Incorporating diverse values of nature in decision-making-theory and practice.

Values play a significant role in decision-making, especially regarding nature. Decisions impact people and nature in complex ways and understanding which values are prioritised, and which are left out is an important task for improving the equity and effectiveness of decision-making. Based on work done for the IPBES Values Assessment, this paper develops a framework to support analyses of how decision-making influences nature as well as whose values get prioritised. The framework is used to analyse key areas of environmental policy: a) the present model for nature protection in market economies, b) the role of valuation in bringing nature values into decisions, and c) values embedded in environmental policy instruments, exemplified by protected areas for nature conservation and payments for ecosystem services. The analyses show that environmental policies have been established as mere additions to decision-making structures that foster economic expansion, which undermines a wide range of nature's values. Moreover, environmental policies themselves are also focused on a limited set of nature's diverse values. This article is part of the theme issue 'Bringing nature into decision-making'.

Effect of the COVID-19 Pandemic on the Epidemiology of Pediatric Traumatic Brain Injury in Brazil.

Aim In response to the coronavirus 2019 disease (COVID-19) pandemic, governments worldwide implemented measures to prevent infection, resulting in restricted school activities, restricted children's freedom of movement, and increased risk of violence and injuries at home, including traumatic brain injury (TBI), among children. In Brazil, the consequences of the COVID-19 pandemic on the causes, severity, and mortality of pediatric TBI have not yet been investigated. Thus, our study aimed to determine whether the COVID-19 pandemic has affected the epidemiology of pediatric TBI among Brazilian children. Materials and methods We investigated the patients with TBI aged <18 years who visited a tertiary trauma center in Brazil in 2019 and 2020. TBI-related variables, such as classification, mechanism, clinical manifestations, need for intervention, morbidity, and mortality, were recorded. Furthermore, we used a nationwide databank to collect information on mortality from external causes of trauma and violence in the pediatric population in 2019 and 2020. The Mann-Whitney test was used to compare quantitative variables related to the mechanisms and severity of TBI in both periods in order to determine the impact of the COVID-19 pandemic. Results Of the patients with traumatic brain injury, 1371 visited the trauma center in 2019 and 1052 in 2020. No difference was noted in the incidence rate of abusive head trauma between these periods (p=0.142) or in mortality from violence in Brazil. Recreational causes of pediatric TBI increased during the first year of the COVID-19 pandemic in Brazil and falls from bicycles significantly increased during the pandemic (p<0.001). Conclusion A global reduction in pediatric admissions to emergency rooms as well as no impact on mortality and severity of pediatric TBI were observed during the COVID-19 pandemic in Brazil. Additionally, a public education program regarding child safety during recreational activities, particularly how to avoid falls from bicycles was recommended.

Papel das ligas estudantis de apoio à nefrologia na prevenção da doença renal crônica / The role of the student coalition of support to nephrology in the prevention of chronic kidney disease

No Brasil, assim como no resto do mundo, a Doença Renal Crônica (DRC) vem sendo encarada como um sério problema de saúde pública. A gravidadeda situação requer medidas urgentes capazes de prevenir a progressão e as complicações da doença. Nesse sentido, as Ligas Acadêmicas de Apoio àNefrologia, movimento que congrega estudantes de medicina e, em alguns casos, discentes de outros cursos da área de saúde e afins, tem se destacadoparticipando das campanhas de prevenção incentivadas pela Sociedade Brasileira de Nefrologia, assim como, a nível local, nos diferentes de níveis deprevenção em colaboração com o Programa de Saúde da Família e os nefrologistas. Estimular a criação de mais Ligas parece ser uma excelente estratégia para atrair, para a nefrologia, jovens já comprometidos com a prevenção como estratégia de atuação.

In Brazil, as well as worldwide, chronic kidney disease (CKD) has become a tremendous health problem. The seriousness of the problem has demanded urgent measures to prevent the burden of illness, disability, and premature death usually seen with the disease. The Student Coalition of Support to Nephrology is an activity developed by students of medicine, and, in some places, already working in a multidisciplinary way with students of several other courses, actively participating in screening programs such as the PREVINA-SE of the Brazilian Society of Nephrology and, locally, taking part in all levels of prevention of CKD together with Family Health Care Professionals and nephrologists. Stimulate the set up of more Student Coalitions of Support toNephrology seems to be an interesting strategy to attract young students who are already compromised with the prevention of kidney diseases, to thepractice of nephrology.

Implications for physical design: The effect of depth on the performance of waste stabilization ponds.

Studies on experimental primary facultative ponds showed that varying the depth from 1.25 m to 2.3 m had no effect on the rates of BOD removal. In contrast k values for FC removal rates were higher in the shallower (1.25 m) facultative ponds. The risk of odour release via H2S production was higher in the 2.2 m ponds than the 1.25 m ponds and NH3 removal was much better in the 1.25 m facultative ponds. A comparison of the efficiency of shallow 5-pond series (1.0 m and 0.61 m deep) with a 2.2 m deep series showed that the shallow systems were more efficient at FC removal, but the deeper series actually saved land area for the same FC final effluent quality under tropical conditions. However, efficient nutrient removal (N and P) only occurred in the shallow series and effluent standards for nutrient concentrations are unlikely to be met by 2.2 m deep 5-pond series in contrast to the norms for pathogen removal.