Condições demográficas e socioeconômicas associadas à insegurança alimentar em domicílios de Campinas, SP

To evaluate the association of food insecurity with demographic and socioeconomic conditions in households in Campinas, São Paulo state, Brazil. Methods: This is a cross-sectional study conducted on a representative sample of the urban population of the Southern, Southwestern, and Northwestern Health Districts of Campinas, between 2011-2012. Characteristics of the head of household, family history and household patterns were investigated. The dependent variable was food security condition, categorized as food security, mild food insecurity, and moderate/severe food insecurity. All independent variables with p-value <0.20 in the bivariate multinomial logistic regression were included in the final model of multiple multinomial logistic regression, adjusted to household head age; the remaining variables had p-value <0.05. Results: In the 691 households analyzed, there was 65% of food security, 27.9% of mild food insecurity, and 7.1% of moderate/severe food insecurity. The conditions associated with mild food insecurity were monthly per capita income less than the minimum wage, household head unemployed for more than six months between 2004-2010, living in properties given to the family/occupied/other, and density higher than two people per bedroon. The moderate/severe food insecurity was associated with informal employment condition of the household head and the presence of a beneficiary of the Bolsa Família (Family Allowance Program), a cash transfer-type program, in the household. The higher the score of the consumer goods, the lower the probability of mild food insecurity or moderate/severe food insecurity. There was a higher probability of mild food insecurity and moderate/severe food insecurity in unfinished masonry-built houses/other. Conclusion: More than one third of the households investigated experienced some form of food insecurity. Mild food insecurity was associated with demographic conditions, while moderate/severe food insecurity was associated with socioeconomic conditions, especially those related to the household head296845857FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informaçãoAvaliar a associação da insegurança alimentar com as condições demográficas e socioeconômicas em domicílios de Campinas (SP). Métodos: Estudo transversal com amostra representativa da população urbana dos Distritos de Saúde Sul, Sudoeste e Noroeste de Campinas, realizado entre 2011-2012. Estudaram-se as características do chefe de família, dos antecedentes familiares e do domicílio. A variável dependente foi condição de segurança alimentar, categorizada em segurança alimentar, insegurança alimentar leve e insegurança alimentar moderada/grave. Todas as variáveis independentes com p-valor<0,20 na regressão logística multinomial bivariada foram incluídas no modelo final de regressão logística multinomial múltipla, ajustado pela idade do chefe da família, permanecendo aquelas com p<0,05. Resultados: Nos 691 domicílios analisados, houve 65,0% em segurança alimentar, 27,9% em insegurança alimentar leve e 7,1% em insegurança alimentar moderada/grave. As condições associadas à insegurança alimentar leve foram renda familiar mensal per capita menor que um salário mínimo, desemprego do chefe da família por mais de seis meses entre 2004-2010, residir em domicílios de condição cedido/invasão/outro e com densidade maior que duas pessoas por dormitório. A insegurança alimentar moderada/grave esteve associada à informalidade do emprego do chefe da família e ter titular do Bolsa Família no domicílio. Quanto maior o escore de bens de consumo, menor foi a chance de insegurança alimentar leve ou moderada/grave, enquanto que houve maior chance da presença de qualquer tipo de insegurança alimentar nos domicílios construídos com alvenaria inacabada/outros. Conclusão: Mais de um terço dos domicílios apresentam alguma forma de insegurança alimentar. A insegurança alimentar leve está associada às condições demográficas, enquanto que a moderada/grave associa-se às condições socioeconômicas, principalmente relacionadas ao chefe da famíli

Cash transference and food insecurity in Brazil: analysis of national data

OBJECTIVE: The 2004 National Household Survey Data was analyzed to test the hypothesis that cash transference from government social programs is associated with household food security. METHODS: Secondary data were used from the National Household Sample Survey which interviewed residents of 112,716 households. The present analysis included permanent and temporary private households, where food security items were informed by a resident of the household, restricting the collection of data to households with per capita monthly income of up to 1 minimum wage, representing 51.2% of the sample. Three models for estimating the amount of cash transference were developed; model 3 was chosen because it was less likely to overestimate effects. To analyze how cash transference affected the prevalence of food security, only households that received cash transference were included in the analysis, representing 14.2% of the interviewed households. The association between food security and cash transference, controlled for other independent variables, was estimated using a logistic regression model with stepwise method for each of the three income strata. RESULTS: The mean per capita cash transference was of R$81.68 per family. Multiple logistic regression showed an increased chance of food security of 8$10.00 contributed by social programs. Rural residence, male head of household, and Caucasian head of household were factors that also presented a higher chance of food security. CONCLUSION: The hypothesis was confirmed, showing a positive association between cash transfer and household food security, regardless of the effects of other explanatory factors.OBJETIVO: O objetivo deste trabalho foi analisar, na Pesquisa Nacional por Amostra de Domicílios 2004, a hipótese de que a participação em programas governamentais de Transferência de Renda está associada à situação de segurança alimentar no domicílio. MÉTODOS: Utilizaram-se dados secundários da Pesquisa Nacional por Amostra de Domicílios com entrevistas em 112.716 domicílios. Incluíram-se neste trabalho os domicílios particulares permanentes e improvisados, em que as informações sobre segurança alimentar foram fornecidas por um morador, limitando-se ainda àqueles com rendimento domiciliar per capita de até um salário-mínimo, representando isto 51,2% dos domicílios da amostra. Foram elaborados três modelos de estimativas de transferência de renda com resultados semelhantes; escolheu-se o Modelo 3 por resultar em menor probabilidade de superestimar efeitos. Para estimar o efeito da transferência de renda na prevalência de segurança alimentar, foram incluídos apenas os domicílios que recebiam transferência de renda correspondendo a 14,2% do total de domicílios entrevistados. A associação entre segurança alimentar e transferência de renda, controlando por outras variáveis independentes, foi estimada mediante modelos de regressão logística, método stepwise, para cada uma das três faixas de rendimento domiciliar per capita. RESULTADOS: Os programas de transferência de renda considerados neste estudo apresentaram um valor médio de benefícios de R$81,68 por domicílio. A regressão logística múltipla mostrou aumento em torno de 8,0% na chance de segurança alimentar, para cada 10 reais de acréscimo nos valores das transferências. As condições de: residência em área rural, pessoa de referência do sexo masculino e de raça/cor branca também apresentaram associação positiva com segurança alimentar. CONCLUSÃO: Os resultados confirmam a hipótese do estudo, indicando associação positiva da transferência de renda sobre a segurança alimentar, independentemente do efeito de outras condições explicativas.39s51

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Azimuthal anisotropy of charged jet production in root s(NN)=2.76 TeV Pb-Pb collisions

We present measurements of the azimuthal dependence of charged jet production in central and semi-central root s(NN) = 2.76 TeV Pb-Pb collisions with respect to the second harmonic event plane, quantified as nu(ch)(2) (jet). Jet finding is performed employing the anti-k(T) algorithm with a resolution parameter R = 0.2 using charged tracks from the ALICE tracking system. The contribution of the azimuthal anisotropy of the underlying event is taken into account event-by-event. The remaining (statistical) region-to-region fluctuations are removed on an ensemble basis by unfolding the jet spectra for different event plane orientations independently. Significant non-zero nu(ch)(2) (jet) is observed in semi-central collisions (30-50% centrality) for 20 <p(T)(ch) (jet) <90 GeV/c. The azimuthal dependence of the charged jet production is similar to the dependence observed for jets comprising both charged and neutral fragments, and compatible with measurements of the nu(2) of single charged particles at high p(T). Good agreement between the data and predictions from JEWEL, an event generator simulating parton shower evolution in the presence of a dense QCD medium, is found in semi-central collisions. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Forward-central two-particle correlations in p-Pb collisions at root s(NN)=5.02 TeV

Two-particle angular correlations between trigger particles in the forward pseudorapidity range (2.5 2GeV/c. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B. V.Peer reviewe

Event-shape engineering for inclusive spectra and elliptic flow in Pb-Pb collisions at root(NN)-N-S=2.76 TeV

Peer reviewe

Pseudorapidity and transverse-momentum distributions of charged particles in proton-proton collisions at root s=13 TeV

The pseudorapidity (eta) and transverse-momentum (p(T)) distributions of charged particles produced in proton-proton collisions are measured at the centre-of-mass energy root s = 13 TeV. The pseudorapidity distribution in vertical bar eta vertical bar <1.8 is reported for inelastic events and for events with at least one charged particle in vertical bar eta vertical bar <1. The pseudorapidity density of charged particles produced in the pseudorapidity region vertical bar eta vertical bar <0.5 is 5.31 +/- 0.18 and 6.46 +/- 0.19 for the two event classes, respectively. The transverse-momentum distribution of charged particles is measured in the range 0.15 <p(T) <20 GeV/c and vertical bar eta vertical bar <0.8 for events with at least one charged particle in vertical bar eta vertical bar <1. The evolution of the transverse momentum spectra of charged particles is also investigated as a function of event multiplicity. The results are compared with calculations from PYTHIA and EPOS Monte Carlo generators. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Peer reviewe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030