Institutional design for metropolitan governance and planning in São Paulo

O artigo apresenta a experiência do Plano de Desenvolvimento Urbano Integrado da Região Metropolitana de São Paulo (PDUI da RMSP) sob a ótica da participação da Prefeitura de São Paulo no processo colegiado que se estabeleceu entre os anos de 2015 e 2016, e que estruturou um desenho institucional para o seu desenvolvimento. Trata-se de discutir os desafios e dilemas considerados, as estratégias elencadas e as pactuações realizadas, tanto relativas aos conteúdos do PDUI quanto ao seu processo de elaboração na RMSP. O objetivo é refletir, nesse percurso, o método, os conceitos e o alcance do instrumento do PDUI para o desenvolvimento da política metropolitana brasileira a partir do caso de São Paulo. As fontes de referência são eminentemente os produtos dos trabalhos desenvolvidos nesse período, que foram objeto de formulação, debate e deliberação nos fóruns colegiados da gestão pública, sob a responsabilidade do Conselho de Desenvolvimento da Região Metropolitana de São Paulo.This paper presents the experience of the Integrated Urban Development Plan of the Metropolitan Region of São Paulo (IUDP of the MRSP) under the perspective of participation of the São Paulo City Government in the collegiate process that took place between 2015 and 2016, and which structured an institutional design for its development. It discusses the considered challenges and dilemmas, the listed strategies and partnerships related to the contents of the IUDP, as well as to its elaboration process in the MRSP. The objective is to reflect, throughout this journey, about the method, concepts and scope of the IUDP instrument for the development of Brazilian metropolitan policy based on the case of São Paulo. The main reference sources are the products resulting from the works carried out during this period. They were subject to formulation, debate and deliberation in collegiate forums of public management under responsibility of the Development Council of the Metropolitan Region of São Paulo

Valor Justo em Desapropriações: Uma Análise também Econômica e Regulatória

A desapropriação, enquanto forma drástica de intervenção do Estado na propriedade privada, requer o pagamento de indenização que, por imposição da Constituição – tanto do Brasil quanto de outros ordenamentos jurídicos –, deve ser necessariamente prévia e justa. Todavia, não há certeza a respeito de qual deva ser esse valor justo a ser pago pelo Estado. O objetivo desse artigo é lançar luz sobre o conceito de justa compensação. Estabeleceremos, para tanto, uma zona de certeza negativa a respeito do que não pode ser considerado como valor justo de modo que que, ao final, consigamos sugerir uma proposta acerca do que entendemos como justa compensação

Valor Justo em Desapropriações: Uma Análise também Econômica e Regulatória

A desapropriação, enquanto forma drástica de intervenção do Estado na propriedade privada, requer o pagamento de indenização que, por imposição da Constituição – tanto do Brasil quanto de outros ordenamentos jurídicos –, deve ser necessariamente prévia e justa. Todavia, não há certeza a respeito de qual deva ser esse valor justo a ser pago pelo Estado. O objetivo desse artigo é lançar luz sobre o conceito de justa compensação. Estabeleceremos, para tanto, uma zona de certeza negativa a respeito do que não pode ser considerado como valor justo de modo que que, ao final, consigamos sugerir uma proposta acerca do que entendemos como justa compensação

From Theory to Practice: Can LEAP/FAO Biodiversity Assessment Guidelines Be a Useful Tool for Knowing the Environmental Status of Livestock Systems?

Biodiversity loss is a global concern, and agriculture is one of the economic sectors responsible for this impact. The assessment of ecosystems under the influence of livestock production is essential for knowing their integrity and ability to provide ecosystem services. The aim of this investigation was to evaluate the application of LEAP/FAO guidelines for quantitative assessment of biodiversity in the livestock sector at the local scale (farm level) in a group of six study cases in Uruguay. A set of 20 indicators was used, including seven key thematic issues: habitat protection, habitat change, wildlife conservation, invasive species, pollution, aquatic biodiversity, off-farm feed, and landscape-scale conservation. The results show that the LEAP biodiversity assessment guidelines can be useful to characterize the state of ecosystems under pastoral use and some specific components of their biodiversity, as well as assess the interaction of the production system with the environment and plan management accordingly. This work also provides an analysis of the methodology used and recommendations to facilitate its application by the sector. The results from the application of the indicators show a great deal of wild biodiversity that uses grazing systems based on native grasslands as habitats and the acceptable integrity of these ecosystems. On average, farms have 83% of their native ecosystem, with a value of 3.5 for the Ecosystem Integrity Index. In terms of the richness of different groups, there was an average number of species of 112 herbaceous plants, 48 woody plants, 48 spiders, 150 birds, and 14 fish. The main goal of this work is to help in the wider application of the guidelines by facilitating decisions about methodology, necessary resources, and technical support. Moreover, another goal is to show the importance of native grasslands-based livestock systems for biodiversity conservation.Fil: de Santiago, María Fernanda. Instituto de Investigaciones Agropecuarias.; ChileFil: Barrios, Margenny. Universidad de la Republica. Centro Universitario Regional del Este.; UruguayFil: D'Anatro, Alejandro. Universidad de la República. Facultad de Ciencias; UruguayFil: García, Luis Fernando. Universidad de la República; UruguayFil: Mailhos, Ary. Universidad de la República; UruguayFil: Pompozzi, Gabriel Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rehermann, Sofía. Universidad de la Republica. Centro Universitario Regional del Este.; UruguayFil: Simó, Miguel. Universidad de la República. Facultad de Ciencias; UruguayFil: Tesitore, Giancarlo. Universidad de la Republica. Centro Universitario Regional del Este.; UruguayFil: Teixeira de Mello, Franco. Universidad de la Republica. Centro Universitario Regional del Este.; UruguayFil: Valtierra, Victoria. Universidad de la República; UruguayFil: Blumetto, Oscar. Instituto Nacional de Investigación Agropecuaria; Urugua

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

<p>Abstract</p> <p>Background</p> <p>Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.</p> <p>Methods</p> <p>This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.</p> <p>Discussion</p> <p>The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.</p> <p>Trial Registration</p> <p>Clinical Trials <a href="http://www.clinicaltrials.gov/ct2/show/NCT00970931">NCT00970931</a>.</p

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio