Access to the Brazilian City - from the perspectives of low-income residents in Recife

This paper describes a study of the transport and accessibility needs of residents living in low-income communities in the City of Recife in Brazil. It discusses the theoretical background underpinning the academic and policy rationale for such a study. We outline the qualitative methodological approach, which was adopted to engage in meaningful knowledge exchanges with what are often considered by policymakers to be the ‘hard-to-reach’ citizens of Brazil’s favelas. In the exploration of our study results, we describe the complex relationship between the mobilities and livelihoods of the research participants. A key question the paper seeks to examine is how far the restricted mobility and activity patterns of citizens in these low-income communities influences or interacts with their quality of life outcomes in terms of their wealth, health and wellbeing? A second question is whether transport planning and policy can have a role to play in enhancing their future life chances? Currently, transport planners and policymakers in Brazil know very little about the specific accessibility and mobility needs of people living in Brazilian low-income communities. Our aim is to shed some light on the issue of their mobility needs in the context of a wider set of policy discussions about how to protect the livelihoods and wellbeing of low-income populations within rapidly emerging urban economies

Effects of combined training performed two or four times per week on 24-h blood pressure, glycosylated hemoglobin and other health-related outcomes in aging individuals with hypertension : rationale and study protocol of a randomized clinical trial

Background: Acute blood pressure lowering after exercise seems to predict the extent of blood pressure reduction after chronic exercise training interventions. Based on that, the same weekly amount of exercise performed more frequently could be more beneficial for controlling blood pressure. Purpose: To compare the effects of a combined training program (resistance plus aerobic exercise) performed four or two times per week on 24-h ambulatory blood pressure and other healthrelated outcomes in middle-aged and older individuals with hypertension. Methods: This study will be a randomized, parallel group, two-arm, superiority trial. Ninety-eight participants aged 50–80 years with a previous physician diagnosis of hypertension will be randomized to perform two or four sessions per week of combined training using the same total weekly overload. Primary outcomes will be 24-h ambulatory blood pressure and glycosylated hemoglobin; secondary outcomes will be endothelial function, physical fitness and quality of life. The outcomes will be assessed at baseline and at the end of 12 weeks period. Results: Our conceptual hypothesis is that a combined exercise program performed four or two times per week with equalized weekly volume/overload will improve all outcomes in comparison to the baseline values, and that reductions in 24-h blood pressure and glycosylated hemoglobin will be more pronounced in the group that trained four times a week than twice. The results of this trial are expected to provide evidences to support that higher weekly frequency of combined training should be emphasized in aging adults with hypertension

Use of hyghly reactive rice husk ash in the production of cement matrix reinforced with Green coconut fiber

[EN] This study evaluated the influence of partial replacement of Portland cement by rice husk ash (RHA) to enable the use of green coconut husk fiber as reinforcement for cementitious matrix. The use of highly reactive pozzolanic ash contributes for decreasing the alkaline attack on the vegetable fiber, originated from waste materials. The slurry dewatering technique was used for dispersion of the raw materials in aqueous solution, followed by vacuum drainage of water and pressing for the production of pad composites, as a simplified simulation of the Hatschek process for industrial manufacture. Five formulations were evaluated, two of them without any mineral additions. One of the mixtures served as a reference (without green coconut fibers) and the remaining ones were reinforced with the green coconut fibers (5% by weight of binder) and with the content of Portland cement replacement by RHA equal to 0, 30, 40 and 50%. The composites were analyzed at 28 days of age and after aging by immersion in warm wáter (65 ◦C), which lasted for 28 additional days. Physical and mechanical tests were applied for assessment of the performance of composites. Thermogravimetric analysis was used to observe the consumption of portlandite and chemically combined water content in the hydrated products for pastes presenting the same levels of Portland cement replacement by RHA (i.e., 0 50%) and with the water/binder ratio kept constant and equal to 0.5. The mechanical performance evaluated by bending test after 28 days reached the MOR of 15.7 MPa after the accelerate aging, for the composites reinforced with the green coconut fiber and with high levels of Portland cement replacement by RHA demonstrating that the use of Green coconut fiber for reinforcement can be very promising for the production of binary cement based matrix. The thermogravimetry showed that the replacement of Portland cement by the RHA helped in maintaining the mechanical behavior of the green coconut fiber in the composite subjected to the accelerated aging tests, and resulted in improved mechanical performance, providing a lightweight composite.To the Fundacao de Amparo Pesquisa do Estado de Sao Paulo (FAPESP) for financial support and ICITECH Universitat Politecnica de Valencia for facilitating the research development. To the Federal Agency CNPq, Brazil for grants provided to the USP team. Project 3018/2009 financed by Generalitat Valenciana, COMBURES project financed by Centro de Cooperacion al Desarrollo de la Universitat Politecnica de Valencia (ADSIDEO COOPERACIO) and Maicerias Espanolas DACSA S.A. for supplying RHA samples.Pereira, C.; Savastano, HJ.; Paya Bernabeu, JJ.; Santos, SF.; Borrachero Rosado, MV.; Monzó Balbuena, JM.; Soriano Martínez, L. (2013). Use of hyghly reactive rice husk ash in the production of cement matrix reinforced with Green coconut fiber. Industrial Crops and Products. 49:88-96. https://doi.org/10.1016/j.indcrop.2013.04.038S88964

Weekday sunlight exposure, but not vitamin D intake, influences the association between vitamin D receptor genotype and circulating concentration 25-hydroxyvitamin D in a pan-European population: the Food4Me study

Scope Little is known about diet- and environment-gene interactions on 25-hydroxyvitamin D (25(OH)D concentration. This cross-sectional study aimed to investigate i) predictors of 25(OH)D concentration and relationships with vitamin D genotypes and ii) whether dietary vitamin D intake and sunlight exposure modified these relationships. Methods and results Participants from the Food4Me study (n = 1312; age 18–79) were genotyped for vitamin D receptor (VDR) and vitamin D binding protein at baseline and a genetic risk score was calculated. Dried blood spot samples were assayed for 25(OH)D concentration and dietary and lifestyle information collected. Circulating 25(OH)D concentration was lower with increasing genetic risk score, lower in females than males, higher in supplement users than non-users and higher in summer than winter. Carriage of the minor VDR allele was associated with lower 25(OH)D concentration in participants with the least sunlight exposure. Vitamin D genotype did not influence the relationship between vitamin D intake and 25(OH)D concentration. Conclusion Age, sex, dietary vitamin D intake, country, sunlight exposure, season and vitamin D genetic risk score were associated with circulating 25(OH)D concentration in a pan-European population. The relationship between VDR genotype and 25(OH)D concentration may be influenced by weekday sunlight exposure but not dietary vitamin D intake

Sequential multi-stage extraction of biocompounds from Spirulina platensis: Combined effect of ohmic heating and enzymatic treatment

A sequential multi-stage procedure was applied on the extraction of biocompounds from Spirulina platensis. The process consisted in three steps: 1) aqueous extraction, using conventional thermal extraction (CE), ohmic heating (OH, 7V/cm), enzymatic treatment (EAE, 0.8 mgLysozyme/mL), or both OH and EAE combined; 2) ethanolic extraction; 3) CHCl3/MeOH extraction. The results evidenced that the combined OH-EAE extraction allowed selective recovery of phycobiliproteins in the 1st step, with increments of more than 100% in yield in comparison with CE. Pigments and lipids were selectively extracted in the 2nd step. The combination of OH and EAE in the 1st step resulted in higher amounts of extracted compounds in the following phases compared to processes using non-combined technologies. Results demonstrate that the intensification of extraction steps facilitates the use of environmentally friendly technologies in a multi-stage process capable of recovering and isolating different fractions with bio-functional properties, targeting waste reduction and circular economy. Industrial relevance Spirulina plantensis represents a potential biomass feedstock due to its potential as a source of compounds of great economic value (including antioxidants, proteins, lipids and natural pigments, in particular blue colorants). The combined use of ohmic heating and enzymes in the aqueous extraction step fosters the use of environmentally friendly technologies to implement sequential high yield and high purity extraction of the different valuable fractions with bio-functional properties, targeting waste reduction and contributing to the implementation of circular economy strategies. This can be integrated with a design of Industry 4.0 driving the development of new products.This research was funded by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit, by program Marie Skłodowska-Curie grant (MSCA-RISE; FODIAC; 778388) and by project OH2O - POCI-01-0145-FEDER-029145 (funded by FCT, COMPETE2020 – Competitiveness and Internationalization Operational Program and European Fund for Regional Development - FEDER). Pedro Santos is recipient of a PhD fellowship supported by a doctoral advanced training (call NORTE-69-2015-15), funded by the European Social Fund under the scope of Norte2020 - Programa Operacional Regional do Norte (NORTE-08-5369-FSE-000036). Sílvia Miranda acknowledges the financial support provided by FCT through the Doctoral grant SFRH/BD/144188/2019. Spirulina platensis was kindly supplied by EVRA S.r.l. (Potenza, Italy).info:eu-repo/semantics/publishedVersio

Tracking the emergence of disparities in the subnational spread of COVID-19 in Brazil using an online application for real-time data visualisation: A longitudinal analysis

Background: Brazil is one of the countries worst affected by the COVID-19 pandemic with over 20 million cases and 557,000 deaths reported by August 2021. Comparison of real-time local COVID-19 data between areas is essential for understanding transmission, measuring the effects of interventions, and predicting the course of the epidemic, but are often challenging due to different population sizes and structures. Methods: We describe the development of a new app for the real-time visualisation of COVID-19 data in Brazil at the municipality level. In the CLIC-Brazil app, daily updates of case and death data are downloaded, age standardised and used to estimate the effective reproduction number (Rt). We show how such platforms can perform real-time regression analyses to identify factors associated with the rate of initial spread and early reproduction number. We also use survival methods to predict the likelihood of occurrence of a new peak of COVID-19 incidence. Findings: After an initial introduction in S\~o Paulo and Rio de Janeiro states in early March 2020, the epidemic spread to northern states and then to highly populated coastal regions and the Central-West. Municipalities with higher metrics of social development experienced earlier arrival of COVID-19 (decrease of 11·1 days 95% CI:8.9,13.2 in the time to arrival for each 10% increase in the social development index). Differences in the initial epidemic intensity (mean Rt) were largely driven by geographic location and the date of local onset. Interpretation: This study demonstrates that platforms that monitor, standardise and analyse the epidemiological data at a local level can give useful real-time insights into outbreak dynamics that can be used to better adapt responses to the current and future pandemics. Funding: This project was supported by a Medical Research Council UK (MRC-UK) -S{\~{a}}o Paulo Research Foundation (FAPESP) CADDE partnership award (MR/S0195/1 and FAPESP 18/14389-0

Infection by the hepatitis C virus in chronic renal failure patients undergoing hemodialysis in Mato Grosso state, central Brazil: a cohort study

BACKGROUND: Hepatitis C virus (HCV) is a significant problem for patients undergoing hemodialysis therapy. This situation has never been studied in Mato Grosso state, central Brazil. This study was conducted aiming to estimate the prevalence of the anti-HCV and the incidence of seroconversion in the main metropolitan region of the state. METHODS: 433 patients from the six hemodialysis units were interviewed and anti-HCV was tested by a third-generation enzyme immunoassay. An open cohort of patients who tested negative for anti-HCV at the entry of the study was created and seroconversions was assessed monthly. The staff responsible for the units were interviewed to assess whether the infection control measures were being followed. Logistic and Cox regression analysis were performed in order to assess risk factor to HCV. RESULTS: The entry on the study took place between January 2002 and June 2005. 73 out of 433 (16.9%, CI95%: 13.3–20.8) was found to be anti-HCV reactive. The multivariate analysis indicated as risk factors associated to anti-HCV the duration of the hemodialysis treatment, the number of transfusions received, and the unit of treatment. An open cohort of 360 patients who tested negative for anti-HCV was created, with a following average of 24 (± 15) months. Forty seroconversions were recorded corresponding to an incidence density of 4.6/1000 patient-months, ranges 0 to 30 among the units. Cox regression indicated the time of hemodialysis (RR = 2.2; CI95%: 1.1–4.6; p < 0.05) and the unit where treatment was performed (RR = 42.4; CI95%: 9.9–180.5; p < 0.05) as risk factors for seroconversion. The three units with highest anti-HCV prevalence and incidence were identified as those that more frequently failed to apply control measures. CONCLUSION: The study demonstrated high prevalence and incidence of anti-HCV in some of the hemodialysis units. Time on hemodialysis therapy was an independent factor associated to HCV. Blood transfusion was associated with anti-HCV in initial survey but was not important in incident cases. Failure of applying control meaures was more evident in units with the highest HCV prevalence and incidence. The results suggest that nosocomial transmission was the main spread factor of HCV in the studied population

Water aerobics II: maternal body composition and perinatal outcomes after a program for low risk pregnant women

<p>Abstract</p> <p>Background</p> <p>To evaluate the effectiveness and safety of water aerobics during pregnancy.</p> <p>Methods</p> <p>A randomized controlled trial carried out in 71 low-risk sedentary pregnant women, randomly allocated to water aerobics or no physical exercise. Maternal body composition and perinatal outcomes were evaluated. For statistical analysis Chi-square, Fisher's or Student's t-tests were applied. Risk ratios and their 95% CI were estimated for main outcomes. Body composition was evaluated across time using MANOVA or Friedman multiple analysis.</p> <p>Results</p> <p>There were no significant differences between the groups regarding maternal weight gain, BMI or percentage of body fat during pregnancy. Incidence of preterm births (RR = 0.84; 95%CI:0.28–2.53), vaginal births (RR = 1.24; 95%CI:0.73–2.09), low birthweight (RR = 1.30; 95%CI:0.61–2.79) and adequate weight for gestational age (RR = 1.50; 95%CI:0.65–3.48) were also not significantly different between groups. There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session.</p> <p>Conclusion</p> <p>Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition, type of delivery, preterm birth rate, neonatal well-being or weight.</p

Exercise in obese pregnant women: The role of social factors, lifestyle and pregnancy symptoms

Background Physical activity may reduce the risk of adverse maternal outcomes, yet there are very few studies that have examined the correlates of exercise amongst obese women during pregnancy. We examined which relevant sociodemographic, obstetric, and health behaviour variables and pregnancy symptoms were associated with exercise in a small sample of obese pregnant women. Methods This was a secondary analysis using data from an exercise intervention for the prevention of gestational diabetes in obese pregnant women. Using the Pregnancy Physical Activity Questionnaire (PPAQ), 50 obese pregnant women were classified as "Exercisers" if they achieved ≥900 kcal/wk of exercise and "Non-Exercisers" if they did not meet this criterion. Analyses examined which relevant variables were associated with exercise status at 12, 20, 28 and 36 weeks gestation. Results Obese pregnant women with a history of miscarriage; who had children living at home; who had a lower pre-pregnancy weight; reported no nausea and vomiting; and who had no lower back pain, were those women who were most likely to have exercised in early pregnancy. Exercise in late pregnancy was most common among tertiary educated women. Conclusions Offering greater support to women from disadvantaged backgrounds and closely monitoring women who report persistent nausea and vomiting or lower back pain in early pregnancy may be important. The findings may be particularly useful for other interventions aimed at reducing or controlling weight gain in obese pregnant women