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1.
J Ambul Care Manage ; 45(1): 13-21, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34392258

RESUMEN

Federally Qualified Health Centers (FQHCs) have been essential in response to COVID-19 outbreaks among vulnerable populations. Our rural FQHC had a primary role in early detection of and response to a poultry plant-related outbreak at the outset of the pandemic that disproportionately and gravely affected the local Hispanic community. The health center activated a rapid local response that included the community's first mass testing event and first acute respiratory treatment clinic, both of which were central to abatement. Lessons learned from this experience provide important guidance for the potential role of FQHCs in infection outbreak preparedness in marginalized communities.


Asunto(s)
COVID-19 , Instituciones de Atención Ambulatoria , Humanos , Pandemias , SARS-CoV-2 , Poblaciones Vulnerables
3.
Vínculo ; 18(3): 34-39, set.-dez. 2021.
Artículo en Portugués | LILACS, Index Psicología - Revistas | ID: biblio-1347945

RESUMEN

Grupo de psicóticos, defronta com desamparo frente à mudança de setting para cidade vizinha. A característica comum é que todos os componentes são egressos de internação psiquiátrica, onde foram atendidos em grupo terapia pelo respectivo terapeuta. Viveram momentos regredidos, desagregados e desamparados pela doença. No tratamento multidisciplinar hospitalar criou-se forte vínculo terapêutico, que prosseguiu no consultório. Este grupo adquiriu a característica psicodinâmica trazida da experiência institucional. Portanto, no consultório experimentamos um setting dinâmico, além da sala: (parque público, caminhadas, praça de alimentação de shopping, comemorações na sala, pão de queijo, etc.). Assim estamos juntos por mais de quinze anos.


Group of psychotics faces helplessness facing the change of setting to neighboring city. The common feature is that all components are discharged from psychiatric hospitalization, where they were treated in group therapy by the respective therapist. They lived moments regressed, disaggregated and helpless by the disease. In hospital multidisciplinary treatment, a strong therapeutic bond was created, which continued in the office. This group acquired the dynamic psycho characteristic brought from institutional experience. Therefore, in the office we experimented with a dynamic setting in addition to the room: (public park, hiking, mall food court, room celebrations, cheese bread, etc.). So we have been together for over fifteen years.


Grupo de psicóticos, se enfrenta a la impotencia ante el cambio de escenario a la ciudad vecina. La característica común es que todos los componentes son dados de alta de la hospitalización psiquiátrica, donde fueron tratados en terapia grupal por su terapeuta. Vivieron momentos regresados, desglosados e indefensos por la enfermedad. En el tratamiento hospitalario multidisciplinario, se creó un fuerte vínculo terapéutico, que continuó en la oficina. Este grupo adquirió la característica psicótica dinámica traída de la experiencia institucional. Por lo tanto, en la oficina, experimentamos un entorno dinámico más allá de la sala: (parque público, senderismo, patio de comidas, fiestas, pan de queso, etc.). Así que hemos estado juntos por más de quince anos.


Asunto(s)
Humanos , Psicoterapia de Grupo , Trastornos Psicóticos , Poblaciones Vulnerables , Apego a Objetos
5.
Cien Saude Colet ; 26(10): 4749-4759, 2021 Oct.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34730660

RESUMEN

This article aims to assess the association between being a prisoner or homeless and treatment failure in cases of tuberculosis diagnosed in Brazil in 2015. We examined cases of tuberculosis in prisoners and the homeless in Brazil in 2015 reported to the national notifiable diseases information system using descriptive analysis and logistic regression. There were 82,056 cases of tuberculosis in 2015. Of these, 7,462 (10.3%) were prisoners and 2,782 (3.9%) were homeless. The rate of treatment success in prisoners was 78.6%, while the rate of failure in the homeless was 63.2%. Being a prisoner was a protective factor against treatment failure (adjusted odds ratio 0.68, 95%CI 0.63-0.73), while being homeless was a risk factor for treatment failure (adjusted odds ratio 2.38, 95%CI 2.17-2.61). Treatment success and failure rates differed between prisoners and the homeless. Our findings reinforce the need for public health policies tailored to the specific needs of these groups implemented in conjunction with social services and public security agencies in order to have a significant impact on TB incidence.


Asunto(s)
Personas sin Hogar , Prisioneros , Tuberculosis , Brasil/epidemiología , Humanos , Resultado del Tratamiento , Tuberculosis/tratamiento farmacológico , Tuberculosis/epidemiología , Poblaciones Vulnerables
6.
Acad Pediatr ; 21(8S): S126-S133, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34740419

RESUMEN

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. Rural children experience decreased availability and accessibility of primary care and specialty care (especially mental health care) due to a decreased number of health care providers as well as geographical and transportation-related barriers. Other geographic and socioeconomic determinants, especially concerning poverty and substandard housing conditions, are likely important contributors to the observed health disparities. Increased funding for research focused on rural populations is needed to provide innovative solutions for the unique health needs of rural children. Policy changes positioned to correct the trajectory of poor health among children should consider the needs of rural children as an under-researched and under-resourced vulnerable population.


Asunto(s)
Pobreza , Población Rural , Niño , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Humanos , Factores Socioeconómicos , Estados Unidos/epidemiología , Población Urbana , Poblaciones Vulnerables
7.
Rev Med Chil ; 149(6): 906-912, 2021 Jun.
Artículo en Español | MEDLINE | ID: mdl-34751350

RESUMEN

The Disability Qualification System in Chile and its regulations have inequities as they are applied in a general way and do not consider the peculiar characteristics of vulnerable populations. These people, who are mostly unprotected, have less access to health care levels and receive a lower quality of services. The authors, using a clinical case, we analyze the three main obstacles to obtain a disability pensión. A change in applicants' evaluation, considering a broader range of information on the process, a greater symmetry in the evaluated parameters, including biopsychosocial aspects and a better interrelation between Health Services and the Evaluation System would narrow the existing gap between vulnerable and non-vulnerable populations.


Asunto(s)
Personas con Discapacidad , Chile , Accesibilidad a los Servicios de Salud , Humanos , Poblaciones Vulnerables
8.
Eur J Public Health ; 31(Supplement_4): iv9-iv13, 2021 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-34751368

RESUMEN

Studies from several countries have shown that the COVID-19 pandemic has disproportionally affected migrants. Many have numerous risk factors making them vulnerable to infection and poor clinical outcome. Policies to mitigate this effect need to take into account public health principles of inclusion, universal health coverage and the right to health. In addition, the migrant health agenda has been compromised by the suspension of asylum processes and resettlement, border closures, increased deportations and lockdown of camps and excessively restrictive public health measures. International organizations including the World Health Organization and the World Bank have recommended measures to actively counter racism, xenophobia and discrimination by systemically including migrants in the COVID-19 pandemic response. Such recommendations include issuing additional support, targeted communication and reducing barriers to accessing health services and information. Some countries have had specific policies and outreach to migrant groups, including facilitating vaccination. Measures and policies targeting migrants should be evaluated, and good models disseminated widely.


Asunto(s)
COVID-19 , Migrantes , Control de Enfermedades Transmisibles , Humanos , Pandemias/prevención & control , SARS-CoV-2 , Poblaciones Vulnerables
10.
Artículo en Inglés | MEDLINE | ID: mdl-34769796

RESUMEN

BACKGROUND: Rat infestation is a major public health issue globally, and particularly in poor urban communities in South Africa. Rats pose significant threats to residents in the form of disease spread and sustained physical injuries. The dearth of knowledge about the experiences of affected residents may curtail the initiation of rat control programs. This study aimed to explore the lived experiences of rat infestation among residents of Katlehong Township in Gauteng Province. METHODS: This was a qualitative research study where data were gathered from selected community participants from Katlehong Township in Gauteng Province. A semi-structured interview guide was used to collect data through in-depth interviews. The interviews were digitally recorded and transcribed verbatim, and thematic data analysis was conducted using NVivo12 data processing software. The data were presented in themes and quotations that reflect the views of the participants. RESULTS: Exactly 20 community members aged between 18 and 56 years participated in the study, 80% being females. Over half of the participants were unemployed (60%), inclusive of students. Majority of the participants were either Zulu or Xhosa speakers. Several themes emerged from the data, which included the residents' experiences of rat infestation, troublesome rats, dirty rats, reasons for rat infestation, and sustained physical injuries. Participants intimated that waste in the environment and overcrowding in homes contributed to rodent infestation. CONCLUSION: Rat infestation remains a problem that causes severe distress among the residents of Katlehong Township. The experiences reported varied from psychological trauma to bite injuries and destruction of household property. Effective rodent control strategies need to be put in place to manage both the physical and mental risks posed by rat infestation in socially underprivileged communities.


Asunto(s)
Relaciones Interpersonales , Poblaciones Vulnerables , Animales , Femenino , Humanos , Masculino , Investigación Cualitativa , Ratas , Sudáfrica
11.
Artículo en Inglés | MEDLINE | ID: mdl-34769798

RESUMEN

Mental health promotion of economically disadvantaged youths is a popular issue in current China. Economically disadvantaged youths are at greater risk of depression. Ostracism may be an important predictor of depression for them. However, no consensus has been reached on the underlying mechanism between ostracism and depression. A total of 1207 economically disadvantaged youths were recruited from six universities in China. These youths were asked to complete questionnaires measuring depression, ostracism, psychological capital, and perceived social support. A moderated mediation model was examined by using IBM SPSS STATISTICS 27macro program PROCESS version 3.5, in which psychological capital was a mediating variable, and perceived social support was a moderating variable. Lack of causal inferences and self-report bias due to the cross-sectional and self-report survey need to be considered when interpreting results. The results revealed that ostracism was positively associated with depression among economically disadvantaged youths. Psychological capital partially mediated the association. Perceived social support moderated the indirect association between ostracism and depression via psychological capital among economically disadvantaged females. Training and intentional practice of psychological capital could be the core to develop the depression interventions targeting economically disadvantaged youths with experience of ostracism. Gender and perceived social support need to be considered in developing the interventions.


Asunto(s)
Capital Social , Aislamiento Social , Adolescente , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Apoyo Social , Poblaciones Vulnerables
13.
Methodist Debakey Cardiovasc J ; 17(4): 15-27, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34824678

RESUMEN

Disease prevention frameworks and clinical practice guidelines in the United States (US) have traditionally ignored upstream social determinants of health (SDOH), which are critical for reducing disparities in cardiovascular disease (CVD)-the leading cause of death in the US. Existing evidence demonstrates a protective effect of social support, social cohesion, and community engagement on overall health and wellbeing. Increasing community and social support is a major objective of the Healthy People 2030 initiative, with special provisions for vulnerable populations. However, to date, existing evidence of the association between community and social context (CSC)-an integral SDOH domain-and CVD has not been reviewed extensively. In particular, the individual and cumulative impact of CSC on CVD risk and the pathways linking CSC to cardiovascular outcomes are not well understood. In this review, we critically appraise current knowledge of the association between CSC and CVD, describe potential pathways linking CSC to CVD, and identify opportunities for evidence-based policy and practice interventions to improve CVD outcomes.


Asunto(s)
Enfermedades Cardiovasculares , Determinantes Sociales de la Salud , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/terapia , Atención a la Salud , Humanos , Estados Unidos/epidemiología , Poblaciones Vulnerables
14.
Adv Health Care Manag ; 202021 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-34779184

RESUMEN

Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.


Asunto(s)
COVID-19 , Humanos , Atención Primaria de Salud , SARS-CoV-2 , Encuestas y Cuestionarios , Poblaciones Vulnerables
15.
Washington, D.C.; PAHO; 2021-11-16.
No convencional en Inglés | PAHO-IRIS | ID: phr-55194

RESUMEN

This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and analyzed at the regional level. In addition to presenting the epidemiological and programmatic situation of TB in the Americas, the report aims to raise awareness and to motivate and encourage all stakeholders in the prevention and control of this disease, to accelerate efforts towards TB elimination in the Region, and to achieve the targets of the End TB Strategy. The report records the Region's achievements, but also the gaps in the work being carried out in diagnosis, treatment, comorbidities, vulnerable populations, risk factors, and funding, among other issues. Based on the information presented, specific recommendations are provided for further progress.


Asunto(s)
Tuberculosis , Epidemiología , Mortalidad , VIH , Poblaciones Vulnerables , Pueblos Indígenas , Salud de Poblaciones Indígenas , Factores de Riesgo , Adolescente , Salud del Adolescente , Niño , Salud del Niño , Américas
16.
Pan Afr Med J ; 39: 277, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34754354

RESUMEN

Introduction: malnutrition due to inadequate food supply is a major challenge in low- and middle-income countries. The purpose of this study is to identify the sociocultural drivers of malnutrition. Methods: we conducted a qualitative study in the Amoron´I Mania region, Madagascar. The study involved pregnant women, mothers and fathers, grandmothers and health actors such as "matrones", community workers and health workers. A total of 24 semi-structured individual interviews and 6 focus groups were used to collect data. Thematic analysis was used. Results: malnutrition refers to a lack of food and undernourishment. It revolves around the amount of rice consumption, socio-cultural factors and insufficient financial resources. Vulnerable groups were mainly composed of children and pregnant women. Severe malnutrition including signs was reported, but there was evidence for local adaptation. Thus, families were trying by different means to fight against malnutrition. Conclusion: the socio-cultural context modulates knowledge and perception of the causes, the manifestations and the vulnerability or non-vulnerability of an individual as well as the severity of malnutrition.


Asunto(s)
Abastecimiento de Alimentos , Conocimientos, Actitudes y Práctica en Salud , Desnutrición/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Grupos Focales , Personal de Salud/estadística & datos numéricos , Humanos , Entrevistas como Asunto , Madagascar/epidemiología , Masculino , Desnutrición/fisiopatología , Persona de Mediana Edad , Percepción , Embarazo , Investigación Cualitativa , Índice de Severidad de la Enfermedad , Poblaciones Vulnerables/estadística & datos numéricos , Adulto Joven
17.
Rev Lat Am Enfermagem ; 29: e3488, 2021.
Artículo en Inglés, Español, Portugués | MEDLINE | ID: mdl-34730764

RESUMEN

OBJECTIVE: to map the indicators of Good Nursing Practices in Primary Health Care, from the perspective of Collective Health, reported to the vulnerable social groups. METHOD: this is a scoping review according to the PRISMA Extension for Scoping Reviews. The searches were carried out in2020 in six databases and in a virtual library. Independent reviewers performed the reading of the full texts, as well as treatment, analysis and synthesis of the content. RESULTS: a total of 13 articles were found, the first from 2007 and the last from 2020. The data were classified according to the following empirical categories: assessment and control of health conditions(3 indicators); assessment of knowledge about health(3 indicators); use of sociodemographic characteristics to estimate risks or vulnerabilities(3 indicators); assessment and monitoring of health needs(5 indicators); promotion of safety and trust in health services(6 indicators); and assessment of the care process(4 indicators). CONCLUSION: the articles showed a variety of indicators that assess the interventions carried out in the context of Nursing in Primary Care with vulnerable social groups. These indicators are related to health conditions, especially those of the biopsychological body, reported to vulnerable populations, especially women, children, adolescents and older adults.


Asunto(s)
Atención Primaria de Salud , Poblaciones Vulnerables , Adolescente , Anciano , Niño , Servicios de Salud , Humanos
18.
BMC Med Educ ; 21(1): 589, 2021 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-34801016

RESUMEN

BACKGROUND: Accessing subspecialty care is hard for underserved patients in the U.S. Published curricula in underserved medicine for Internal Medicine residents target future-primary care physicians, with unknown impact on future medicine subspecialists. METHODS: The aim was to retain interest in caring for underserved patients among Internal Medicine residents who plan for subspecialist careers at an urban university hospital. The two-year Underserved Medicine and Public Health (UMPH) program features community-based clinics, evening seminars, reflection assignments and practicum projects for 3-7 Internal Medicine residents per year. All may apply regardless of anticipated career plans after residency. Seven years of graduates were surveyed. Data were analyzed using descriptive statistics. RESULTS: According to respondents, UMPH provided a meaningful forum to discuss important issues in underserved medicine, fostered interest in treating underserved populations and provided a sense of belonging to a community of providers committed to underserved medicine. After residency, 48% of UMPH graduates pursued subspecialty training and 34% practiced hospitalist medicine. 65% of respondents disagreed that "UMPH made me more likely to practice primary care" and 59% agreed "UMPH should target residents pursuing subpecialty careers." CONCLUSIONS: A curriculum in underserved medicine can retain interest in caring for underserved patients among future-medicine subspecialists. Lessons learned include [1] building relationships with local community health centers and community-practicing physicians was important for success and [2] thoughtful scheduling promoted high resident attendance at program events and avoided detracting from other activities required during residency for subspecialist career paths. We hope Internal Medicine residency programs consider training in underserved medicine for all trainees. Future work should investigate sustainability, whether training results in improved subspecialty access, and whether subspecialists face unique barriers caring for underserved patients. Future curricula should include advocacy skills to target systemic barriers.


Asunto(s)
Internado y Residencia , Poblaciones Vulnerables , Selección de Profesión , Curriculum , Humanos , Salud Pública
19.
Int J Public Health ; 66: 584308, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34744556

RESUMEN

Objectives: The concept of vulnerability has been used more frequently in several studies, in an attempt to better understand the specificities and needs of different population groups, both in environmental and socio-economical terms. The aim of this study is to identify, characterize and analyze populations in situations of socio-environmental vulnerability in the city of Rio de Janeiro, based on social, economic, environmental and public health indicators organized into a summary index - the Socio-Environmental Vulnerability Index. Methods: The methodology integrated 15 indicators in a Multi-Criteria Decision Analysis into a Geographic Information System. Results: According to our results, socio-environmental vulnerability in Rio de Janeiro is aggravated by at-risk situations and environmental degradation. These aspects are jeopardized by the population density in slum areas, where the most disadvantaged groups live in a process of environmental and urban exclusion. Conclusion: The study concludes about the importance of these tools in guiding resource allocation and their contribution to formulating and implementing more effective public policies.


Asunto(s)
Ambiente , Poblaciones Vulnerables , Brasil , Ciudades , Sistemas de Información Geográfica , Humanos , Áreas de Pobreza , Factores Socioeconómicos
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