridade com 12 anos ou mais de estudo (11,3% versus 22,0%; p=0,059, X2 tendência), de privados de liberdade (0,9% versus 2,1%; p=0,026, X2 tendência), de doentes mentais (0,4% versus 3,0%; p=0,027, X2 tendência), de casos descobertos por elucidação diagnóstica (7,4% versus 12,6%; p=0.049, X2 tendência), de atendidos na Unidade Básica de Saúde (79,3% versus 90,1%; p < 0,0001, X2 tendência), de contatos investigados (1,3% versus 4,8%; p=0,040, X2 tendência). Por sua vez, houve declínio na proporção de coinfecção TB/HIV (13,2% versus 8,6%; p=0,018, X2 tendência), e hospitalizações durante o tratamento (21,6% versus 12,9%; p < 0,0001, X2 tendência). Foram tratados inicialmente com esquema RHZ 29,8% (477/1603) e 70,2% (1126/1603) com esquema RHZE. A taxa de cura manteve-se em torno de 80,0%. Por outro lado, houve declínio da proporção de retratamento pós-cura (4,7% versus zero; p < 0,0001, X2 de tendência); de óbitos por TB (3,4% versus 0,9%; p=0,090, X2 tendência), e óbitos por outras causas (3,4% versus 2,1%; p=0,028, X2 tendência). O abandono de tratamento manteve-se em torno de 13,7%, sendo que 70,0% (154/220) deles, não retornaram para retratamento. Conclusão: Após a introdução do RHZE, verificou-se a diminuição da gravidade da TB, mas as taxas de cura e de abandono não se alteraram significativamente, além disso, elevada proporção dos que abandonaram o tratamento não retornaram aos serviços. Tais resultados sugerem a necessidade de estratégias adicionais com vistas a elevar a adesão ao tratamento da TB com foco em grupos de maior risco para abandono de tratamento / Background: The burden of tuberculosis (TB) in Brazil is still expressive and the proportion of unfavorable treatment outcomes is high. In order to make TB control activities more effective, the four-drug fixed-dose combination (RHZE) was implemented in 2010. Despite good socioeconomic indicators, the city of Santos (Sao Paulo, Brazil) still presents high rates of TB incidence and treatment abandonment. Objectives: To describe both pulmonary tuberculosis (PTB) and the main treatment outcomes in the period before and after the introduction of the four-drug fixed-dose combination regimen (RHZE) in the city of Santos. Methods: Descriptive study covering patients living in Santos, 15 years of age or older, with PTB diagnosed by bacteriological or clinical and radiological criteria whose first treatment with either regimen (RHZ) or RHZE occurred in the city of Santos between 01/01/2008 and 12/31/2014. Case definitions are those adopted by Brazil\'s National TB Control Program (NTP). The variables of interest were sociodemographic characteristics, aspects related to diagnosis and treatment, comorbidity and health service characteristics. The descriptive analysis was done by cohorts of patients defined according to the year of their first treatment. We used Pearson\'s chi-square test, Fisher\'s exact test and chi-square test for trend for comparative proportions analyzes and the Kruskal-Wallis test for the continuous variables. Results: Of the 1603 cases studied, 67.2% were male, 39 years old on average, 44.4% had 8 to 11 years of schooling, 53.6% were white, 11.5% had TB/HIV coinfection; 55.0% were discovered by outpatient lab testing, 60.9%were under supervised treatment and 17.8%were hospitalized during treatment. When we compared the 2008 and 2014 cohorts, we found an increase of 12 years of schooling or more (11.3% versus 22.0%; p=0.059, X2 trend), prisoners (0.9% versus 2.1%; p =0.026, X2 trend), mentally ill (0.4% versus 3.0%; p=0.027, X2 trend),cases detected by diagnostic elucidation (7.4% versus 12.6%; p=0.049, X2 trend), patients seen at a Local Health Care Center (79.3% versus 90.1%; p < 0.0001, X2 trend) and investigated household contacts (1.3% versus 4.8%; p=0.040, X2 trend). However, there was decline in the proportion of TB/HIV coinfection (13.2% versus 8.6%; p=0.018, X2 trend) and hospitalizations during treatment (21.6% versus 12.9%; p < 0.0001, X2 trend). 29.8% (477/1603) were initially treated with the RHZ regimen and 70.2% (1126/1603) with the RHZE regimen. The cure rates remained at around 80.0%. However, there was a decline in the proportion of post-cure retreatment (4.7% versus zero; p < 0.0001, X2 trend); deaths from TB (3.4 % versus 0.9%; p=0.090, X2 trend) and deaths from other causes (3.4% versus 2.1 %; p=0.028, X2 trend). Treatment abandonment remained at around 13.7% while (154/220) cases, (70.0%), did not return for retreatment. Conclusion: After the introduction of the RHZE regimen, there was a decrease in TB severity. Nevertheless, treatment abandonment and cure rates showed no significant change. Moreover, a high proportion of patients who abandoned treatment did not return for retreatment. Such results suggest the necessity of additional strategies to improve patient adherence to TB treatment focusing on patients at high risk of abandoning the treatment
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Programação paralela em GPU aplicada à técnica N-Scheme para solução de problemas eletrostáticos utilizando o método de elementos finitos /Kewitz, Leonardo Koch, 1989-, Vanti, Marcelo Grafulha, 1963-, Universidade Regional de Blumenau. Programa de Pós-Graduação em Engenharia Elétrica. January 2015 (has links) (PDF)
Orientador: Marcelo Grafulha Vanti. / Dissertação (Mestrado em Engenharia Elétrica) - Programa de Pós-Graduação em Engenharia Elétrica, Centro de Ciências Tecnológicas, Universidade Regional de Blumenau, Blumenau,
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”Kvinnlig idrottare” eller bara idrottare? : En kvantitativ studie – Stereotyper och könsmönster i svensk sportjournalistik / "Female athlete" or just “athletes”? : A quantitative study - Stereotypes and gender patterns in Swedish sports journalismHallin, Gustaf January 2019 (has links)
My ambition with this study is to seek clearance in how the media shape male and female floorball players in Sweden. I´ve used a quantitative content analysis for that purpose. One of my main questions was with which attributes female or male players gets ascribed. I studied over 300 articles in Swedish newspapers Aftonbladet and Expressen. 194 articles were mainly about male players, and 112 articles were about female players. Eighteen articles couldn´t be defined, and fall under that variable. A total of 323 articles were found. I found that female players are more discriminated in terms of speaking directly in the article. The male players were more represented in the articles, with own quotes. One interesting thing found was that objectification is a rare thing on these platforms. If anything is to be said regarding that, it´s the fact that male players are more subject to objectification. But the results were so few, that it would be unwise to make a big deal out of it. Also interesting is that male players more often are mentioned as “athletes” and female players are more often mentioned as “people” or just “persons”. They are described with their name. But, female players are at the same time also more often than the male players, described with qualities as players and with achievements that follows with those skills. Another result was that male players all together, gets more space in the media, than the female players. Due to the fact that the male players gets a lot more articles, and also more pictures, if you look at the code-scheme.
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The determinants of insurance participation: a mixed-methods study exploring the benefits, challenges and expectations among healthcare providers in Lagos, NigeriaShobiye, Hezekiah Olayinka 23 October 2018 (has links)
BACKGROUND: In order to accelerate universal health coverage, Nigeria’s National Health Insurance Scheme (NHIS) decentralized the implementation of government health insurance to the States in 2014. Lagos has passed its State Health Scheme (LSHS) into law with a statewide roll out set to commence in 2018. The LSHS aims to improve access to quality care by reducing the financial burden of obtaining care for Lagos residents. Public and private healthcare providers are a critical component of this ambitious insurance roll out. Yet, little or no understanding exists on how to engage providers, the factors that influence their participation in insurance and expectations from the LSHS. In addition, little is known about the geographic distribution of NHIS accredited facilities and enrollees in Lagos State.
METHODS: This study used a mixed-methods cross sectional design to analyze primary and secondary data. Primary data included both quantitative and qualitative data and were collected from representatively selected 60 healthcare providers in 6 Local Government Areas (LGAs) in Lagos State through questionnaires probing issues on the challenges and benefits of insurance participation, capacity pressure, resource availability and changes in financial management. Secondary data were obtained from NHIS and Lagos State inventory of health facilities, and household survey reports, and were visually mapped using a geographic information system (GIS) software.
RESULTS: Facilities participating in insurance were more likely to be bigger with mid to very high patient volume and workforce. In addition, private were more likely than public facilities to participate in insurance. Furthermore, increase in patient volume and revenue were motivating factors for providers to participate in insurance, while low tariffs, delay and denial of payments, and patients’ unrealistic expectations were inhibiting factors. Also, NHIS enrollees were more likely to be located in the urban than rural LGAs. However, many urban LGAs have larger population sizes and as a result, were also characterized with higher number of non-NHIS enrollees and fewer NHIS accredited facilities. For the LSHS, many private facilities anticipate an increased patient volume and revenue but also worry that low tariffs without guaranteeing a high patient volume would be a major challenge. For many public facilities, inadequate infrastructure, lack of workforce, and insufficient drugs and commodities remain major challenges.
CONCLUSION: For the LSHS to be successful, effective contracting of healthcare providers especially those in the low income and densely populated LGAs is essential. However, this would require that provider payment is adequate and regular. In addition, the government would need to invest heavily in improving the infrastructure and the amount of workforce, drugs and commodities available to public facilities.
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Modélisation dynamique de systèmes complexes pour le calcul de grandeurs fiabilistes et l’optimisation de la maintenance / Dynamic modeling of complex systems for reliability calculations and maintenance optimizationLair, William 18 November 2011 (has links)
L’objectif de cette thèse est de proposer une méthode permettant d’optimiser la stratégie de maintenance d’un système multi-composants. Cette nouvelle stratégie doit être adaptée aux conditions d’utilisation et aux contraintes budgétaires et sécuritaires. Le vieillissement des composants et la complexité des stratégies de maintenance étudiées nous obligent à avoir recours à de nouveaux modèles probabilistes afin de répondre à la problématique. Nous utilisons un processus stochastique issu de la Fiabilité Dynamique nommé processus markovien déterministe par morceaux (Piecewise Deterministic Markov Process ou PDMP). L’évaluation des quantités d’intérêt (fiabilité, nombre moyen de pannes...) est ici réalisé à l’aide d’un algorithme déterministe de type volumes finis. L’utilisation de ce type d’algorithme, dans ce cadre d’application, présente des difficultés informatiques dues à la place mémoire. Nous proposons plusieurs méthodes pour repousser ces difficultés. L’optimisation d’un plan de maintenance est ensuite effectuée à l’aide d’un algorithme de recuit simulé. Cette méthodologie a été adaptée à deux systèmes ferroviaires utilisés par la SNCF, l’un issu de l’infrastructure, l’autre du matériel roulant. / The aim of this work is to propose a methodology to optimize a multi-components system maintenance. This new maintenance strategy must be adapted to budget and safety constraints and operating conditions. The aging of components and the complexity of studied maintenance strategies require us to use new probabilistic models in order to address the problem. A stochastic process from Dynamic Reliability calculations are here established by using a deterministic algorithm method based on a finite volume scheme. Using this type of algorithm in this context of application presents difficulties due to computer memory space. We propose several methods to counter these difficulties. The optimization of a maintenance plan is then performed using simulated annealing algorithm. This methodology was used to optimize the maintenance of two rail systems used by the French national railway company (SNCF).
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Developments of the ISOLDE RILIS for radioactive ion beam production and the results of their application in the study of exotic mercury isotopesDay Goodacre, Thomas January 2017 (has links)
This work centres around development and applications of the Resonance Ionization Laser Ion Source (RILIS) of the ISOLDE radioactive ion beam facility based at CERN. The RILIS applies step-wise resonance photo-ionization, to achieve an unparalleled degree of element selectivity, without compromising on ion source efficiency. Because of this, it has become the most commonly used ion source at ISOLDE, operating for up to 75% of ISOLDE experiments. In addition to its normal application as an ion source, the RILIS can be exploited as a spectroscopic tool for the study of nuclear ground state and isomer properties, by resolving the influence of nuclear parameters on the atomic energy levels of the ionization scheme. There are two avenues of development by which to widen the applicability of the RILIS: laser ionization scheme development, enabling new or more efficient laser ionized ion beams and the development of new laser-atom interaction regions. New ionization schemes for chromium, tellurium, germanium, mercury and radium have been determined. Additionally, for the first time, the anode cavity of the VADIS, ISOLDE's variant of the FEBIAD type arc discharge ion source was used as the laser-atom interaction region. A new element selective RILIS mode of operation was established, enabling the ISOLDE RILIS to be coupled with molten targets for the first time, increasing the flexibility of ISOLDE operation and opening a direction for future developments. This combined ion source was termed the VADLIS or Versatile Arc Discharge and Laser Ion Source. A combination of the developments presented in this thesis: an improvement of the laser ionization efficiency and the ability to couple the RILIS with molten targets, satisfied the pre-requisites for the long-awaited extension of the laser spectroscopy studies of exotic mercury isotopes. A sudden onset of extreme shape staggering in the neutron deficient mercury isotopes was revealed by optical pumping and laser spectroscopy experiments at ISOLDE in the 1970s and 1980s, with measurements conducted down to 181Hg. Despite this being one of the most remarkable examples of shape coexistence in the nuclear chart, in the intervening decades the cessation point of this odd-even staggering had yet to be unambiguously determined through measurements of nuclear ground state charge radii. This open question was successfully resolved using the ISOLDE RILIS for in-source resonance ionization spectroscopy. The experiment was performed as part of a large collaboration, using the Leuven Windmill system for alpha-detection; direct ion counting with the ISOLTRAP multi-reflection time-of-fight mass spectrometer (MR-ToF MS); and ion beam current measurements using the ISOLDE Faraday cups. The sensitivity of the technique enabled the measurements to be extended down to 177Hg, providing a definitive answer, that the extreme shape staggering stops at 180Hg. In addition to extending the measurements at the neutron deficient end of the mercury isotope chain, the relative mean square charge radii of both 207Hg and 208Hg was determined. This extended the measurements beyond the N = 126 shell closure, enabling the characterization of the "kink" in the trend of the isotope shifts.
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Um esquema regenerativo visível em cadeias de alcance variável não limitada / A visible regenerative scheme in unbounded variable length chainsEsteves, Divanilda Maia 21 March 2007 (has links)
O objetivo central desta tese é demonstrar a existência de uma estrutura regenerativa visível para cadeias de alcance variável não limitadas. Também apresentamos um algoritmo de identificação de seqüências de instantes de regeneração que converge quase certamente quando o tamanho da amostra diverge. / Our main aim is prove the existence of a regeneration scheme in unbounded variable length chains. We present an algorithm to identify sequences of regeneration times which converges almost surely as the sample length.
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Esquema terapêutico de dose fixa combinada (RHZE) e o controle da tuberculose em área de elevada carga da doença: Município de Santos (SP) / Treatment regimen of four drug fixed dose combination (RHZE) and the control of tuberculosis in high burden of disease area: City of Santos (SP)Ana Carolina Chiou Nascimento 23 June 2017 (has links)
Introdução: A carga da tuberculose (TB) no Brasil ainda é expressiva e a proporção de desfechos de tratamento desfavoráveis é elevada. Para tornar mais efetivas as atividades de controle da TB, implantou-se, em 2010, o esquema terapêutico de dose fixa combinada (RHZE). Contrastando com bons indicadores socioeconômicos, o município de Santos (SP) ainda apresenta elevadas taxas de incidência de TB e de abandono de tratamento. Objetivos: Descrever a tuberculose pulmonar (TBP), os principais desfechos de tratamento em período prévio e posterior a introdução do esquema terapêutico de dose fixa combinada (RHZE), no município de Santos. Métodos: Estudo descritivo, abrangendo pacientes com TBP diagnosticados por critérios clínico-radiológicos ou bacteriológicos, com 15 anos ou mais, residentes, e cujo primeiro tratamento com esquema RHZ ou RHZE ocorreu no município de Santos entre 01/01/2008 a 31/12/2014. As definições de caso são as adotadas pelo Programa Nacional de Controle da Tuberculose (PNCT). As variáveis estudadas foram características sociodemográficas, aspectos relativos ao diagnóstico e tratamento, comorbidades e características do serviço de saúde. A análise descritiva se fez por coortes de pacientes definidas segundo o ano do primeiro tratamento. Para as análises comparativas de proporções aplicaram-se os testes qui-quadrado de Pearson, Exato de Fisher e qui-quadrado de tendência e para variáveis contínuas o de Kruskal - Wallis. Resultados: Dos 1603 pacientes estudados, 67,2 % eram do sexo masculino, a mediana de idade foi de 39 anos, 44,4% com escolaridade entre 8 e 11 anos de estudo, 53,6% de etnia branca, 11,5% coinfectados TB/HIV; 55,0% descoberto por demanda ambulatorial, 60,9% submetidos ao tratamento supervisionado e 17,8% hospitalizados durante o tratamento. Comparando a coorte de pacientes com início de tratamento em 2008 com a de 2014, verificamos a elevação da escolaridade com 12 anos ou mais de estudo (11,3% versus 22,0%; p=0,059, X2 tendência), de privados de liberdade (0,9% versus 2,1%; p=0,026, X2 tendência), de doentes mentais (0,4% versus 3,0%; p=0,027, X2 tendência), de casos descobertos por elucidação diagnóstica (7,4% versus 12,6%; p=0.049, X2 tendência), de atendidos na Unidade Básica de Saúde (79,3% versus 90,1%; p < 0,0001, X2 tendência), de contatos investigados (1,3% versus 4,8%; p=0,040, X2 tendência). Por sua vez, houve declínio na proporção de coinfecção TB/HIV (13,2% versus 8,6%; p=0,018, X2 tendência), e hospitalizações durante o tratamento (21,6% versus 12,9%; p < 0,0001, X2 tendência). Foram tratados inicialmente com esquema RHZ 29,8% (477/1603) e 70,2% (1126/1603) com esquema RHZE. A taxa de cura manteve-se em torno de 80,0%. Por outro lado, houve declínio da proporção de retratamento pós-cura (4,7% versus zero; p < 0,0001, X2 de tendência); de óbitos por TB (3,4% versus 0,9%; p=0,090, X2 tendência), e óbitos por outras causas (3,4% versus 2,1%; p=0,028, X2 tendência). O abandono de tratamento manteve-se em torno de 13,7%, sendo que 70,0% (154/220) deles, não retornaram para retratamento. Conclusão: Após a introdução do RHZE, verificou-se a diminuição da gravidade da TB, mas as taxas de cura e de abandono não se alteraram significativamente, além disso, elevada proporção dos que abandonaram o tratamento não retornaram aos serviços. Tais resultados sugerem a necessidade de estratégias adicionais com vistas a elevar a adesão ao tratamento da TB com foco em grupos de maior risco para abandono de tratamento / Background: The burden of tuberculosis (TB) in Brazil is still expressive and the proportion of unfavorable treatment outcomes is high. In order to make TB control activities more effective, the four-drug fixed-dose combination (RHZE) was implemented in 2010. Despite good socioeconomic indicators, the city of Santos (Sao Paulo, Brazil) still presents high rates of TB incidence and treatment abandonment. Objectives: To describe both pulmonary tuberculosis (PTB) and the main treatment outcomes in the period before and after the introduction of the four-drug fixed-dose combination regimen (RHZE) in the city of Santos. Methods: Descriptive study covering patients living in Santos, 15 years of age or older, with PTB diagnosed by bacteriological or clinical and radiological criteria whose first treatment with either regimen (RHZ) or RHZE occurred in the city of Santos between 01/01/2008 and 12/31/2014. Case definitions are those adopted by Brazil\'s National TB Control Program (NTP). The variables of interest were sociodemographic characteristics, aspects related to diagnosis and treatment, comorbidity and health service characteristics. The descriptive analysis was done by cohorts of patients defined according to the year of their first treatment. We used Pearson\'s chi-square test, Fisher\'s exact test and chi-square test for trend for comparative proportions analyzes and the Kruskal-Wallis test for the continuous variables. Results: Of the 1603 cases studied, 67.2% were male, 39 years old on average, 44.4% had 8 to 11 years of schooling, 53.6% were white, 11.5% had TB/HIV coinfection; 55.0% were discovered by outpatient lab testing, 60.9%were under supervised treatment and 17.8%were hospitalized during treatment. When we compared the 2008 and 2014 cohorts, we found an increase of 12 years of schooling or more (11.3% versus 22.0%; p=0.059, X2 trend), prisoners (0.9% versus 2.1%; p =0.026, X2 trend), mentally ill (0.4% versus 3.0%; p=0.027, X2 trend),cases detected by diagnostic elucidation (7.4% versus 12.6%; p=0.049, X2 trend), patients seen at a Local Health Care Center (79.3% versus 90.1%; p < 0.0001, X2 trend) and investigated household contacts (1.3% versus 4.8%; p=0.040, X2 trend). However, there was decline in the proportion of TB/HIV coinfection (13.2% versus 8.6%; p=0.018, X2 trend) and hospitalizations during treatment (21.6% versus 12.9%; p < 0.0001, X2 trend). 29.8% (477/1603) were initially treated with the RHZ regimen and 70.2% (1126/1603) with the RHZE regimen. The cure rates remained at around 80.0%. However, there was a decline in the proportion of post-cure retreatment (4.7% versus zero; p < 0.0001, X2 trend); deaths from TB (3.4 % versus 0.9%; p=0.090, X2 trend) and deaths from other causes (3.4% versus 2.1 %; p=0.028, X2 trend). Treatment abandonment remained at around 13.7% while (154/220) cases, (70.0%), did not return for retreatment. Conclusion: After the introduction of the RHZE regimen, there was a decrease in TB severity. Nevertheless, treatment abandonment and cure rates showed no significant change. Moreover, a high proportion of patients who abandoned treatment did not return for retreatment. Such results suggest the necessity of additional strategies to improve patient adherence to TB treatment focusing on patients at high risk of abandoning the treatment
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