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Andrade-Romo Z, La Hera-Fuentes G, Ochoa-Sánchez LE, Chavira-Razo L, Aramburo-Muro T, Castro-León L, Amaya-Tapia G, Andrade-Pérez JS, Bautista-Arredondo S. Effectiveness of an intervention to improve ART adherence among men who have sex with men living with HIV: a randomized controlled trial in three public HIV clinics in Mexico. AIDS Care 2024; 36:816-831. [PMID: 38422450 DOI: 10.1080/09540121.2023.2299322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024]
Abstract
We conducted a parallel-group randomized controlled trial in three HIV clinics in Mexico to evaluate a user-centred habit-formation intervention to improve ART adherence among MSM living with HIV. We randomized 74 participants to the intervention group and 77 to the control group. We measured adherence at one, four, and ten months through medication possession ratio and self-reported adherence. Additionally, we measured viral load, CD4 cell count, major depression disorder symptoms, and alcohol and substance use disorder at baseline, fourth and tenth months. We found no statistically significant effect on adherence between groups. However, the intervention demonstrated positive results in major depression disorder symptoms (21% vs. 6%, p = 0.008) and substance use disorder (11% vs. 1%, p = 0.018) in the fourth month. The latter is relevant because, in addition to its direct benefit, it might also improve the chances of maintaining adequate adherence in the long term. This trial was retrospectively registered at ClinicalTrials.gov (trial number NCT03410680) on 8 January 2018.Trial registration: ClinicalTrials.gov identifier: NCT03410680.
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Affiliation(s)
- Zafiro Andrade-Romo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Gina La Hera-Fuentes
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Luz Edith Ochoa-Sánchez
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | - Laura Chavira-Razo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | - Tania Aramburo-Muro
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
| | | | - Gerardo Amaya-Tapia
- Infectious Diseases Department, Hospital General de Occidente, Zapopan, México
| | | | - Sergio Bautista-Arredondo
- Health Economics and Health Systems Innovation Division, National Institute of Public Health of Mexico, Cuernavaca, México
- School of Public Health, UC Berkeley, Berkeley, USA
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Barreto MDS, Wolf I, Souza NCD, Buzzerio LF, Vieira VCDL, Figueiredo-Barbieri MDC, Marcon SS. Experiences of Providers and Immigrants/Refugees with Health Care: A Meta-Synthesis of the Latin American Context. Can J Nurs Res 2024; 56:151-163. [PMID: 38641885 DOI: 10.1177/08445621231215845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
INTRODUCTION The experiences of providers and immigrants/refugees related to healthcare in the Latin American context have not yet been aggregated. This study aimed to synthesize the qualitative evidence on this theme. METHOD A systematic review of qualitative evidence with meta-synthesis. After identification, eligible studies were evaluated for methodological quality, and information was systematically analyzed. RESULTS The sample comprised 26 articles. The meta-theme shows that the experiences of providers and immigrants/refugees are determined by multilevel factors. In a macro-context, these factors involve the vulnerabilities of immigrants/refugees and the healthcare system/model, and in a closer context, they involve the lack of professional training in cultural skills and communication; language barriers; and prejudice/xenophobia. Within healthcare, the relationship is mostly conflictual, asymmetric, and unable to solve problems, leading to negative repercussions for both. CONCLUSIONS Managers involved in developing public policies and providers must consider improving the interrelationship between healthcare services and the migrant population.
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Affiliation(s)
| | - Isadora Wolf
- Nursing Department, State University of Maringá (UEM), Maringá, Brazil
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Ambrosio MDG, Lachman JM, Zinzer P, Gwebu H, Vyas S, Vallance I, Calderon F, Gardner F, Markle L, Stern D, Facciola C, Schley A, Danisa N, Brukwe K, Melendez-Torres GJ. A Factorial Randomized Controlled Trial to Optimize User Engagement With a Chatbot-Led Parenting Intervention: Protocol for the ParentText Optimisation Trial. JMIR Res Protoc 2024; 13:e52145. [PMID: 38700935 DOI: 10.2196/52145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Violence against children (VAC) is a serious public health concern with long-lasting adverse effects. Evidence-based parenting programs are one effective means to prevent VAC; however, these interventions are not scalable in their typical in-person group format, especially in low- and middle-income countries where the need is greatest. While digital delivery, including via chatbots, offers a scalable and cost-effective means to scale up parenting programs within these settings, it is crucial to understand the key pillars of user engagement to ensure their effective implementation. OBJECTIVE This study aims to investigate the most effective and cost-effective combination of external components to optimize user engagement with ParentText, an open-source chatbot-led parenting intervention to prevent VAC in Mpumalanga, South Africa. METHODS This study will use a mixed methods design incorporating a 2 × 2 factorial cluster-randomized controlled trial and qualitative interviews. Parents of adolescent girls (32 clusters, 120 participants [60 parents and 60 girls aged 10 to 17 years] per cluster; N=3840 total participants) will be recruited from the Ehlanzeni and Nkangala districts of Mpumalanga. Clusters will be randomly assigned to receive 1 of the 4 engagement packages that include ParentText alone or combined with in-person sessions and a facilitated WhatsApp support group. Quantitative data collected will include pretest-posttest parent- and adolescent-reported surveys, facilitator-reported implementation data, and digitally tracked engagement data. Qualitative data will be collected from parents and facilitators through in-person or over-the-phone individual semistructured interviews and used to expand the interpretation and understanding of the quantitative findings. RESULTS Recruitment and data collection started in August 2023 and were finalized in November 2023. The total number of participants enrolled in the study is 1009, with 744 caregivers having completed onboarding to the chatbot-led intervention. Female participants represent 92.96% (938/1009) of the sample population, whereas male participants represent 7.03% (71/1009). The average participant age is 43 (SD 9) years. CONCLUSIONS The ParentText Optimisation Trial is the first study to rigorously test engagement with a chatbot-led parenting intervention in a low- or middle-income country. The results of this study will inform the final selection of external delivery components to support engagement with ParentText in preparation for further evaluation in a randomized controlled trial in 2024. TRIAL REGISTRATION Open Science Framework (OSF); https://doi.org/10.17605/OSF.IO/WFXNE. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52145.
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Affiliation(s)
| | - Jamie M Lachman
- University of Oxford, Oxford, United Kingdom
- Parenting for Lifelong Health, Oxford, United Kingdom
- University of Cape Town, Cape Town, South Africa
| | | | | | - Seema Vyas
- University of Oxford, Oxford, United Kingdom
| | | | | | | | - Laurie Markle
- Parenting for Lifelong Health, Oxford, United Kingdom
| | - David Stern
- Innovations in Development, Education and the Mathematical Sciences International, Reading, United Kingdom
| | - Chiara Facciola
- Innovations in Development, Education and the Mathematical Sciences International, Reading, United Kingdom
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Farinhas JH, de França DA, Serpa MC, Biondo LM, Doline FR, Giuffrida R, Santarém VA, Dos Santos AP, Labruna MB, Kmetiuk LB, Biondo AW. One Health approach to Coxiella burnetii in Brazilian indigenous communities. Sci Rep 2024; 14:10142. [PMID: 38698247 DOI: 10.1038/s41598-024-60850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/29/2024] [Indexed: 05/05/2024] Open
Abstract
Indigenous health has posted complex challenges worldwide, particularly due to historical economic, territorial, social and environmental processes, which may lead to emergence and reemergence of pathogens. In addition to few Coxiella burnetii serosurveys in vulnerable populations, especially in developing tropical countries, no comprehensive One Health approach has focused on human-animal infection along with potential environmental determinants. Accordingly, this study aimed to assess the seroprevalence of anti-C. burnetii antibodies in indigenous populations and their dogs from 10 indigenous communities distributed in southern and southeastern Brazil, along with the correspondent healthcare professionals. In overall, 8/893 (0.90%; 95% CI 0.45-1.76) indigenous and 1/406 (0.25%) dog samples were seropositive, with 7/343 (2.04%) individuals the 1/144 (0.69%) dog from the Ocoy community, located in the city of São Miguel do Iguaçu, bordering Argentina at south, and far 10 km at west from Paraguay. All 84 healthcare professionals tested seronegative.
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Affiliation(s)
- João Henrique Farinhas
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, PR, 80035-050, Brazil
| | - Danilo Alves de França
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animals Science, São Paulo State University, Botucatu, SP, 18618-681, Brazil
| | - Maria Carolina Serpa
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, 05508-270, Brazil
| | - Leandro Meneguelli Biondo
- National Institute of the Atlantic Forest (INMA), Brazilian Ministry of Science, Technology, and Innovation, Santa Teresa, ES, 29650-000, Brazil
| | - Fernando Rodrigo Doline
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, PR, 80035-050, Brazil
| | - Rogério Giuffrida
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, , São Paulo, Brazil
| | - Vamilton Alvares Santarém
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, , São Paulo, Brazil
| | | | - Marcelo B Labruna
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, 05508-270, Brazil
| | - Louise Bach Kmetiuk
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, PR, 80035-050, Brazil
| | - Alexander Welker Biondo
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, PR, 80035-050, Brazil.
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, 47907, USA.
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Zapata Mayor JC, Hoyos Hernández PA. Health care: life stories by trans women in Colombia. Int J Equity Health 2024; 23:85. [PMID: 38689319 PMCID: PMC11061956 DOI: 10.1186/s12939-023-01859-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/12/2023] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND In Colombia, health care for people with trans life experiences is characterised by countless barriers to health services and care. Commonly, trans people have experienced stigma and discrimination among health professionals, a lack of services and professionals specialized to guarantee affirmative processes from non-hegemonic gender perspectives, and there exists a marked pathologization and medicalization of services. Therefore, it is necessary to provide affirmative health services to improve health and well-being from the recognition of their needs and experiences. The article describes life narratives about health care for the gender transitions of trans women in Colombia. METHODS A qualitative narrative study was conducted with 139 trans women in seven cities in Colombia. In-depth interviews and discussion groups were conducted between June 2019 and March 2020. Data were analyzed using thematic analysis and the Atlas Ti cloud program. National and international ethical guidelines were followed in the development of the research. RESULTS This research provided an overview of the health experiences of Colombian trans women. They reported their experiences of pathologizing approaches to transgender healthcare, stigma, discrimination, and barriers to accessing preventive, specialized, and regular healthcare services. For this reason, they opted for self-medicated gender transition processes and self-management of health care. An important aspect to consider within healthcare is that not all women want binary gender transition processes. CONCLUSION Participants felt that in Colombia there is a lack of affirmative health care for transgender women and that there are many limitations to care related to the gender transition processes. This exposes them to more situations that violate their rights and influences their lack of confidence and their search for professional health care. In Colombia, it is important to develop strategies for education, information, and communication, as well as a handbook for health workers on specialized healthcare for trans women.
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Silva ÉT, Ferreira RC, Diniz FC, Gomes MR, Martins AMEDBL, Chalub LLFH, Senna MIB. Disparities in the protagonism of oral health teams in the work process of Primary Healthcare. Rev Saude Publica 2024; 58:14. [PMID: 38695443 PMCID: PMC11037909 DOI: 10.11606/s1518-8787.2024058005759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/08/2023] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE Evaluate and compare the protagonism of Oral Health teams (OHt) in the teamwork process in Primary Healthcare (PHC) over five years and estimate the magnitude of disparities between Brazilian macro-regions. METHODS Ecological study that used secondary data extracted from the Sistema de Informação em Saúde para a Atenção Básica (SISAB - Health Information System for Primary Healthcare) from 2018 to 2022. Indicators were selected from a previously validated evaluative matrix, calculated from records in the Collective Activity Form on the degree of OHt's protagonism in team meetings and its degree of organization concerning the meeting agendas. A descriptive and amplitude analysis of the indicators' variation over time was carried out, and the disparity index was also calculated to estimate and compare the magnitude of differences between macro-regions in 2022. RESULTS In Brazil, between 3.06% and 4.04% of team meetings were led by OHt professionals. The Northeast and South regions had the highest (3.71% to 4.88%) and lowest proportions (1.21% to 2.48%), respectively. From 2018 to 2022, there was a reduction in the indicator of the "degree of protagonism of the OHt" in Brazil and macro-regions. The most frequent topics in meetings under OHt's responsibility were the work process (54.71% to 70.64%) and diagnosis and monitoring of the territory (33.49% to 54.48%). The most significant disparities between regions were observed for the indicator "degree of organization of the OHt concerning case discussion and singular therapeutic projects". CONCLUSIONS The protagonism of the OHt in the teamwork process in PHC is incipient and presents regional disparities, which challenges managers and OHt to break isolation and lack of integration, aiming to offer comprehensive and quality healthcare to the user of the Unified Health System (SUS).
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Affiliation(s)
- Érika Talita Silva
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Raquel Conceição Ferreira
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Fabiano Costa Diniz
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | - Milena Ribeiro Gomes
- Universidade Federal de Minas GeraisFaculdade de OdontologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Belo Horizonte, MG, Brasil.
| | | | - Loliza Luiz Figueiredo Houri Chalub
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Odontologia Social e PreventivaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontologia Social e Preventiva. Belo Horizonte, MG, Brasil
| | - Maria Inês Barreiros Senna
- Universidade Federal de Minas GeraisFaculdade de OdontologiaDepartamento de Clínica, Patologia e Cirurgia OdontológicasBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Clínica, Patologia e Cirurgia Odontológicas. Belo Horizonte, MG, Brasil
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Müller MR, Ortega F. Mental Health Collaborative Care in Brazil and the Economy of Attention: Disclosing Barriers and Therapeutic Negotiations. Cult Med Psychiatry 2024:10.1007/s11013-024-09852-w. [PMID: 38652342 DOI: 10.1007/s11013-024-09852-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 04/25/2024]
Abstract
The introduction of mental health collaborative care (MHCC) is one of the strategies to scale up access to mental health care in primary health care in Brazil. This article investigates an experience of mental health collaborative care in the city of Rio de Janeiro, Brazil. It is a qualitative study involving interviews with physicians and mental health professionals working in primary health care units located in the northern part of the city of Rio de Janeiro, Brazil. The aim is to examine the various strategies and negotiations that primary health care professionals deploy to identify mental distress and plan health care interventions. We discuss the results within the economy of attention framework. We argue that divergences in diagnostic design and therapeutic planning carried out by professionals and users or observed in MHCC meetings illustrate the health-disease-care seeking phenomenon as a negotiated process, entangled in complex interactions. Our results evince that those interactions are not always evident and configure 'what is at stake' in mental suffering. The incorporation of cultural and structural determinants in collaborative care may enable the expansion of mental health initiatives sensitive to local needs and realities.
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Affiliation(s)
- Manuela Rodrigues Müller
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro, Brazil
| | - Francisco Ortega
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Av. Catalunya 35, 43002, Tarragona, Spain.
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Borges LCR, Marcon SS, Brito GS, Terabe M, Pleutim NI, Mendes AH, Teston EF. Adherence to Covid-19 vaccination during the pandemic: the influence of fake news. Rev Bras Enferm 2024; 77:e20230284. [PMID: 38655979 PMCID: PMC11034379 DOI: 10.1590/0034-7167-2023-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/17/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES to understand how fake news has influenced adherence to Covid-19 immunization, from the perspective of health professionals. METHODS a qualitative, descriptive-exploratory study was conducted in Campo Grande - MS. Twenty nursing professionals working in vaccine rooms or managing immunobiologicals participated through semi-structured interviews. The interviews were audio-recorded, fully transcribed, and subjected to thematic content analysis. RESULTS two categories emerged in which the professionals highlighted an increase in vaccine hesitancy among the population, influenced by fake news and denialist actions, which negatively interfered with the population's trust in vaccines and in the professionals administering them. FINAL CONSIDERATIONS concerns about vaccine safety and denialist actions by authorities and media outlets can contribute to the phenomenon of non-vaccination. The valorization of science, the promotion of educational actions, and raising public awareness about immunization were presented as strategies to increase vaccine coverage.
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Affiliation(s)
| | | | | | - Miriam Terabe
- Universidade Estadual de Maringá, Maringá, Paraná, Brazil
| | | | | | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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de Lima LV, Pavinati G, Bossonario PA, Monroe AA, Pelissari DM, Alves KBA, Magnabosco GT. Clusters of heterogeneity of tuberculosis-HIV coinfection in Brazil: a geospatial study. Rev Saude Publica 2024; 58:10. [PMID: 38656045 PMCID: PMC11037911 DOI: 10.11606/s1518-8787.2024058005531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/23/2023] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To analyze the geospatialization of tuberculosis-HIV coinfection in Brazil, from 2010 to 2021, and the correlation with socioeconomic, housing, and health indicators. METHODS An ecological study of Brazilian municipalities and states, with data from HIV and tuberculosis information systems, previously reported by the Ministry of Health. The crude and smoothed coefficients were calculated by the local empirical Bayesian method of incidence of coinfection per 100,000 inhabitants in the population aged between 18 and 59 years. Univariate (identification of clusters) and bivariate (correlation with 20 indicators) Moran's indices were used. RESULTS A total of 122,223 cases of coinfection were registered in Brazil from 2010 to 2021, with a mean coefficient of 8.30/100,000. The South (11.44/100,000) and North (9.93/100,000) regions concentrated the highest burden of infections. The coefficients dropped in Brazil, in all regions, in the years of covid-19 (2020 and 2021). The highest coefficients were observed in the municipalities of the states of Rio Grande do Sul, Mato Grosso do Sul, and Amazonas, with high-high clusters in the capitals, border regions, coast of the country. The municipalities belonging to the states of Minas Gerais, Bahia, Paraná, and Piauí showed low-low clusters. There was a direct correlation with human development indices and aids rates, as well as an indirect correlation with the proportion of poor or of those vulnerable to poverty and the Gini index. CONCLUSIONS The spatial analysis of tuberculosis-HIV coinfection showed heterogeneity in the Brazilian territory and constant behavior throughout the period, revealing clusters with high-burden municipalities, especially in large urban centers and in states with a high occurrence of HIV and/or tuberculosis. These findings, in addition to alerting to the effects of the covid-19 pandemic, can incorporate strategic planning for the control of coinfection, aiming to eliminate these infections as public health problems by 2030.
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Affiliation(s)
- Lucas Vinícius de Lima
- Universidade Estadual de MaringáPrograma de Pós-Graduação em EnfermagemMaringáPRBrazil Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil
| | - Gabriel Pavinati
- Universidade Estadual de MaringáPrograma de Pós-Graduação em EnfermagemMaringáPRBrazil Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil
| | - Pedro Augusto Bossonario
- Universidade de São PauloPrograma de Pós-Graduação Enfermagem em Saúde PúblicaRibeirão PretoSPBrazil Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil
| | - Aline Aparecida Monroe
- Universidade de São PauloPrograma de Pós-Graduação Enfermagem em Saúde PúblicaRibeirão PretoSPBrazil Universidade de São Paulo. Programa de Pós-Graduação Enfermagem em Saúde Pública. Ribeirão Preto, SP, Brazil
| | - Daniele Maria Pelissari
- Brazilian Ministry of HealthDepartamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente TransmissíveisBrasíliaDFBrazil Brazilian Ministry of Health. Departamento de HIV/aids, Tuberculose, Hepatites Virais e Infecções Sexualmente Transmissíveis. Brasília, DF, Brazil
| | - Kleydson Bonfim Andrade Alves
- Pan American Health OrganizationDepartment of Communicable Diseases and Environmental Determinants of HealthBrasíliaDFBrazil Pan American Health Organization. Department of Communicable Diseases and Environmental Determinants of Health. Brasília, DF, Brazil
| | - Gabriela Tavares Magnabosco
- Universidade Estadual de MaringáPrograma de Pós-Graduação em EnfermagemMaringáPRBrazil Universidade Estadual de Maringá. Programa de Pós-Graduação em Enfermagem. Maringá, PR, Brazil
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de Mendonça JMT, Eshriqui I, de Almeida LY, Gomes VV, Schunk L, de Sousa AAF, Santos LKDO, Fortes S. The knowledge of primary health care professionals regarding mental health: diagnosis by mhGAP. Rev Saude Publica 2024; 57Suppl 3:4s. [PMID: 38629668 PMCID: PMC11037900 DOI: 10.11606/s1518-8787.2023057005272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/03/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To analyze knowledge about priority topics in mental health care of strategic actors who work in regions where the Health Care Planning (PAS) methodology is used. METHODS This is a quantitative, descriptive, cross-sectional, and observational study carried out with professionals from six health regions, distributed in three Brazilian states (Goiás, Rondônia and Maranhão) and linked to the project "Saúde mental na APS" (Mental health in PHC) of the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS - Institutional Development Support Program of the Brazilian Unified Health System). The sample was made up of professionals who participated in the intervention guide multiplier training stage for mental, neurological and alcohol and other drug use disorders in the primary health care network, from July to September 2022. Data collection was through a self-administered instrument, in electronic format, consisting of a block with socioeconomic items and a structured questionnaire to assess participants' knowledge about priority topics in mental health. Descriptive analyses and comparison of proportions were conducted to analyze the data. RESULTS A total of 354 health professionals participated in the study. Regarding the percentage of correct answers in the questionnaire on priority topics in mental health, the highest medians were identified in the "Depression" module. On the other hand, the content referring to the modules "Essential care and practices" and "Other important complaints" presented the lowest values. Furthermore, some participant characteristics were found to be associated with the percentage of correct answers in the questionnaire modules. CONCLUSIONS The findings reveal opportunities for improvement, mainly in knowledge related to communication skills and the approach to emotional and physical distress without diagnostic criteria for a specific disease, offering support for planning actions aimed at intensifying the consideration of these themes during the operational stages of PAS.
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Affiliation(s)
- Joana Moscoso Teixeira de Mendonça
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Ilana Eshriqui
- Universidade do Estado do Rio de JaneiroDepartamento de Especialidades MédicasRio de JaneiroRJBrazil Universidade do Estado do Rio de Janeiro. Departamento de Especialidades Médicas. Rio de Janeiro, RJ, Brazil
| | - Leticia Yamawaka de Almeida
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Valmir Vanderlei Gomes
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Lívia Schunk
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Ana Alice Freire de Sousa
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Larissa Karollyne de Oliveira Santos
- Hospital Israelita Albert EinsteinCentro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrazil Hospital Israelita Albert Einstein. Centro de Estudos, Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brazil
| | - Sandra Fortes
- Universidade do Estado do Rio de JaneiroDepartamento de Especialidades MédicasRio de JaneiroRJBrazil Universidade do Estado do Rio de Janeiro. Departamento de Especialidades Médicas. Rio de Janeiro, RJ, Brazil
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11
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Tanaka OY, Akerman M, Louvison MCP, Bousquat A, Pinto NRDS, Meira ALP, Godoi LPDS, Pereira APCEM, Spedo SM, de Oliveira MB, Eshriqui I, Paresque MAC. Challenges to implementing planning processes in Brazilian health regions. Rev Saude Publica 2024; 57Suppl 3:2s. [PMID: 38629666 PMCID: PMC11037912 DOI: 10.11606/s1518-8787.2023057005138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/15/2023] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To recognize elements that facilitated or hindered the PlanificaSUS implementation stages. METHODS A multiple case study was carried out in four pre-selected health regions in Brazil-Belo Jardim (PE), Fronteira Oeste (RS), Sul-Mato-Grossense (MT) and Valença (BA) using systemic arterial hypertension and maternal and child care as tracer conditions. Participant observation (in regional interagency commissions) and in-depth interviews with key informants from state and municipal management and primary health care and specialized outpatient care service professionals within the project were carried out in these four regions. Analysis was built according to political, technical-operational, and contextual dimensions. RESULTS The political dimension evinced that the regions found the project an opportunity to articulate states and municipalities and an important political bet to build networks and lines of care but that there remained much to be faced in the disputes related to building the Unified Health System (SUS). In the technical operational dimension, it is important to consider that primary health care stimulated a culture of local planning and favored traditional tools to organize and improve it, such as organizing registrations, agendas, and demands. However, centralized training and planning-inducing processes fail to always respond to local needs and can produce barriers to implementation. CONCLUSIONS It is worth considering the central and regional role of state managers in the commitment related to the project and the effect of mobilizing primary health care and expanding its power. There remains much to be faced in the disputes at stake in bullring SUS.
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Affiliation(s)
- Oswaldo Yoshimi Tanaka
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Marco Akerman
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Marília Cristina Prado Louvison
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Aylene Bousquat
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Nicanor Rodrigues da Silva Pinto
- Universidade Federal de São PauloPrograma de Pós-Graduação em Saúde da FamíliaSão PauloSPBrasilUniversidade Federal de São Paulo. Programa de Pós-Graduação em Saúde da Família. São Paulo, SP, Brasil
| | - Ana Lígia Passos Meira
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Lídia Pereira da Silva Godoi
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Ana Paula Chancharulo e Morais Pereira
- Universidade do Estado da BahiaDepartamento de Ciências da VidaSalvadorBABrasilUniversidade do Estado da Bahia. Departamento de Ciências da Vida. Salvador, BA, Brasil
| | - Sandra Maria Spedo
- Universidade Federal de São PauloPrograma de Pós-Graduação em Saúde da FamíliaSão PauloSPBrasilUniversidade Federal de São Paulo. Programa de Pós-Graduação em Saúde da Família. São Paulo, SP, Brasil
| | - Monique Batista de Oliveira
- Universidade de São PauloFaculdade de Saúde PúblicaSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil
| | - Ilana Eshriqui
- Hospital Israelita Albert EinsteinCentro de Estudos Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brasil
| | - Marcio Anderson Cardozo Paresque
- Hospital Israelita Albert EinsteinCentro de Estudos Pesquisa e Prática em Atenção Primária à Saúde e RedesSão PauloSPBrasilHospital Israelita Albert Einstein. Centro de Estudos Pesquisa e Prática em Atenção Primária à Saúde e Redes. São Paulo, SP, Brasil
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12
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Maritim B, Koon AD, Kimaina A, Goudge J. Citizen engagement in national health insurance in rural western Kenya. Health Policy Plan 2024; 39:387-399. [PMID: 38334694 PMCID: PMC11005831 DOI: 10.1093/heapol/czae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 11/01/2023] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
Effective citizen engagement is crucial for the success of social health insurance, yet little is known about the mechanisms used to involve citizens in low- and middle-income countries. This paper explores citizen engagement efforts by the National Health Insurance Fund (NHIF) and their impact on health insurance coverage within rural informal worker households in western Kenya. Our study employed a mixed methods design, including a cross-sectional household survey (n = 1773), in-depth household interviews (n = 36), six focus group discussions with community stakeholders and key informant interviews (n = 11) with policymakers. The findings reveal that NHIF is widely recognized, but knowledge of its services, feedback mechanisms and accountability systems is limited. NHIF enrolment among respondents is low (11%). The majority (63%) are aware of NHIF, but only 32% know about the benefit package. There was higher awareness of the benefit package (60%) among those with NHIF compared to those without (28%). Satisfaction with the NHIF benefit package was expressed by only 48% of the insured. Nearly all respondents (93%) are unaware of mechanisms to provide feedback or raise complaints with NHIF. Of those who are aware, the majority (57%) mention visiting NHIF offices for assistance. Most respondents (97%) lack awareness of NHIF's performance reporting mechanisms and express a desire to learn. Negative media reports about NHIF's performance erode trust, contributing to low enrolment and member attrition. Our study underscores the urgency of prioritizing citizen engagement to address low enrolment and attrition rates. We recommend evaluating current citizen engagement procedures to enhance citizen accountability and incorporate their voices. Equally important is the need to build the capacity of health facility staff handling NHIF clients in providing information and addressing complaints. Transparency and information accessibility, including the sharing of performance reports, will foster trust in the insurer. Lastly, standardizing messaging and translations for diverse audiences, particularly rural informal workers, is crucial.
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Affiliation(s)
- Beryl Maritim
- Consortium for Advanced Research Training in Africa (CARTA), P.O. Box 10787, Nairobi 00100, Kenya
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 51 2193, 60 York Rd, Parktown, Johannesburg 2193, South Africa
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, 00100, Nairobi 00100, Kenya
| | - Adam D Koon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, E8143, Baltimore, MD 21205, USA
| | - Allan Kimaina
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, 00100, Nairobi 00100, Kenya
| | - Jane Goudge
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 51 2193, 60 York Rd, Parktown, Johannesburg 2193, South Africa
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13
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Kelly NR, Osa ML, Luther G, Guidinger C, Folger A, Williamson G, Esquivel J, Budd EL. Preliminary evaluation of a brief worksite intervention to reduce weight stigma and weight bias internalization. Eval Program Plann 2024; 104:102434. [PMID: 38615372 DOI: 10.1016/j.evalprogplan.2024.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
Weight-based discrimination (WBD) is common and associated with reduced physical and emotional functioning. WBD is common in the workplace, yet no studies have evaluated a WBD intervention delivered in a worksite setting. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a 3-hour, remote-delivered WBD intervention at a large public university. Six workshops including 94 participants (41.76 ± 9.37 y; 92.8% women) were delivered December 2020 through May 2021; 88.3% of participants enrolled in the study and 88.8% of enrolled participants completed pre- and post-intervention surveys. Participants strongly agreed the workshop contributed to a more inclusive work environment (M=4.98 ± 0.2; 1 =Strongly Disagree to 5 =Strongly Agree); and was highly needed (4.9 ± 0.3) and liked (4.8 ± 0.5). Qualitative feedback cited benefits of remote delivery in providing body size anonymity and wanting access to intervention materials and more time for discussion and action steps to reduce WBD. Participants experienced significant, medium reductions in explicit weight bias (ps < .001), significant, small reductions in weight bias internalization (p < .001), and statistically non-significant (p = .08), small-to-medium reductions in implicit bias. Targeting worksites as a delivery mechanism has the potential to reduce WBD, thereby improving the health and well-being of diverse employees and creating a more inclusive workspace.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA.
| | - Maggie L Osa
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Gabriella Luther
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Austin Folger
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Juliana Esquivel
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
| | - Elizabeth L Budd
- Counseling Psychology and Human Services, University of Oregon, USA; The Prevention Science Institute, University of Oregon, USA
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Galvão DLS, Araújo WJS, Brandão Neto W, Barros MBSCD, Monteiro EMM. Intersectionality and challenges in support for chest-feeding transgender men. Cien Saude Colet 2024; 29:e19262023. [PMID: 38655964 DOI: 10.1590/1413-81232024294.19262023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/14/2023] [Indexed: 04/26/2024] Open
Abstract
This article tried, from an intersectional standpoint, to grasp the challenges experienced by health professionals and service users of human milk banks in provision of care for transgender men chestfeeding. This exploratory, descriptive qualitative study drew on interviews of six human milk bank staff, who had previously assisted trans men in relation to chestfeeding and two bisexual trans men, who chestfed. The data was treated by thematic analysis, supported by Atlas.ti software, version 9.0. Lacunas in the educational, institutional and management spheres, associated with personal and social issues, reproduce a pre-conceived normative model and disregard the special demands of providing chestfeeding care for the trans population. Cisheteronormativity and "professional supremacy" operate in personal, social and institutional respects to segregate transgender men in lactation support services. Intersectional analysis of these challenges affords an overall view of segregative factors and enables public policies to be introduced to promote social justice.
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Affiliation(s)
- Danielle Laet Silva Galvão
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
| | | | - Waldemar Brandão Neto
- Programa de Pós-Graduação em Enfermagem, Universidade de Pernambuco. Recife PE Brasil
| | | | - Estela Maria Meirelles Monteiro
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
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15
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Dantas DDS, Almeida GPDLL, Ferreira BDO, Therense M, Neves ALMD. Meanings and perceptions of parenthood among transgender men who became pregnant before gender transition. Cien Saude Colet 2024; 29:e19532023. [PMID: 38655967 DOI: 10.1590/1413-81232024294.19532023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/18/2023] [Indexed: 04/26/2024] Open
Abstract
This qualitative study, with five participating interlocutors, sought to understand the senses and meanings of parenting among trans men who became pregnant before gender transition. Analysis was conducted in light of social theories of gender. The results demonstrated an experience of parenthood subject to a field of tensions and negotiations, as well as subjective production that oscillated between transgression and accommodation of the cultural perspective of their own experience. The forms of violence found to be practiced reiterated social vulnerabilities, exposed healthcare service weaknesses and produced harmful effects on transgender men who become pregnant before gender transition.
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Affiliation(s)
- Daniela Dos Santos Dantas
- Universidade Federal do Amazonas. Av. General Rodrigo Octavio Jordão Ramos 1200, Coroado I. 69067-005 Manaus AM Brasil.
| | | | - Breno de Oliveira Ferreira
- Universidade Federal do Amazonas. Av. General Rodrigo Octavio Jordão Ramos 1200, Coroado I. 69067-005 Manaus AM Brasil.
- Universidade do Estado do Amazonas. Manaus AM Brasil
| | | | - André Luiz Machado das Neves
- Universidade Federal do Amazonas. Av. General Rodrigo Octavio Jordão Ramos 1200, Coroado I. 69067-005 Manaus AM Brasil.
- Universidade do Estado do Amazonas. Manaus AM Brasil
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16
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Pingel ES. Seeing Inside: How Stigma and Recognition Shape Community Health Worker Home Visits in São Paulo, Brazil. Community Health Equity Res Policy 2024; 44:303-313. [PMID: 36322964 DOI: 10.1177/2752535x221137384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Community Health Worker (CHW) home visits are central to primary care provision in São Paulo, Brazil. Yet CHWs receive little training prior to conducting these visits. In the neighborhood where I conducted ethnographic fieldwork, nearly half of patients were immigrants to Brazil, adding a layer of sociocultural and linguistic difference. I thus investigated how interactions between CHWs and patients unfolded and were shaped by cultural processes. Analyzing fieldnotes and interview data, I found that CHWs cherished relationships with older adult Portuguese-speaking patients, while expressing exasperation and even disgust with more recent immigrants and patients living with stigmatized health conditions. The cultural processes of recognition and stigma shaped CHWs' perceptions of and interactions with patients. I ground these analyses in the history of state-sponsored discourse linking immigrants with poor hygiene, concluding that home visits deserve greater scrutiny as a public health tool that may increase access to care at the expense of health equity.
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Affiliation(s)
- Emily S Pingel
- Department of Sociology, Emory University, Atlanta, GA, USA
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17
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Cardoso PFG, Shimizu MA. Obstetric violence and LGBTQIA+phobia: interlaced oppressions and violations. Cien Saude Colet 2024; 29:e20072023. [PMID: 38655975 DOI: 10.1590/1413-81232024294.20072023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/27/2023] [Indexed: 04/26/2024] Open
Abstract
The cisheteropatriarchal capitalist system has developed by class, racial and sexual oppression and exploitation in establishing unequal, hierarchical power relations. One of these kinds of oppression involves the use of violence against bodies considered wayward and transgressive within this structure. Of the different types of violence, this study focused on obstetric violence, understood as patriarchal gender violence designed to remove the rights, autonomy and agency of trans women and men during the processes of pregnancy, childbirth, postpartum and abortion. This article reflects on obstetric violence and its impacts on homo-parenthood for lesbian women and trans men, on the understanding that the LGBTQIA+ population is one of the most vulnerable and removed from health services, mainly because of the institutional violence suffered by these bodies. Accordingly, the intention is to understand, through social and historical analysis, how these sexist, heteropatriarchal violations, interlacing and reflecting in health care for these people, generate even more forms of oppression against this population.
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Affiliation(s)
| | - Mariana Arissa Shimizu
- Universidade Federal de São Paulo (UNIFESP Baixada Santista). R. Silva Jardim 136, Vila Matias. 11015-020 Santos SP Brasil.
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18
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Freitas MP, Burlandy L, Castro LMC, Santos CRB, Teléfora KDS, Cruz MCCD, Teixeira MRM. Financial constraints and incentives for the prevention and control of obesity in the state of Rio de Janeiro, Brazil. Cien Saude Colet 2024; 29:e01502023. [PMID: 38655951 DOI: 10.1590/1413-81232024294.01502023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/14/2023] [Indexed: 04/26/2024] Open
Abstract
The present study aimed to analyze how these changes, both at the national and state levels, could affect the conditions of the implementation of obesity prevention and control (OCP) actions in primary health care (PHC) in the Rio de Janeiro State from 2014 to 2021. This study was based on policy analysis methods that emphasize the understanding of the implementation contexts, as well as the induction mechanisms and government incentives for the development of actions and integration of two projects that analyzed the OPC actions in PHC in the 92 municipalities of RJS between 2014 and 2018 (PPSUS-RJS) and between 2019 and 2021 (PEO-RJS). The results indicate that, by 2016, it was possible to observe the positive impacts of the structuring of PHC and the federal induction mechanisms in RJS. However, inflections in the expansion and funding of PHC contributed to the weakening of units, teams, and strategies, and led to retraction of resources for both state and municipal actions. Between 2016-2018, RJS's political and financial scenario deteriorated due to national crises, and the positive counterpoints since then were the induction mechanisms and federal resources that remained, in addition to the technical areas of the RJS-HD and state co-financing resources.
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Affiliation(s)
- Matheus Pereira Freitas
- Faculdade de Nutrição, Universidade Federal Fluminense. Rua Mário Santos Braga 30/413, Centro. 24020-140 Niterói RJ Brasil.
| | - Luciene Burlandy
- Departamento de Nutrição Social, Universidade Federal Fluminense. Niterói RJ Brasil
| | | | - Cláudia Roberta Bocca Santos
- Departamento de Nutrição em Saúde Pública, Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil
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Ril SY, Oliveira Junior JBD, Mello MMCE, Portes VDM, Moretti-Pires RO. "You only have one mother!": institutional violence in experiences of double motherhood in healthcare. Cien Saude Colet 2024; 29:e19802023. [PMID: 38655974 DOI: 10.1590/1413-81232024294.19802023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/21/2023] [Indexed: 04/26/2024] Open
Abstract
The objective was to understand experiences of double motherhood during antenatal, childbirth and postpartum healthcare, using a qualitative method involving individual online interviews and asynchronous, online focus groups of cisgender women, mostly in same-sex relationships. The results revealed how these women's experiences of parenting were marginalised, highlighting institutional violence in Brazilian healthcare services, which are presented here in two thematic dimensions: 1) Cisheteronormativity and its impact on experiences of double motherhood; and 2) Institutional violence in healthcare services: from curiosity to LGBTQIA+phobia. It was concluded that cisheteronormativity hinders healthcare for these experiences, especially by rendering the non-gestational mother invisible. This underscores the urgent need to train healthcare personnel, rethink and challenge cisgender and heterosexual norms and promote inclusive policies to ensure equitable care and combat institutional violence.
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Affiliation(s)
- Stephany Yolanda Ril
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. R. Delfino Conti s/n, Trindade. 88040-370 Florianópolis SC Brasil.
| | - João Batista de Oliveira Junior
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. R. Delfino Conti s/n, Trindade. 88040-370 Florianópolis SC Brasil.
| | - Mônica Machado Cunha E Mello
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. R. Delfino Conti s/n, Trindade. 88040-370 Florianópolis SC Brasil.
| | - Virgínia de Menezes Portes
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. R. Delfino Conti s/n, Trindade. 88040-370 Florianópolis SC Brasil.
| | - Rodrigo Otávio Moretti-Pires
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. R. Delfino Conti s/n, Trindade. 88040-370 Florianópolis SC Brasil.
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Ayala EV, Roca AR. Between choices and decisions. Genetics in homoparental families through surrogacy in Argentina. Cien Saude Colet 2024; 29:e19122023. [PMID: 38655962 DOI: 10.1590/1413-81232024294.19122023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 04/26/2024] Open
Abstract
Comprehensive access to medically assisted reproduction procedures and techniques in Argentina has been assured by National Law No. 26,862 since 2013. This Law does not include surrogacy procedures, and the lack of specific regulation shifts practices to a paralegal setting. In this context, planned parenthood by male couples through surrogacy is performed through actions that convey demands for access rights and active State policies. For these couples, the argument is that surrogacy is the only option to have a child with a genetic bond with at least one of the two parents and recognize both filiatory bonds. This work results from field work in progress with parents from the Province of Buenos Aires running this practice in Argentina. Based on in-depth interviews, we attempted to rebuild personal experiences and analyze the meanings that the narratives construct regarding their parenting, the biological connections in establishing or defining family relationships, and the importance of genetics in constructing and maintaining affiliations.
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Affiliation(s)
- Estefania Victoria Ayala
- Instituto de Ciencias Antropológicas, Facultad de Filosofía y Letras, Universidad de Buenos Aires. José Bonifacio 1337, 7mo piso, CABA. Buenos Aires Argentina.
| | - Alejandra Rosario Roca
- Instituto de Ciencias Antropológicas, Facultad de Filosofía y Letras, Universidad de Buenos Aires. José Bonifacio 1337, 7mo piso, CABA. Buenos Aires Argentina.
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Sally EDOF, Gomes DS, Dantas LDOC, Henriques P. NBCAL violation of products that compete with breastfeeding on the social network Instagram. Cien Saude Colet 2024; 29:e20312022. [PMID: 38655976 DOI: 10.1590/1413-81232024294.20312022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/26/2023] [Indexed: 04/26/2024] Open
Abstract
The article aims to identify NBCAL violations and analyze the content of messages posted on the Instagram social network. This qualitative-quantitative study consisted of a convenience sample of profiles identified through specific terms preceded by the hashtag symbol (#). Data were collected for two months by trained researchers using a structured questionnaire. We calculated the product promotion frequency that characterized violation of the NBCAL per category and manufacturer. The messages were analyzed using the content analysis technique. We identified 64 personal accounts of mothers with violations in 89 products, mainly food (n = 72), dairy compounds (54.2%), and infant formulas (45.8%) were the most publicized. Two thematic categories emerged from the posted texts, one related to the quality of the products and the other about breastfeeding difficulty, especially low milk production. The study identified NBCAL violations on the Instagram social network, alerting the need to recognize digital marketing to include it in the rules imposed by the Norm in the virtual context, considering the capillarity of social networks in disseminating information to the public in question.
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Affiliation(s)
- Enilce de Oliveira Fonseca Sally
- Departamento de Nutrição Social, Faculdade de Nutrição Emilia de Jesus Ferreiro, Universidade Federal Fluminense. R. Mário Santos Braga 30, 4º andar, Centro. 24020-140 Niterói RJ Brasil.
| | - Daiane Silva Gomes
- Faculdade de Nutrição Emilia de Jesus Ferreiro, Universidade Federal Fluminense. Niterói RJ Brasil
| | | | - Patrícia Henriques
- Departamento de Nutrição Social, Faculdade de Nutrição Emilia de Jesus Ferreiro, Universidade Federal Fluminense. R. Mário Santos Braga 30, 4º andar, Centro. 24020-140 Niterói RJ Brasil.
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Richardson CG. The Underutilization of Mental Health Care Services in the Lives of People with Blindness or Visual Impairment: A Literature Review on Rehabilitation Factors Toward Provision. Clin Ophthalmol 2024; 18:953-980. [PMID: 38566829 PMCID: PMC10986414 DOI: 10.2147/opth.s442430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Roughly 3 million adult Americans have a visual impairment or blindness, and over 4 million adults aged 40 and older. Despite data demonstrating an elevated prevalence of mental health symptoms in people with BVI, this population remains largely untreated. Given that people with BVI often interface with multiple systems of rehabilitative care that are designed to improve quality of life, the relatively low rates of initiation of mental health care services are particularly alarming. In this review, the systematic processes of mental health care services across pertinent rehabilitation groups are identified and critically examined. Patients and Methods A comprehensive literature review was conducted. The literature review utilized a critical systems typology, whereby relevant literature was selected, reviewed, and analyzed intra and extra organizationally. In addition, a thorough discussion of disability-related factors was provided, lending a socio-political lens to the problem. Results Considerable data indicates that short-term mental health care services for people with BVI are ineffective treatment methods, albeit primarily employed in health-rehabilitative processes. Multiple studies offered data indicating the presence of diverse and entangled mental health issues relative to vocational rehabilitation services, mobility tool utility, and emotional reactions to vision loss. Many studies suggested that disability identity work be integrated into health-rehabilitative processes for people with BVI. Conclusion To improve the utility of mental health care services for people with BVI, a reenergization of the mental health care needs of this population must occur. A critical podcast or forum focused on educating listeners about the health-rehabilitation factors that influence the provision of mental health care services can aid to improve future mental health policy and practice for people with BVI. Disability scholars need to advance research on integrating critical theories in work with people with BVI and accelerate qualitative, community-based methods to enhance understanding of this population and their unique mental health needs.
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Preest E, Greenhalgh T, Farrier C, van der Westhuizen HM. Children's experiences of mask-wearing: a systemic review and narrative synthesis. J Eval Clin Pract 2024. [PMID: 38534010 DOI: 10.1111/jep.13982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
RATIONALE Masks have been widely used as a preventative tool during the COVID-19 pandemic. However, the use of masks by children has been controversial, with international guidelines recommending a risk-based approach to national policymakers. AIMS AND OBJECTIVES We aimed to conduct a systematic review that explores children's experiences of mask-wearing, drawing on an evidence base that describes mask-wearing in different contexts including air pollution, and to prevent the spread of infectious disease. METHODS We searched MEDLINE, Embase and PsycINFO in June 2021, with repeat searches in August 2022 and January 2024, for primary research studies exploring children's experiences of masks. Included studies reported on participants between 4 and 14 years (inclusive), with no restrictions on language where an English translation was available. Two reviewers independently screened titles and abstracts and reviewed full texts, with discrepancies resolved by a third reviewer. We used the Mixed Methods Appraisal Tool for quality appraisal and narrative synthesis to identify key findings. We also conducted stakeholder consultation (Patient and Public Involvement (PPI)) with nine children, where they submitted annotated drawings of their preferred masks to complement our review findings. RESULTS We screened 982 titles and abstracts and reviewed 94 full texts. 45 studies were included in the synthesis. Children's experiences of mask-wearing were influenced by their perceived necessity, social norms around their use and parental attitudes. Challenges related to mask-wearing were described, including difficulty reading facial expressions and physical discomfort. Children found it easier to wear masks when sitting and in cooler environments, and they benefited from unmasking during outdoor break time at school. As part of the PPI consultation, children highlighted the importance of mask design and the environmental impact of masks. CONCLUSION Children's experiences of mask-wearing were varied and context-dependent, with several mask-design challenges raised. Future policy on mask-wearing needs to consider the context in which mask-wearing would be most beneficial, and how local adaptations to policy can respond to children's needs.
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Affiliation(s)
- Elin Preest
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Christian Farrier
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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França M, Dourado I, Grangeiro A, Greco D, Magno L. Racial HIV Testing Inequalities in Adolescent Men who have Sex with Men and Transgender Women in Three Brazilian Cities. AIDS Behav 2024:10.1007/s10461-024-04297-z. [PMID: 38526640 DOI: 10.1007/s10461-024-04297-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/27/2024]
Abstract
Many barriers to human immunodeficiency virus (HIV) testing among Black people exist. This study analysed the association between race/skin colour and lifetime HIV testing among adolescent men who have sex with men (AMSM) and transgender women (ATGW) in three Brazilian cities. This cross-sectional study was nested within the PrEP1519 cohort, a multicentre study of AMSM and ATGW aged 15-19 years in Belo Horizonte, Salvador, and São Paulo, Brazil. The outcome variable was the lifetime HIV testing (no or yes). The main exposure variable was self-reported race/skin colour as White and a unique Black group (composed of Pardo-mixed colour and Black, according to the Brazilian classification). Descriptive statistics and bivariate and multiple logistic regression analyses were conducted to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) to determine the association between the main exposure and outcome, adjusted for covariates. White adolescents were tested more frequently than the unique Black group (64.0% vs. 53.7%, respectively; Ρ = 0.001). Multiple logistic regression analysis showed that the unique Black group of AMSM and ATGW had 26% (adjusted OR [aOR], 0.74; 95% CI, 0.55-0.98) and 38% (aOR, 0.62; 95% CI, 0.45-0.87) lower odds of being tested for HIV in a lifetime than Whites in model 1 and 2, respectively. Our findings highlight the role of racism in lifetime HIV testing among AMSM and ATGW. Therefore, an urgent need for advances exists in public policies to combat racism in Brazil.
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Affiliation(s)
- Marcus França
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Alexandre Grangeiro
- Faculdade de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brazil
| | - Dirceu Greco
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
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Gleriano JS, Krein C, Chaves LDP. Aspects that facilitate access to care for viral hepatitis: An evaluative research. SAO PAULO MED J 2024; 142:e2023078. [PMID: 38477774 DOI: 10.1590/1516-3180.2023.0078.r1.29112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 11/29/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Viral hepatitis is a major public health concern worldwide. OBJECTIVES This study aimed to analyze the factors that facilitate access to care for viral hepatitis. DESIGN AND SETTING Using a sequential mixed method, this evaluation research was conducted in the state of Mato Grosso, Brazil. METHODS Mapping of references and selection of regions were made based on the quantity and heterogeneity of services. The stakeholders, including the managers of the State Department of Health and professionals from reference services, were identified. Nine semi-structured interviews were conducted using content analysis and discussions guided by the dimensions of the analysis model of universal access to health services. RESULTS In the political dimension, decentralizing services and adhering to the Intermunicipal Health Consortium are highly encouraged. In the economic-social dimension, a commitment exists to allocate public funds for the expansion of referral services and subsidies to support users in their travel for appointments, medications, and examinations. In the organizational dimension, the availability of inputs for testing, definition of user flow, ease of scheduling appointments, coordination by primary care in testing, collaboration following the guidelines and protocols, and engagement in extramural activities are guaranteed. In the technical dimension, professionals actively commit to the service and offer different opening hours, guarantee the presence of an infectious physician, expand training opportunities, and establish intersectoral partnerships. In the symbolic dimension, professionals actively listen to the experiences of users throughout their care trajectory and demonstrate empathy. CONCLUSIONS The results are crucial for improving comprehensiveness, but necessitate managerial efforts to enhance regional governance.
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Affiliation(s)
- Josué Souza Gleriano
- PhD. Nurse, Adjunct Professor, Department of Nursing, Faculty of Agricultural, Biological, Engineering and Health Sciences, Universidade do Estado de Mato Grosso (UNEMAT), Tangará da Serra (MT), Brazil
| | - Carlise Krein
- Msc. Nurse, Department of General and Specialized Nursing, Ribeirão Preto School of Nursing, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
| | - Lucieli Dias Pedreschi Chaves
- PhD. Nurse, Associate Professor, Department of General and Specialized Nursing, Ribeirão Preto School of Nursing, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil
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Pedroso JMG, Araujo CNDP, Corradi-Webster CM. The joy and pain of being a harm reduction worker: a qualitative study of the meanings about harm reduction in Brazil. Harm Reduct J 2024; 21:56. [PMID: 38439094 PMCID: PMC10910711 DOI: 10.1186/s12954-024-00962-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/11/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Although harm reduction is highlighted as an effective intervention for alcohol and drug use, a funding gap for harm reduction interventions has been identified, mainly in low- and middle-income countries. In these countries, tensions between abstinence and harm reduction models have impaired the shift from punitive practices to evidence-based interventions committed to guaranteeing the human rights of people who use drugs. Since 2015, the Brazilian government has adopted a more punitive and abstinence-focused drug policy that jeopardizes the care of people who use alcohol and other drugs and the comprehension of the harm reduction workers' perspective in relation to their practice. Therefore, this study aimed to comprehend the meanings constructed by Brazilian harm reduction workers regarding their practices with vulnerable populations amidst a context of political tension. METHODS We conducted 15 in-depth semi-structured qualitative interviews with harm reduction workers employed in public health services for at least 6 months. Data were analyzed using thematic analysis. RESULTS The thematic axis "The joy and pain of being a harm reduction worker in Brazil" was constructed and divided into four major themes: (1) Invisibility of harm reduction work; (2) Black, poor, and people who use drugs: identification with the service users; (3) Between advocacy and profession: harm reduction as a political act; (4) Small achievements matter. Despite the perceived invisibility of harm reduction workers in the public health and alcohol and drug fields, valuing small achievements and advocacy were important resources to deal with political tension and punitive strategies in Brazil. The findings also highlight the important role of harm reduction workers due to their personal characteristics and understanding of drug use behavior, which bring the target audience closer to actions within the public health system. CONCLUSION There is an urgent need to acknowledge harm reduction based on peer support as a professional category that deserves adequate financial support and workplace benefits. Additionally, expanding evidence-based harm reduction interventions and community-based voluntary drug use treatment centers should be prioritized by public policies to address the human rights violations experienced by people who use drugs.
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Affiliation(s)
- João Maurício Gimenes Pedroso
- Psychology Department, Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-900, Brazil.
- Central Paulista University Center - UNICEP, São Carlos, SP, 13563-470, Brazil.
| | - Cristiana Nelise de Paula Araujo
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, 32608, USA
| | - Clarissa Mendonça Corradi-Webster
- Psychology Department, Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-900, Brazil
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Reichenberger V, Corona AP, Ramos VD, Shakespeare T, Hameed S, Penn-Kekana L, Kuper H. Access to primary healthcare services for adults with disabilities in Latin America and the Caribbean: a review and meta-synthesis of qualitative studies. Disabil Rehabil 2024:1-10. [PMID: 38433528 DOI: 10.1080/09638288.2024.2320268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE This review and meta-synthesis of qualitative studies aims to provide an overview of qualitative evidence on primary healthcare access of people with disability in Latin America and the Caribbean, as well as to identify barriers that exist in this region. METHODS Six databases were searched for studies from 2000 to 2022. 34 qualitative studies were identified. RESULTS Barriers exist on both demand and supply sides. The thematic synthesis process generated three broad overarching analytical themes, which authors have related to Levesque et al.'s aspects of "ability to perceive," "availability, accommodation and ability to reach" and "appropriateness and ability to engage." Access to information and health literacy are compromised due to a lack of tailored health education materials. Barriers in the urban environment, including inadequate transportation, and insufficient healthcare facility accessibility create challenges for people with disabilities to reach healthcare facilities independently. Attitudinal barriers contribute to suboptimal care experiences. CONCLUSION People with disabilities face several barriers in accessing healthcare. Lack of healthcare provider training, inappropriate urban infrastructure, lack of accessible transport and inaccessibility in healthcare centers are barriers that need to be addressed. With these actions, people with disabilities will be closer to having their rights met.
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Affiliation(s)
- Veronika Reichenberger
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Paula Corona
- Department of Hearing and Speech Sciences, Multidisciplinary Institute of Rehabilitation and Health, Federal University of Bahia, Salvador, Brazil
| | - Vinicius Delgado Ramos
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Shaffa Hameed
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Loveday Penn-Kekana
- Epidemiology and Public Health, Maternal and Neonatal Health Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
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Santos MPAD, Bastos JL. Antiracist ethos and the collective oral health as a pathway for life. Cien Saude Colet 2024; 29:e06732023. [PMID: 38451647 DOI: 10.1590/1413-81232024293.06732023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/15/2023] [Indexed: 03/08/2024] Open
Abstract
This article proposes a reflection on the imperative of antiracism in collective oral health, which, as a science, field, core, and praxis, contributes significantly to the reconstruction of an ethos that considers equity and enables citizenship and democracy. As a paradigm, we assumed the concept of "Buccality" and the guidelines of the National Comprehensive Health Policy for the Black Population, emphasizing the defense of the right to health as a prerogative of the right to life and the combat against racism and all forms of discrimination systematically. As a critical exercise, we discussed the status quo of collective oral health. We pointed to adopting a racial pro-equity perspective as an intentional, political choice socially agreed upon with all of society for social justice. Finally, we propose recommendations for dismantling systemic racism in collective oral health.
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Affiliation(s)
- Marcia Pereira Alves Dos Santos
- Faculdade de Odontologia, Universidade Federal do Rio de Janeiro. R. Prof. Rodolpho Paulo Rocco 325, Ilha da Cidade Universitária. 21941-913 Rio de Janeiro RJ Brasil.
| | - João Luiz Bastos
- Faculty of Health Sciences, Simon Fraser University. Burnaby BC Canada
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29
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Silva MEB, Anuciação D, Trad LAB. Violence and vulnerability: the everyday life of black youth in suburbs of two Brazilian state capitals. Cien Saude Colet 2024; 29:e04402023. [PMID: 38451640 DOI: 10.1590/1413-81232024293.04402023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/13/2023] [Indexed: 03/08/2024] Open
Abstract
Violence is a serious public health issue and constitutes a historical social phenomenon with diverse causes and consequences, and multiple manifestations. The main victims continue to be populations left vulnerable and marginalised, where dimensions including gender, class, race and social belonging intersect. Although studies to explain the phenomenon of violence do address ethnic and racial issues, they tend not to consider violence as stemming also from institutional racism. This paper examines data from a qualitative and quantitative study drawing on focus groups and semi-structured interviews to evaluate symbolic and structural violence experienced by young black people from 15 to 29 years old residing in peripheral neighbourhoods of two Brazilian state capitals - Recife and Fortaleza. The focus is on their standpoints that situate the intersectionality, especially among race/skin colour, territorial belonging and class, in the very definition of identity. In both capitals, the young black people revealed a common reality: life projects constrained by economic limitations and by the concrete or symbolic demarcation of social spaces to which they are denied access.
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Affiliation(s)
- Maria Edna Bezerra Silva
- Faculdade de Medicina, Universidade Federal de Alagoas. Av. Lourival Melo Mota s/n, Tabuleiro do Martins. 57072-900 Maceió AL Brasil.
| | - Diana Anuciação
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | - Leny Alves Bonfim Trad
- Programa Integrado de Pesquisa e Cooperação Técnica Comunidade, Família e Saúde - Contextos, Trajetórias e Políticas Públicas, Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
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30
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de Almeida MN, Caixeta CC, Santos Silva ND, de Morais NM, Dos Santos PD, Gonçalves LP, Achatz RW, Silva Guimarães D, Chaudhary N. Challenges and Concerns in Assisting Indigenous People with Suicide Attempts. Integr Psychol Behav Sci 2024; 58:319-337. [PMID: 37697148 DOI: 10.1007/s12124-023-09803-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/13/2023]
Abstract
There has been an alarming rise in suicide attempts among Indigenous people in Brazil, leading to national concerns about the provision of psychosocial care and professional support. In this study, we make an attempt to understand the perspectives of professionals in assisting Indigenous people from a specific group, the Inỹ, and identify the specific challenges of addressing issues through the mental health care system related specifically to suicide prevention. Using a qualitative approach with participant observation and semi-structured interviews, the research included Indigenous and their families assisted by three public institutions and the professionals that work in public psychosocial assistance. For this paper, we examined the tensions, conflicts, and challenges of the healthcare professionals at one of these institutions, a Psychosocial Care Center in the state of Goiás/Brazil. For data analysis, a sociocultural protocol was built to identify dialogical tensions between the different thematic fields of mental health care. The findings reveal that the theme of suicide was an important concern in the daily work with the community. Still, there were significant issues related to the assumptions, methodology, and meaning of care between the professionals and the community, on account of which the objective of the programme to address suicide attempts had not been effective or successful. The discussion of the results raises several critical questions about the possible contributions of dialogical cultural psychology in the context of Indigenous health. Also, it has important implications for the global issue of the wellbeing of Indigenous people.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nandita Chaudhary
- University of Delhi, Delhi, India
- Federal University of Bahia, Salvador, Brazil
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31
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Souto RDA, Souzas R, Silva EKPD, Pereira LL, Nery JS. Therapeutic itineraries of quilombola adults for oral health care in a rural district of Bahia, Brazil. Cien Saude Colet 2024; 29:e04302023. [PMID: 38451639 DOI: 10.1590/1413-81232024293.04302023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/13/2023] [Indexed: 03/08/2024] Open
Abstract
This study examined the oral health-related therapeutic itineraries of quilombola adults in a rural district of Vitória da Conquista, Bahia. This qualitative study involved ten semi-structured interviews of adult members of the quilombola community, in May 2021, which were then transcribed and analysed using content analysis. The results showed little or poor oral hygiene at some stage of life, especially in childhood and adolescence, the use of popular oral health care practices, and experiences of professional care featuring tooth extraction. Use of health services was mostly reported only in the period prior to the COVID-19 pandemic. Responses as to perceived ease of access to health services in the community varied. One common complaint as to satisfaction with oral health was the need to use or replace dental prostheses. This study concluded that oral health must be promoted jointly with disease prevention, dental rehabilitation and recognition for the knowledge and worldview of the quilombola population.
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Affiliation(s)
- Ricardo de Almeida Souto
- Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira, Universidade Federal da Bahia (UFBA). R. Hormindo Barros 58, Quadra 17, Lote 58, Bairro Candeias. 45029-094 Vitória da Conquista BA Brasil.
| | - Raquel Souzas
- Instituto Multidisciplinar em Saúde - Campus Anísio Teixeira, Universidade Federal da Bahia (UFBA). R. Hormindo Barros 58, Quadra 17, Lote 58, Bairro Candeias. 45029-094 Vitória da Conquista BA Brasil.
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Reis LADOD, Miranda SS, Fonseca BRD, Pereira M, Natividade MDS, Aragão E, Lara TP, Nery JS. Association between racial iniquities and oral health status: a systematic review. Cien Saude Colet 2024; 29:e04882023. [PMID: 38451644 DOI: 10.1590/1413-81232024293.04882023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/28/2023] [Indexed: 03/08/2024] Open
Abstract
The present study aimed to investigate the association between racial iniquities and oral health status. This is a systematic review with a protocol registered on the Prospero Platform (CRD42021228417), with searches carried out in electronic databases and in gray literature. Our study identified 3,028 publications. After applying the eligibility criteria and risk of bias analysis, 18 studies were selected. The results indicate that individuals of black/brown race/skin color have unfavorable oral health conditions, mainly represented by self-rated oral health, tooth loss, caries, and periodontitis. The results showed racial iniquities in oral health in different countries, for all analyzed indicators, with a greater vulnerability of the black population.
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Affiliation(s)
- Laila Araújo de Oliveira Dos Reis
- Faculdade de Odontologia, Universidade Federal da Bahia (UFBA). R. Augusto Viana s/n, Palácio da Reitoria, Canela. 40110-909 Salvador BA Brasil.
| | | | - Bruna Rebouças da Fonseca
- Faculdade de Odontologia, Universidade Federal da Bahia (UFBA). R. Augusto Viana s/n, Palácio da Reitoria, Canela. 40110-909 Salvador BA Brasil.
| | | | | | - Erika Aragão
- Instituto de Saúde Coletiva, UFBA. Salvador BA Brasil
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Luiz ODC, Nisida V, Silva Filho AMD, Souza ASPD, Nunes APN, Nery FSD. Racial iniquity in mortality from cervical cancer in Brazil: a time trend study from 2002 to 2021. Cien Saude Colet 2024; 29:e05202023. [PMID: 38451646 DOI: 10.1590/1413-81232024293.05202023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/26/2023] [Indexed: 03/08/2024] Open
Abstract
This ecological study examined time series, from 2002 to 20121, of age-adjusted coefficients of cervical cancer mortality, in Brazil, in women aged 20 years or more, by race. The information sources were Brazil's mortality information system (Sistema de Informação sobre Mortalidade - SIM) and the official bureau of statistics (Instituto Brasileiro de Geografia e Estatística - IBGE). Annual changes in age-adjusted mortality rates were calculated using the Prais-Winsten linear regression method. Black women die more and the rate is decreasing less. Racial inequality has increased over the years. In 2002, there were 0.08 more deaths per 100,000 women in the black population than among white women; in 2021, the number was one death. Health policymaking should consider racial differences in the implementation of strategies and goals.
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Affiliation(s)
- Olinda do Carmo Luiz
- Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
| | | | | | - Allex Sander Porfírio de Souza
- Faculdade de Medicina, Universidade de São Paulo (USP). Av. Dr. Arnaldo 455, Cerqueira César. 01246-903 São Paulo SP Brasil.
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Silva LB, Campos DDS, Araújo MVRD, Reis RS. "Even if we are the caring hand": Black doctors and structural racism in the context of primary health care. Cien Saude Colet 2024; 29:e07622023. [PMID: 38451650 DOI: 10.1590/1413-81232024293.07622023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/30/2023] [Indexed: 03/08/2024] Open
Abstract
This study scrutinizes structural racism's influence on the training and work of Black professionals in primary health care (PHC) in Rio de Janeiro, particularly focusing on the experiences of Black female physicians. Employing a qualitative approach via a Focus Group, conducted in November 2022, we adopted symbolic interactionism to interpret racism-related experiences. Our findings encompass two primary dimensions: the manifestation of structural and institutional racism within the Unified Health System (SUS), and how racism permeates health work processes and consequences. Results highlight enduring impacts, spanning education to PHC roles, hindering healthcare process recalibration. Participants identify institutional and structural racism, from managerial neglect to territorial violence and physician scarcity, constraining comprehensive care. It is crucial to unveil and grasp racism's structural essence within healthcare, aligned with the vision of health as a fundamental right.
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Affiliation(s)
- Letícia Batista Silva
- Escola Politécnica de Saúde Joaquim Venâncio, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
- Universidade Federal Fluminense. Niterói RJ Brasil
| | | | | | - Regimarina Soares Reis
- Escola Politécnica de Saúde Joaquim Venâncio, Fundação Oswaldo Cruz. Av. Brasil 4365, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
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Oliveira PSD, Miranda SVCD, Queiroz PDSF, Santos BA, Rodrigues Neto JF, Sampaio CA. Therapeutic itineraries of quilombola women in northern Minas Gerais, Brazil. Cien Saude Colet 2024; 29:e01762023. [PMID: 38451637 DOI: 10.1590/1413-81232024293.01762023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/21/2023] [Indexed: 03/08/2024] Open
Abstract
Quilombolas are ethnic-racial groups, of black ancestry, and had their territories consolidated in Brazil in regions with difficult access and far from large centers. The objective of this study is to know the therapeutic itinerary (IT) adopted by quilombola women in traditional communities located in the North of the state of Minas Gerais. This is a qualitative study with the theoretical model using the Arthur Kleinman health care system. The study scenario was 23 quilombola communities in northern Minas Gerais. Forty quilombola women aged between 25 and 89 years were interviewed. Data analysis was performed following the IT. Units of analysis emerged that were grouped into three categories: quilombola women and the meaning of health and care; the professional care system in quilombola communities; and route of care in situations experienced by women. The therapeutic itinerary of the communities is mainly related to the actions of popular medicine. It was also possible to observe that there are weaknesses in relation to health care due to factors such as difficulty of access to institutionalized services.
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Affiliation(s)
- Pâmela Scarlatt Durães Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
| | - Sérgio Vinícius Cardoso de Miranda
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
| | - Patrícia de Sousa Fernandes Queiroz
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
| | - Bruna Amorim Santos
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
| | - João Felício Rodrigues Neto
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
| | - Cristina Andrade Sampaio
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Cula Mangabeira 562, Santo Expedito. 39401-002 Montes Claros MG Brasil.
- Departamento de Saúde Mental e Saúde Coletiva, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
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Queiroz NS, Vilela FC, Cavaco AM, Melo AC. Evaluation of Clinical Communication in Pharmacy Undergraduates in Brazil: A Multicentric Study. Am J Pharm Educ 2024; 88:100671. [PMID: 38360187 DOI: 10.1016/j.ajpe.2024.100671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess the clinical communication characteristics of pharmacy undergraduates, estimate differences in this specific competency, and produce recommendations for further education and training. METHODS Analysis of communication competence between 110 pharmacy students in the last graduation year from each of the 5 Brazilian regions and a simulated patient with complaints of mild allergic rhinitis passive of resolution with non-prescription medicines. The simulated appointment was recorded, and the video was analyzed using the 2 main elements: biomedical/task-focused and socio-emotional exchange of the Roter Interaction Analysis System. RESULTS The total of utterances/speech from the pharmacist to the patient was 183.4; there was a statistically significant difference according to the Brazilian region. In the consultation, the frequency with which pharmacy students returned to the segment was evaluated, with a total mean clinical history segment 2 of mean 5.60; in segment 4, which is the counseling phase, an average of 4.80. In the task codes and the socio-emotional codes, there was a statistically significant difference between the codes when compared by region. We compare by sex because it is said that women talk more than men. There was a statistically significant difference in socio-emotional code and biomedical/focused and task being higher for women. CONCLUSION The level of communication competence of students should be that desired for graduation, in all regions. There seems to be a difference between training and level of competence. Considering gender, although the consultation time is similar, it appears that the quality of communication is higher for women.
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Affiliation(s)
- Nathane S Queiroz
- Federal University of São João Del Rei (UFSJ), São João del Rei, Brazil
| | | | | | - Angelita C Melo
- Department of Clinical Pharmacy, Federal University of São João del Rei, Brazil.
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Silva Filho AMD, Araújo EMD, Souza IMD, Luiz ODC, Máximo G, Queiroz FDA, Cavalcante L, Nisida V. Years of Potential Life Lost due to COVID-19 according to race/color and gender in Brazil between 2020 and 2021. Cien Saude Colet 2024; 29:e04702023. [PMID: 38451643 DOI: 10.1590/1413-81232024293.04702023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/03/2023] [Indexed: 03/08/2024] Open
Abstract
Mortality caused by the COVID-19 pandemic has impacted indicators of Years of Potential Life Lost (YPLL) worldwide. This study aimed to estimate the YPLL due to mortality caused by COVID-19, according to sex, age group, and race/color in Brazil, from March 2020 to December 2021. Deaths caused by COVID-19 were characterized, in which the rates and ratios of standardized YPLL rates, the average number of years of potential life lost (ANYPLL), and the average age at death (AAD) were estimated and compared. Overall, 13,776,969.50 potential years of life were lost, which resulted in an average loss of 22.5 potential years not lived. A greater loss of potential years of life was identified in men (58.12%) and in the age groups from 0 to 59 years in the black (58.92%) and indigenous (63.35%) populations, while in the age groups of 60 years and over, a greater loss of YPLL was observed in the white (45.89%) and yellow (53.22%) populations. Women recorded the highest ADD, with the exception of indigenous women. White men (1.63), brown men (1.59), and black men (1.61) had the highest rates when compared to white women. Although COVID-19 has a greater impact on the elderly, it was the black and indigenous populations under the age of 60 who had the greatest loss of potential years of life.
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Affiliation(s)
- Aloisio Machado da Silva Filho
- Programa de Pós-Graduação em Modelagem em Ciências da Terra e do Ambiente, Universidade Estadual de Feira de Santana (UEFS). Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | | | | | | | - Giovanni Máximo
- Universidade Federal dos Vales do Jequitinhonha e Mucuri. Diamantina MG Brasil
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Oliveira KAD, Castro CTD, Pereira M, Cordeiro RC, Ribeiro DDA, Rivemales MDCC, Araújo EMD, Santos DBD. Racial and ethnic disparities in premature births among pregnant women in the NISAMI cohort, Brazil. Cien Saude Colet 2024; 29:e11862023. [PMID: 38451655 DOI: 10.1590/1413-81232024293.11862023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/26/2023] [Indexed: 03/08/2024] Open
Abstract
The incidence of premature birth has increased worldwide, unequally distributed by race/ethnicity. Racism generates economic inequalities, educational disparities, and differential access to health care, which increases the risk of preterm birth. Thus, this study aimed to evaluate the factors associated with preterm birth and racial and ethnic disparities in premature birth among pregnant women attending prenatal care at the Brazilian Unified Health System health units in the urban area of Santo Antônio de Jesus, Bahia, Brazil. This study used data from 938 pregnant women aged between 18 to 45 years within the NISAMI prospective cohort. Premature birth prevalence was 11.8%, with a higher prevalence among black than non-black women (12.9% versus 6.0%, respectively). Maternal age between 18 and 24 years was the only factor associated with premature birth. A higher risk of premature birth was found among black women than non-black women (RR 3.22; 95%CI 1.42-7.32). These results reveal the existence of racial and social inequalities in the occurrence of premature birth.
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Affiliation(s)
- Kelly Albuquerque de Oliveira
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | | | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Rosa Cândida Cordeiro
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | - Denize de Almeida Ribeiro
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | | | - Edna Maria de Araújo
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | - Djanilson Barbosa Dos Santos
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
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Gerhardt TE, Migon NB, Madrid RDS, Soares JO, Lubisco RP, Eschiletti JDC, Santos JD. We quilombola women: a documentary about COVID-19 vaccination among quilombolas as an anti-racist device. Cien Saude Colet 2024; 29:e04482023. [PMID: 38451642 DOI: 10.1590/1413-81232024293.04482023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 12/04/2023] [Indexed: 03/08/2024] Open
Abstract
We quilombola women, a documentary that considers the quilombola identity and the right to COVID-19 vaccination, evokes notions of priority, rights, privileges and identity during the process of matching the number of vaccine doses available to citizens' arms. Omission by a Brazilian federal government grounded in necro-politics and denial, plus a lack of information, led quilombo communities to take it on themselves to draw up lists of those eligible for vaccination. The production team's aim was to use images as political language in the health field, so as to document and give visibility to these issues as one illustration of combating social and health inequalities and inequities rooted in structural racism. By combining science and art and interlacing references from the sociology of images, visual anthropology, plus the work and aesthetic devices of Eduardo Coutinho, the audiovisual production method brought out three key categories: I, We, and They, quilombola women. This article explores these categories underpinning construction of the documentary narrative, which drew on the potential of images, which in turn served as anti-racist, political and educational devices, both in the course of the production process and during the public screenings.
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Affiliation(s)
- Tatiana Engel Gerhardt
- Departamento de Saúde Coletiva, Universidade Federal do Rio Grande do Sul. R. São Manoel 963, Rio Branco. 90.620-110 Porto Alegre RS Brasil.
- Programa de Pós-Graduação em Desenvolvimento Rural, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Natália Bristot Migon
- Programa de Pós-Graduação em Desenvolvimento Rural, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Rosemeri da Silva Madrid
- Programa de Pós-Graduação em Desenvolvimento Rural, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Jaqueline Oliveira Soares
- Divisão de Equidades na área técnica da Política de Saúde da População Negra, Secretaria Estadual de Saúde do Rio Grande do Sul. Porto Alegre RS Brail
| | | | - Joana da Costa Eschiletti
- Escola de Enfermagem e de Saúde Coletiva, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Joseane Dos Santos
- Programa de Pós-Graduação em Desenvolvimento Rural, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Costa JLD, Montagner MI, Montagner MÂ, Alves SMC, Delduque MC. Experiences and strategies of people with sickle cell disease in the Federal District: the biographical rupture. Cien Saude Colet 2024; 29:e11782023. [PMID: 38451654 DOI: 10.1590/1413-81232024293.11782023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/21/2023] [Indexed: 03/08/2024] Open
Abstract
This is a study on sickle cell disease, a chronic illness that affects many Brazilians, that aims to understand and analyze how people address the adversities arising from the diagnosis and the biographical rupture. The description of people's experiences and strategies conjures a picture that expresses the respondents' habitus, built in a dialectical relationship with the vulnerability determined by the disease. We adopted a qualitative approach and focused interviews as proposed by Merton, combined with the snowball technique, applied to groups related to sickle cell disease on social networks. Seven participants were selected because they were privileged informants with the disease, were over eighteen, lived in the Federal District, and were non-exclusive users of the Unified Health System. The interview material was categorized from the focal groups employed. The results indicated the following categories: biographical rupture, experience and coping strategies, and healthcare. It is necessary to sensitize professionals and the population about the challenging living conditions of people with sickle cell disease and the consolidation of public policies and care networks to accommodate this population.
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Affiliation(s)
- Jéssica Luciano da Costa
- Faculdade de Ceilândia, Universidade de Brasília. Campus Universitário, Centro Metropolitano, Ceilândia Sul. 72220-275 Brasília DF Brasil.
| | - Maria Inez Montagner
- Faculdade de Ceilândia, Universidade de Brasília. Campus Universitário, Centro Metropolitano, Ceilândia Sul. 72220-275 Brasília DF Brasil.
| | | | | | - Maria Célia Delduque
- Programa de Pós-Graduação em Saúde Coletiva, Universidade de Brasília. Brasília DF Brasil
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41
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Souza IMD, Araújo EMD, Silva Filho AMD. Incomplete recording of race/colour in health information systems in Brazil: time trend, 2009-2018. Cien Saude Colet 2024; 29:e05092023. [PMID: 38451645 DOI: 10.1590/1413-81232024293.05092023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/04/2023] [Indexed: 03/08/2024] Open
Abstract
This ecological study of time trends and multiple groups evaluated incompleteness in the race/colour field of Brazilian health information system records and the related time trend, 2009-2018, for the diseases and disorders most prevalent in the black population. The Romero and Cunha (2006) classification was applied in order to examine incompleteness using secondary data from Brazil's National Notifiable Diseases System, Hospital Information System and Mortality Information System, by administrative regions of Brazil, while percentage underreporting and time trend were calculated using simple linear regression models with Prais-Winsten correction (p-value<0.05). All records scored poorly except those for mortality from external causes (excellent), tuberculosis (good) and infant mortality (fair). An overall downward trend was observed in percentage incompleteness. Analysis by region found highest mean incompleteness in the North (30.5%), Northeast (33.3%) and Midwest (33.0%) regions. The Southeast and Northeast regions showed the strongest downward trends. The findings intended to increase visibility on the implications of the race/color field for health equity.
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Affiliation(s)
- Ionara Magalhães de Souza
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Av. Carlos Amaral, R. do Cajueiro, 1015. 44574-490 Santo Antônio de Jesus BA Brasil.
| | - Edna Maria de Araújo
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Feira de Santana (UEFS). Novo Horizonte BA Brasil
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Bezerra CC, Toledo NDN, Brucki SMD, Souza-Talarico JN. COVID-19 and Cognitive and Mental Health During Post-Infection Phase: A Study Among Middle-Aged and Older Indigenous Adults From Brazilian Amazons. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad197. [PMID: 38157407 DOI: 10.1093/geronb/gbad197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES To examine the rate of self-reported coronavirus disease-2019 (COVID-19) and its association with mental and cognitive health during the post-infection phase among middle-aged and older indigenous adults. METHODS A cross-sectional study was conducted, including 141 individuals ≥50 and over from an urban indigenous community in Amazonas, Brazil. COVID-19 was deduced from self-reported infections. Cognitive function was evaluated using the Mini-Mental State Exam, Brief Cognitive Screening Battery (BCSB), and language fluency tests. Meanwhile, mental health was assessed through validated scales examining happiness, stress, and depression symptoms. The association between the rate of COVID-19 and cognitive and mental well-being was analyzed using logistic and linear regressions, adjusted for covariates. RESULTS From March 2020 to February 2022, 65.2% of the urban indigenous group tested positive for COVID-19. Lower functional capacity decreased the odds of contracting COVID-19 (p = .03). Adjusted linear regression models showed that COVID-19 was associated with higher BCSB learning (p = .017) and delayed recall (p = .028). Women, higher age, lower functional capacity, and hospitalization were associated with worse cognitive performance (p < .05). No impact of mental health indicators on past COVID-19 infection was noted. DISCUSSION COVID-19 was prevalent among urban Indigenous Brazilians. Unexpectedly, it was linked to enhanced learning and memory, not mental health issues. Cognitive performance was lower for men, older individuals, those with less functional ability, and hospitalized patients, indicating that participant characteristics and disease severity affect the COVID-19 and cognition relationship. Longitudinal studies across diverse Indigenous communities are necessary to understand COVID-19's impact on their cognitive and mental health.
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Affiliation(s)
- Camila Carlos Bezerra
- Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
- School of Nursing at Manaus, Federal University of Amazonas, Manaus, Amazonas, Brazil
| | | | | | - Juliana Nery Souza-Talarico
- Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
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Guarnido-Rueda A, Amate-Fortes I, Oliver-Márquez FJ, Martínez-Navarro D. Income or educational attainment: which is more effective in the fight against overweight? Evidence from Spain and Andalusia. J Biosoc Sci 2024; 56:270-291. [PMID: 38044837 DOI: 10.1017/s0021932023000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual's overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease.
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Affiliation(s)
- Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Francisco J Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120, Almeria, Spain
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Madureira KG, Barsaglini R. The Mata Cavalo/Brazil quilombo and the COVID-19 syndemic: racism and the right to (r)exist in question. Cien Saude Colet 2024; 29:e08322023. [PMID: 38451651 DOI: 10.1590/1413-81232024293.08322023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 03/08/2024] Open
Abstract
Quilombola communities have felt the effects of racism deepened by COVID-19, whose repercussions are amplified in contexts of racial inequalities, characterizing it as a syndemic. The term refers to the synergy of biological, economic, environmental, political, and social elements that enhance coexisting conditions and states, impacting life and affecting health. Thus, our study seeks to analyze the repercussions of the COVID-19 syndemic based on the perceptions of quilombola community leaders in Mato Grosso, Brazil. In a qualitative study, three leaders were interviewed in May 2022, using a semi-structured script and treating the data through thematic analysis. The COVID-19 syndemic highlighted the structural precariousness of transport, roads, sanitation, and access to water, food, and health services. Isolation, deaths, and fears had psychosocial repercussions, but little attention was paid to mental health. Anti-racist proposals call for: repairing precariousness by recognizing the State's debt to the black population; valuing experiences, way of life, cosmovision, and Afro-centered ancestral civilizational values. Finally, the aim is to strengthen, reaffirm, and implement anti-racist actions, such as the Statute of Racial Equality and the PNSIPN, in all possible spaces, policies, and institutions.
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Affiliation(s)
- Kleber Gonçalves Madureira
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. R. Quarenta e Nove 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
| | - Reni Barsaglini
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso. R. Quarenta e Nove 2367, Boa Esperança. 78060-900 Cuiabá MT Brasil.
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Marchetti SP, Badagnan HF, Dumaressq L, Tófoli LFFD, Worcman NDC. [Healthcare difficulties among people who have a drug use problem: an integrative review]. Cien Saude Colet 2024; 29:e17712022. [PMID: 38451657 DOI: 10.1590/1413-81232024293.17712022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/13/2023] [Indexed: 03/08/2024] Open
Abstract
The scope of this study was to understand the difficulties involving healthcare for people with a drug use problem within the context of specialized mental health services, both nationally and internationally. It involves an integrative review conducted in the PubMed, LILACS, Web of Science, SCOPUS, and EMBASE databases, with the following key words: Drug Users; Mental Health Services; Health Care. Eighteen studies were selected, the inclusion criteria being primary studies, available in full, published in English, Spanish and Portuguese, between January 2016 and January 2021. The inclusion criteria were primary studies, available in full, published in English, Spanish and Portuguese, during the period from January 2016 through January 2021. The analysis identified that the difficulties in healthcare for people with a drug use problem are linked to the dimensions of public health policies, models of care adopted, and the stakeholders involved, and that these aspects are interrelated. It also emphasizes the need for specialized training, as well as further in-depth research that addresses the therapeutics of the drug use problem, and the development of new healthcare technologies for this population group.
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Affiliation(s)
- Silvana Proença Marchetti
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo. R. Prof. Hélio Lourenço 3900, Vila Monte Alegre. 14040-902 Ribeirão Preto SP Brasil.
| | | | - Leila Dumaressq
- Departamento de Saúde Coletiva, Universidade Estadual de Campinas. Campinas SP Brasil
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Mota CS, Lira ADS, Queiroz MCAD, Santos MPAD. Àgô Sankofa: an overview of the progression of sickle cell disease in Brazil in the past two decades. Cien Saude Colet 2024; 29:e06772023. [PMID: 38451649 DOI: 10.1590/1413-81232024293.06772023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/19/2024] [Indexed: 03/08/2024] Open
Abstract
Sickle cell disease (SCD) is an emblematic case of historical health neglect in Brazil and reflects how institutional racism produces health inequalities. This article engaged in a historical journey of this disease, showing the delayed implementation of health policies for people with sickle cell disease, often concealed in Public Power's (in)actions and omissions. The lack of commitment to implement the recommendations of the Brazilian Ministry of Health, such as neonatal screening, and the difficulty in incorporating technologies for health care result from this modus operandi. The advances and setbacks in programmatic actions and the constant pressure on several governmental entities have characterized the reported saga in the last twenty years. The present text discusses the policies for people with SCD, appropriating the Sankofa symbol, meaning that building the present is only possible by remembering past mistakes. Thus, we recognize this trajectory and this historical moment in which there is a concrete possibility of moving forward and achieving the longed-for comprehensive care for people with SCD. There is an invitation to glance at a new perspective, one in which hope is the trigger for the movements needed to guarantee the rights of people with SCD.
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Affiliation(s)
- Clarice Santos Mota
- Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Basílio da Gama s/n, Canela. 40110-040 Salvador BA Brasil.
- GT Racismo e Saúde, Associação Brasileira de Saúde Coletiva (Abrasco). Rio de Janeiro RJ Brasil
| | | | | | - Márcia Pereira Alves Dos Santos
- GT Racismo e Saúde, Associação Brasileira de Saúde Coletiva (Abrasco). Rio de Janeiro RJ Brasil
- Faculdade de Odontologia, Universidade Federal do Rio de Janeiro. Rio de Janeiro RJ Brasil
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Gomes RF, Oliveira PSD, Silva MLO, Miranda SVCD, Sampaio CA. Therapeutic itineraries in health care in Quilombola communities. Cien Saude Colet 2024; 29:e01602023. [PMID: 38451635 DOI: 10.1590/1413-81232024293.01602023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/17/2023] [Indexed: 03/08/2024] Open
Abstract
This article aimed to map therapeutic itineraries in health care within rural Quilombola communities in the north of Minas Gerais, Brazil. This is a section of a qualitative research conducted in six visited communities. The data was collected through 18 individual interviews, analyzed using the theoretical-methodological framework of Therapeutic Itineraries, and organized into three empirical themes. The narratives allowed for understanding the paths taken in health care by the Quilombola population, identifying the components of the popular subsystem (natural resources, the use of teas and home remedies), the family subsystem (transmission of knowledge and cultural heritage of care), and the professional subsystem (hospital level, medical care, primary and specialized attention). The difficulties of access are not only due to geographical distances, but also broader aspects of social determination, such as institutional racism, low availability of services, the need for payment for transportation and medical procedures. In this sense, it is necessary to have an approach and interventions from public policies to address ethnic-racial, economic, and access inequalities in health care services.
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Affiliation(s)
- Rafael Fernandes Gomes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | - Pâmela Scarlatt Durães Oliveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | | | - Sérgio Vinícius Cardoso de Miranda
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
| | - Cristina Andrade Sampaio
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Montes Claros. Av. Rui Braga s/n, Vila Mauricéia. 39401-089 Montes Claros MG Brasil.
- Departamento de Saúde Mental e Saúde Coletiva, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
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de Almeida MS, Carneiro BR, Santos ARO, da Silva Pires CG, Santos FL, de Sousa ÁFL, de Sousa AR, Pereira Á, de Oliveira LB, Carneiro LM, Mendes IAC. Exploring men's health in medium and high complexity care in Brazil: A deductive thematic analysis of social determinants. Belitung Nurs J 2024; 10:96-104. [PMID: 38425679 PMCID: PMC10900053 DOI: 10.33546/bnj.3008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/05/2023] [Accepted: 12/28/2023] [Indexed: 03/02/2024] Open
Abstract
Background Men's health is influenced by a complex interplay of social, economic, and cultural determinants. Understanding how these aspects affect the health of adult cisgender men in medium and high-complexity healthcare settings is essential for improving healthcare services and promoting better health outcomes. Objective This study aimed to analyze the health status of adult cisgender men in medium and high-complexity healthcare settings based on social determinants and conditioners. Methods This study employed a qualitative design involving 45 adult cisgender men receiving care in medium/high complexity services in Bahia, Brazil. Semi-structured interviews were conducted from July 2019 to February 2020, and data were interpreted based on Dahlgren and Whitehead's Model of Social Determinants of Health using deductive thematic analysis. Results Proximal determinants included biological aspects, preventive behaviors, lifestyle/social life, and aging processes. Intermediate factors included work conditions, access/utilization of healthcare services/medications, and psychosocial factors. Macro determinants involved income distribution, power dynamics, resource allocation, health inequalities/iniquities, morbidity, culture, political decisions, environmental factors, and structural elements. Conclusion The health status of men in medium/high complexity care was profoundly influenced by structural social determinants. These determinants impacted healthcare attention, service organization, cultural influences, the reproduction of hegemonic masculinity patterns, lifestyle, social support, and socioeconomic conditions necessary to realize the right to health. Nursing practices should conduct comprehensive assessments that extend beyond physical health indicators.
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da Silva PH, Ferreira Júnior WS, Zank S, do Nascimento ALB, de Abreu MC. The influence of exotic and native plants on illnesses with physical and spiritual causes in the semiarid region of Piauí, Northeast of Brazil. J Ethnobiol Ethnomed 2024; 20:24. [PMID: 38409039 PMCID: PMC10895823 DOI: 10.1186/s13002-024-00667-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Local medical systems (LMS) include native and exotic plants used for the treatment of diseases of physical and spiritual nature. The incorporation of exotic plants into these systems has been the subject of many studies. In this context, an analysis was conducted on the influence of the origin of plants on diseases of physical and spiritual nature in order to evaluate the therapeutic versatility of native and exotic species in these therapeutic targets, to investigate whether exotic plants mainly fill gaps not met by native plants (diversification hypothesis), and identify which species are prioritized in the redundant targets in these two therapeutic groups in the rural community of Morrinhos, Monsenhor Hipólito, Piauí. METHODS Data collection took place in 2 stages. First, free lists and semi-structured interviews with local residents (n = 134) were conducted to survey plants used for therapeutic purposes and the associated illnesses. Then, another phase of interviews was carried out to evaluate the prioritization between native and exotic plants in redundant therapeutic targets. To test the diversification hypothesis (DH) in each group of illnesses, data were analyzed using generalized linear models (Poisson and Binomial GLMs); versatility was measured by the number of therapeutic indications and compared between resources using the Mann-Whitney test, and prioritization in each group was verified by comparing the proportions of native and exotic plants with the χ2 test. RESULTS One hundred and thirty-two species of plants were surveyed, being 71 exotic and 61 native, with indications for physical and spiritual illnesses. The results revealed that the diversification hypothesis did not explain the inclusion of exotic plants in the local medical system to treat physical or spiritual illnesses and that the therapeutic versatility of exotic and native resources in the two groups was also similar (p > 0.05). However, exotic plants were prioritized in illnesses with physical causes and native plants in illnesses with spiritual causes. CONCLUSIONS The local medical system presents similar and distinct patterns in the therapeutic targets, depending on the perspective evaluated. Therefore, it is necessary to investigate the patterns of use of medicinal plants in different sociocultural contexts in order to broaden the debate about the role of plant origin in the selection of treatments for illnesses with different causes.
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Affiliation(s)
- Paulo Henrique da Silva
- Programa de Pós-Graduação em Biodiversidade e Conservação (PPGBC), Universidade Federal do Piauí (UFPI), Floriano, Piauí, Brazil.
| | | | - Sofia Zank
- Laboratório de Ecologia Humana e Etnobotânica (ECOHE), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - André Luiz Borba do Nascimento
- Programa de Pós-Graduação em Biodiversidade e Conservação (PPGBC), Universidade Federal do Maranhão (UFMA), São Luís, Maranhão, Brazil
| | - Maria Carolina de Abreu
- Programa de Pós-Graduação em Biodiversidade e Conservação (PPGBC), Universidade Federal do Piauí (UFPI), Floriano, Piauí, Brazil
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Duque E, Durán Vázquez JF. Working conditions and attitudes towards work: the case of Portuguese youth from Braga. Front Sociol 2024; 9:1356527. [PMID: 38419916 PMCID: PMC10899689 DOI: 10.3389/fsoc.2024.1356527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
The purpose of this study is to explore the working conditions and attitudes towards work among the youth of Braga, Portugal. Focusing on residents of the Municipality of Braga born between 1990 and 2000, we employed a quantitative approach using a non-probabilistic convenience sampling method, with a sample size of 406 people. The survey, conducted through questionnaires, reveals a complex interplay between the youth's work attitudes and their conditions. Despite the predominance of precarious employment, their work experiences and expectations do not entirely reflect this instability. Our findings suggest a shift in the role of work in the youths' identity compared to previous generations. This shift, common in post-industrial societies, shows that their identity is increasingly tied to the sociability their work enables and other life spheres where they seek fulfilment, as evidenced by how they utilize their earnings from these occupations.
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Affiliation(s)
- Eduardo Duque
- Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa & Communication and Society Research Centre (CECS) of the University of Minho, Braga, Portugal
| | - José F Durán Vázquez
- Department of Sociology, Political Science and Management and Philosophy, Universidade of Vigo, Vigo, Spain
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