Carbon footprints of tailings dams' disasters: A study in the Brumadinho region (Brazil).

Tailings dams' breaks are environmental disasters with direct and intense degradation of soil. This study analyzed the impacts of B1 tailings dam rupture occurred in the Ribeirão Ferro-Carvão watershed (Brumadinho, Brazil) in January 25, 2019. Soil organic carbon (SOC) approached environmental degradation. The analysis encompassed wetlands (high-SOC pools) located in the so-called Zones of Decreasing Destructive Capacity (DCZ5 to DCZ1) defined along the Ferro-Carvão's stream bed and banks after the disaster. Remote sensed water indices were extracted from Landsat 8 and Sentinel-2 satellite images spanning the 2017-2021 period and used to distinguish the wetlands from other land covers. The annual SOC was extracted from the MapBiomas repository inside and outside the DCZs in the same period, and assessed in the field in 2023. Before the dam collapse, the DCZs maintained stable levels of SOC, while afterwards they decreased substantially reaching minimum values in 2023. The reductions were abrupt: for example, in the DCZ3 the decrease was from 51.28 ton/ha in 2017 to 4.19 ton/ha in 2023. Besides, the SOC increased from DCZs located near to DCZs located farther from the dam site, a result attributed to differences in the percentages of clay and silt in the tailings, which also increased in the same direction. The Ferro-Carvão stream watershed as whole also experienced a slight reduction in the average SOC levels after the dam collapse, from nearly 43 ton/ha in 2017 to 38 ton/ha in 2021. This result was attributed to land use changes related with the management of tailings, namely opening of accesses to remove them from the stream valley, creation of spaces for temporary deposits, among others. Overall, the study highlighted the footprints of tailings dams' accidents on SOC, which affect not only the areas impacted with the mudflow but systemically the surrounding watersheds. This is noteworthy.

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment.

Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.

Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations.

Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.

Interdisciplinaridade na assistência ao parto: percepção dos enfermeiros obstetras / Interdisciplinarity in childbirth care: perception of obstetric nurses

Objetivo: avaliar a percepção dos enfermeiros obstetras sobre a atuação interdisciplinar na assistência ao parto natural. Método: trata-se de um estudo qualitativo, descritivo, exploratório, realizado com seis enfermeiros obstetras de uma maternidade escola. Coletaram-se os dados aplicando-se um formulário para a entrevista semiestruturada submetido à Análise de Conteúdo de Bardin. Resultados: identificaram-se as seguintes temáticas: a prática interdisciplinar na formação profissional; a assistência de Enfermagem no contexto da interdisciplinaridade e o atendimento interdisciplinar ao parto: uma experiência ao alcance. Conclusão: observou-se a deficiência da abordagem interdisciplinar na formação acadêmica de todos os entrevistados, o que tem causado prejuízos na relação interpessoal e no processo de humanização ao parto. Identificaram-se enfermeiros que encontram dificuldades diante da atuação em equipe, em particular, em relação à assistência ao recém-nascido na sala de parto.(AU)

Objective: to evaluate the perception of obstetric nurses about the interdisciplinary role in natural childbirth care. Method: this is a qualitative, descriptive, exploratory study conducted with six obstetric nurses from a maternity school. Data was collected by applying a form for the semi-structured interview submitted to Bardin Content Analysis. Results: the following themes were identified: interdisciplinary practice in vocational training; Nursing care in the context of interdisciplinarity and interdisciplinary delivery care: an experience within reach. Conclusion: the deficiency of the interdisciplinary approach in the academic formation of all interviewees was observed, which has caused damage to the interpersonal relationship and the process of humanization at childbirth. Nurses were identified who find it difficult to face teamwork, in particular in relation to newborn care in the delivery room.(AU)

Objetivo: evaluar la percepción de los enfermeros obstétricos sobre el papel interdisciplinario en la atención natural del parto. Método: este es un estudio cualitativo, descriptivo, exploratorio realizado con seis enfermeros obstétricos de una escuela de maternidad. Los datos se recopilaron mediante la aplicación de un formulario para la entrevista semiestructurada sometido al Análisis de Contenido de Bardin. Resultados: se identificaron los siguientes temas: la práctica interdisciplinaria en la formación profesional; la atención de Enfermería en el contexto de la interdisciplinariedad y la atención interdisciplinaria del parto: una experiencia al alcance. Conclusión: se observó la deficiencia del enfoque interdisciplinario en la formación académica de todos los entrevistados, lo que ha causado daños a la relación interpersonal y al proceso de humanización en el parto. Se identificaron enfermeros a quienes les resulta difícil enfrentar el trabajo en equipo, en particular en relación con el cuidado del recién nacido en la sala de partos.(AU)

Recommendations of the Brazilian Society of Rheumatology for diagnosis and treatment of Chikungunya fever. Part 1 - Diagnosis and special situations / Recomendações da Sociedade Brasileira de Reumatologia para diagnóstico e tratamento da febre chikungunya. Parte 1 - Diagnóstico e situações especiais

Abstract Chikungunya fever has become a relevant public health problem in countries where epidemics occur. Until 2013, only imported cases occurred in the Americas, but in October of that year, the first cases were reported in Saint Marin island in the Caribbean. The first autochthonous cases were confirmed in Brazil in September 2014; until epidemiological week 37 of 2016, 236,287 probable cases of infection with Chikungunya virus had been registered, 116,523 of which had serological confirmation. Environmental changes caused by humans, disorderly urban growth and an ever-increasing number of international travelers were described as the factors responsible for the emergence of large-scale epidemics. Clinically characterized by fever and joint pain in the acute stage, approximately half of patients progress to the chronic stage (beyond 3 months), which is accompanied by persistent and disabling pain. The aim of the present study was to formulate recommendations for the diagnosis and treatment of Chikungunya fever in Brazil. A literature review was performed in the MEDLINE, SciELO and PubMed databases to ground the decisions for recommendations. The degree of concordance among experts was established through the Delphi method, involving 2 in-person meetings and several online voting rounds. In total, 25 recommendations were formulated and divided into 3 thematic groups: (1) clinical, laboratory and imaging diagnosis; (2) special situations; and (3) treatment. The first 2 themes are presented in part 1, and treatment is presented in part 2.

Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias. Até 2013, as Américas haviam registrado apenas casos importados quando, em outubro desse mesmo ano, foram notificados os primeiros casos na Ilha de Saint Martin, no Caribe. No Brasil, os primeiros relatos autóctones foram confirmados em setembro de 2014 e até a semana epidemiológica 37 de 2016 já haviam sido registrados 236.287 casos prováveis de infecção pelo chikungunya vírus (CHIKV), 116.523 confirmados sorologicamente. As mudanças ambientais causadas pelo homem, o crescimento urbano desordenado e o número cada vez maior de viagens internacionais têm sido apontados como os fatores responsáveis pela reemergência de epidemias em grande escala. Caracterizada clinicamente por febre e dor articular na fase aguda, em cerca de metade dos casos existe evolução para a fase crônica (além de três meses), com dor persistente e incapacitante. O objetivo deste trabalho foi elaborar recomendações para diagnóstico e tratamento da febre chikungunya no Brasil. Para isso, foi feita revisão da literatura nas bases de dados Medline, SciELO e PubMed, para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Foram geradas 25 recomendações, divididas em três grupos temáticos: (1) diagnóstico clínico, laboratorial e por imagem; (2) situações especiais e (3) tratamento. Na primeira parte estão os dois primeiros temas e o tratamento na segunda.

Recommendations of the Brazilian Society of Rheumatology for the diagnosis and treatment of chikungunya fever. Part 2 - Treatment / Recomendações da Sociedade Brasileira de Reumatologia para diagnóstico e tratamento da febre chikungunya. Parte 2 - Tratamento

Abstract Chikungunya fever has become an important public health problem in countries where epidemics occur because half of the cases progress to chronic, persistent and debilitating arthritis. Literature data on specific therapies at the various phases of arthropathy caused by chikungunya virus (CHIKV) infection are limited, lacking quality randomized trials assessing the efficacies of different therapies. There are a few studies on the treatment of musculoskeletal manifestations of chikungunya fever, but these studies have important methodological limitations. The data currently available preclude conclusions favorable or contrary to specific therapies, or an adequate comparison between the different drugs used. The objective of this study was to develop recommendations for the treatment of chikungunya fever in Brazil. A literature review was performed via evidence-based selection of articles in the databases Medline, SciELO, PubMed and Embase and conference proceedings abstracts, in addition to expert opinions to support decision-making in defining recommendations. The Delphi method was used to define the degrees of agreement in 2 face-to-face meetings and several online voting rounds. This study is part 2 of the Recommendations of the Brazilian Society of Rheumatology (Sociedade Brasileira de Reumatologia - SBR) for the Diagnosis and Treatment of chikungunya fever and specifically addresses treatment.

Resumo A febre chikungunya tem se tornado um importante problema de saúde pública nos países onde ocorrem as epidemias, visto que metade dos casos evolui com artrite crônica, persistente e incapacitante. Os dados na literatura sobre terapêuticas específicas nas diversas fases da artropatia ocasionada pela infecção pelo vírus chikungunya (CHIKV) são limitados, não existem estudos randomizados de qualidade que avaliem a eficácia das diferentes terapias. Há algumas poucas publicações sobre o tratamento das manifestações musculoesqueléticas da febre chikungunya, porém com importantes limitações metodológicas. Os dados atualmente disponíveis não permitem conclusões favoráveis ou contrárias a terapêuticas específicas, bem como uma adequada avaliação quanto à superioridade entre as diferentes medicações empregadas. O objetivo deste trabalho foi elaborar recomendações para o tratamento da febre chikungunya no Brasil. Foi feita uma revisão da literatura com seleção de artigos baseados em evidência, nas bases de dados Medline, SciELO, PubMed e Embase e de resumos de anais de congressos, além da opinião dos especialistas para dar apoio às decisões tomadas para definir as recomendações. Para a definição do grau de concordância foi feita uma metodologia Delphi, em duas reuniões presenciais e várias rodadas de votação on line. Este artigo refere-se à parte 2 das Recomendações da Sociedade Brasileira de Reumatologia para Diagnóstico e Tratamento da Febre Chikungunya, que trata especificamente do tratamento.