Kangaroo Mother Care for Preterm Infants and Child Development – Evidence from São Paulo, Brazil

Abstract Background An estimated 15 million children are born prematurely each year globally, resulting in a high burden of under-five mortality and neurodevelopmental disability. Kangaroo Mother Care (KMC) is recognized as key intervention to support the development of preterm infants. Even though the benefits of KMC have been well documented in randomized controlled trials, evidence on the impact of KMC in routine care settings remains limited.Methods This paper examines the associations between maternal Kangaroo Mother Care efforts and child development among preterm infants born at the University Hospital of São Paulo, Brazil. Primary study outcomes were physical development (HAZ) and cognitive development at age 3.Results Practicing Kangaroo Mother Care was positively associated with physical development (+0.91 SD, 95% confidence intervals [0.126, 1.695]), and cognition (+0.37 SD, [0.034, 0.806]) of preterm children at age 3.Conclusion The results presented suggest that KMC has a large potential to improve children’s cognitive and physical development. New programs to increase KMC uptake in the setting studied may be beneficial for both mothers and their preterm children.

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Kangaroo mother care for preterm infants and child development – evidence from São Paulo, Brazil

Early Child Development and Care ◽

10.1080/03004430.2021.1885393 ◽

2021 ◽

pp. 1-9

Author(s):

Silas Onyango ◽

Alexandra Brentani ◽

Günther Fink

Keyword(s):

Child Development ◽

Preterm Infants ◽

Sao Paulo ◽

Kangaroo Mother Care ◽

São Paulo

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COVID-19 in patients hospitalized and healthcare workers: what have changed after the first wave in a university hospital

10.1101/2021.05.11.21257011 ◽

2021 ◽

Author(s):

Luiz Vinicius Leao Moreira ◽

Gabriela Barbosa ◽

Luciano Kleber de Souza Luna ◽

Alberto Fernando Oliveira Justo ◽

Ana Paula Cunha Chaves ◽

...

Keyword(s):

Viral Load ◽

Healthcare Workers ◽

Sao Paulo ◽

Hospitalized Patients ◽

University Hospital ◽

São Paulo ◽

The Mean ◽

Wave Methods ◽

The Impact ◽

Pandemic Wave

Objective: To assess the COVID-19 frequency rates in hospitalized patients (HP) and healthcare workers (HCW), viral load inference, and the impact of vaccination and variants of concern (VOC) during the first pandemic wave. Methods: We evaluated the COVID-19 diagnostics at Hospital Sao Paulo, Brazil, from March 2020 to April 2021, in 10,202 samples (6,502 HP and 3,700 HCW) tested by RT-qPCR, inferring viral load by cycle threshold (Ct) values, and frequency rates. Results: SARS-CoV-2 was detected in 31.27% of individuals (32.23% HP and 29.80% HCW). The mean age of HP positives was 57.26 +/- 18.29 years (median = 59), with a mean Ct value of 25.55 +/- 6.07. Neither age nor Ct values in both groups have significantly differed during the first and second waves or even since the predominance of VOC P.1 on March 2021. Conclusions: The COVID-19 epidemic curves of HP and HCW accompanied the variations reported in Sao Paulo city, as well as the variation of hospitalization and occupancy of ICU beds. The VOC P.1 has no impact on the viral load, since its predominance in March 2021. The vaccination of HCW may have contributed to a decrease in the positivity rates, although more studies will provide a better understanding of the impact of immunization on the COVID-19 pandemic.

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COVID-19 in hospitalized patients and healthcare workers: what have changed after the first wave in a university hospital

10.21203/rs.3.rs-570168/v1 ◽

2021 ◽

Author(s):

Luiz Moreira ◽

Gabriela Rodrigues Barbosa ◽

Luciano Kleber de Souza Luna ◽

Alberto Fernando Oliveira Justo ◽

Ana Paula Cunha Chaves ◽

...

Keyword(s):

Viral Load ◽

Healthcare Workers ◽

Sao Paulo ◽

Hospitalized Patients ◽

University Hospital ◽

São Paulo ◽

Cycle Threshold ◽

Ct Value ◽

The Mean ◽

The Impact

Abstract ObjectiveTo assess the COVID-19 frequency rates in hospitalized patients (HP) and healthcare workers (HCW), viral load inference, and the impact of vaccination and variants of concern (VOC) during the COVID-19 pandemic.Materials and methodWe evaluated the COVID-19 diagnostics at Hospital São Paulo, Brazil, from March 2020 to April 2021, in 10,202 samples (6,502 HP and 3,700 HCW) tested by RT-qPCR, inferring viral load by cycle threshold (Ct) values, and frequency rates.ResultsSARS-CoV-2 was detected in 31.27% of individuals (32.23% HP and 29.80% HCW). The mean age of HP positives was 57.26 ± 18.29 years (median = 59), with a mean Ct value of 25.55 ± 6.07. Neither age nor Ct values in both groups have significantly differed during the first and second waves or even since the predominance of VOC P.1 on March 2021.ConclusionsThe COVID-19 epidemic curves of HP and HCW accompanied the variations reported in São Paulo city, as well as the variation of hospitalization and occupancy of ICU beds. The VOC P.1 has no impact on the viral load, since its predominance in March 2021. The vaccination of HCW may have contributed to a decrease in the positivity rates, although more studies will provide a better understanding of the impact of immunization on the COVID-19 pandemic.

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THE IMPACT OF DIFFERENT URBAN LAND USE TYPES ON AIR POLLUTION IN THE MEGACITY OF SÃO PAULO

Revista Presença Geográfica ◽

10.36026/rpgeo.v7i1.5366 ◽

2020 ◽

Vol 7 (1) ◽

pp. 91

Author(s):

Júlio Barboza Chiquetto ◽

Maria Elisa Siqueira Silva ◽

Rita Yuri Ynoue ◽

Flávia Noronha Dutra Ribieiro ◽

Débora Souza Alvim ◽

...

Keyword(s):

Land Use ◽

Air Pollution ◽

Urban Land ◽

Sao Paulo ◽

Urban Land Use ◽

São Paulo ◽

Land Use Types ◽

The Impact

A poluição do ar é influenciada por fatores naturais e antropogênicos. Quatro pontos de monitoramento (veicular, comercial, residencial e background urbano (BGU))da poluição do ar em São Paulo foram avaliados durante 16 anos, revelando diferenças significativas devidoao uso do solo em todas as escalas temporais. Na escala diurna, as concentrações de poluentes primários são duas vezes mais altas nos pontos veicular e residencial do que no ponto BGU, onde a concentração de ozonio (O3) é 50% mais alta. Na escala sazonal, as concentrações de monóxido de carbono(CO) variaram em 80% devido ao uso do solo, e 55% pela sazonalidade.As variações sazonais ede uso do solo exercem impactos similares nas concentrações de O3 e monóxido de nitrogênio (NO). Para o material particulado grosso (MP10) e o dióxido de nitrogênio(NO2), as variações sazonais são mais intensas do que as por uso do solo. Na série temporal de 16 anos, o ponto BGU apresentou correlações mais fortes e significativas entre a média mensal de ondas longas (ROL) e o O3 (0,48) e o MP10 (0,37), comparadas ao ponto veicular (0,33 e 0,22, respectivamente). Estes resultados confirmam que o uso do solo urbano tem um papel significativo na concentração de poluentes em todas as escalas de análise, embora a sua influência se torne menos pronunciada em escalas maiores, conforme a qualidade do ar transita de um sistema antropogênico para um sistema natural. Isto poderá auxiliar decisões sobre políticas públicas em megacidades envolvendo a modificação do uso do solo.

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Modelling the impact of delaying vaccination against SARS-CoV-2 assuming unlimited vaccine supply

Theoretical Biology and Medical Modelling ◽

10.1186/s12976-021-00143-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Marcos Amaku ◽

Dimas Tadeu Covas ◽

Francisco Antonio Bezerra Coutinho ◽

Raymundo Soares Azevedo ◽

Eduardo Massad

Keyword(s):

Mathematical Model ◽

Vaccination Campaign ◽

Vaccination Rate ◽

Sao Paulo ◽

The State ◽

São Paulo ◽

Health Authorities ◽

The World ◽

The Moment ◽

The Impact

Abstract Background At the moment we have more than 177 million cases and 3.8 million deaths (as of June 2021) around the world and vaccination represents the only hope to control the pandemic. Imperfections in planning vaccine acquisition and difficulties in implementing distribution among the population, however, have hampered the control of the virus so far. Methods We propose a new mathematical model to estimate the impact of vaccination delay against the 2019 coronavirus disease (COVID-19) on the number of cases and deaths due to the disease in Brazil. We apply the model to Brazil as a whole and to the State of Sao Paulo, the most affected by COVID-19 in Brazil. We simulated the model for the populations of the State of Sao Paulo and Brazil as a whole, varying the scenarios related to vaccine efficacy and compliance from the populations. Results The model projects that, in the absence of vaccination, almost 170 thousand deaths and more than 350 thousand deaths will occur by the end of 2021 for Sao Paulo and Brazil, respectively. If in contrast, Sao Paulo and Brazil had enough vaccine supply and so started a vaccination campaign in January with the maximum vaccination rate, compliance and efficacy, they could have averted more than 112 thousand deaths and 127 thousand deaths, respectively. In addition, for each month of delay the number of deaths increases monotonically in a logarithmic fashion, for both the State of Sao Paulo and Brazil as a whole. Conclusions Our model shows that the current delay in the vaccination schedules that is observed in many countries has serious consequences in terms of mortality by the disease and should serve as an alert to health authorities to speed the process up such that the highest number of people to be immunized is reached in the shortest period of time.

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The Impact of COVID-19 on Urban Agriculture in São Paulo, Brazil

Sustainability ◽

10.3390/su13116185 ◽

2021 ◽

Vol 13 (11) ◽

pp. 6185

Author(s):

André Ruoppolo Biazoti ◽

Angélica Campos Nakamura ◽

Gustavo Nagib ◽

Vitória Oliveira Pereira de Souza Leão ◽

Giulia Giacchè ◽

...

Keyword(s):

Urban Agriculture ◽

Technical Assistance ◽

Community Gardens ◽

Sao Paulo ◽

Food Chains ◽

São Paulo ◽

Sales Channels ◽

Paulo State ◽

The Impact ◽

The City

During the initial months of the COVID-19 pandemic, farmers worldwide were greatly affected by disruptions in the food chain. In 2020, São Paulo city experienced most of the effects of the pandemic in Brazil, with 15,587 deaths through December 2020. Here, we describe the impacts of COVID-19 on urban agriculture (UA) in São Paulo from April to August 2020. We analyzed two governmental surveys of 2100 farmers from São Paulo state and 148 from São Paulo city and two qualitative surveys of volunteers from ten community gardens and seven urban farmers. Our data showed that 50% of the farmers were impacted by the pandemic with drops in sales, especially those that depended on intermediaries. Some farmers in the city adapted to novel sales channels, but 22% claimed that obtaining inputs became difficult. No municipal support was provided to UA in São Paulo, and pre-existing issues were exacerbated. Work on community gardens decreased, but no garden permanently closed. Post COVID-19, UA will have the challenge of maintaining local food chains established during the pandemic. Due to the increase in the price of inputs and the lack of technical assistance, governmental efforts should be implemented to support UA.

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Relationship between preterm birth and air pollution in Santos, Sao Paulo, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.111 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M E L Brandao ◽

B A L F Braga ◽

M L C Martins ◽

P L A A Pereira

Keyword(s):

Air Pollution ◽

Preterm Birth ◽

Air Pollutants ◽

First Trimester ◽

Sao Paulo ◽

São Paulo ◽

Air Humidity ◽

Relative Air Humidity ◽

The Impact ◽

Fourth Quartile

Abstract Santos is a seaboard Brazilian city recognized by its port activity where the road and rail infrastructure along with the large transportation operation, displays an important factor to contribute with all kinds of toxic and air pollutants. Recent studies have suggested associations between air pollution and various birth outcomes. Pollutant gases such as NOx, O3 and particulate matter PM2,5, PM10 have been cited as factors involved in such outcomes. The present study aims to assess the relationship between atmospheric pollutants and perinatal outcomes in the city of Santos from Jan. 2012 to Dec. 2015. Cross-sectional study that analyzed 10.319 singleton births in an area set with 2 km radius of the monitoring stations. Birth weight and information on mother and pregnancy were obtained at the Brazilian “Born Alive National Information System”. Daily records of air pollutants (PM10, PM2.5, NO2 and O3), temperature and relative air humidity, for the study period, were obtained from São Paulo State Environmental Agency (CETESB). Associations between preterm birth and air pollutants mean levels at each gestational trimester were investigated using multiple logistic regression model controlled by the variables: infant sex, type of delivery, maternal education. prenatal care, and number of previous live births, temperature and relative air humidity. NO2 e PM2,5 was not associated with preterm birth. O3 was significantly associated in the first trimester in the fourth quartile (OR = 1,47 CI 95% 1,05; 2,07). PM10 was significantly associated in the first trimester for the fourth quartile (OR = 1,28 CI 95% 1,00; 1,64), second trimester for the second quartile (OR = 1,37 CI 95% 1,07; 1,77). Conclusions the results shows evidence that maternal exposure to air pollution especially during the first trimester of pregnancy may contribute to preterm birth. Further actions are needed towards controlling air pollution are strongly recommended for promoting early-life health. Key messages This is the first research of this kind that was made in Santos. It brings important evidence of the impact in the life of the population, especially those whose is not even born yet. It can be used as a resource to guide public policies in health, especially the guidelines that dictate the concentration of air pollutants and air quality.

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Impact of vehicular emissions on the formation of fine particles in the Sao Paulo Metropolitan Area: a numerical study with the WRF-Chem model

Atmospheric Chemistry and Physics ◽

10.5194/acp-16-777-2016 ◽

2016 ◽

Vol 16 (2) ◽

pp. 777-797 ◽

Cited By ~ 29

Author(s):

A Vara-Vela ◽

M. F. Andrade ◽

P. Kumar ◽

R. Y. Ynoue ◽

A. G. Muñoz

Keyword(s):

Size Distribution ◽

Metropolitan Area ◽

Atmospheric Aerosols ◽

Fine Particles ◽

Sao Paulo ◽

Vehicular Emissions ◽

São Paulo ◽

Mass Size Distribution ◽

Mass Size ◽

The Impact

Abstract. The objective of this work is to evaluate the impact of vehicular emissions on the formation of fine particles (PM2.5; ≤  2.5 µm in diameter) in the Sao Paulo Metropolitan Area (SPMA) in Brazil, where ethanol is used intensively as a fuel in road vehicles. The Weather Research and Forecasting with Chemistry (WRF-Chem) model, which simulates feedbacks between meteorological variables and chemical species, is used as a photochemical modelling tool to describe the physico-chemical processes leading to the evolution of number and mass size distribution of particles through gas-to-particle conversion. A vehicular emission model based on statistical information of vehicular activity is applied to simulate vehicular emissions over the studied area. The simulation has been performed for a 1-month period (7 August–6 September 2012) to cover the availability of experimental data from the NUANCE-SPS (Narrowing the Uncertainties on Aerosol and Climate Changes in Sao Paulo State) project that aims to characterize emissions of atmospheric aerosols in the SPMA. The availability of experimental measurements of atmospheric aerosols and the application of the WRF-Chem model made it possible to represent some of the most important properties of fine particles in the SPMA such as the mass size distribution and chemical composition, besides allowing us to evaluate its formation potential through the gas-to-particle conversion processes. Results show that the emission of primary gases, mostly from vehicles, led to a production of secondary particles between 20 and 30 % in relation to the total mass concentration of PM2.5 in the downtown SPMA. Each of PM2.5 and primary natural aerosol (dust and sea salt) contributed with 40–50 % of the total PM10 (i.e. those ≤  10 µm in diameter) concentration. Over 40 % of the formation of fine particles, by mass, was due to the emission of hydrocarbons, mainly aromatics. Furthermore, an increase in the number of small particles impaired the ultraviolet radiation and induced a decrease in ozone formation. The ground-level O3 concentration decreased by about 2 % when the aerosol-radiation feedback is taken into account.

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Knowledge and attitudes towards dementia in a sample of medical residents from a university-hospital in São Paulo, Brazil

Dementia & Neuropsychologia ◽

10.1590/s1980-57642016dn10100007 ◽

2016 ◽

Vol 10 (1) ◽

pp. 37-41 ◽

Cited By ~ 5

Author(s):

Alessandro Ferrari Jacinto ◽

Paulo José Fortes Villas Boas ◽

Vânia Ferreira de Sá Mayoral ◽

Vanessa de Albuquerque Citero

Keyword(s):

Descriptive Analysis ◽

Sao Paulo ◽

University Hospital ◽

Medical Residents ◽

Good Knowledge ◽

Public Healthcare ◽

São Paulo ◽

Medical Specialties ◽

Dementia Prevalence ◽

Knowledge And Attitudes

An estimated 61% of the 24.3 million people diagnosed with dementia worldwide live in underdeveloped countries, including Brazil, where a public healthcare system covers the majority of the population. This care is usually provided by General Practitioners (GP) and in Brazil many doctors recently graduated from medical school and residents of different medical specialties practice as GPs. Objective : The aim of this study was to describe the knowledge and attitudes about dementia in a sample of Brazilian medical residents from a university-hospital in São Paulo, Brazil. Methods : A total of 152 Brazilian medical residents participated in the study. Participants answered a "Knowledge Quiz" (KQ) and "Attitude Quiz" (AQ) about dementia issues, transculturally adapted for use in Brazilian physicians. A descriptive analysis of the correct answers on knowledge and of the attitude aspects was performed. Results : The medical residents showed poor knowledge (<50%) about dementia prevalence and incidence and a good knowledge on disease management and diagnosis. Participants tended to be optimistic about caring for demented patients. Conclusion : In this study, it is likely that the physicians' good knowledge about dementia issues is the reason for their optimism dealing with demented patients.

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