RESUMO Objetivo: Analisar os fatores associados à hospitalização em enfermaria e unidade de terapia intensiva (UTI), e ao óbito pela COVID-19 em gestantes com caso confirmado. Métodos: Pesquisa observacional, transversal, realizada com dados de gestantes com caso confirmado para COVID-19 provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe e do Sistema Estadual Notifica COVID-19, do Paraná. Investigou-se a associação entre variáveis independentes e dependentes (hospitalização em enfermaria e UTI, e óbito) pelo modelo de regressão de Poisson com variância robusta. Resultados: 4.719 gestantes compuseram a população do estudo; 9,6 e 5,1% foram hospitalizadas em enfermaria e UTI, respectivamente; 1,9% evoluíram para óbito. Houve associação entre a idade materna avançada e internação em enfermaria (RP=1,36; IC95% 1,10–1,62) e UTI (RP=2,25; IC95% 1,78–2,71), e óbito (RP=3,22; IC95% 2,30–4,15). Verificou-se associação entre o terceiro trimestre gestacional e hospitalização em enfermaria (RP=5,06; IC95% 2,82–7,30) e UTI (RP=6,03; IC95% 3,67–8,39) e óbito (RP=13,56; IC95% 2,90–24,23). O segundo trimestre associou-se à internação em UTI (RP=2,67; IC95% 1,36–3,99). Gestantes com cardiopatia apresentaram maior frequência de hospitalização em enfermaria (RP=2,24; IC95% 1,43–3,05) e UTI (RP=2,66; IC95% 1,46–3,87). A obesidade foi associada à admissão em UTI (RP=3,79; IC95% 2,71–4,86) e ao óbito (RP=5,62; IC95% 2,41–8,83). Conclusão: A idade materna avançada, o final do período gestacional e comorbidades foram fatores associados a quadros graves de COVID-19.

ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19.

RESUMO Este estudo tem o objetivo de apresentar a avaliação de um projeto de capacitação em serviço para profissionais de saúde nas ações de prevenção e controle da hanseníase, problematizando o modelo de avaliação adotado, com foco na utilização para a gestão em saúde. Foi realizada uma avaliação ex-post em 18 municípios prioritários brasileiros participantes das capacitações. Empregou-se a estratégia Rapid Evaluation Methods (REM), priorizando: a) abordagem colaborativa; b) técnicas qualitativas; e c) enfoque conceitual da translação do conhecimento. Foram realizadas 24 entrevistas grupais, envolvendo 278 participantes. A abordagem de ensino em serviço foi importante para revalorização das ações de prevenção e controle da hanseníase e para conferir um lugar privilegiado de discussão técnica, de reflexão e de mudanças na atenção primária e em sua relação com a especializada. Conclui-se que o modelo de avaliação possibilitou que as controvérsias e convergências surgissem, assim como as recomendações para ajustes da intervenção junto à gestão em tempo oportuno.

ABSTRACT This study aims to present the evaluation of an in-service training project for health professionals in leprosy prevention and control actions, questioning the adopted evaluation model, focusing on its use for health management. An ex-post evaluation was carried out in 18 priority Brazilian municipalities participating in the training project. Rapid Evaluation Methods (REM) strategy was employed, prioritizing: a) a collaborative approach; b) qualitative techniques; and c) a conceptual approach to knowledge translation. Twenty-four group interviews were carried out, involving 278 participants. The in-service teaching approach was important for revaluing leprosy prevention and control actions and to provide a privileged place for technical discussion, reflection and changes in primary health care and in its relationship with specialized care. It can be concluded that the evaluation model enabled controversies and convergences to emerge, as well as recommendations for managers to adjust the intervention timely.

Abstract Background Dental anesthetic management in implantable cardioverter defibrillator (ICD) recipients with cardiac channelopathies (CCh) can be challenging due to the potential risk of life-threatening arrhythmias and appropriate ICD therapies during procedural time. Objectives The present study assessed the hypothesis that the use of local dental anesthesia with 2% lidocaine with 1:100,000 epinephrine or without a vasoconstrictor can be safe in selected ICD and CCh patients, not resulting in life-threatening events (LTE). Methods Restorative dental treatment under local dental anesthesia was made in two sessions, with a wash-out period of 7 days (cross-over trial), conducting with a 28h - Holter monitoring, and 12-lead electrocardiography, digital sphygmomanometry, and anxiety scale assessments in 3 time periods. Statistical analysis carried out the paired Student’s t test and the Wilcoxon signed-rank test. In all cases, a significance level of 5% was adopted. All patients were in stable condition with no recent events before dental care. Results Twenty-four consecutive procedures were performed in 12 patients (9 women, 3 men) with CCh and ICD: 7 (58.3%) had long QT syndrome (LQTS), 4 (33.3%) Brugada syndrome (BrS), and 1 (8.3%) Catecholaminergic polymorphic ventricular tachycardia (CPVT). Holter analysis showed no increased heart rate (HR) or sustained arrhythmias. Blood pressure (BP), electrocardiographic changes and anxiety measurement showed no statistically significant differences. No LTE occurred during dental treatment, regardless of the type of anesthesia. Conclusion Lidocaine administration, with or without epinephrine, can be safely used in selected CCh-ICD patients without LTE. These preliminary findings need to be confirmed in a larger population with ICD and CCh.

ABSTRACT. This study aimed to evaluate cassava genotypes to identify the ones with the best nutritional values for ruminant diets. Nine genotypes were used: Amansa Burro (BGM 549), Aramaris (BGM 116), Brasília, Cambadinha (BRS Guaíra), Curvelinha, Engana Ladrão (BGM 1269), Trouxinha (BGM 1468), BRS Gema de Ovo, and BRS Dourada. A completely randomized block experimental design with nine treatments (genotypes) and three blocks (replicates) were employed. The roots were analyzed for dry matter production (DMP) in tonnes per hectare, crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), starch, and in vitro dry matter digestibility (IVDMD). The multivariate analysis was carried out using Ward’s hierarchical agglomerative clustering based on Mahalanobis distance. The groups formed were evaluated by Scott-Knott test. The group formed by genotype Engana Ladrão was chosen as the best one for having the highest DMP t ha-1 and IVDMD values and the lowest NDF and ADF contents.

ABSTRACT This study aims to present the evaluation of an in-service training project for health professionals in leprosy prevention and control actions, questioning the adopted evaluation model, focusing on its use for health management. An ex-post evaluation was carried out in 18 priority Brazilian municipalities participating in the training project. Rapid Evaluation Methods (REM) strategy was employed, prioritizing: a) a collaborative approach; b) qualitative techniques; and c) a conceptual approach to knowledge translation. Twenty-four group interviews were carried out, involving 278 participants. The in-service teaching approach was important for revaluing leprosy prevention and control actions and to provide a privileged place for technical discussion, reflection and changes in primary health care and in its relationship with specialized care. It can be concluded that the evaluation model enabled controversies and convergences to emerge, as well as recommendations for managers to adjust the intervention timely.

RESUMO Este estudo tem o objetivo de apresentar a avaliação de um projeto de capacitação em serviço para profissionais de saúde nas ações de prevenção e controle da hanseníase, problematizando o modelo de avaliação adotado, com foco na utilização para a gestão em saúde. Foi realizada uma avaliação ex-post em 18 municípios prioritários brasileiros participantes das capacitações. Empregou-se a estratégia Rapid Evaluation Methods (REM), priorizando: a) abordagem colaborativa; b) técnicas qualitativas; e c) enfoque conceitual da translação do conhecimento. Foram realizadas 24 entrevistas grupais, envolvendo 278 participantes. A abordagem de ensino em serviço foi importante para revalorização das ações de prevenção e controle da hanseníase e para conferir um lugar privilegiado de discussão técnica, de reflexão e de mudanças na atenção primária e em sua relação com a especializada. Conclui-se que o modelo de avaliação possibilitou que as controvérsias e convergências surgissem, assim como as recomendações para ajustes da intervenção junto à gestão em tempo oportuno.

Resumen Estudio histórico-social que describe el trabajo de reclutamiento, formación y supervisión de parteras y mujeres curiosas desarrollado por la Fundación Servicio Especial de Salud Pública (FSESP) en Alagoas en el período de 1960 a 1990 y analiza el saber y la práctica de estas parteras y mujeres curiosas. Se utilizaron fuentes documentales y orales, producidas en entrevistas realizadas a partir de la historia oral temática, otorgado por dos visitadores de salud, seis parteras, tres mujeres curiosas, un médico y una enfermera. Los resultados mostraron que parteras y mujeres curiosas fueron reclutadas y capacitadas por los visitadores de salud. Cuando pudieron ayudar en el parto, recibieron una bolsa con materiales y fueron acompañados por visitadores de salud o enfermeras para limpiar la bolsa y renovar las instrucciones. Se analizó la actuación de parteras/ mujeres curiosas a partir del referencial teórico de Marie Françoise Collière, revelando que brindaron cuidados basados en conocimientos y prácticas adquiridas a través de la experiencia, buscando asegurar la continuidad de la vida. Se concluyó que la FSESP era un importante servicio de salud en Alagoas por sus actividades de educación en salud, revisión, cuidado y atención a parturientas y recién nacidos, y también evidenció prácticas que han sido mejoradas a lo largo de los años.

Résumé Cette étude historique-sociale décrit le travail de recrutement, formation et contrôle de sages-femmes curieuses développée par la Fondation Service Spécial de Santé Publique (FSESP) en Algoas entre 1960 et 1990. On analyse aussi le savoir et la pratique de ces sages-femmes, en consultant des sources documentaires et orales, ainsi que des entretiens faites à deux agents de santé, six sages-femmes, trois femmes curieuses, un médecin et une infirmière. Les résultats ont montré les sages-femmes et les femmes curieuses ont été recrutées et formées par les agents de santé. Lorsqu'elles ont pu aider dans les accouchements, elles ont reçu des instruments pour participer de cet événement. Finalement, on a analysé le rôle des sages-femmes à partir des théories de Marie Françoise Collière, lesquelles théories ont permis de montrer que ces femmes ont mis en place des connaissances basées sur l'expérience afin de garantir la continuité de la vie. On conclut que la FSESP était un important service de santé en Alagoas de par ses activités d'éducation en santé, soins et attention aux parturientes et nouveaux nés, des pratiques améliorés au fil des années.

Abstract Carried out by the Fundación Servicio Especial en Salud Pública (FSESP) in Algoas between 1960 and 1990, this is a socio-historical study that describes the work of recruiting, training and supervising midwives and curious women. Both written and oral sources were used, produced in interviews from oral thematic history. The participants were two health visitors, six midwives, three curious women, a doctor, and a nurse. The results showed that the midwives and curious women were recruited and trained by the health visitors. When they could assist a birth, they received a bag with materials and were accompanied by the health visitors or nurses to clean the bags and renew the instructions. The actions of the midwives /curious women were analyzed from the referential theory of Marie Françoise Collière, which revealed that they provided care to patients based on knowledge and practices acquired through experience, seeking to secure the continuity of life. It was concluded that the FSESP was an important health service in Alagoas due to its activities in health education, revision, care and treatment of women in labor and newborns. Additionally, practices that have been improved throughout the years were found.

Resumo Estudo histórico-social que descreve o trabalho de recrutamento, treinamento e supervisão das parteiras e curiosas desenvolvido pela Fundação Serviço de Saúde Pública (FSESP) em Alagoas no recorte temporal de 1960 a 1990 e analisa o saber e o fazer destas parteiras e curiosas. Foram utilizadas fontes documentais e orais, estas produzidas em entrevistas realizadas com recurso da história oral temática, concedidas por duas visitadoras sanitárias, seis parteiras, três curiosas, um médico e uma enfermeira. Os resultados evidenciaram que as parteiras e curiosas eram recrutadas por visitadoras sanitárias para serem treinadas. Quando estavam aptas para partejar, recebiam uma bolsa com materiais e eram supervisionadas pelas visitadoras ou enfermeiras a fim de realizar a limpeza da bolsa e renovar as instruções. A atuação das parteiras/curiosas fora analisada com base no referencial teórico de Marie Françoise Collière, revelando que as mesmas prestavam cuidados a partir de saberes e fazeres adquiridos pela experiência buscando assegurar a continuidade da vida. Concluiu-se que a FSESP foi um importante serviço de saúde em Alagoas tendo em vista suas atividades de educação em saúde, reciclagem, atenção e cuidado às parturientes e recém-nascidos, além de revelar práticas que foram sendo aperfeiçoadas ao longo dos anos.

Abstract The objective of this study was to obtain and characterize a freeze-dried powder of taioba leaves (Xanthosoma taioba) as a source of bioactive substances and potential food applications. The fresh leaves were cooked and lyophilized for further analysis. Its bioactive contents expressed in flavonoids, ascorbic acid and total polyphenols were quantified. Total antioxidant activity (TAA) was determined by ABTS assays. The chemical composition via infrared spectroscopy (FTIR) and its microstructure were visualized by scanning electron microscopy (SEM). The bioactive contents of flavonoids, ascorbic acid and polyphenols were 17.15 mg/100 g, 58.3 mg/100 g and 24.15 mg Eq. of gallic acid/100 g, respectively. A high content of TAA was found. ABTS 37.35 (µg TE/g). The FTIR spectrum revealed high-intensity bands at 3350 cm-1, 2928 cm-1, 1637 cm-1, and 1055 cm-1 related to vibrations associated with typical bands of −OH groups present in cellulose membranes, hemicellulose, carbohydrates, lignin and water. The micrographs showed irregular structures of the ground leaves with a fibrous structure. These results indicate a high potential of this raw material in food formulations as a source of bioactives suitable for applications in various industrial segments.

Abstract Agroindustrial disposal generates tons of passion fruit albedo during pulp and juice processing. The reduction of this environmental pollution potential and its use involves research such as this one, which aims to determine the bioactive compounds in the passion fruit albedo (Passiflora edulis), its technological, functional potential and its morphological structures, aiming at food application. The methodologies applied followed internationally accepted and recommended guidelines. The results showed that the albedo flour obtained a yield of 9.76%, and from this, a semifine powder flour was prepared (75.8%), with 4.95% moisture, 40.72% reducing sugars, water activity of 0.37, pH of 5.29, total titratable acidity of 0.99 and total soluble solids of 1.5 °Brix. In addition, the presence of bioactive compounds such as polyphenols (18.88 mg AGE/100 g), flavonoids (13.51 mg/100 g), anthocyanins (1.74 mg/100 g) and chlorophyll b (69.65 mg/100 g) was evidenced, highlighting a considerable amount of vitamin C (377.36 mg/100 g) and pectin concentration (40.5%). In addition, the presence of bioactive compounds such as polyphenols (18.88 mg AGE/100 g), flavonoids (13.51 mg/100 g), anthocyanins (1.74 mg/100 g) and chlorophyll b (69.65 mg/100 g) was evidenced, highlighting a considerable amount of vitamin C (377.36 mg/100 g) and pectin concentration (40.5%).

Abstract Sex steroid hormones are critical in gonadal differentiation in turtles. The gonads are not the only organs responsible for producing these hormones during this phase. Mesonephros play an important role in steroidogenesis. The present study aimed to investigate the presence of steroidogenic cells in mesonephros of Podocnemis expansa during gonadal differentiation and to evaluate their morphology and ultrastructure. Ten embryos of P. expansa were collected from 5 nests on day 36 of incubation, during spawning period on an artificial beach. Embryos were extracted from eggs by slicing the shell and euthanized. They were dissected under a stereoscopic microscope to collect the gonad-mesonephro complex, in which were fixed and subsequently processed for light microscopy, immunohistochemistry and transmission electron microscopy analysis. During histological analysis was observed mesonephros has typical morphological structure. Immunohistochemistry showed immunoreaction to aromatase in cells of intertubular space. Confirming these findings, it was possible to observe a type of intertubular cell in several regions of mesonephro, being more predominant in region close to blood vessels, distal and proximal tubules. In ultrastructural analysis these cells were characterized by having a clear, large, and rounded nucleus with evident nucleolus and cytoplasm rich in electron-dense droplets. This study demonstrated for the first time the presence of cells with morphological, immunohistochemical and ultrastructural characteristics similar to steroid-producing cells in P. expansa mesonephrons, suggesting that this organ may contribute to gonadal differentiation in this species.

Resumo Realizou-se pesquisa qualitativa com o objetivo de compreender as repercussões psicossociais da pandemia do SARS-CoV-2 na população atingida pelo rompimento da Barragem de Fundão, em 2015, pertencente à mineradora Samarco e suas mantenedoras - VALE e BHP Billiton - em Mariana (MG). Foram utilizadas as técnicas de observação participante e grupos focais. As narrativas de profissionais de saúde e pessoas atingidas foram analisadas através da Análise de Conteúdo, a partir dos fatores socioculturais, simbólicos e políticos encontrados nesse contexto de sobreposição de desastre da mineração e pandemia. Os resultados mostram que a vivência dos atingidos durante a pandemia apresenta singularidades, tais como a intensificação da ruptura de laços sociais e comunitários, que já era identificada desde o rompimento. O luto durante a pandemia também é potencializado pelo luto coletivo já vivenciado desde a tragédia. Há uma intensificação do sofrimento diante da falta de informação e da prorrogação da entrega do reassentamento. É possível identificar a pandemia como mais um ponto de sofrimento para essa população vulnerabilizada.

Abstract Qualitative research was developed with the aim of understanding the psychosocial repercussions of the SARS-CoV-2 pandemic on the population affected by the collapse of the Fundão Dam in Mariana (MG), in 2015, belonging to the Samarco mining company and its maintainers VALE and BHP Billiton. Participant observation techniques and focus groups were used. The narratives of health professionals and affected people were analyzed through Content Analysis, from the sociocultural, symbolic and political factors found in this context of overlapping mining disaster and pandemic. The results show that the experience of those affected during the pandemic presents singularities such as the intensification of the rupture of social and community ties that had already been identified since the disaster. Grief during the pandemic is also enhanced by the collective grief already experienced since the tragedy. There is an intensification of suffering due to the lack of information and the postponement of the resettlement delivery. It is possible to identify the pandemic as another point of suffering for this vulnerable population.

Resumo Realizou-se pesquisa qualitativa com o objetivo de compreender as repercussões psicossociais da pandemia do SARS-CoV-2 na população atingida pelo rompimento da Barragem de Fundão, em 2015, pertencente à mineradora Samarco e suas mantenedoras - VALE e BHP Billiton - em Mariana (MG). Foram utilizadas as técnicas de observação participante e grupos focais. As narrativas de profissionais de saúde e pessoas atingidas foram analisadas através da Análise de Conteúdo, a partir dos fatores socioculturais, simbólicos e políticos encontrados nesse contexto de sobreposição de desastre da mineração e pandemia. Os resultados mostram que a vivência dos atingidos durante a pandemia apresenta singularidades, tais como a intensificação da ruptura de laços sociais e comunitários, que já era identificada desde o rompimento. O luto durante a pandemia também é potencializado pelo luto coletivo já vivenciado desde a tragédia. Há uma intensificação do sofrimento diante da falta de informação e da prorrogação da entrega do reassentamento. É possível identificar a pandemia como mais um ponto de sofrimento para essa população vulnerabilizada.

Abstract Qualitative research was developed with the aim of understanding the psychosocial repercussions of the SARS-CoV-2 pandemic on the population affected by the collapse of the Fundão Dam in Mariana (MG), in 2015, belonging to the Samarco mining company and its maintainers VALE and BHP Billiton. Participant observation techniques and focus groups were used. The narratives of health professionals and affected people were analyzed through Content Analysis, from the sociocultural, symbolic and political factors found in this context of overlapping mining disaster and pandemic. The results show that the experience of those affected during the pandemic presents singularities such as the intensification of the rupture of social and community ties that had already been identified since the disaster. Grief during the pandemic is also enhanced by the collective grief already experienced since the tragedy. There is an intensification of suffering due to the lack of information and the postponement of the resettlement delivery. It is possible to identify the pandemic as another point of suffering for this vulnerable population.

Abstract The objective of this study was to evaluate the behavior of active compounds concentration present in the industrial by-product of acerola during drying using convective dehydration at 40, 50 and 60 °C. For this, flavones and flavonols, total proanthocyanidins, vitamin C, total phenolic content and antioxidant capacity as function of drying time were determined. The drying data were adjusted using the models of Page, Lewis, Henderson & Pabis, Modified Page and Logarithmic. In relation to the applied models, Page model presented the best fit. Acerola by-products dried at 40 °C showed higher concentrations of active compounds and higher antioxidant capacity. Although the drying process provoked changes in concentration of the active compounds, in the studied temperature range, significant concentrations of those bioactive compounds were observed. Thus, acerola by-product may present potential for application in different foods.

Abstract Introduction The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) is a widely-used scale, and the first to include a dimensional approach to understanding schizotypy. Objective To adapt the short version of the O-LIFE (O-LIFE-S) into Brazilian Portuguese. Method a) Two independent bilingual professionals translated the original instrument into Brazilian Portuguese; b) a third bilingual professional summarized the two translations; c) a fourth bilingual expert translated the Portuguese version back into English; d) this back-translation was adjusted by a committee of psychology experts; e) a pilot study was conducted with 10 participants from the general population. Results O-LIFE-S was considered ready to be used in a formal validation study in Brazil. Conclusion The scale appears to cover the dimensional approach to schizotypy. However, a future validation study needs to be conducted to determine the internal consistency and reliability of the Brazilian Portuguese version of the O-LIFE-S .

RESUMO Em Mariana, estado de Minas Gerais, após o Rompimento da Barragem de Fundão, famílias passaram por processo de desterritorialização, em que foram deslocadas da área rural para a área urbana. Assim, o objetivo do estudo foi compreender o processo de desterritorialização nesse contexto, as implicações da perda desse locus social para a vida dos atingidos e para a construção de respostas e políticas públicas de saúde. Foi realizada pesquisa qualitativa no período de 2016 a 2018 no município de Mariana, utilizando as técnicas de observação participante e entrevistas com pessoas atingidas. As entrevistas foram analisadas a partir da Análise de Conteúdo, e a discussão foi orientada pelo referencial teórico dos conceitos de território, desterritorialização e sofrimento social. Na observação e nos relatos dos participantes, é marcante a relação simbólica com seu lugar de origem, traduzidos na forma de vínculos e pertencimento. As perdas, em suas diferentes dimensões, impactam a vida desde o luto até o sofrimento social. Até o reassentamento, é necessário que as interpretações desse novo viver não sejam patologizadas para que as pessoas consigam estar conscientes desse processo e serem protagonistas das escolhas.

ABSTRACT In Mariana, state of Minas Gerais, after the Fundao Dam rupture, families went through a process of deterritorialization, in which they were moved from rural to urban areas. Thus, the aim of the study was to understand the process of deterritorialization in this context, the implications of the loss of this social locus for the lives of those affected and for the construction of public health responses and policies. A qualitative research was conducted from 2016 to 2018 in the city of Mariana, using participant observation techniques and interviews with affected people. The interviews were analyzed based on Content Analysis and the discussion was guided by the theoretical framework of the concepts of territory, deterritorialization, and social suffering. In the observation and reports of the participants, the symbolic relationship with their place of origin is remarkable, translated in the form of bonds and belonging. Losses, in their different dimensions, impact life from grief to social suffering. Until the resettlement is achieved, it is necessary that the interpretations of this new living are not pathologized so that people can be aware of this process and be the protagonists of their choices.

RESUMO Em Mariana, estado de Minas Gerais, após o Rompimento da Barragem de Fundão, famílias passaram por processo de desterritorialização, em que foram deslocadas da área rural para a área urbana. Assim, o objetivo do estudo foi compreender o processo de desterritorialização nesse contexto, as implicações da perda desse locus social para a vida dos atingidos e para a construção de respostas e políticas públicas de saúde. Foi realizada pesquisa qualitativa no período de 2016 a 2018 no município de Mariana, utilizando as técnicas de observação participante e entrevistas com pessoas atingidas. As entrevistas foram analisadas a partir da Análise de Conteúdo, e a discussão foi orientada pelo referencial teórico dos conceitos de território, desterritorialização e sofrimento social. Na observação e nos relatos dos participantes, é marcante a relação simbólica com seu lugar de origem, traduzidos na forma de vínculos e pertencimento. As perdas, em suas diferentes dimensões, impactam a vida desde o luto até o sofrimento social. Até o reassentamento, é necessário que as interpretações desse novo viver não sejam patologizadas para que as pessoas consigam estar conscientes desse processo e serem protagonistas das escolhas.

ABSTRACT In Mariana, state of Minas Gerais, after the Fundao Dam rupture, families went through a process of deterritorialization, in which they were moved from rural to urban areas. Thus, the aim of the study was to understand the process of deterritorialization in this context, the implications of the loss of this social locus for the lives of those affected and for the construction of public health responses and policies. A qualitative research was conducted from 2016 to 2018 in the city of Mariana, using participant observation techniques and interviews with affected people. The interviews were analyzed based on Content Analysis and the discussion was guided by the theoretical framework of the concepts of territory, deterritorialization, and social suffering. In the observation and reports of the participants, the symbolic relationship with their place of origin is remarkable, translated in the form of bonds and belonging. Losses, in their different dimensions, impact life from grief to social suffering. Until the resettlement is achieved, it is necessary that the interpretations of this new living are not pathologized so that people can be aware of this process and be the protagonists of their choices.