scholarly journals The impact of COVID-19 pandemic course in the number and severity of hospitalizations for other natural causes in a large urban center in Brazil

2021 ◽  
Vol 1 (12) ◽  
pp. e0000054
Author(s):  
Luisa C. C. Brant ◽  
Pedro C. Pinheiro ◽  
Isis E. Machado ◽  
Paulo R. L. Correa ◽  
Mayara R. Santos ◽  
...  
Keyword(s):  
Rebound Effect ◽  
Healthcare Facilities ◽  
Wilcoxon Rank Sum Test ◽  
Hospital Deaths ◽  
Regulatory Measures ◽  
Belo Horizonte ◽  
Competing Causes ◽  
The Impact ◽  
The City ◽  
Series Study

The COVID-19 pandemic may indirectly impact hospitalizations for other natural causes. Belo Horizonte is a city with 2.5 million inhabitants in Brazil, one of the most hardly-hit countries by the pandemic, where local authorities monitored hospitalizations daily to guide regulatory measures. In an ecological, time-series study, we investigated how the pandemic impacted the number and severity of public hospitalizations by other natural causes in the city, during 2020. We assessed the number and proportion of intensive care unit (ICU) admissions and in-hospital deaths for all-natural causes, COVID-19, non-COVID-19 natural causes, and four disease groups: infectious, respiratory, cardiovascular, and neoplasms. Observed data from epidemiological week (EW) 9 (first diagnosis of COVID-19) to EW 48, 2020, was compared to the mean for the same EW of 2015–2019 and differences were tested by Wilcoxon rank-sum test. The five-week moving averages of the studied variables in 2020 were compared to that of 2015–2019 to describe the influence of regulatory measures on the indicators. During the studied period, there was 54,722 hospitalizations by non-COVID-19 natural causes, representing a 28% decline compared to the previous five years (p<0.001). There was a concurrent significant increase in the proportion of ICU admissions and deaths. The greater reductions were simultaneous to the first social distancing decree or occurred in the peak of COVID-19 hospitalizations, suggesting different drivers. Hospitalizations by specific causes decreased significantly, with greater increase in ICU admissions and deaths for infectious, cardiovascular, and respiratory diseases than for neoplasms. While the first reduction may have resulted from avoidance of contact with healthcare facilities, the second reduction may represent competing causes for hospital beds with COVID-19 after reopening of activities. Health policies must include protocols to address hospitalizations by other causes during this or future pandemics, and a plan to face the rebound effect for elective deferred procedures.

scholarly journals The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment

2021 ◽  
pp. e20210018
Author(s):  
Pedro Daibert de Navarro1,2 ◽  
João Paulo Amaral Haddad3 ◽  
Juliana Veiga Costa Rabelo1 ◽  
Claudia Hermínia de Lima e Silva4 ◽  
Isabela Neves de Almeida2,5 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intervention Group ◽  
Total Sample ◽  
Clinical Severity ◽  
Tuberculosis Treatment ◽  
Kaplan Meier ◽  
Belo Horizonte ◽  
Treatment Abandonment ◽  
The Impact ◽  
The City

Objective: Evaluate the impact of the instrument of the "Stratification by Degree of Clinical Severity and Abandonment Risk of Tuberculosis Treatment" (SRTB) on the tuberculosis outcome. Methods: This study was a pragmatic clinical trial involving patients with a confirmed diagnosis of tuberculosis treated at one of the 152 primary health care units in the city of Belo Horizonte, Brazil, between May of 2016 and April of 2017. Cluster areas for tuberculosis were identified, and the units and their respective patients were divided into intervention (use of SRTB) and nonintervention groups. Results: The total sample comprised 432 participants, 223 and 209 of whom being allocated to the nonintervention and intervention groups, respectively. The risk of treatment abandonment in the nonintervention group was significantly higher than was that in the intervention group (OR = 15.010; p < 0.001), regardless of the number of risk factors identified. Kaplan-Meier curves showed a hazard ratio of 0.0753 (p < 0.001). Conclusions: The SRTB instrument was effective in reducing abandonment of tuberculosis treatment, regardless of the number of risk factors for that. This instrument is rapid and easy to use, and can be adapted to different realities. Its application showed characteristics predisposing to a non-adherence to the treatment and established bases to mitigate its impact.

scholarly journals Cardiovascular Mortality during the COVID-19 Pandemics in a Large Brazilian City: a Comprehensive Analysis

2021 ◽  
Author(s):  
Luisa Campos Caldeira Brant ◽  
Pedro C Pinheiro ◽  
Antonio L P Ribeiro ◽  
Isis E Machado ◽  
Paulo R L Correa ◽  
...  
Keyword(s):  
Social Vulnerability ◽  
Capital City ◽  
Hospitalization Rates ◽  
Icd 10 ◽  
Hospital Deaths ◽  
Belo Horizonte ◽  
Substantial Decline ◽  
Age Range ◽  
The Impact ◽  
At Home

Introduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse effects on CVD morbimortality. Objective: To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo Horizonte (BH), the 6th greater capital city in Brazil, including: mortality, mortality at home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the differential effect according to sex, age range, social vulnerability, and pandemics phase. Methods: Ecological study analysing data from the Mortality and Hospital Information System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD-10. Social vulnerability was classified by a composite socioeconomic index as high, medium and low. The observed age-standardized rates for epidemiological weeks 10-48, 2020, were compared to the expected rates (mean of 2015-2019). Wilcoxon rank-sum test was used to test differences, and risk ratios with their 95% confidence intervals were calculated. National demographic estimates was used to calculate rates. Results: We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96-1.06). However, CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20-1.46) than in hospitals (RiR 0.89, 95%CI 0.79-0.99), as a result of a substantial decline in hospitalization rates, even though proportional in-hospital deaths increased. The rise in home deaths was greater in older adults and in had an increasing gradient in those more socially vulnerable (RiR 1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21). Conclusion: The greater occurrence of CVD deaths at home, in parallel with lower hospitalization rates, suggests that CVD care was disrupted during the COVID-19 pandemics, which more adversely affected older and more socially vulnerable individuals, exacerbating health inequities in BH.

scholarly journals Anionic Surfactants Monitoring In Healthcare Facilities - A Case of Belo Horizonte City, Brazil

2021 ◽  
Author(s):  
Graziela Torres Trajano ◽  
Olívia Maria S Ribeiro Vasconcelos ◽  
Luiz Carlos Moutinho Pataca ◽  
Marcos Paulo Gomes Mol
Keyword(s):  
Wastewater Treatment ◽  
Cationic Surfactants ◽  
Anionic Surfactants ◽  
Wastewater Treatment Plants ◽  
Aquatic Environments ◽  
Healthcare Facilities ◽  
Hospital Effluents ◽  
Belo Horizonte ◽  
Negative Impacts ◽  
The City

Abstract Surfactants are substances that when in aquatic environments, can cause negative impacts. Hospital effluents carry numerous chemicals daily, including surfactants, used in sanitization and disinfection procedures. These chemicals are found in different concentrations in the effluents and reach water bodies due to a lack of proper removal in the wastewater treatment plants. The present study investigated data about effluents monitoring from healthcare facilities located in the city of Belo Horizonte, Brazil, focusing on anionic surfactants. The results showed, in 2018, a total of 72 establishments monitoring this parameter, resulting in a median concentration of 1 mg⋅L-1 of anionic surfactants in the period. Cationic surfactants still do not have specific legislation in the studied country that dictates a limit for discharge into sewage, however, these compounds are used in the formulation of routine hospital products.

scholarly journals AS REPERCUSSÕES DAS OPERAÇÕES URBANAS EM BELO HORIZONTE: O CASO DA OCUPAÇÃO DO IZIDORO

e-xacta ◽  
2017 ◽  
Vol 10 (1) ◽  
pp. 17
Author(s):  
Reginaldo Magalhães de Almeida ◽  
Juliana Lamego Balbino Nizza ◽  
Amanda Pereira de Oliveira Diniz ◽  
Jorge Eulampio Monteiro Junior
Keyword(s):  
Private Property ◽  
Implementation Process ◽  
Real Estate Enterprises ◽  
Spatial Inequalities ◽  
Actual Effectiveness ◽  
The Law ◽  
Belo Horizonte ◽  
Private Domain ◽  
The Impact ◽  
The City

<p class="Padro"><em>Instrumentos jurídicos e urbanísticos como as Operações Urbanas refletem diretamente no cotidiano das cidades. Cada vez mais utilizado, entende-se que o conhecimento da aplicação das Operações Urbanas é importante para os profissionais do campo do Direito e da Arquitetura. Portanto, este artigo analisa criticamente as repercussões do processo de implementação das Operações Urbanas em Belo Horizonte. Entende-se que a ineficácia da implementação desse instrumento pode estimular o surgimento de processos urbanos conflitantes, como as ocupações de propriedades privadas da cidade. Como estudo de caso da implantação dessa lei, selecionou-se a “Operação Urbana do Izidoro”, regulamentada pela Lei n° 9.959/10 de Belo Horizonte. Prevista para ser implantada em uma grande área vazia de domínio privado da cidade, atualmente vem passando por um dos maiores processos de ocupação de população de baixa renda de Minas </em><em>Gerais. </em><em>Utilizou-se ainda como metodologia, primeiramente, uma ampla revisão bibliográfica de autores referenciais do campo da Arquitetura e do Direito e posteriormente, realizou-se um levantamento de dados em processos técnico-administrativos da Prefeitura de Belo Horizonte e visitas de campo. Esses dados foram analisados e depois consolidados para a utilização neste artigo. </em><em>Ao final, como resultado, conclui-se que, em que pese os discursos sobre as Operações Urbanas como um instrumento de desenvolvimento urbano, conforme definido na lei conhecida como Estatuto da Cidade, em Belo Horizonte, seu uso vem se dando principalmente como um instrumento de viabilização da implantação de grandes empreendimentos imobiliários, que, ao desconsiderarem alguns segmentos sociais, acabam por contribuir para o aumento das desigualdades socioespaciais da cidade e dos processos de ocupações. Além disso, destaca-se a distância existente entre as intenções estabelecidas na elaboração desse instrumento e a sua real efetividade. </em></p><p><em>ABSTRACT</em></p><p><em>Legal and urbanistic instruments such as the Urban Operations directly reflect the daily life of cities. Increasingly used, it is understood that knowledge of the application of the Urban Operations is important for practitioners of the law and architecture field. Therefore, this article critically examines the impact of the Urban Operations implementation process in Belo Horizonte. It is understood that the ineffectiveness of the implementation of this instrument can stimulate the emergence of conflicting urban processes, such as the occupation of private property of the city. As if the implementation of this law study, we selected the "Urban Operation of Izidoro", regulated by Law No. 9.959/10 of Belo Horizonte. Expected to be deployed in a large empty area of private domain of the city, is currently undergoing one of the largest low population occupation processes income of Minas Gerais</em><em>. Firstly, the methodology involved the bibliographical review of reference authors from the field of Architecture and Law, in technical-administrative processes of the City Hall of Belo Horizonte and field visits. This data was analyzed and then consolidated for use in this article. At the end, as a result, it is concluded that, in spite of the speeches about Urban Operations as an instrument of urban development, as defined in the Law known as the Statute of the City, in Belo Horizonte, its use is mainly given as an instrument of making feasible the implantation of large real estate enterprises, which, by disregarding some social segments, end up contributing to the increase of socio-spatial inequalities of the city and of occupation processes. In addition, the distance between the intentions established in the elaboration of this instrument and its actual effectiveness is highlighted.</em></p>

scholarly journals Mortality from Homicides in Slums in the City of Belo Horizonte, Brazil: An Evaluation of the Impact of a Re-Urbanization Project

2019 ◽  
Vol 16 (1) ◽  
pp. 154 ◽  
Author(s):  
Maria De Salles Dias ◽  
Amélia De Lima Friche ◽  
Sueli Mingoti ◽  
Dário Da Silva Costa ◽  
Amanda De Souza Andrade ◽  
...  
Keyword(s):  
Social Development ◽  
Urban Renewal ◽  
Poisson Regression ◽  
Poisson Regression Model ◽  
Homicide Rates ◽  
Socioeconomic Characteristics ◽  
Belo Horizonte ◽  
The Impact ◽  
The City ◽  
Cumulative Time

Background: Homicide rates in Brazil are among the highest worldwide. Although not exclusive to large Brazilian cities, homicides find their most important determinants in cities’ slums. In the last decade, an urban renewal process has been initiated in the city of Belo Horizonte, in Brazil. Named Vila Viva project, it includes structuring urban interventions such as urban renewal, social development actions and land regularization in the slums of the city. This study evaluates the project’s effect on homicide rates according to time and interventions. Methods: Homicide rates were analyzed comparing five slums with interventions (S1–S5) to five grouped non-intervened slums (S0), with similar socioeconomic characteristics from 2002 to 2012. Poisson regression model estimates the effect of time of observation and the effect of time of exposure (in years) to a completed intervention, besides the overall risk ratio (RR). Results: Using the time of observation in years, homicide rates decreased in the studied period and even more if considered cumulative time of exposure to a completed intervention for S1, S2, S3 and S4, but not for S5. Conclusions: Although the results of the effect of the interventions are not repeated in all slums, a downward trend in homicide rates has been found, which is connected to the interventions. New approaches could be necessary in order to verify the nexus between slum renewal projects and the reduction of homicide rates.

The impact of a mega-event on city branding: The European Capital of Culture 2010 and the image of Istanbul

2013 ◽  
Vol 3 (1) ◽  
pp. 29-50 ◽  
Author(s):  
Evinç Doğan ◽  
Ibrahim Sirkeci
Keyword(s):  
Visual Analysis ◽  
Place Branding ◽  
World City ◽  
City Branding ◽  
City Image ◽  
European Capital Of Culture ◽  
National Boundaries ◽  
Symbolic Production ◽  
The Impact ◽  
The City

This study examines the ways in which the city image of Istanbul is re-created through the mega-events within the context of the European Capital of Culture (ECoC) 2010. Istanbul “took the stage” as one of the three ECoC cities (Essen for the Ruhr in Germany and Pécs in Hungary), where the urban spaces were projected as the theatre décor while residents and visitors became the spectators of the events. Organisers and agents of the ECoC 2010 seemed to rebrand Istanbul as a “world city” rather than a “European capital”. With a series of transnational connotations, this can be considered as part of an attempt to turn Istanbul to a global city. In this study we examine posters used during the ECoC 2010 to see whether this was evident in the promoted images of Istanbul. The research employs a hermeneutic approach in which representations, signs and language are the means of symbolic meaning, which is analysed through qualitative methods for the visual data (Visual Analysis Methods), namely Semiotics and Discourse Analysis. The analysed research material comes from a sample of posters released during the ECoC 2010 to promote 549 events throughout the year. Using stratified random sampling we have drawn 28 posters (5% of the total) reflecting the thematic groups of events in the ECoC 2010. Particular attention is also paid to the reflexivity of the researchers and researchers’ embeddedness to the object of research. The symbolic production and visual representation are therefore investigated firstly through the authoritative and historically constituted discourses in the making of Istanbul image and secondly through the orders of cultural consumption and mediatisation of culture through spectacular events. Hence enforcing a transnationalisation of the image of the city where the image appears to be almost stateless transcending the national boundaries. Findings and methodology used in this study can be useful in understanding similar cases and further research into the processes of city and place branding and image relationships. 

Urbanization of fauna on the example of marsh frog (Pelophylax ridibundus)

2015 ◽  
Vol 26 (3-4) ◽  
pp. 116-123
Author(s):  
A. P. Korzh ◽  
T. V. Zahovalko
Keyword(s):  
Urban Areas ◽  
Cognitive Modeling ◽  
Negative Impact ◽  
Natural Populations ◽  
Cellular Level ◽  
Anthropogenic Factors ◽  
Migration Routes ◽  
Corrective Effect ◽  
The Impact ◽  
The City

Recently, the number of published works devoted to the processes of synanthropization of fauna, is growing like an avalanche, which indicates the extreme urgency of this theme. In our view, the process of forming devices to coexist with human and the results of his life reflects the general tandency of the modern nature evolution. Urbanization is characteristic for such a specific group of animals like amphibians, the evidence of which are numerous literature data. Many researchers use this group to assess the bioindicative quality of the environment. For this aim a variety of indicators are used: from the cellular level of life of organization up to the species composition of the group in different territories. At the same time, the interpretation of the results is not always comparable for different areas and often have significantly different interpretations by experts. Urban environment, primarily due to the contamination is extremely aggressive to amphibians. As a consequence, the urban populations of amphibians may be a change in the demographic structure, affecting the reproductive ability of the population, the disappearance of the most sensitive species or individuals, resizing animals, the appearance of abnormalities in the development, etc. At the same time play an important amphibians in the ecosystems of cities, and some species in these conditions even feel relatively comfortable. Therefore, it is interesting to understand the mechanisms of self-sustaining populations of amphibians in urban environments. To assess the impact of natural and anthropogenic factors on the development of amphibian populations were used cognitive modeling using the program Vensim PLE. Cognitive map of the model for urban and suburban habitat conditions were the same. The differences concerned the strength of connections between individual factors (migration, fertility, pollution) and their orientation. In general, factors like pollution, parasites, predators had negative impact on the population, reducing its number. The birth rate, food and migration contributed to raising number of individuals. Some of the factors affected on the strength to of each other as well: the majority of the factors affected the structure of the population, had an influence on the fertility. Thanks to it the model reflects the additive effect of complex of factors on the subsequent status of the population. Proposed and analyzed four scenarios differing strength and duration of exposure. In the first scenario, a one-time contamination occurs and not subsequently repeated. The second and third scenario assumes half board contamination, 1 year (2 scenario) and two years (scenario 3). In the fourth scenario, the pollution affected the population of amphibians constantly. In accordance with the results of simulation, much weaker than the natural populations respond to pollution - have them as an intensive population growth and its disappearance at constant pollution is slow. Changes to other parameters of the model showed that this pollution is the decisive factor -only the constant action leads to a lethal outcome for the populations. All other components of the model have a corrective effect on the population dynamics, without changing its underlying trand. In urban areas due to the heavy impact of pollution maintaining the population is only possible thanks to the migration process – the constant replenishment of diminishing micropopulations of natural reserves. This confirms the assumption that the form of existence metapopulations lake frog in the city. In order to maintain the number of amphibians in urban areas at a high level it is necessary to maintain existing migration routes and the creation of new ones. Insular nature of the placement of suitable habitats in urban areas causes the metapopulation structure of the types of urbanists. Therefore, the process of urbanization is much easier for those species whicht are capable of migration in conditions of city. In the initial stages of settling the city micropopulationis formed by selective mortality of the most susceptible individuals to adverse effects. In future, maintaining the categories of individuals is provided mainly due to migration processes metapopulisation form of the species of existence is supported). It should be noted that the changes in the previous levels are always saved in future. In the case of reorganizations of individuals we of morphology can assume the existence of extremely adverse environmental conditions that threaten the extinction of the micropopulations. 

TO THE QUESTION OF THE IMPACT OF CLIMATE CHANGE ON THE ECOLOGICAL STATE OF ARTIFICIAL PLANTATIONS OF PITSUNDSKAYA PINE IN THE SEASIDE AREA OF GELENDZHIK

2017 ◽  
Author(s):  
Elizaveta Derevenets ◽  
Elizaveta Derevenets
Keyword(s):  
Negative Impact ◽  
Standard Technique ◽  
Negative Influence ◽  
Exhaust Gases ◽  
The Road ◽  
Industrial Enterprises ◽  
Federal Highway ◽  
On The Road ◽  
The Impact ◽  
The City

Gelendzhik is the resort town, there aren't a lot of industrial enterprises here. The main pollutant is transport. The work purpose is the assessment of a condition of the artificial landings of a pine located along the Federal highway "Don" and landings, which is nearly the sea coast. Researches were conducted to a standard technique of the General vital state (A. S. Bogolyubov). The assessment of a condition of pines was carried out during 6 years: from 2010 to 2015. For carrying out research we used 6 experimental grounds on the Markotkhsky spine and 2 control grounds within the town. We investigated 24 trees on each platform, middle age of the trees were 30 - 40 years. Results. 1. The condition of trees in the pine forests located in immediate proximity with the Federal highway "Don" (No. 1, 2, 3) is unsatisfactory. As even weak influences of the majority of atmospheric gaseous pollutants (sulphurous gas, nitrogen oxides, etc.) give effect of a necrosis and hloroz of pine needles, the condition of pines is connected with technogenic pollution. So near the Federal highway "Don" the air environment is strongly polluted by exhaust gases. Information of 2012 confirm that negative influence of the route on Markotkh's vegetation decreases at reduction of load of the route. 2. On the sites located above on a slope (No. 4,5,6) thanks to remoteness and the wind mode intensity of influence of pollutants is lower and a condition of pines the quite satisfactory. 3. Trees on the sites located near the sea (No. 7,8) are in a good shape. Small deterioration of a state is noted in very droughty years. Conclusion. Results of six years' research show that the condition of the plantings which are in close proximity with the road worsens. It is explained by increase in intensity of the movement on the road, especially during a resort season. Gelendzhik is the city with a good ecological shape, but the damage to environment is already caused. If not to take measures, we can lose a unique part of the nature in the future, recreate it will be impossible. Measures of reduction of negative impact of exhaust gases were offered. Results of researches are transferred to ecological department of the City administration of Gelendzhik.

Regional determinants in the development of the Lviv startup ecosystem

2019 ◽  
pp. 74-86
Author(s):  
Marianna Kokhan ◽  
Anastasiya Mazur
Keyword(s):  
Global Market ◽  
Scientific Development ◽  
Local Policy ◽  
It Industry ◽  
Successful Development ◽  
Corporate Universities ◽  
Regional Leadership ◽  
Focus Strategy ◽  
The Impact ◽  
The City

The article considers the concept of startups and ecosystems of startup development. It investigates the innovativeness ratings of countries and regional ecosystems of startups and the factors influencing the successful development of startups. The article considers the ranking of the best regional startup ecosystems in the world. It covers the experience of the leading regions, whose effectiveness is driven by attention to financing, networking, expanding access to markets, attracting and nurturing talents, accumulating experience and scientific development. Particular attention is given to the impact of the specialization and effectiveness of the regional focus strategy. Based on the methodology and results of the Global Startup Ecosystem Ranking 2019, authors have empirically investigated the startup ecosystem of the Lviv city. Authors described and systemized the startups operating in the city, the elements, and dynamics of the urban startup infrastructure. The preconditions for successful development of startups - financing, talents, experience, connectedness, access to markets - have been identified. The effectiveness of the activity of city authorities, the local policy of promoting the startup environment development - documents, measures and results – have been investigated. The main factors of Lviv’s regional leadership in the development of digital startups in Ukraine are: the dynamic development of the IT industry, the development of digital competencies and the concentration of talent in leading universities, the development of corporate universities and innovative infrastructure, the development of infrastructure and comfort in the city. For the development of the Lviv startup ecosystem, it is recommended to focus the efforts on further accumulation and transfer of experience, retention of talents, improvement of technology transfer systems, focusing on areas of exclusive competence while expanding access to finance and the global market.

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