Saúde e reparação integral de comunidades camponesas em territórios da transposição do rio São Francisco / Health and comprehensive repair of peasant communities in territories of the São Francisco River transposition

Resumo A saúde é um complexo de situações de condições de vida alinhadas a contextos e lugares no tempo. O processo de reparação a partir do entendimento ampliado da saúde é um conjunto de direitos, ações e medidas protagonizadas por diferentes sujeitos nas diversas dimensões da vida. Este artigo tem como objetivo analisar as percepções e ações de reparação direcionadas a camponeses que sofreram perdas materiais e simbólicas no decurso das obras da transposição do Rio São Francisco, em Sertânia, Pernambuco. Trata-se de um estudo de caso com abordagem qualitativa. Os sujeitos desta pesquisa foram camponeses maiores de 18 anos, sem especificação de sexo, residentes em três comunidades nas proximidades do canal Eixo Leste da transposição. Foram realizadas entrevistas semiestruturadas nas comunidades e uma oficina participativa. Observou-se que há uma insuficiência no reconhecimento dos direitos de reparação pelos habitantes e, consequentemente, uma não efetivação das ações desenvolvidas nesse aspecto. As ações de reparação focaram compensações monetárias para a perda de bens materiais, porém sendo muitas vezes subdimensionadas ou até mesmo ausentes. É imprescindível que a reparação seja pensada na perspectiva da complexidade do caso, considerando todas as dimensões da saúde e da vida.

Abstract Health is a complex of situations of living conditions aligned to contexts and places at a given time. The redress process based on the expanded understanding of health is a set of rights, actions, and measures carried out by different subjects in the different dimensions of life. This article aims to analyze the perceptions and redress actions directed to peasants who suffered material and symbolic losses during the transposition of the São Francisco River, in Sertânia, Pernambuco. This is a case study with a qualitative approach. The subjects of this research were peasants over 18 years of age, of without specifying gender, living in three peasant communities near the Eixo Leste of the transposition. Semi-structured interviews and a participatory workshop were carried out in the communities. An insufficiency in the recognition of reparation rights by the inhabitants and, consequently, a non-effectiveness of the actions developed to that end were observed. Remedial actions focused on monetary compensation from the loss of material goods, but were often undersized or even absent. It is essential that the repair be thought of from the perspective of the complexity of the case, considering all dimensions of health and life.

"The people here knew how I used to live, but now I have to start again:" Lived experiences and expectations of the displaced and non-displaced women affected by the Thwake Multipurpose Dam construction in Makueni County, Kenya.

BACKGROUND: Dam construction and associated disruptive activities such as population displacement can have significant societal consequences, especially for those socially and economically disadvantaged. Though community-level health and social consequences of displacements have been documented, there is little understanding of the individual-level consequences and intra-household gendered dynamics. OBJECTIVE/METHODS: We sought to explore the experiences and expectations of displaced (n = 30) and non-displaced (n = 20) women in Makueni County, Kenya, where Kenya's second largest dam, Thwake Multipurpose Dam, is being constructed. We used qualitative techniques, including photo-elicitation interviews, go-along interviews, key informant interviews, and participant observation, to understand the lived experiences of women affected by the dam construction processes and their associated disruptions. RESULTS: We found that both displaced and non-displaced women experienced the impacts of dam construction in four areas, i.e., economic (income loss), health (hearing damage), social (disrupted social networks), and environmental (flooding) domains. Though both groups described adverse effects, the displaced women perceived worse economic and social outcomes than non-displaced ones. Further, older and married women in both groups had the worst lived experiences and negative perceptions about the consequences for social well-being, e.g., loss of cultural identity, land ownership, and access to important religious sites. Changes in livelihood also transformed gender roles as women assumed economic responsibilities to cushion their families from hunger. CONCLUSION: Development projects such as dams negatively impact the host community-displaced and the non-displaced experience adverse health, social, and environmental effects. However, poor women who are smallholder farmers bear the greatest burden. Assessment of individual-level experiences and intrahousehold dynamics might enhance our understanding of the biosocial outcomes of these consequences. Therefore, integrative biosocial approaches should be considered when examining the impacts of dam construction.

Design of a syringe extension device (Chloe SED®) for low-resource settings in sub-Saharan Africa: a circular economy approach.

Underfunded healthcare infrastructures in low-resource settings in sub-Saharan Africa have resulted in a lack of medical devices crucial to provide healthcare for all. A representative example of this scenario is medical devices to administer paracervical blocks during gynaecological procedures. Devices needed for this procedure are usually unavailable or expensive. Without these devices, providing paracervical blocks for women in need is impossible resulting in compromising the quality of care for women requiring gynaecological procedures such as loop electrosurgical excision, treatment of miscarriage, or incomplete abortion. In that perspective, interventions that can be integrated into the healthcare system in low-resource settings to provide women needing paracervical blocks remain urgent. Based on a context-specific approach while leveraging circular economy design principles, this research catalogues the development of a new medical device called Chloe SED® that can be used to support the provision of paracervical blocks. Chloe SED®, priced at US$ 1.5 per device when produced in polypropylene, US$ 10 in polyetheretherketone, and US$ 15 in aluminium, is attached to any 10-cc syringe in low-resource settings to provide paracervical blocks. The device is designed for durability, repairability, maintainability, upgradeability, and recyclability to address environmental sustainability issues in the healthcare domain. Achieving the design of Chloe SED® from a context-specific and circular economy approach revealed correlations between the material choice to manufacture the device, the device's initial cost, product durability and reuse cycle, reprocessing method and cost, and environmental impact. These correlations can be seen as interconnected conflicting or divergent trade-offs that need to be continually assessed to deliver a medical device that provides healthcare for all with limited environmental impact. The study findings are intended to be seen as efforts to make available medical devices to support women's access to reproductive health services.

Changes to acute-care hospitalizations among Indigenous children and youth: Results from the 2006 and 2011 Canadian Census Health and Environment Cohorts.

Background: This study described the differences in the hospitalization rates of First Nations children and youth living on and off reserve, Inuit children and youth living in Inuit Nunangat (excluding Nunavik), and Métis children and youth, relative to non-Indigenous children and youth and examined rate changes across 2006 and 2011. Data and methods: The 2006 and the 2011 Canadian Census Health and Environment Cohorts provided five years of hospital records that Statistics Canada linked to peoples' self-reported Indigenous identity as recorded on the census. Causes of hospitalizations were based on the most responsible diagnosis coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada, aggregated by chapter code. Age-standardized hospitalization rates (ASHRs) were calculated per 100,000 population. Rate ratios (RRs) were reported for each Indigenous group relative to non-Indigenous children and youth. Results: For the 2006 and the 2011 cohorts, ASHRs were generally higher among Indigenous children and youth than among non-Indigenous children and youth. For some health conditions, hospitalization patterns also varied across the two time periods within the given Indigenous groups. Among children, leading elevated RRs occurred for diseases of the respiratory system, the digestive system and injuries. Elevated mental health-related RRs were observed among all Indigenous groups for both cohort years of youth. Significant increases in mental health-related ASHRs were observed in 2011 compared with 2006 among all youth groups, except for Inuit youth living in Inuit Nunangat, possibly due in part to data limitations. Among Indigenous youth, elevated RRs were observed for pregnancy, childbirth and the puerperium, and for injuries. For all youth (except Inuit), childbirth-related ASHRs decreased in 2011 compared with 2006. Interpretation: Findings align with previously observed hospitalization disparities between Indigenous and non-Indigenous children and youth. These data enabled the tracking of changes over time to partly address national information gaps about population health outcomes for children and youth, namely hospitalization.

A PETAR method for risk assessment of human health and environment on the regional scale.

Risk assessments are necessary to effectively reveal the state of the degradation of living environments on a regional scale. However, risk assessments are often limited by time, cost, and technology, which make conducting effective evaluations difficult. Thus, in this study, the procedure for ecological tiered assessment of risk (PETAR) method was used to analyze the human health and environmental risks in Daye, China. This method first used the United States Environmental Protection Agency's risk assessment approach to qualitatively determine the risk sources, pressures, receptors, and effect endpoints and constructed a conceptual model of threats to the human living environment. Each risk-prone subregion was then evaluated using the fuzzy logic method. Next, a quantitative assessment was conducted for the subregions with the most serious environmental degradation. Finally, quantitative analyses were performed to verify the original hypotheses. The results showed that the high-risk areas were distributed in the industrial regions of Daye, wherein mining and processing clusters and mining settlements are widespread and confirmed the locations of the particular subregions with the most serious human health and environmental risks. This study also validated the practicality of the PETAR method for human health risk assessments in mining areas with large-scale, multifactor, and multihazard paths. Integr Environ Assess Manag 2023;19:239-253. © 2022 SETAC.

O derramamento de petróleo no litoral pernambucano a partir das narrativas do Jornal do Commercio / The oil spill on the coast of Pernambuco from narratives of Jornal do Commercio / El derrame de petróleo en la costa de Pernambuco desde las narrativas de Jornal do Commercio

Em 2019, o litoral nordestino foi atingido por um derramamento de petróleo, considerado o maior desastre ambiental desse tipo no Brasil. Após a notícia repercutir rapidamente nas mídias sociais, a mídia hegemônica ­ TV, internet e jornal ­ começou a veicular reportagens sobre o desastre priorizando as vozes institucionais e especializadas em detrimento das vozes dos territórios afetados. Este artigo analisa o discurso midiático a respeito do derramamento de petróleo no estado de Pernambuco. Realizou-se pesquisa documental com dados do Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis (Ibama) e a partir de matérias publicadas pelo Jornal do Commercio. Para análise utilizou-se o método do Discurso do Sujeito Coletivo (DSC). Como resultado, elaborou-se uma linha do tempo que interligou a identificação do petróleo às matérias do jornal, classificando as narrativas conforme os impactos ambientais, socioeconômicos e os danos à saúde. O tema da saúde teve baixa visibilidade no jornal, demonstrando ser necessário se repensar as práticas comunicacionais frente a desastres ambientais.

In 2019, the northeast coast of Brazil was hit by an oil spill that was considered the biggest environmental disaster of its kind in the country. The news quickly reverberated in the social media, however, the hegemonic media (TV, internet and newspapers) started to broadcast news about the disaster focusing on the institutional voices and on specialists to the detriment of the voices of the people living in the affected areas. This paper analyzes the media discussion about the oil spill off the coast of Pernambuco. Documentary research was carried out with data from Ibama and articles published by Jornal do Commercio. For the analysis we used the Collective Subject Discourse (CSD) method. As a result, we created a timeline linking the finding of the oil to the journalist articles, classifying the narratives according to environmental, socioeconomic and health impacts. The topic of health had low visibility on the newspaper, showing the need to rethink the communication practices in the face of environmental disasters.

En 2019, la costa noreste fue golpeada por un derrame de petróleo, considerado el mayor desastre ambiental de este tipo en Brasil. Luego que la noticia resonara en las redes sociales, los medios hegemónicos comenzaron a difundir reportajes sobre el desastre, priorizando las voces institucionales y especializadas en detrimento de las voces de los territorios afectados. Este artículo analiza el discurso mediático sobre el derrame de petróleo en Pernambuco. La investigación documental fue realizada con datos del Ibama y artículos publicados en el Jornal do Commercio. Para el análisis se utilizó el método discursivo del sujeto colectivo. Como resultado, se elaboró una línea de tiempo que vincula la identificación del petróleo con Jornal do Commercio y se identificaron narrativas considerando los impactos ambientales, socioeconómicos y de salud. El tema de la salud tuvo poca visibilidad en el periódico, demostrando la necesidad de repensar las prácticas de comunicación frente a los desastres ambientales

Meio ambiente e saúde: caminhos para uma divulgação científica multidisciplinar? / Environment and health: paths for a multidisciplinary scientific dissemination? / Medio ambiente y salud: ¿caminos para una divulgación científica multidisciplinar?

O trabalho que fundamenta este artigo traçou dois caminhos metodológicos para analisar a divulgação científica sobre a relação entre desmatamento, mudanças climáticas e saúde em uma experiência selecionada. Foi realizada revisão de literatura para identificar como o tema emergia em artigos científicos publicados no Brasil entre 2020 e 2021. A partir do referencial temático identificado por meio de palavras-chave, foram analisados 42 vídeos publicados pelo canal Ciência com Certeza no YouTube. Considerando os conceitos de divulgação científica e comunicação científica segundo Bueno (2010), é possível afirmar que o projeto caracteriza-se como de comunicação científica extrapares por estar direcionado ao público especializado de diversas áreas do conhecimento. A disponibilização pública das gravações das palestras não o caracteriza como um projeto de divulgação científica, embora tenha potencial de ampliar seu direcionamento para públicos leigos. Também foi constatado que a relação entre meio ambiente e saúde não foi tema central das palestras no período analisado

In the work on which this article is based, two methodological paths were used to analyze scientific dissemination about the relationship between deforestation, climate change and health in a selected project. A literature review was carried out to identify how the theme emerged in scientific articles published in Brazil between 2020 and 2021. Based on the thematic framework identified through keywords, 42 videos published by the Ciência com Certeza project on its YouTube channel were analyzed. Considering Bueno's (2010) concepts of scientific communication and scientific dissemination, it can be said that the project is characterized as a multidisciplinary scientific communication project as it is aimed at specialised audiences from different areas of knowledge. The public availability of recordings of lectures does not characterize it as a scientific dissemination project, although it has the potential to broaden its targeting to lay audiences. It was also found that the relationship between environment and health was not a central theme of the lectures during the analyzed period

En el trabajo que fundamenta este artículo se utilizaron dos caminos metodológicos para analizar la divulgación científica sobre la relación entre deforestación, cambio climático y salud en una experiencia seleccionada. Se realizó una revisión de literatura para identificar cómo surgía el tema en los artículos científicos publicados en Brasil entre 2020 y 2021. A partir del marco temático identificado a través de palabras clave, se analizaron 42 videos publicados por el proyecto Ciência com Certeza en su canal en el YouTube. Considerando los conceptos de comunicación científica y divulgación científica presentados por Bueno (2010), se puede decir que el proyecto se caracteriza como comunicación científica multidisciplinar, ya que está dirigido a públicos especializados de diferentes áreas del conocimiento. La disponibilidad pública de las grabaciones de conferencias no lo caracteriza como un proyecto de divulgación científica, aunque tiene el potencial de ampliar su focalización en el gran público. También se ha constatado que la relación entre medio ambiente y salud no fue el tema central de las conferencias durante el período analizado

Epidemiological and geographical distribution profile of urban sporotrichosis in the city of São Paulo

Abstract Background Sporotrichosis is the most frequent subcutaneous mycosis in Latin America, where it is considered endemic. At the end of the 20th century, the first cases of zoonotic transmission were described in Rio de Janeiro, triggering an epidemic outbreak that spread to other regions of Brazil. The lack of disease notification omits its real occurrence in the country, which happens in its most populous city, São Paulo. Objective To evaluate the epidemiological aspects of the patients seen at a hospital in São Paulo aiming at establishing the geographic distribution of this disease. Methods This is a retrospective study that analyzed data from medical records of patients with a clinical and laboratory diagnosis of sporotrichosis attended at a tertiary hospital in the city of São Paulo between 2012 and 2020. Results Twenty patients were included. As for zoonotic surveillance, 30% denied contact with an animal, and 70% reported previous contact with a sick cat, with no other animals being mentioned. One case was allochthonous and the others autochthonous, showing a dissemination behavior from a focus in the eastern area of the capital. Study limitations The present study was based on data from only one hospital. Studies that include data from other hospitals and other regions must be carried out to obtain a complete picture of this disease. Conclusions As in other regions of the country, zoonotic sporotrichosis presents itself as an endemic disease with an increase in the number of cases. The findings highlight epidemiological characteristics of great importance so that public health policies can contain disease progression.

Determinação social da saúde numa comunidade quilombola: análise com a matriz de processos críticos / Social determination of health in a quilombola community: analysis with the critical processes matrix

Resumo: Este artigo objetivou analisar a determinação social da saúde numa comunidade quilombola do agreste pernambucano. Trata-se de uma pesquisa-ação, na qual se realizaram dez entrevistas e seis encontros do Círculo de Cultura, sendo analisados por meio da Matriz de Processos Críticos. Os resultados mostram que ser saudável no quilombo passa pelo fortalecimento da integralidade em saúde e pelo viver dignamente. O artigo apresenta uma perspectiva analítica para a compreensão da determinação social nos quilombos.

Abstract: This article aimed to analyze the social determination of health in a quilombola community in the rural region of Pernambuco. It is an action-research, where ten interviews and six meetings of the Culture Circle were carried out, being analyzed through the Critical Processes Matrix. The results show that being healthy in the quilombo involves strengthening integrality in health and living with dignity. The article presents an analytical perspective for understanding the social determination in quilombos.

Epidemiological and geographical distribution profile of urban sporotrichosis in the city of São Paulo.

BACKGROUND: Sporotrichosis is the most frequent subcutaneous mycosis in Latin America, where it is considered endemic. At the end of the 20th century, the first cases of zoonotic transmission were described in Rio de Janeiro, triggering an epidemic outbreak that spread to other regions of Brazil. The lack of disease notification omits its real occurrence in the country, which happens in its most populous city, São Paulo. OBJECTIVE: To evaluate the epidemiological aspects of the patients seen at a hospital in São Paulo aiming at establishing the geographic distribution of this disease. METHODS: This is a retrospective study that analyzed data from medical records of patients with a clinical and laboratory diagnosis of sporotrichosis attended at a tertiary hospital in the city of São Paulo between 2012 and 2020. RESULTS: Twenty patients were included. As for zoonotic surveillance, 30% denied contact with an animal, and 70% reported previous contact with a sick cat, with no other animals being mentioned. One case was allochthonous and the others autochthonous, showing a dissemination behavior from a focus in the eastern area of the capital. STUDY LIMITATIONS: The present study was based on data from only one hospital. Studies that include data from other hospitals and other regions must be carried out to obtain a complete picture of this disease. CONCLUSIONS: As in other regions of the country, zoonotic sporotrichosis presents itself as an endemic disease with an increase in the number of cases. The findings highlight epidemiological characteristics of great importance so that public health policies can contain disease progression.

Demarcação de terra indígena, saúde e novas territorialidades na transposição do São Francisco no povo Pipipã, em Floresta-PE / Demarcation of indigenous land, health and new territorialities in the transposition of the São Francisco River in the Pipipã people, in Floresta-PE, Brazil

Resumo A demarcação de terra interconecta-se com a reprodução social e a saúde dos povos indígenas. Encontra-se desafiada pela economia globalizada e a implantação de grandes empreendimentos desenvolvimentistas nos territórios indígenas. Este artigo objetiva refletir sobre demarcação de terra indígena, saúde e novas territorialidades na implantação da transposição do rio São Francisco, no povo Pipipã, em Floresta-PE. A abordagem teórico-metodológica para o estudo é a reprodução social e a saúde formulada por Juan Samaja. Trata-se de estudo analítico, qualitativo, com a realização de entrevistas, observação participante e oficinas participativas nas aldeias cortadas pelo Eixo Leste da transposição. Evidencia-se meio século de mobilizações dos Pipipã pela demarcação de terra, marcadas por entraves políticos nos âmbitos municipal, estadual e nacional. A demarcação de terra inter-relacionou-se com a saúde e representou o maior sonho dos indígenas. Para vencerem o medo, no contexto da transposição, assumiram compromissos de união, participação e marcação do território com os rituais. A transposição desestruturou relações, inseriu novas territorialidades, ampliou os desafios de demarcação de terra, agravou a saúde indígena e não promoveu o acesso à água transposta, principal objetivo do projeto, configurando uma situação de injustiça ambiental.

Abstract Land demarcation is interconnected with the social reproduction and health of indigenous peoples. It is challenged by the globalized economy and the implementation of large developmental projects in indigenous territories. This article aims to reflect on the demarcation of indigenous land, health and new territorialities in the implementation of the transposition of the São Francisco River, in the Pipipã people, in Floresta-PE. The theoretical-methodological approach to the study is social reproduction and health formulated by Juan Samaja. This is an analytical, qualitative study, with interviews, participant observation and participatory workshops in the villages crossed by the East Axis of transposition. There is evidence of half a century of mobilizations by the Pipipã for land demarcation, marked by political obstacles at the municipal, state and national levels. Land demarcation was interrelated with health and represented the greatest dream of the indigenous people. To overcome fear, in the context of transposition, they assumed commitments of union, participation and marking the territory with rituals. The transposition disrupted relationships, introduced new territorialities, expanded the challenges of land demarcation, worsened indigenous health and did not promote access to transposed water, the main objective of the project, configuring a situation of environmental injustice.

Saúde ambiental: a profissão de catador de materiais recicláveis com abordagem do estudo teórico crítico / Environmental health: the profession of recyclable material collector with a critical theoretical study approach

Resumo Sabendo que a Epistemologia é o estudo da ciência com implicações sobre as teorias do conhecimento, este artigo não pretende entrar em seu mérito puramente conceitual, mas conjeturar e apresentar os caminhos da ciência, a partir de uma abordagem crítica em torno da Saúde Ambiental, com suas repercussões na profissão de catador. Na tentativa de transcrever os caminhos da ciência com relação ao tema proposto, este estudo tem como objetivo relacionar a problemática dos resíduos sólidos urbanos com a profissão de catador de materiais recicláveis, focando na saúde ambiental e no uso da abordagem do estudo teórico crítico através de uma revisão da literatura. Entende-se que é necessário questionar os caminhos que levam a profissão de catador de materiais recicláveis a não ser protagonista das possíveis soluções do acúmulo dos resíduos sólidos urbanos, proporcionando o enfrentamento das questões econômicas, políticas e tecnológicas pouco eficazes.

Abstract Knowing that epistemology means studying science with a view to its implications for theories of knowledge, this study aims not to enter into its purely conceptual merits but rather to conjecture and show scientific paths from a critical approach to environmental health with its repercussions for waste pickers. In an attempt to transcribe the paths of science regarding the proposed theme, this study aims to relate the problem of urban solid waste with the recyclable material collector profession, focusing on environmental health via a critical theoretical study of literature review. We understand that we need to question the paths leading the recyclable material collector profession toward a leading role in the possible solutions for the accumulation of urban solid waste, confronting ineffective economic, political, and technological issues.

NASF-AB no campo e nas águas: o cuidado em torno do trabalho, ambiente e saúde de famílias agricultoras e pescadoras / NASF-AB in the field and in the waters: the care around work, environment and health of farming and fishing families / NASF-AB en el campo y en las aguas: el cuidado acerca del trabajo, el medio ambiente y la salud de las familias campesinas y pesqueras

Resumo O Núcleo Ampliado de Saúde da Família e Atenção Básica foi criado no Brasil para apoiar e ampliar a atenção e a gestão na Saúde da Família. Analisa-se a sua atuação quanto à saúde do trabalhador e saúde e ambiente em territórios do campo e das águas com as famílias que vivem da pesca artesanal e da agricultura camponesa. Pesquisa qualitativa que se ancorou em referenciais da Sociologia das Ausências e da Saúde Coletiva, na abordagem particular que esta faz das relações entre saúde, ambiente e trabalho. A pesquisa valeu-se do emprego de grupos focais na produção de narrativas de profissionais do Núcleo Ampliado de Saúde da Família e Atenção Básica em municípios do semiárido e do litoral do Nordeste. Evidenciaram-se singularidades socioeconômicas e culturais das populações do campo e das águas; invisibilidades e potencialidades sobre seus modos de vida e trabalho; cargas e doenças relacionadas ao trabalho; e aspectos da atuação do Núcleo Ampliado de Saúde da Família e Atenção Básica mediante interações com o trabalho e o ambiente nesses territórios. Os cuidados oferecidos a estas populações consideram parcialmente suas especificidades socioculturais, produtivas, ambientais e de saúde, sendo preciso ampliar o reconhecimento de seus modos de vida e trabalho visando intervenções mais exitosas sobre os problemas e necessidades de saúde - o que aponta desafios à formação em saúde para o Sistema Único de Saúde.

Abstract The Extended Family Health and Primary Care Center (Núcleo Ampliado de Saúde da Família e Atenção Básica - NASF-AB) was created in Brazil to support and expand Family Health care and management. Its performance regarding workers' health and health and environment in rural and water territories is analyzed with families that live from artisanal fishing and peasant agriculture. This is a qualitative research that was anchored in references from the Sociology of Absences and Collective Health, in the latter's particular approach to the relations between health, environment, and work. The research used focus groups to produce narratives of professionals from the Extended Center for Family Health and Primary Care in municipalities in the semiarid and coastal regions of the Northeast. The socioeconomic and cultural singularities of the rural and water populations were evidenced; invisibilities and potentialities about their ways of life and work; work-related burdens and diseases; and aspects of the performance of the Extended Family Health Center and Primary Care through interactions with work and the environment in these territories. The care offered to these populations partially considers their sociocultural, productive, environmental, and health specificities, and it is necessary to expand the recognition of their ways of life and work, aiming at more successful interventions on health problems and needs; which poses challenges to health education for the Unified Health System.

Resumen El Núcleo Ampliado de Salud de la Familia y Atención Básica fue creado en Brasil para apoyar y ampliar la atención y gestión en Salud de la Familia. Se analiza su desempeño en materia de salud de los trabajadores y salud y medio ambiente en territorios del campo y de las aguas con las familias que viven de la pesca artesanal y de la agricultura campesina. Investigación cualitativa que se basó en referentes de la Sociología de las Ausencias y de la Salud Colectiva, en el particular abordaje que esta hace de la relación entre salud, medio ambiente y trabajo. La investigación se basó en la utilización de grupos focales en la producción de narrativas por parte de profesionales del Núcleo Ampliado de Salud de la Familia y Atención Básica en municipios de la región semiárida y del litoral del Nordeste. Se evidenciaron singularidades socioeconómicas y culturales de las poblaciones del campo y de las aguas; invisibilidades y potencialidades sobre sus formas de vida y trabajo; cargas y enfermedades relacionadas con el trabajo; y aspectos de la actuación del Núcleo Ampliado de Salud de la Familia y Atención Primaria a través de interacciones con el trabajo y el medio ambiente en estos territorios. La atención ofrecida a estas poblaciones considera parcialmente sus especificidades socioculturales, productivas, ambientales y de salud, siendo necesario ampliar el reconocimiento de sus modos de vida y de trabajo, visando intervenciones más exitosas sobre los problemas y necesidades de salud; lo que apunta desafíos a la formación en salud para el Sistema Único de Salud.

Performance Analysis of IoT-Based Health and Environment WSN Deployment.

With the development of Internet of Things (IoT) applications, applying the potential and benefits of IoT technology in the health and environment services is increasing to improve the service quality using sensors and devices. This paper aims to apply GIS-based optimization algorithms for optimizing IoT-based network deployment through the use of wireless sensor networks (WSNs) and smart connected sensors for environmental and health applications. First, the WSN deployment research studies in health and environment applications are reviewed including fire monitoring, precise agriculture, telemonitoring, smart home, and hospital. Second, the WSN deployment process is modeled to optimize two conflict objectives, coverage and lifetime, by applying Minimum Spanning Tree (MST) routing protocol with minimum total network lengths. Third, the performance of the Bees Algorithm (BA) and Particle Swarm Optimization (PSO) algorithms are compared for the evaluation of GIS-based WSN deployment in health and environment applications. The algorithms were compared using convergence rate, constancy repeatability, and modeling complexity criteria. The results showed that the PSO algorithm converged to higher values of objective functions gradually while BA found better fitness values and was faster in the first iterations. The levels of stability and repeatability were high with 0.0150 of standard deviation for PSO and 0.0375 for BA. The PSO also had lower complexity than BA. Therefore, the PSO algorithm obtained better performance for IoT-based sensor network deployment.

Iniciativas de organização comunitária e Covid-19: esboços para uma vigilância popular da saúde e do ambiente / Communitary organization initiatives and COVID-19: sketches for popular surveillance of health and environment / Iniciativas de organización comunitaria y COVID-19: esbozos para la vigilancia popular de la salud y del ambiente

Resumo O contexto da pandemia da Covid-19 está relacionado à interação dos seres humanos com a natureza, na medida em que invadimos e destruímos nichos ecológicos importantes, criando modelos de produção animal e de trocas comerciais não sustentáveis. Lavar as mãos é uma das ações mais eficazes de prevenção à Covid-19. Mas como seguir este procedimento onde a água não é garantida com a frequência necessária? Outro aspecto importante da vigilância é a exposição crônica à contaminação do ar, favorecendo as altas taxas de mortalidade pela Covid-19. As populações do campo, da floresta e das águas são também um dos grupos mais vulneráveis e, ao mesmo tempo, possuem modos de vida determinantes para a sustentabilidade socioambiental do planeta. Gabinetes de crise, comitês populares, articulações solidárias, plataformas, observatórios acadêmico-populares, barreiras sanitárias populares, portais na internet de monitoramento participativo são algumas das formas que, espontaneamente, têm surgido nas favelas e nos territórios de povos tradicionais para dar conta de enfrentar a Covid-19, dada a ausência de políticas efetivas, principalmente no âmbito federal. Temos que criar métodos, estratégias e iniciativas que possibilitem que a vigilância sobre a saúde e o ambiente possa contribuir para resolver problemas e necessidades de forma horizontal, participativa, democrática e cientificamente qualificada.

Abstract The COVID-19 pandemic context is related to the interaction of human beings with the environment, as we invade and destroy important ecological niches, creating unsustainable models of animal production and trade. Washing your hands is one of the most effective actions to prevent COVID-19. But how to follow this procedure where water is not guaranteed as often as necessary? Another important aspect of surveillance is chronic exposure to air contamination, favoring high mortality rates from COVID-19. The populations of the countryside, the forest and the waters are also one of the most vulnerable groups and, at the same time, have ways of life that are decisive for the socio-environmental sustainability of the planet. Crisis offices, popular committees, solidarity articulations, platforms, academic-popular observatories, popular health barriers, internet portals for participatory monitoring are some of the ways that, spontaneously, have emerged in the favelas and in the territories of traditional peoples to cope with facing COVID-19, given the absence of effective policies, mainly at the federal level. We have to create methods, strategies and initiatives that enable health and environmental surveillance to contribute to solving problems and needs in a horizontal, participatory, democratic and scientifically qualified way.

Resumen El contexto de la pandemia del COVID-19 está relacionado a la interacción de los seres humanos con la naturaleza, en la medida en que invadimos y destruimos nichos ecológicos importantes, creando modelos de producción animal y de intercambio comercial que no son sustentables. Lavarse las manos es una de las acciones más eficaces de prevención al COVID-19. Pero, ¿cómo seguir este procedimiento donde el agua no está garantizada con la frecuencia debida? Otro aspecto importante de la vigilancia es la exposición crónica a la contaminación del aire, que favorece a las altas tasas de mortalidad por COVID-19. Los pobladores del campo, de los bosques y de las orillas de las aguas también son de los grupos más vulnerables y, al mismo tiempo, tienen modos de vida determinantes para la sustentabilidad socioambiental del planeta. Gabinetes de crisis, comités populares, articulaciones solidarias, plataformas, observatorios académico populares, barreras sanitarias populares, portales en la internet de monitoramiento participativo son algunas de las formas que, espontáneamente, han surgido en las favelas y en los territorios de los pueblos tradicionales para intentar enfrentar al COVID-19, dada la ausencia de políticas efectivas, principalmente en el ámbito federal. Tenemos que crear métodos, estrategias e iniciativas que posibiliten que la vigilancia sobre la salud y el ambiente pueda contribuir para resolver problemas y necesidades de forma horizontal, participativa, democrática y científicamente calificada.

Environmental and health impacts of industrial wastewater effluents in Pakistan: a review.

In developing countries, one of the most severe modern-day dilemmas is the management of industrial wastewater. In these countries, industrial wastewater effluents are directly discharged into the natural drain, a sewer system, an internal septic tank or a nearby field. Some of these industrial wastewater effluents are inadequately treated or untreated before being discharged. In recent years, in developing countries, urbanization and industrial activities have led to environmental deterioration. This paper was designed to review the health and environmental impacts of inadequately treated or untreated industrial wastewater effluents in Pakistan. The quality of industrial wastewater effluents is responsible for the degradation of the receiving water bodies. This is due to the reason that inadequately treated or untreated industrial wastewater effluents may cause eutrophication in the receiving water bodies and also form a favorable condition for toxin-producing waterborne pathogens. In order to comply with the wastewater guidelines and legislations, there is a need for proper treatment before discharge. In order to minimize the risk to the environment and public health, there is a need for proper treatment processes for industrial wastewater effluents. To achieve unpolluted discharge of industrial wastewater into the receiving water bodies, regular monitoring, proper and suitable treatment, careful planning and appropriate legislation are recommended.

A transposição do rio São Francisco e a saúde do povo Pipipã, em Floresta, Pernambuco / The São Francisco River transposition and Pipipã people's health, in Floresta, Pernambuco, Brazil

Resumo Ações governamentais de implantação de projetos de desenvolvimento nos territórios indígenas, cujo modelo explorador está vinculado à expectativa de suposto progresso econômico e social, vêm afetando as perspectivas de futuro dos povos em diversos países e no Brasil. O estudo analisou os processos socioambientais de vulnerabilização do povo Pipipã, localizados no município de Floresta, Pernambuco, decorrentes da transposição do rio São Francisco. A pesquisa foi realizada na perspectiva da determinação social da saúde e propõe o movimento dialético, no intuito de promover os diálogos necessários para a devida compreensão da complexidade dos problemas de saúde. Os procedimentos metodológicos se pautaram na técnica qualitativa de coleta e análise de dados. As estratégias de pesquisa utilizadas no estudo foram análise de documentos, entrevistas e observação participante, que favoreceram a compreensão dos processos sociais destrutivos determinados pela transposição do São Francisco e das percepções do povo Pipipã sobre a relação com a saúde e a doença. A pesquisa evidenciou que, em função da transposição do São Francisco, os Pipipã foram vulnerabilizados material e simbolicamente, e novas territorialidades e vulnerabilidades foram estabelecidas compulsoriamente, encontrando-se, portanto, a etnia ameaçada em seus processos de reprodução social.

Abstract Government actions to implement development projects in indigenous territories, whose operational model is linked to the prospect of supposed economic and social progress, have affected the perspectives for the future of people in several countries and in Brazil. This study analyzed the socioenvironmental processes of vulnerabilization of the Pipipã people resulting from the transposition of the São Francisco River in the municipality of Floresta, Pernambuco, Brazil. The research used the perspective of social determination of health and proposed a dialectical movement aiming to favor the needed dialogues for a proper understanding of the complexity of health problems. Qualitative research methodological procedures were used for data collection and analysis. Documents, interviews and participant observation were analyzed, emphasizing the understanding of the destructive social processes determined by the transposition of São Francisco river and the perceptions of the Pipipã people about the relationship between health and disease. The research evidenced that the São Francisco river transposition made the Pipipã people materially and symbolically more vulnerable, created compulsorily new territorialities and vulnerabilities raising a threat to the processes of social reproduction of the Ethnic group.

A Review on Graphene-Based Nanomaterials in Biomedical Applications and Risks in Environment and Health.

Graphene-based nanomaterials (GBNs) have attracted increasing interests of the scientific community due to their unique physicochemical properties and their applications in biotechnology, biomedicine, bioengineering, disease diagnosis and therapy. Although a large amount of researches have been conducted on these novel nanomaterials, limited comprehensive reviews are published on their biomedical applications and potential environmental and human health effects. The present research aimed at addressing this knowledge gap by examining and discussing: (1) the history, synthesis, structural properties and recent developments of GBNs for biomedical applications; (2) GBNs uses as therapeutics, drug/gene delivery and antibacterial materials; (3) GBNs applications in tissue engineering and in research as biosensors and bioimaging materials; and (4) GBNs potential environmental effects and human health risks. It also discussed the perspectives and challenges associated with the biomedical applications of GBNs.

Information and Communication Technologies, Genes, and Peer-Production of Knowledge to Empower Citizens' Health.

The different and seemingly unrelated practices of Information and Communication Technologies (ICT) used to collect and share personal and scientific data within networked communities, and the organized storage of human genetic samples and information-namely biobanking-have merged with another recent epistemic and social phenomenon, namely scientists and citizens collaborating as "peers" in creating knowledge (or peer-production of knowledge). These different dimensions can be found in joint initiatives where scientists-and-citizens use genetic information and ICT as powerful ways to gain more control over their health and the environment. While this kind of initiative usually takes place only after rights have been infringed (or are put at risk)-as the two cases presented in the paper show-collaborative scientists-and-citizens' knowledge should be institutionally allowed to complement and corroborate official knowledge-supporting policies.

Human health alters the sustainability of fishing practices in East Africa.

Understanding feedbacks between human and environmental health is critical for the millions who cope with recurrent illness and rely directly on natural resources for sustenance. Although studies have examined how environmental degradation exacerbates infectious disease, the effects of human health on our use of the environment remains unexplored. Human illness is often tacitly assumed to reduce human impacts on the environment. By this logic, ill people reduce the time and effort that they put into extractive livelihoods and, thereby, their impact on natural resources. We followed 303 households living on Lake Victoria, Kenya over four time points to examine how illness influenced fishing. Using fixed effect conditional logit models to control for individual-level and time-invariant factors, we analyzed the effect of illness on fishing effort and methods. Illness among individuals who listed fishing as their primary occupation affected their participation in fishing. However, among active fishers, we found limited evidence that illness reduced fishing effort. Instead, ill fishers shifted their fishing methods. When ill, fishers were more likely to use methods that were illegal, destructive, and concentrated in inshore areas but required less travel and energy. Ill fishers were also less likely to fish using legal methods that are physically demanding, require travel to deep waters, and are considered more sustainable. By altering the physical capacity and outlook of fishers, human illness shifted their effort, their engagement with natural resources, and the sustainability of their actions. These findings show a previously unexplored pathway through which poor human health may negatively impact the environment.