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Birthe Stemplewitz ◽  
Joel Luethy ◽  
Mau-Thek Eddy ◽  
Martin Spitzer ◽  
Ulrike Brocks ◽  

Abstract Purpose This study aims to evaluate the impact of the first coronavirus 2019 (COVID-19) wave in 2020 on patients scheduled for intravitreal injections (IVI) in a German metropolitan region. Methods We performed a multicentre prospective survey and retrospective analysis of the records of patients treated with intravitreal injections during the 20-week period from March to July 2020 in all four hospital eye departments in the city of Hamburg using a questionnaire (on treatment adherence, SarsCoV2-related personal, familial and social data) and treatment data. Results A total of 1038 patients (2472 IVI, 1231 eyes) and 818 questionnaires were evaluated. Longer duration of therapy, lower visual acuity (VA) of the treated and higher VA of the fellow untreated eye was were associated with a higher probability of visit cancellation. Every additional year of life posed a 2.6% lower risk of noncompliance. A COVID-19 infection in the family environment displayed a 5.5-fold chance of visit cancellation. Patients treated for neovascular age-related macular degeneration (nAMD) had a 36% reduced risk of visit cancellation compared to patients with diabetic macular oedema (DME). Conclusion A long preceding treatment period, low VA of the treated eye, high VA of the untreated eye, COVID-19 in the family and DME were identified as risk factors for IVI visit cancellations during the COVID-19 pandemic. Compliance to treatment might be improved in the future by taking these risk factors into account when scheduling patients for IVI during the exceptional circumstances of a pandemic.

2022 ◽  
Vol 10 (1) ◽  
pp. 7-18
Joane Souza ◽  
Renan Almeida ◽  
Ruth Almeida ◽  
Rafael Chagas ◽  
Ian Almeida

The aim of this work is to discuss and analyzing which criteria adopted for fish consumption in the Belém, Pará State, Metropolitan Region through the analysis of the consumer socioeconomic profile, the origin of his knowledge about the theme and his preferences about their fish buying and consumption habits, based on the answers obtained through a questionnaire. The methodology was the application of a questionnaire through the Google Forms platform,composed of 16 questions related to the themes addressed in this work directed to fish consumers in the municipalities of Ananindeua, Belém, Benevides, Castanhal, Marituba, Santa Bárbara do Pará and Santa Isabel do Pará. The questionnaire reached a total of 239 people. When asked about the preference in the choice of fish the dourada appears with about 68% as the preferred species for consumption in the BMR. The survey shows that most purchase places for consumption are the neighborhood fairs with 59% of the answers. Most respondents (about 60%) prefer fresh fish as the most sought-after form of conservation. As to the reason for the choice, the main answer obtained was the taste present in 89% of the interviews. Many respondents claimed that they would consume all types of fish, on the other hand, Tamuatá was chosen as the fish that respondents would not eat because it was seen in poor hygiene environments and had a strong flavor and odor. When asked how they learned to identify the fish freshness, 67% of respondents answered that this knowledge came through family teaching, showing that preference is a personal question and is related to the consumer cultural tradition.

2021 ◽  
Vol 66 (4) ◽  
pp. 729-740

2021 ◽  
Vol 12 (3) ◽  
pp. 167-181
Izabela Penha de Oliveira Santos ◽  
Ana Paula Fracalanza ◽  
Robert Coates ◽  
Jeroen Warner

Frequent cases of water scarcity in Brazil reveal a water governance and administration crisis. During the water crisis (2013-2016), the São Paulo Metropolitan Region experienced a disaster scenario. This article analyses how it was constituted as a socially constructed disaster episode. A case study was carried out in the Novo Recreio neighbourhood (Guarulhos, SP) through ethnographic observations, interviews, and newspaper articles. The results were analysed based on the Pressure and Release Model (PAR). It was concluded that the water crisis period in SPMR has disproportionately affected the Guarulhos population, especially in Novo Recreio. Furthermore, the study demonstrated that public policies and the neighbourhood's territorial formation are related to its population's current frail living conditions and increased socio-environmental vulnerability in the face of continuous water scarcity, thus corroborating the social construction of the risk of water scarcity.

Atmosphere ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 52
Pedro José Pérez-Martínez ◽  
Tiago Magalhães ◽  
Isabela Maciel ◽  
Regina M. de Miranda ◽  
Prashant Kumar

This paper presents an analysis of the effects of the COVID-19 pandemic on the air quality of the Metropolitan Region of São Paulo (MRSP). The effects of social distancing are still recent in the society; however, it was possible to observe patterns of environmental changes in places that had adhered transportation measures to combat the spread of the coronavirus. Thus, from the analysis of the traffic volumes made on some of the main access highways to the MRSP, as well as the monitoring of the levels of fine particulate matter (PM2.5), carbon monoxide (CO) and nitrogen dioxide (NO2), directly linked to atmospheric emissions from motor vehicles–which make up about 95% of air polluting agents in the region in different locations–we showed relationships between the improvement in air quality and the decrease in vehicles that access the MRSP. To improve the data analysis, therefore, the isolation index parameter was evaluated to provide daily information on the percentage of citizens in each municipality of the state that was effectively practicing social distancing. The intersection of these groups of data determined that the COVID-19 pandemic reduced the volume of vehicles on the highways by up to 50% of what it was in 2019, with the subsequent recovery of the traffic volume, even surpassing the values from the baseline year. Thus, the isolation index showed a decline of up to 20% between its implementation in March 2020 and December 2020. These data and the way they varied during 2020 allowed to observe an improvement of up to 50% in analyzed periods of the pollutants PM2.5, CO and NO2 in the MRSP. The main contribution of this study, alongside the synergistic use of data from different sources, was to perform traffic flow analysis separately for light and heavy duty vehicles (LDVs and HDVs). The relationships between traffic volume patterns and COVID-19 pollution were analyzed based on time series.

Hand ◽  
2021 ◽  
pp. 155894472110588
Joseph Meyerson ◽  
Andrew Liechty ◽  
Tyler Shields ◽  
David Netscher

Background: Twenty percent of the US population is described as being rural and may have limited access to hand surgeons, especially on an emergency basis. Little is known about case type, call hours, employment status, and other relevant details of rural hand surgery. Methods: We surveyed members of the American Society of Surgery for the Hand to begin to describe the problem. Results: There were 471 responses from 2256 members surveyed with 387 completing 100% of questions asked. Ninety (19%) identified themselves as primarily located in a rural population and 381 (81%) in a metropolitan region. In our study, rural hand surgeons were more likely to be employed by a community hospital, followed by independent private practice, multispecialty group, academics, and then locum tenens. Rural surgeons’ practices were 80% solely hand surgery, while metropolitan surgeons’ practices were 89% ( P < .01). Metropolitan surgeons felt that of the transfers from rural facilities, 46% did not need emergency hand care and that 60% of the time, there was not actually a need for specialty hand surgery care. Conclusions: Our survey begins to shed light on the details of rural hand surgery practice. We found that rural surgeons are more likely to be employed in community hospitals and take more call. When available, hand surgery specialists could prevent unnecessary transfer of patients to metropolitan areas. More work needs to be done to describe the differences between rural and metropolitan hand surgery practices as well as create rural hand surgeons.

2022 ◽  
Vol 304 ◽  
pp. 114279
Yara L.F. Santos ◽  
Aurora M. Yanai ◽  
Camila J.P. Ramos ◽  
Paulo M.L.A. Graça ◽  
Jose A.P. Veiga ◽  

2021 ◽  
Vol 14 (1) ◽  
pp. 146
Oya Duman ◽  
Raine Mäntysalo ◽  
Kaisa Granqvist ◽  
Emily Johnson ◽  
Niko-Matti Ronikonmäki

Land use and transport integration has been considered a must-have approach in achieving sustainable urban development. However, successful applications of the concept have been few, as institutional reforms to support land use and transport integration have lagged behind. Accordingly, this article argues that understanding difficulties in land use and transport integration requires an analysis of the long-term evolution of formal and informal institutional frameworks in planning practices. For this purpose, this article presents a case study of land use and transport planning in Finland’s Helsinki Metropolitan Region, which combines interview research on planners’ perceptions with a document analysis of the historical trajectories of the region’s plans, policy documents and related institutional and organizational changes. The historical-institutional approach of the article draws on discursive institutionalism as a novel analytical approach for studying how land use and transport integration is institutionally conditioned.

2021 ◽  
Vol 18 ◽  
pp. 1-18
Clara Luiza Miranda ◽  
Leticia Tabachi Silva ◽  
Martha Machado Campos ◽  
Vinícius Lamego de Paula Lamego Paula ◽  
Thais Rezende Arthur

O presente artigo aborda a pandemia de covid-19 a partir da hipótese de que as condições socioespaciais preexistentes são decisivas no processo de disseminação da doença. A dinâmica pandêmica revela, como fatores agravantes, a rápida disseminação do vírus em bairros periféricos e a elevada letalidade na população de menor renda devido, sobretudo,ao menor acesso a condições sanitárias adequadas, serviços de saúde e informação. O objetivo deste estudo é relacionar precariedade do habitat e saúde em cinco municípios da Região Metropolitana da Grande Vitória, utilizando como principal fonte de pesquisa o Mapeamento de Ações Comunitárias de Enfrentamento à covid-19, que registrou a atuação do governo em áreas vulneráveis durante a pandemia. Ademais, foram utilizados também estudos relativos à questão étnico-racial, à interface entre demografia e geografia e à área de saúde. A conclusão assinala a desigualdade socioespacial como fator preponderante ao analisar os impactos da pandemia.

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