Urban Noise as an Environmental Impact Factor in the Urban Planning Process

This research focuses on an analysis of the perception of urban noise in the daily lives of the residents of two different areas: (1) a residential neighborhood and (2) a city center, respectively, considering (1) an acoustically ideal urban environment and (2) an acoustically polluted urban environment. To this end, a random sample of individuals from both areas was asked to fill out a questionnaire. Sound pressure levels were also measured in each of the evaluated areas. The World Health Organization (WHO) considers a quiet area as one in which the measured sound pressure level is up to 55 dB(A). The average measured sound pressure levels were 53.5 and 72.9 dB(A), respectively, in the quiet area and in the area considered acoustically polluted. Data were subjected to a multivariate factor analysis. The main complaints reported by the interviewees were as follows: headache, irritability, poor concentration and insomnia. Interviewees in the city center stated that street traffic noise was the main source of annoyance, while the residents of the residential area stated that the main source of discomfort was air traffic noise

AVALIAÇÃO DO RUÍDO DE TRÁFEGO NOTURNO – ESTUDO DE CASO NA CIDADE DE CURITIBA, BRASIL

As imissões sonoras noturnas geradas por um trecho urbano de uma rodovia brasileira, foram avaliados através de medições in situ. A partir dos dados coletados foi elaborada uma modelagem matemática para alguns descritores acústicos (Leq – nível sonoro equivalente; L10, L50 e L90 - níveis sonoros estatísticos), em função da correlação destes entre si e com variáveis de tráfego, para cálculo de níveis sonoros no período noturno. Os modelos desenvolvidos apresentam três características: a) são para aplicação ao ruído de tráfego noturno, b) aplicação de regressão linear e não logarítmica, c) aplicação de intervalos de classe para descrever a complexidade da faixa dinâmica de imissões sonoras, desde os níveis mais baixos até os mais elevados. Verificou-se que para amostras grandes (n > 30) e predição do valor do nível sonoro equivalente (Leq), a avaliação com intervalos de classe de ruído é a mais indicada

A exposição do enfermeiro aos riscos ocupacionais no cuidado de pessoas com lesão de pele

Objetivo: identificar na produção científica nacional e internacional como ocorre a exposição do enfermeiro aos riscos ocupacionais no cuidado de pessoas com lesão de pele. Método: revisão integrativa com coleta dos dados realizada em dezembro de 2016, no Portal de Periódicos da CAPES, encontrando-se publicações nas bases PubMed, LILACS e BVS. Resultados: dos 598 artigos encontrados, foram selecionados para análise 33 publicações. O compilado dos artigos levou ao perfil das publicações de 2000 a 2016 e derivou em três categorias temáticas: o trabalho do enfermeiro no cuidado de pessoas com lesão de pele, consequências da exposição ao risco ocupacional na realização do cuidado, atuação livre de riscos. Considerações finais: o estudo contribui para que enfermeiros repensem práticas de saúde e segurança do trabalho no cuidado de pessoas com lesão de pele, vislumbrando a saúde e a qualificação do trabalho ao protagonizarem o cuidar

DESAFIOS NA COMERCIALIZAÇÃO DE PRODUTOS DA AGRICULTURA FAMILIAR PARA O PROGRAMA NACIONAL DE ALIMENTAÇÃO ESCOLAR

This study analyzed the challenges faced by responsible agents of the National School Feeding Programme (PNAE) in the commercialization of products from family farming in Piauí territories. Cross-sectional study that includes fifteen counties that integrate the regions of Serra da Capivara and Vale do Sambito. The choice of counties was based on purchase percentages between the years 2017 to 2018. The data collection was made through interviews with managers and/or nutritionists, Secretary of Agriculture and farmers. The data were typed in Microsoft Office Excel spreadsheet and analyzed in statistics software package called Stata version 1.2. The analysis between territories and independent variables were evaluated by Pearson’s Chi-square test (x²) and Exact Fisher’s test. The articulation between responsible agents, the schedule execution of the delivery products and elaboration of the sale projects by the farmers were highlighted as the main difficulties faced by managers and/or nutritionists. It was identified that managers know about the local production but they consider it as insufficient and with a few variety of products at all. Farmers highlighted some problems with operation of Municipal Inspection Seal, absence of Law and/or Decree in most of counties in addition to low productivity or irregularities in the offer of products, bureaucracy as well and lack of informations to join the programme. It is necessary a joint operation between responsible agents and execution of intersectorial actions to offer the demand for products that favor the scope of PNAE objectives.Este estudio analizó los desafíos que enfrentan los actores sociales del Programa Nacional de Alimentación Escolar en la comercialización de géneros de agricultura familiar en Piaui Enses. Estudio transversal que incluye quince municipios que integran los territorios, Serra da Capivara y Vale do Sambito. La selección de municipios se basó en los porcentajes de compras de agricultura familiar, en los años 2017 y 2018. La recolección de datos se realizó a través de entrevistas con gerentes y/o nutricionistas, secretario de agricultura y agricultores. Los datos fueron ingresados en una hoja de cálculo del programa Microsoft Office Excel y analizados en el paquete estadístico stata versión 12. El análisis de la asociación entre los territorios y las variables independientes se evaluó mediante la prueba de Chi-cuadrado de Pearson (x2) y la prueba exacta de Fisher. Se destacaron como dificultades que enfrentan los gerentes y/o nutricionistas, la articulación entre actores sociales, el cumplimiento del cronograma de entrega de géneros y la preparación del proyecto de ventas por parte de los agricultores. Se identificó que los directivos conocen la producción local, sin embargo, la consideran insuficiente y con poca variedad de productos. Se destacó por los obstáculos de los agricultores en el funcionamiento del Sello de Inspección Municipal, ausencia de Proyecto de Ley y/o Decreto de Creación, en la mayoría de los municipios, además de baja productividad o irregularidad de la oferta de géneros, seguido de burocracias y escasez de información para sumarse al programa.   Esse estudo analisou os desafios enfrentados pelos atores sociais do Programa Nacional de Alimentação Escolar na comercialização de gêneros da agricultura familiar em Territórios Piauienses. Estudo transversal incluindo quinze municípios que integram os territórios, Serra da Capivara e Vale do Sambito. A seleção dos municípios se baseou nos percentuais de compras da agricultura familiar, nos exercícios, 2017 e 2018. A coleta de dados foi realizada por meio de entrevistas, com gestores e/ou nutricionistas, secretário de agricultura e agricultores. Os dados foram digitados em planilha do programa Microsoft Office Excel e analisados no pacote estatístico Stata versão 12. A análise de associação entre os territórios e as variáveis independentes foram avaliadas por teste Qui-quadrado de Pearson (x2) e teste exato de Fisher. Foram destacadas como dificuldades enfrentadas por gestores e/ou nutricionistas, a articulação entre os atores sociais, cumprimento do cronograma de entrega dos gêneros e elaboração do projeto de venda por parte dos agricultores. Identificou-se que os gestores conhecem a produção local, no entanto, a consideram insuficiente e com pouca variedade de produtos. Foi destacado pelos agricultores entraves no funcionamento do Selo de Inspeção municipal, ausência de Projeto de Lei e/ou Decreto de Criação, na maioria dos municípios, além de baixa produtividade ou irregularidade da oferta dos gêneros, seguida de burocracias e escassez de informações para aderir ao programa. Torna-se necessária atuação conjunta entre os atores e a execução de ações intersetoriais para a oferta e demanda de produtos da agricultura familiar, que favoreça o alcance dos objetivos do PNAE

Estudo em raiz e ráquis foliar de spathelia excelsa: fitoquímica e atividade frente ao fungo Moniliophthora perniciosa associado ao cupuaçuzeiro (Theobroma grandiflorum)

The chemical composition of Spathelia excelsa (Krause) R. S. Cowan & Brizicky was investigated and the limonoids harrisonin (1) and deacetylspathelin (2), alkaloids folinin and casimiroin mixture (3a, b), plus a further casimiroin (3b) were identified in methanol extract from root. The CH2Cl2 extract from the rachis yielded protolimonoid 3β-angeloyl-21,24-epoxy-7α,21α,23α,25-tetrahydroxy-4α,4β,8β,10β-tetramethyl-25-dimethyl-14,18-cyclo-5α,13α,14α,17α-cholestane (4), and methanol extract, the limonoids limonin diosphenol (5) and perforatin (6), as well as the chromone biflorin (7). Harrisonin and biflorin were isolated for the first time in this genus. On the antifungal assay against witches' broom (Moniliophthoraperniciosa) compound 3b was found to be active

Integrated genomic characterization of oesophageal carcinoma

Oesophageal cancers are prominent worldwide; however, there are few targeted therapies and survival rates for these cancers remain dismal. Here we performed a comprehensive molecular analysis of 164 carcinomas of the oesophagus derived from Western and Eastern populations. Beyond known histopathological and epidemiologic distinctions, molecular features differentiated oesophageal squamous cell carcinomas from oesophageal adenocarcinomas. Oesophageal squamous cell carcinomas resembled squamous carcinomas of other organs more than they did oesophageal adenocarcinomas. Our analyses identified three molecular subclasses of oesophageal squamous cell carcinomas, but none showed evidence for an aetiological role of human papillomavirus. Squamous cell carcinomas showed frequent genomic amplifications of CCND1 and SOX2 and/or TP63, whereas ERBB2, VEGFA and GATA4 and GATA6 were more commonly amplified in adenocarcinomas. Oesophageal adenocarcinomas strongly resembled the chromosomally unstable variant of gastric adenocarcinoma, suggesting that these cancers could be considered a single disease entity. However, some molecular features, including DNA hypermethylation, occurred disproportionally in oesophageal adenocarcinomas. These data provide a framework to facilitate more rational categorization of these tumours and a foundation for new therapies

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. METHODS: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017