Os impactos dos racismos nas ocupações da população negra: reflexões para a terapia e a ciência ocupacional / The impacts of racisms on the occupations of the Black population: reflections for occupational therapy and science

Resumo No Brasil, os racismos são estruturais e estruturantes, pois estão enraizados nos arcabouços das sociedades, nas relações interpessoais e nas instituições, atravessando as ocupações significativas dos sujeitos e coletivos. Isto explica as disparidades em diversos setores da sociedade brasileira, notadamente na empregabilidade das pessoas negras, bem como nos seus modos de adoecer e morrer. Entendendo o papel que os racismos desempenham nas ocupações das pessoas negras, este estudo propõe sistematizar observações que nos permitam compreender o fenômeno da produção de injustiças, com base em relações racializadas e, eventualmente, sugerir formas de enfrentamento dessa realidade. Desta forma, discutimos como os racismos foram instaurados no Brasil, reunindo elementos para a compreensão da ocupação humana e seus condicionantes. Em seguida, refletimos sobre os conceitos de justiça e injustiça ocupacional, que evidenciam os processos ocupacionais vivenciados pelas pessoas negras. Considerando que na terapia ocupacional e na ciência ocupacional brasileira ainda são incipientes os estudos que relacionam racismos e ocupação, apontamos algumas estratégias para reorientar as práticas profissionais de terapeutas ocupacionais, de modo a torná-las proativas e transformadoras.

Abstract In Brazil, the many forms of racisms are structural and structuring, since they are rooted deep within society, in interpersonal relationships, and in institutions, traversing significant occupations of subjects and collectives. This explains the disparities in various sectors of Brazilian society, notably in the employability of Black people, as well as in their forms of getting sick and dying. In understanding the role that racisms play in the occupations of Black people, this study proposes to systematize observations that allow us to understand the phenomenon of the production of injustices based on racialized relations and, eventually, suggest ways to confront this reality. Thus, we discuss how racisms were established in Brazil, gathering elements for the understanding of human occupation and its conditioning factors. We then reflect on the concepts of occupational justice and injustice, which bring light to the occupational processes experienced by Black people. Considering that, in occupational therapy and in Brazilian occupational science, studies relating racisms and occupation are still incipient, we point out some strategies to reorient occupational therapists, practices to make them proactive and transformative.

Organizações sociais civis em tempos de pandemia: um relato a partir do conceito de reconstrução ocupacional coletiva / Civil society organizations in times of pandemic: a report from the concept of collective occupational reconstruction

RESUMO Introdução Este artigo relata ações coletivas desenvolvidas por participantes de duas Organizações Sociais Civis representantes de pessoas com diagnóstico de esclerose múltipla, localizadas na região Sul do Brasil, durante o período da pandemia de COVID-19. Objetivo Evidenciar as estratégias e ações que constituíram parte do processo de reconstrução ocupacional coletiva das Organizações Sociais Civis. Portanto, descreve os resultados de processos coletivos a partir da reflexão sobre os fenômenos observados pelas autoras. Método Trata-se de um trabalho descritivo, do tipo relato de experiência, com a abordagem qualitativa. As práticas ocorreram de forma remota durante o período da pandemia (entre março e dezembro de 2020). Resultados Verificou-se que os dispositivos de mídias sociais contribuíram para a manutenção das ocupações coletivas do grupo, facilitando o processo de reconstrução ocupacional coletiva das Organizações Sociais Civis. Entre os dispositivos utilizados, destaca-se os aplicativos de mensagens e de videochamadas, que facilitaram o desenvolvimento das práticas coletivas, minimizando os impactos negativos do distanciamento físico. Conclusão Os dispositivos de mídias sociais apresentam-se como recursos potentes para a manutenção do fazer coletivo e nos processos de reconstrução ocupacional.

ABSTRACT Introduction This article reports collective actions developed by participants of two Civil Society Organizations representing people diagnosed with multiple sclerosis, located in southern Brazil, during the period of the COVID-19 pandemic. Objective To highlight the strategies and actions that comprised part of the collective occupational reconstruction process of the Civil Society Organizations. Therefore, it describes the results of collective processes, based on reflection on the phenomena observed by the authors. Method This is a descriptive, qualitative research based on an experience report. The practices occurred remotely during the pandemic period (March to December 2020). Results It was found that social media platforms contributed to maintain the collective occupations of the group, facilitating the process of collective occupational reconstruction of Civil Society Organizations. Among the used tools, instant messaging and video calling applications stood out, which facilitated the development of collective practices, thus minimizing the impacts of physical distance. Conclusion Social media platforms are powerful resources to maintain collective action and occupational reconstruction processes.

"Nós, mulheres quilombolas, sabemos a dor uma da outra": uma investigação sobre sororidade e ocupação / "We, quilombola women, know each other's pain": an investigation on sisterhood and occupation

Resumo Introdução No Brasil, as mulheres quilombolas foram e são essenciais para a sobrevivência dos quilombos. Elas são as responsáveis por transmitir as tradições, preservar os recursos naturais e cuidar do lar e da terra. Assim, os marcadores históricos de organização social e familiar orientam a produção e reprodução de seus papéis ocupacionais nesse contexto. Objetivos Neste artigo, refletimos sobre a insurgência das mulheres quilombolas a partir da peculiaridade da sororidade, dororidade e disparidade de gênero nas ocupações de mulheres quilombolas. Método Esta reflexão resultou de estudo conduzido com nove mulheres residentes em um quilombo localizado no interior do estado da Bahia, Brasil, através de entrevistas, escrevivências e uso do método Photovoice. Resultados O estudo evidenciou que as ocupações realizadas pelas participantes são atravessadas pelo gênero e condicionadas pelo racismo e sexismo, além dos modos peculiares de funcionamento interno do grupo e das formas tradicionais de vida no quilombo. Conclusões As mulheres assumem a maior parte do gerenciamento do quilombo da Pinguela através do senso de coletividade e união, que permite que elas articulem uma contínua rede de solidariedade e apoio. No Brasil, os estudos sobre o trabalho de terapeutas ocupacionais com mulheres quilombolas são escassos; portanto, sugerimos que, em sua prática profissional, terapeutas ocupacionais assumam um compromisso ético-político e adotem perspectivas críticas articuladas a partir do feminismo afro-latino-americano para desenvolver práticas coletivas como forma de intervenção.

Abstract Introduction In Brazil, the quilombola women have been essential for the survival of the quilombo communities. They are responsible for transmitting traditions, preserving natural resources, and caring for the home and the land. Thus, the historical markers of social and family organization guide the production and reproduction of their occupational roles in this context. Objectives In this article, we reflect on the insurgence of quilombola women from the peculiarity of sisterhood, dororidade, and gender disparity in these women's occupations. Method This reflection resulted from a study conducted with nine women residing in a quilombo community located in the interior of the state of Bahia, Brazil, through interviews, escrevivências (live writing) and Photovoice. Results The study evidenced that occupations performed by the participants are crossed by gender and conditioned by racism and sexism, in addition to the peculiar modes of the internal functioning of the group and the traditional ways of life in this community. Conclusions Women assume most of the management of the Pinguela quilombo community through the sense of collectivity and union that allows them to combine a continuous network of solidarity and support. In Brazil, studies on the work of occupational therapists with quilombola women are scarce; therefore, we suggest that occupational therapists, in their professional practice, assume an ethical-political commitment and adopt critical perspectives from Afro-Latin-American feminism to develop collective practices as a form of intervention.

Health Access of Women in Provincial Correctional Institutions.

Historically, there has been a disparity between men and women rates of incarceration, even though there has been a significant increase in the number of women imprisoned over the past 20 years, globally. Women have unique health care needs that are often not adequately addressed within the correctional institutions in which they are held. The focus of this study was to explore women's experiences when accessing health services within Canadian provincial correctional institutions. Narrative inquiry was used to investigate the life stories of five women who accessed health care in provincial correctional institutions. A total of two storylines and five sub-storylines resulted from the analysis of interviews conducted with the participants. The findings suggest that during incarceration, participants experienced compromising conditions that contributed to the worsening of their health, and faced difficulties accessing their prescribed treatments and medications. Consequently, this contributed to the worsening of their physical and mental wellbeing.

Schizophrenia and work: aspects related to job acquisition in a follow-up study

Objective: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. Method: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale - PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression - CGI), functionality (Global Assessment of Functioning - GAF), personal and social performance (Personal and Social Performance - PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia - MATRICS battery) were applied at baseline and at the end of the study. Results: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). Conclusions: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.

Schizophrenia and work: aspects related to job acquisition in a follow-up study.

OBJECTIVE: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. METHOD: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale - PANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression - CGI), functionality (Global Assessment of Functioning - GAF), personal and social performance (Personal and Social Performance - PSP) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia - MATRICS battery) were applied at baseline and at the end of the study. RESULTS: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). CONCLUSIONS: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.

Illustrating the Importance of Critical Epistemology to Realize the Promise of Occupational Justice.

This article argues that it is vital to embrace critical reflexivity to interrogate the epistemological beliefs and principles guiding occupation-based scholarship to move away from frameworks that are incongruent with calls for occupational justice. For this purpose, we describe an epistemic tension between the stated intentions to demonstrate that occupation-based work can be a means to create a more just society and the epistemological beliefs that have historically dominated occupation-based scholarship. To exemplify the potential implications of this tension, a critical analysis of Creswell's social justice/transformative design is presented, illustrating that work that expresses a commitment to social justice while relying on positivist/postpositivist assumptions often risks perpetuating injustices through neglecting their sociopolitical construction. Drawing upon critical social theory, we highlight how engagement with critical epistemological assumptions can facilitate addressing the sociopolitical "roots" of occupational injustices and highlight directions for social transformation.

Social occupational therapy: conversations about a Brazilian experience.

BACKGROUND: Researchers and practitioners worldwide have advocated for the development of critical perspectives in occupational therapy to examine the structural influences of social exclusion and injustice experienced by individuals, groups, and communities. To take action against social exclusion and injustice, Brazilian occupational therapists have been developing "social occupational therapy," referring to practice that is focused on social issues and funded outside the health system. PURPOSE: This paper presents a Brazilian perspective on the concept and practice of social occupational therapy. Illustrations are drawn from 12 studies, developed between 2008 and 2013, which were completed with socially vulnerable youth through an ongoing university-community engagement partnership in São Carlos, São Paulo State, Brazil. KEY ISSUES: The authors discuss possibilities and challenges for developing a socially committed, transformative occupational therapy outside the health system. IMPLICATIONS: Occupational therapists may wish to seize opportunities to address social issues and attract funding beyond health services.

Directions for advancing the study of work transitions in the 21st century.

OBJECTIVES: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada. PARTICIPANTS: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society. METHODS: A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know. FINDINGS: Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions. CONCLUSIONS: Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work.

Immigrant women's experiences of receiving care in a mobile health clinic.

AIM: This paper is a report of a study of the experiences of Portuguese-speaking immigrant women who used a mobile health clinic for their reproductive health care. BACKGROUND: Upon arrival in Canada, immigrant women often are in better health than their Canadian-born counterparts; however, this health status tends to deteriorate over time. One reason for this change is limited access to services. METHOD: Data collection during 2004 and 2005 involved individual interviews with seven Portuguese-speaking women who received care in a mobile health clinic in Toronto, Canada, and with four clinic care providers. Non-participant observation of the interaction between clients and care providers was also conducted. Interviews conducted in Portuguese were translated into English and transcribed, along with those conducted in English. Interview transcripts were read and re-read in the context of observational notes to develop codes. Emerging codes were grouped together to develop subcategories and categories. FINDINGS: Participants' experiences of accessing and receiving care in the mobile health clinic were shaped by their perceptions of health, which included physical, mental, social and spiritual aspects, and their pre- and postmigration care experiences. As an alternative model of care delivery, the mobile health clinic was perceived by participants to address their care needs and to help overcome postmigration barriers by providing accessible, holistic, and linguistically and culturally appropriate care. CONCLUSION: Mobile health clinics should be considered as an alternative care delivery model for immigrant women who may be at a disadvantage because of their socio-economic, cultural, and racialized statuses.

Undocumented migrants in Canada: a scope literature review on health, access to services, and working conditions.

It is estimated that there are 30-40 million undocumented workers worldwide. Although undocumented migration has become an issue of high international relevance, it has been strikingly understudied in Canada, especially with respect to its impact on health. The purpose of this study is to explore the concept of undocumentedness in Canada through a scoping review of peer-reviewed and grey literature written in English, French, Portuguese and Spanish between 2002 and 2008. The specific aims are to: (i) summarize and disseminate current academic and community-based findings on the health, service access and working conditions of undocumented migrants in Canada; (ii) examine the sources and use of evidence; (iii) identify significant gaps in existing knowledge; (iv) set recommendations for policy and research, including considerations on transnationalism, ethics, interdisciplinary approaches, gender differences, resilience, and impact on the children of non-status parents.