Novos Meisho

Dissertação para obtenção do grau de Mestre em Arquitectura, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.

Estimate of Dementia Prevalence in a Community Sample from Sao Paulo, Brazil

Aims: To estimate dementia prevalence and describe the etiology of dementia in a community sample from the city of Sao Paulo, Brazil. Methods: A sample of subjects older than 60 years was screened for dementia in the first phase. During the second phase, the diagnostic workup included a structured interview, physical and neurological examination, laboratory exams, a brain scan, and DSM-IV criteria diagnosis. Results: Mean age was 71.5 years (n = 1,563) and 58.3% had up to 4 years of schooling (68.7% female). Dementia was diagnosed in 107 subjects with an observed prevalence of 6.8%. The estimate of dementia prevalence was 12.9%, considering design effect, nonresponse during the community phase, and positive and negative predictive values. Alzheimer`s disease was the most frequent cause of dementia (59.8%), followed by vascular dementia (15.9%). Older age and illiteracy were significantly associated with dementia. Conclusions: The estimate of dementia prevalence was higher than previously reported in Brazil, with Alzheimer`s disease and vascular dementia being the most frequent causes of dementia. Dementia prevalence in Brazil and in other Latin American countries should be addressed by additional studies to confirm these higher dementia rates which might have a sizable impact on countries` health services. Copyright (C) 2008 S. Karger AG, Basel

A geografia dos acidentes de trânsito na Região Metropolitana da Grande Vitória (RMGV) – ES

Esta dissertação aborda a espacialização dos acidentes de trânsito notificados entre os anos de 2005 e 2013 nos municípios de Fundão, Serra, Vitória, Cariacica, Vila Velha, Viana e Guarapari, que juntos compõem a Região Metropolitana da Grande Vitória (RMGV). Para o cumprimento deste propósito, realizou-se um diagnóstico temporal e espacial dos acidentes de trânsito ocorridos nessa região, analisando-se o acelerado crescimento da frota veicular, a situação da atual infraestrutura viária e o crescimento demográfico. Além disso, foram listadas as principais variáveis de risco responsáveis por ocasionar acidentes de trânsito. Quanto à fundamentação teórica, foi construída a partir da Geografia dos Transportes, que forneceu subsídios para contextualizar a importância da análise espacial geográfica sobre o fenômeno aqui tratado. Na sequência, estimaram-se os custos gerados por esse fenômeno, chegando à cifra de mais de R$ 900 milhões de custos associados aos acidentes de trânsito da RMGV em 2013. Utilizando-se de técnicas de geoestatística e de geoprocessamento, identificaram-se as áreas de concentração de acidentes de trânsito na RMGV, conforme as tipologias de colisões e choques, capotamentos e tombamentos e atropelamentos. Logrou-se, como conclusão, que 1) além do crescimento em quantidade e concentração das ocorrências, houve também, no decorrer da série histórica, o espraiamento dos registros de acidentes de trânsito na RMGV, e 2) os acidentes, conforme sua tipologia, concentram-se em diferentes áreas da região estudada.

Trajetória do crescimento da cidade de Colatina

It approaches the growth of the city of Colatina-ES, the county seat that has urban economy and urban population, and territory with most of the rural area. Rural areas, however, contribute little to the city s economy and are largely environmentally degraded, idle and waiting for recovery. The objective is to understand the growth of the city of Colatina, and the factors and consequences of this growth. Land division projects, investments and interventions in urban and rural areas were collected for the analysis. As a median-sized city characterized by central and regional polarity, but outside of the main investments in the state, Colatina seeks to take advantage of its situation of commercial warehouse city and road junction to stay alive in the regional economy. The citys economy is based on trade and services, but seeks to attract investment to the industry and logistics. The expansion of the city since the early formation follows the road system, which creates a dispersed spatiality. The characteristics of the urban growth of Colatina are the result of economic development strategies, interests in the property market and a government that abstains from urban control. These factors lead a sprawl urbanization that presents itself costly and not sustainable for urban and rural areas because it creates segregation, higher infrastructure costs, low-density and monofunctional urban spaces, pollution, and worsening of environmental depletion. The challenges for sustainable growth of the city of Colatina depends on a municipal and regional planning, which qualifies and diversifies its urban areas, avoids unnecessary expansion of the urban perimeter, retrieves its environmental degraded areas and leverages the agricultural activities in a productive and less aggressive way to the environment

Early patterns of recovery from disturbance in intertidal algal assemblages: consistency across regions within a marine province

The importance of disturbance and the subsequent rate and pattern of recovery has been long recognised as an important driver of community structure. Community recovery is affected by processes operating at local and regional scales yet the examination of community level responses to a standardised disturbance at regional scales (i.e. among regions under different environmental conditions) has seldom been attempted. Here, we mechanically disturbed rocky intertidal lower shore algal dominated assemblages at three locations within each of three different regions within the Lusitanian biogeographical province (Azores, northern Portugal and the Canary Islands). All organisms were cleared from experimental plots and succession followed over a period of 12 months at which time we formally compared the assemblage structure to that of unmanipulated controls. Early patterns of recovery of disturbed communities varied among regions and was positively influenced by temperature, but not by regional species richness. Different components of the assemblage responded differently to disturbance. Regional differences in the relative abundance and identity of species had a key influence on the overall assemblage recovery. This study highlights how regional-scales differences in environmental conditions and species pool are important determinants of recovery of disturbed communities.

C&SIG na delimitação da estrutura ecológica municipal: aplicação ao município de Cascais

Trabalho de projecto apresentada como requisito parcial para obtenção do grau de Mestre em Ciência e Sistemas de Informação Geográfica.

Application of geographic information system and modelling in health impact assessment for urban road mobility in Vietnam

Transport is an essential sector in modern societies. It connects economic sectors and industries. Next to its contribution to economic development and social interconnection, it also causes adverse impacts on the environment and results in health hazards. Transport is a major source of ground air pollution, especially in urban areas, and therefore contributing to the health problems, such as cardiovascular and respiratory diseases, cancer, and physical injuries. This thesis presents the results of a health risk assessment that quantifies the mortality and the diseases associated with particulate matter pollution resulting from urban road transport in Hai Phong City, Vietnam. The focus is on the integration of modelling and GIS approaches in the exposure analysis to increase the accuracy of the assessment and to produce timely and consistent assessment results. The modelling was done to estimate traffic conditions and concentrations of particulate matters based on geo-references data. A simplified health risk assessment was also done for Ha Noi based on monitoring data that allows a comparison of the results between the two cases. The results of the case studies show that health risk assessment based on modelling data can provide a much more detail results and allows assessing health impacts of different mobility development options at micro level. The use of modeling and GIS as a common platform for the integration of different assessments (environmental, health, socio-economic, etc.) provides various strengths, especially in capitalising on the available data stored in different units and forms and allows handling large amount of data. The use of models and GIS in a health risk assessment, from a decision making point of view, can reduce the processing/waiting time while providing a view at different scales: from micro scale (sections of a city) to a macro scale. It also helps visualising the links between air quality and health outcomes which is useful discussing different development options. However, a number of improvements can be made to further advance the integration. An improved integration programme of the data will facilitate the application of integrated models in policy-making. Data on mobility survey, environmental monitoring and measuring must be standardised and legalised. Various traffic models, together with emission and dispersion models, should be tested and more attention should be given to their uncertainty and sensitivity

The urban morphology of Braga between Late Antiquity and the fourteenth-fifteenth centuries

This paper aims to approach the urban transformation processes occurring in the city of Braga between Late Antiquity and the fourteenth-fifteenth centuries. Our approach is based upon the cross-referencing of documental, iconographic and cartographic data with data emerging from archaeological works conducted across the city throughout the last two decades. Despite the scarcity in sources documenting the historical period under study, a similar circumstance registered in other western European cities, new and emerging archaeological data associated with a regressive analysis of available information for the forthcoming centuries —documents, maps, plans and illustrations, have been contributing towards an advance in the overall knowledge regarding the continuity and changing processes impacting upon the urban area of Braga. Thereby, our goal is to develop a synthesis work describing the major evolutionary stages happening in Braga from the fifth to the fifteenth centuries and based upon anintegrated analysis of the architectonic markers, the morphology present in the urban setting, the existing Christian topography, the defensive system and the main road network.

Análise do ciclo de vida usando Lourenço modelo: caso da cidade de Damasco (1960-2015)

Dissertação de mestrado Internacional em Ambiente Construído Sustentável

Beyond Prejudice : conservation in the City : a case study from Switzerland

Conservation in the city is challenging because of a continued view that the urban realm is antithetical to nature. This was clearly the case when the first Swiss National Park was established at the beginning of the 20th century. New Swiss legislation brought new approaches to the establishment of natural parks, in particular by including human activities as a logical component in their development. In 2010, a Federal think tank discussed opportunities for launching a new kind of park: the Urban Natural Park. This paper reports an analysis of this discussion, together with the study of the literature dealing with conservation in the city and natural parks. It shows that a clear antagonism between city and nature still remains present, reflected in an implicit hierarchy hidden in the designation of natural parks: wild nature is nominated as the best nature; if not wild, the best nature is identified as rural; if neither wild nor rural, nature is thought not to be the concern of natural park policy. The Swiss Biodiversity Strategy implemented in 2012 is a recent recognition of the importance of urban nature for biodiversity conservation. This recognition, however, condemns urban nature to a special status, situated outside the usual framework of conservation management. I conclude by arguing that anti-urban bias must be addressed because it inhibits effective conservation strategy, prevents the identification of existing environmental qualities of cities and, eventually, has negative impacts on biological conservation outside the city because it fosters urban spreading.

Urban health: l'irrémédiable urbanisation de la vie et de la médecine [Urban health: the irremediable urbanization of life and medicine].

Since 2007, the number of people living in cities exceeds that of rural areas. Thus, cities and their organizations have a major influence on all spheres of human life, especially health. This influence may generate inequality, suffering and disease, but also represent an opportunity for health and well-being. This paper introduces the concept of urban health, particularly in terms of primary care medicine and presents solutions that encompass a wide field (politics, urban planning, social inequality, education). Improving urban health requires collaboration of medical with non-medical actors, in order to become of development (re-) urban structure and promotes the health of all.

Efficacy of clinical guideline implementation to improve the appropriateness of chest physiotherapy prescription among inpatients with community-acquired pneumonia

BACKGROUND: Although there is no strong evidence of benefit, chest physiotherapy (CP) seems to be commonly used in simple pneumonia. CP requires equipment and frequently involves the assistance of a respiratory therapist, engendering a significant medical workload and cost. AIM: To measure and compare the efficacy of two modalities of chest physiotherapy (CP) guideline implementation on the appropriateness of CP prescription among patients hospitalised for community-acquired pneumonia (CAP). PATIENTS AND METHODS: We measured the CP prescription rate and duration in all consecutive CAP inpatients admitted in a division of general internal medicine at an urban teaching community hospital during three consecutive one-year time periods: (1) before any guideline implementation; (2) after a passive implementation by medical grand rounds and guideline diffusion through mailing; (3) after adding a one-page reminder in the CAP patient's medical chart highlighting our recommendations. Death and recurrent hospitalisation rates within one year after hospitalisation were recorded to assess whether CP prescription reduction, if any, impaired patient outcomes. RESULTS: During the three successive phases, 127, 157, and 147 patients with similar characteristics were included. Among all CAP inpatients, the CP prescription rate decreased from 68% (86/127) to 51% (80/157), and to 48% (71/147), respectively (P for trend <0.01 for trend). A significant reduction in CP duration was observed after the active guideline implementation (12.0, 11.0, 7.0days, respectively) and persisted after adjustment for length of stay. Reductions in CP prescription rate and duration were also observed among CAP patients with COPD CP prescription rate: 97% (30/31), 67% (24/36), 75% (35/47), respectively (P<0.01 for trend). The mean cost of CP per patient was reduced by 56%, from $709 to $481, and to $309, respectively. Neither the in-hospital deaths, the one-year overall recurrent hospitalisation nor the one-year CAP-specific recurrent hospitalisation significantly differed between the three phases. CONCLUSION: Both passive and active implementation of guidelines appear to improve the appropriateness of CP prescription among inpatients with CAP without impairing their outcomes. Restricting CP use to patients who benefit from this treatment might be an opportunity to decrease CAP medical cost and workload.

Áreas residenciais clandestinas na Cidade da Praia: caso Latada e Achada Eugénio Lima Trás

O principal objectivo desta dissertação é expor a problemática das áreas residenciais clandestinas na cidade da Praia. Este processo de produção do espaço urbano acompanhou o desenvolvimento da urbe, em resultado das razões sociais, económicas, políticas e institucionais tendo consequências urbanísticas e sociais graves. Surge porque as diferentes estruturas não souberam ou não foram capazes de dar resposta aos anseios da população em matéria de habitação e solo para construção. Este estudo apresenta um conjunto de informação acerca da realidade das áreas residenciais clandestinas que visa dar a dimensão da problemática na cidade da Praia, seguido de uma análise mais detalhada de duas áreas residenciais. A caracterização sócio-económica e a análise do processo construtivo permitiram produzir conhecimentos mais profundos sobre estes fragmentos do tecido urbano. Na dissertação procurámos articular a questão do planeamento com a habitação e as áreas residenciais clandestinas através da análise dos diferentes planos propostos ou aplicados na urbe. Procurámos perceber como os planos abordaram esta problemática e as soluções apresentadas para a sua superação. Da mesma forma, a apreciação feita em relação à habitação e à política de solos através das resoluções legais propostas para contornar a situação urbanística da cidade. Para uma melhor compreensão do tema discutimos a sua abrangência teórica na perspectiva de diferentes autores e efectuamos o entrosamento entre a componente empírica da produção do espaço urbano com a reflexão teórica. Perante a fragmentação da urbe em núcleos planeados e espontâneos, partimos na auscultação do poder local para a problemática. A intervenção deste em reverter o actual panorama e a política preconizada em relação a reconversão das áreas residenciais clandestinas visando a sua integração no quadro do ordenamento da aglomeração

Logging residues from regeneration fellings for biofuel production - a GIS-based availability and supply cost analysis

Finland has large forest fuel resources. However, the use of forest fuels for energy production has been low, except for small-scale use in heating. According to national action plans and programs related to wood energy promotion, the utilization of such resources will be multiplied over the next few years. The most significant part of this growth will be based on the utilization of forest fuels, produced from logging residues of regeneration fellings, in industrial and municipal power and heating plants. Availability of logging residues was analyzed by means of resource and demand approaches in order to identify the most suitable regions with focus on increasing the forest fuel usage. The analysis included availability and supply cost comparisons between power plant sites and resource allocation in a least cost manner, and between a predefined power plant structure under demand and supply constraints. Spatial analysis of worksite factors and regional geographies were carried out using the GIS-model environment via geoprocessing and cartographic modeling tools. According to the results of analyses, the cost competitiveness of forest fuel supply should be improved in order to achieve the designed objectives in the near future. Availability and supply costs of forest fuels varied spatially and were very sensitive to worksite factors and transport distances. According to the site-specific analysis the supply potential between differentlocations can be multifold. However, due to technical and economical reasons ofthe fuel supply and dense power plant infrastructure, the supply potential is limited at plant level. Therefore, the potential and supply cost calculations aredepending on site-specific matters, where regional characteristics of resourcesand infrastructure should be taken into consideration, for example by using a GIS-modeling approach constructed in this study.

Raising awareness of chronic kidney disease in a Brazilian urban population

The incidence and prevalence of chronic kidney disease have been increasing in recent years in developing countries. The aim of this study was to report the results of a general chronic kidney disease awareness program applied to an urban population in a large Brazilian city. From January 2002 to January 2005 a total of 8883 individuals in the city of Curitiba (PR, Brazil) were screened for hypertension, body mass index, hematuria, and proteinuria. A family history and previous medical diagnosis of hypertension and diabetes mellitus (DM) were also recorded. Of the 8883 individuals assessed, 56% were women, subject median age was 47 years (range: 17-93 years) and more than 90% were Caucasian. Thirty percent had signs of hematuria, 6% had proteinuria, and 3% had hematuria and proteinuria. The median of mean arterial pressure values was 93 mmHg (range: 71-135 mmHg) and 16% of the population screened had a history of hypertension. A significant positive family history of both hypertension or DM was present in 42% (P < 0.0001; chi-square = 83.18) and 7% (P < 0.0001; chi-square = 161.31) of the hypertensive group, respectively. Finally, the prevalence of hypertension and DM was significantly higher in older individuals with proteinuria. In the present study, a higher prevalence of hematuria and proteinuria was found in older individuals with hypertension and diabetes compared to the general population. These data confirm the need for public awareness of renal disease in high-risk individuals.