Study of Urbanization in Areas of Landsline Risk at the Recreio São Jorge and Novo Recreio Neighborhoods, of the Cabuçu Region, in the Guarulhos Township, State of São Paulo, Brazil

Este artigo, desenvolvido a partir de dissertação de mestrado em Análise Geoambiental da Universidade Guarulhos, apresenta um estudo de urbanização em áreas de risco a escorregamentos dos loteamentos do Recreio São Jorge e Novo Recreio, localizados no município de Guarulhos, São Paulo, Brasil. O estudo adotou a microbacia Taquara do Reino como unidade de planejamento urbano e considerou a carta de zoneamento de risco e suscetibilidade a escorregamentos, assim como a cartografia de restrições legais ao uso do solo. O resultado obtido foi a elaboração de uma alternativa de urbanização como ensaio prático de aplicação dos critérios estudados, considerando a necessidade de melhorar-se as condições ambientais do uso do solo nessa microbacia.This article, developed at the Master´s Program in Geoenvironmental Analysis of the Guarulhos University, presents an urbanization study in areas under landslide risk at the Recreio São Jorge and Novo Recreio neighborhoods, in the city of Guarulhos, State of São Paulo, Brazil. This study adopted the Taquara do Reino watershed as an urban planning unit and considered the zoning map of landslide risk restrictions to land use. This study resulted in the elaboration of an urbanization alternative as a practical test for the studied criteria, considering the need to improve environmental conditions of land use in that watershed

Temporal changes in bio-behavioral and glycemic outcomes following a produce prescription program among predominantly Hispanic/Latino adults with or at risk of type 2 diabetes

In the United States (U.S.), consumption of fresh vegetables and fruits is below recommended levels. Enhancing access to nutritious food through food prescriptions has been recognized as a promising approach to combat diet-related illnesses. However, the effectiveness of this strategy at a large scale remains untested, particularly in marginalized communities where food insecurity rates and the prevalence of health conditions such as type 2 diabetes (T2D) are higher compared to the background population. This study evaluated the impact of a produce prescription program for predominantly Hispanic/Latino adults living with or at risk of T2D. A total of 303 participants enrolled in a 3-month observational cohort received 21 medically prescribed portions/week of fresh produce. A subgroup of 189 participants used continuous glucose monitoring (CGM) to assess the relationship between CGM profile changes and HbA1c level changes.For 247 participants completing the study (76% female, 84% Hispanic/Latino, 32% with T2D, age 56·6 ± 11·9 years), there was a reduction in weight (−1·1 [-1·6 to −0·6] lbs., p 120 mmHg (−4·2 [-6·8 to −1·8] mmHg, p = 0·001). For participants with an HbA1c ≥ 7·0% at baseline, HbA1c fell significantly (−0·5 [-0·9 to −0·1] %, p = 0·01). There were also improvements in food security (p < 0·0001), self-reported ratings of sleep, mood, pain (all p < 0·001), and measures of depression (p < 0·0001), anxiety (p = 0·045), and stress (p = 0·002) (DASS-21). There was significant correlation (r = 0·8, p = 0·001) between HbA1c change and the change in average glucose for participants with worsening HbA1c, but not for participants with an improvement in HbA1c.In conclusion, medical prescription of fresh produce is associated with significant improvements in cardio-metabolic and psycho-social risk factors for Hispanic/Latino adults with or at risk of T2D

Estudo de Urbanização em Áreas de Risco a Escorregamentos nos Loteamentos do Recreio São Jorge e Novo Recreio, Região do Cabuçu, Guarulhos (SP), Brasil

Este artigo, desenvolvido a partir de dissertação de mestrado em Análise Geoambiental da Universidade Guarulhos, apresenta um estudo de urbanização em áreas de risco a escorregamentos dos loteamentos do Recreio São Jorge e Novo Recreio, localizados no município de Guarulhos, São Paulo, Brasil. O estudo adotou a microbacia Taquara do Reino como unidade de planejamento urbano e considerou a carta de zoneamento de risco e suscetibilidade a escorregamentos, assim como a cartografia de restrições legais ao uso do solo. O resultado obtido foi a elaboração de uma alternativa de urbanização como ensaio prático de aplicação dos critérios estudados, considerando a necessidade de melhorar-se as condições ambientais do uso do solo nessa microbacia

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to &lt; 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of &amp; GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P &lt; 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo