Desenvolvimento urbano contemporâneo em cidades médias do interior paulista sob o estatuto da cidade: uma análise comparada de Piracicaba, Bauru e Rio Claro

O artigo traça um quadro do desenvolvimento urbano contemporâneo em cidades médias do interior do estado de São Paulo (Brasil), sob três dimensões complementares: econômica, urbanística e políticoinstitucional. Para tanto, indica os processos interdependentes que estruturam o desenvolvimento urbano com base na análise comparativa desses municípios (Piracicaba, Bauru e Rio Claro). Nesses termos, identifica como essas cidades se inseriram nos processos de transformação da economia nacional nas décadas de 1970-90, e como essa trajetória impactou suas dinâmicas urbano-regionais. Observa-se de que maneira as determinantes econômicas – tanto as vinculadas às mudanças no padrão locacional das indústrias quanto outras associadas à dinâmica imobiliária – impactaram o ordenamento urbanístico e como ocorreram tais processos decisórios. A análise se faz no contexto institucional da promulgação e vigência do Estatuto da Cidade, no qual os municípios refizeram seus Planos Diretores e passaram a contar com novos meios de regular a produção do espaço urbano.The article focuses on contemporary urban development in medium-sized cities in the state of São Paulo (Brazil), under three complementary dimensions: economic, urban and political-institutional. Thus, it indicates the interdependent processes that shape urban development based on comparative analysis of these municipalities (Piracicaba, Bauru and Rio Claro). In these terms it identifies how these cities were inserted in the processes of transformation of the national economy in the decades of 1970-90, and how that path impacted their urban-regional dynamics. We observe how the economic determinants – changes in the industry standard locational and dynamic real estate – impacted the urban planning and decision-making processes. The analysis is done in the context of institutional effectiveness and promulgation enactment of the Statute of the City, when municipalities remade their Master Plans and have acquired new ways to regulate the production of urban space.Peer Reviewe

O Estado Brasileiro Contemporâneo: liberalização econômica, política e sociedade nos governos FHC e Lula

O artigo identifica as características da forma contemporânea do Estado brasileiro – vigente desde 1995 – do ângulo de suas relações com a esfera econômica e de suas políticas frente à desigualdade social. O artigo caracteriza os ideários que orientaram as elites dirigentes, o modo como foi redefinida a política externa brasileira na nova conjuntura internacional posterior à Guerra Fria e as políticas econômicas e de distribuição de renda entre 1995 e 2010. A hipótese central é que há uma nova forma de Estado no Brasil desde 1995 e que as variações entre governos que se sucederam no período são parte da mesma história. O artigo se opõe à caracterização corrente de que os governos FHC e Lula obedeceram a uma diretriz neoliberal. Para isso, procura identificar a diretriz que orientou os dois períodos de governo. Mostra que ela foi liberalizante, sim, mas moderada – no que se refere à redução da intervenção do Estado na economia – mesclando políticas dos ideários neoliberal e liberal-desenvolvimentista. Embora haja bastante continuidade nas políticas do Estado em relação à economia, o artigo mostra que o período Lula teve um papel muito relevante na estabilização do Estado e mesmo da ordem capitalista. Com efeito, a incorporação, à gestão do Estado, de lideranças sindicais, de movimentos sociais e de lideranças de esquerda, somada à ampliação da proteção social aos pobres e miseráveis e a criação de canais de ascensão social para a baixa classe média reforçaram a adesão à ordem capitalista e a estabilidade política, complementando os efeitos estabilizadores já reconhecidos pela literatura das regras democráticas e da estabilidade da moeda

O Estado Brasileiro Contemporâneo: liberalização econômica, política e sociedade nos governos FHC e Lula

O artigo identifica as características da forma contemporânea do Estado brasileiro – vigente desde 1995 – do ângulo de suas relações com a esfera econômica e de suas políticas frente à desigualdade social. O artigo caracteriza os ideários que orientaram as elites dirigentes, o modo como foi redefinida a política externa brasileira na nova conjuntura internacional posterior à Guerra Fria e as políticas econômicas e de distribuição de renda entre 1995 e 2010. A hipótese central é que há uma nova forma de Estado no Brasil desde 1995 e que as variações entre governos que se sucederam no período são parte da mesma história. O artigo se opõe à caracterização corrente de que os governos FHC e Lula obedeceram a uma diretriz neoliberal. Para isso, procura identificar a diretriz que orientou os dois períodos de governo. Mostra que ela foi liberalizante, sim, mas moderada – no que se refere à redução da intervenção do Estado na economia – mesclando políticas dos ideários neoliberal e liberal-desenvolvimentista. Embora haja bastante continuidade nas políticas do Estado em relação à economia, o artigo mostra que o período Lula teve um papel muito relevante na estabilização do Estado e mesmo da ordem capitalista. Com efeito, a incorporação, à gestão do Estado, de lideranças sindicais, de movimentos sociais e de lideranças de esquerda, somada à ampliação da proteção social aos pobres e miseráveis e a criação de canais de ascensão social para a baixa classe média reforçaram a adesão à ordem capitalista e a estabilidade política, complementando os efeitos estabilizadores já reconhecidos pela literatura das regras democráticas e da estabilidade da moeda

ENCLAVES FORTIFICADOS E SEGREGAÇÃO URBANA – O CASO DE JUNDIAÍ

Este artigo examina a proliferação de condomínios fechados no município de Jundiaí (SP). Os estudos sobre esse fenômeno retratam predominantemente as regiões metropolitanas, daí a relevância de pesquisas sobre cidades de médio porte, a fim de identificar semelhanças e diferenças entre essas diferentes escalas urbanas. O objetivo principal foi investigar o fenômeno espacializado dos condomínios fechados como tendência de padrão habitacional, assim como seus impactos sociais, urbanísticos e ambientais, adotando-se como escopo cronológico o período que se inicia a partir da década de 1970 até o presente momento

SEGREGAÇÃO SOCIOESPACIAL E POLÍTICA URBANA EM CIDADES MÉDIAS NO BRASIL CONTEMPORÂNEO (2001-2011)

O Estatuto da Cidade (Lei Federal 10.257/2001) regulamentou o capítulo de política urbana da Constituição Federal Brasileira de 1988, ampliando os poderes dos municípios para legislar sobre seus territórios ao disponibilizar novos instrumentos de regulação e ordenamento urbanístico. Piracicaba, Bauru e Rio Claro, cidades médias do interior do estado de São Paulo, passaram por processos de revisão de seus Planos Diretores na primeira década do século XXI que os adequaram às premissas do EC. A análise comparativa desses processos, de novas políticas urbanas e de implantação das Zonas Especiais de Interesse Social (ZEIS) evidencia as limitações dos referidos planos, cujas diretrizes relativas aos interesses imobiliários e fundiários locais remetem a obstáculos no enfrentamento de seus passivos urbanísticos e ambientais, o que afeta, sobretudo, os segmentos mais pobres da população.SOCIOESPATIAL SEGREGATION AND URBAN POLITICS IN MEDIUM-SIZED CITIES IN CONTEMPORARY BRAZIL (2001-2011)ABSTRACTThe “City Statute” (Federal Law 10.257/2001) regulated the chapter about urban politics of Brazil’s 1988 Constitution and widened the powers of the cities to legislate about their territories by making available new tools for urban regulation and order. The cities of Piracicaba, Bauru and Rio Claro, medium-sized cities of the state of São Paulo, passed through processes of revising their Directive Plans in the first decade of the 21st century to adequate their plans to the principles of the Statute. The comparative analysis of these processes, of the implementing of Special Zones of Social Interest (Zonas Especiais de Interesse Social – ZEIS), and of the urban politics evidences the limitations of the Directive Plans. These limitations occur by these plans being the opposite of the real and land markets’ interests, which cause obstacles in the confronting of urban and environmental passives, affecting especially the poorer spheres of the population.Key words: Urban dynamics; Special Zones of Social Interest; City Statute; Directive PlansLA SÉGRÉGATION SOCIO-SPATIALE ET LA POLITIQUE URBAINE DANS QUELQUES VILLES MOYENNES DU BRÉSIL CONTEMPORAIN(2001-2011)ABSTRACTLe statut de la ville (Loi Fédérale 10.257/2001) a réglementé le chapitre concernant la politique urbaine de la Constitution Fédérale Brésilienne de 1988. Les pouvoirs des municipalités sont ainsi accrus pour leur permettre de légiférer sur leur territoire en leur donnant de nouveaux instruments de réglementation et d’ordonnancement urbain. Piracicaba, Bauru et Rio Claro, villes moyennes de l’état de Sao Paulo, ont entamé des processus de révision de leurs plans directeurs au cours de la première décennie du XXIe siècle, ce qui a permis de les adapter aux prémisses du Statut. L’analyse comparative de ces processus et de la mise en oeuvre de Zones Spéciales d’Intérêt Social (ZSIS) ainsi que de nouvelles politiques urbaines met en évidence les limitations desdits plans qui s’opposent aux intérêts immobiliers et fonciers locaux et affrontent des obstacles quant à leur engagement urbanistique et environnemental, ce qui touche plus particulièrement les populations les plus défavorisées.Key words: Dynamiques urbaines; Zones Spéciales d’Intérêt Social; Statut de la Ville; Plans directeur

A dinâmica urbana de cidades médias do interior paulista sob o Estatuto da Cidade

O artigo examina o alcance do Estatuto da Cidade como novo marco regulatório da política urbana brasileira a partir de estudo comparativo de processos contemporâneos em três cidades médias do interior paulista (Piracicaba, Bauru e Rio Claro). O estudo se faz mediante a análise de três dimensões complementares: econômica, urbanística e político-institucional. São constatados obstáculos endógenos e exógenos que têm condicionado as políticas urbanas e dificultado a aplicação dos indicativos dos Planos Diretores recém-aprovados. Apesar da expressiva incorporação formal dos instrumentos do Estatuto da Cidade, boa parte não tem sido implantada ou não foi regulamentada, cenário que pode ser generalizado como predominante no país e que remete aos padrões contemporâneos do desenvolvimento regional e urbano.

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio

Global, regional, and national under-5 mortality, adult mortality, age-specific mortality, and life expectancy, 1970–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Detailed assessments of mortality patterns, particularly age-specific mortality, represent a crucial input that enables health systems to target interventions to specific populations. Understanding how all-cause mortality has changed with respect to development status can identify exemplars for best practice. To accomplish this, the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) estimated age-specific and sex-specific all-cause mortality between 1970 and 2016 for 195 countries and territories and at the subnational level for the five countries with a population greater than 200 million in 2016. METHODS: We have evaluated how well civil registration systems captured deaths using a set of demographic methods called death distribution methods for adults and from consideration of survey and census data for children younger than 5 years. We generated an overall assessment of completeness of registration of deaths by dividing registered deaths in each location-year by our estimate of all-age deaths generated from our overall estimation process. For 163 locations, including subnational units in countries with a population greater than 200 million with complete vital registration (VR) systems, our estimates were largely driven by the observed data, with corrections for small fluctuations in numbers and estimation for recent years where there were lags in data reporting (lags were variable by location, generally between 1 year and 6 years). For other locations, we took advantage of different data sources available to measure under-5 mortality rates (U5MR) using complete birth histories, summary birth histories, and incomplete VR with adjustments; we measured adult mortality rate (the probability of death in individuals aged 15-60 years) using adjusted incomplete VR, sibling histories, and household death recall. We used the U5MR and adult mortality rate, together with crude death rate due to HIV in the GBD model life table system, to estimate age-specific and sex-specific death rates for each location-year. Using various international databases, we identified fatal discontinuities, which we defined as increases in the death rate of more than one death per million, resulting from conflict and terrorism, natural disasters, major transport or technological accidents, and a subset of epidemic infectious diseases; these were added to estimates in the relevant years. In 47 countries with an identified peak adult prevalence for HIV/AIDS of more than 0·5% and where VR systems were less than 65% complete, we informed our estimates of age-sex-specific mortality using the Estimation and Projection Package (EPP)-Spectrum model fitted to national HIV/AIDS prevalence surveys and antenatal clinic serosurveillance systems. We estimated stillbirths, early neonatal, late neonatal, and childhood mortality using both survey and VR data in spatiotemporal Gaussian process regression models. We estimated abridged life tables for all location-years using age-specific death rates. We grouped locations into development quintiles based on the Socio-demographic Index (SDI) and analysed mortality trends by quintile. Using spline regression, we estimated the expected mortality rate for each age-sex group as a function of SDI. We identified countries with higher life expectancy than expected by comparing observed life expectancy to anticipated life expectancy on the basis of development status alone. FINDINGS: Completeness in the registration of deaths increased from 28% in 1970 to a peak of 45% in 2013; completeness was lower after 2013 because of lags in reporting. Total deaths in children younger than 5 years decreased from 1970 to 2016, and slower decreases occurred at ages 5-24 years. By contrast, numbers of adult deaths increased in each 5-year age bracket above the age of 25 years. The distribution of annualised rates of change in age-specific mortality rate differed over the period 2000 to 2016 compared with earlier decades: increasing annualised rates of change were less frequent, although rising annualised rates of change still occurred in some locations, particularly for adolescent and younger adult age groups. Rates of stillbirths and under-5 mortality both decreased globally from 1970. Evidence for global convergence of death rates was mixed; although the absolute difference between age-standardised death rates narrowed between countries at the lowest and highest levels of SDI, the ratio of these death rates-a measure of relative inequality-increased slightly. There was a strong shift between 1970 and 2016 toward higher life expectancy, most noticeably at higher levels of SDI. Among countries with populations greater than 1 million in 2016, life expectancy at birth was highest for women in Japan, at 86·9 years (95% UI 86·7-87·2), and for men in Singapore, at 81·3 years (78·8-83·7) in 2016. Male life expectancy was generally lower than female life expectancy between 1970 and 2016, an

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe