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1.
Rev. enferm. UERJ ; 28: e39222, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116097

RESUMEN

Objetivo: desenvolver uma reflexão teórica-reflexiva acerca da vulnerabilidade e suas dimensões nos cuidados de enfermagem aos grupos humanos. Conteúdo: Trata-se de uma análise reflexiva, fundamentada no referencial de vulnerabilidade e direitos humanos, que promoveu uma reflexão acerca do tema proposto, com o propósito de uma aprendizagem prática- reflexiva a partir da imersão nos contextos práticos-teóricos sobre o tema, para tecer uma análise de como as dimensões da vulnerabilidade podem ser trabalhadas com os cuidados de enfermagem aos diversos grupos humanos. Considerações finais: Verifica-se, a partir desse estudo, que a vulnerabilidade envolve a combinação de elementos que refletem na dimensão individual, social e programática e estão associadas às experiências de facilidade e dificuldades impostas pelo processo saúdedoença relacionadas ao modo de vida de cada grupo e aos cuidados de enfermagem prestados.


Objective: to develop a reflective and theoretical discussion about vulnerability and its dimensions in nursing care for human groups. Content: this reflective analysis, framed by reference to vulnerability and human rights, conducted group thinking on the proposed theme, with a view to practical and theoretical learning through immersion in related practical and theoretical contexts, so as to build an analysis of how dimensions of vulnerability can be addressed by nursing care for diverse human groups. Final considerations: this study found that vulnerability involves a combination of components reflected in the individual, social and programmatic dimensions and associated with experiences of difficulties and solutions imposed by the health-disease process. related to the lifestyle of each group and the nursing care provided.


Objetivo: desarrollar una discusión reflexiva y teórica sobre la vulnerabilidad y sus dimensiones en el cuidado de enfermería para grupos humanos. Contenido: este análisis reflexivo, enmarcado en referencia a la vulnerabilidad y los derechos humanos, realizó un pensamiento grupal sobre el tema propuesto, con miras al aprendizaje práctico y teórico a través de la inmersión en contextos prácticos y teóricos relacionados, a fin de construir un análisis de cómo las dimensiones de La vulnerabilidad puede ser abordada por el cuidado de enfermería para diversos grupos humanos. Consideraciones finales: este estudio encontró que la vulnerabilidad implica una combinación de componentes reflejados en las dimensiones individuales, sociales y programáticas y asociados con experiencias de dificultades y soluciones impuestas por el proceso de salud-enfermedad. relacionado con el estilo de vida de cada grupo y la atención de enfermería brindada.


Asunto(s)
Humanos , Poblaciones Vulnerables , Vulnerabilidad en Salud , Relaciones Enfermero-Paciente , Atención de Enfermería/tendencias , Equidad en Salud , Acogimiento
2.
Rev. enferm. UERJ ; 28: e39729, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116093

RESUMEN

Objetivo: identificar as principais causas de óbito entre adolescentes de 10 a 19 anos em um município no interior do estado do Rio de Janeiro. Método: estudo descritivo, exploratório de abordagem quantitativa, a partir do levantamento de dados em registros de óbitos do município de Rio das Ostras. O desfecho foi causa básica do óbito. Os dados foram processados no Programa R. Resultados: foram observados 84 (100%) óbitos, com maior prevalência entre adolescentes de 17 a 19 anos, 49 (58,3%), do sexo masculino, 71 (84,5%) e de cor parda, 38 (45,2%). As principais causas de óbitos foram homicídio/perfuração por arma de fogo, 35 (41,7%), e acidentes, 32 (38,1%). Conclusão: o reconhecimento dessa vulnerabilidade configura importante caminho para o enfrentamento e resolução desse grave problema, sobretudo municípios localizados longe de centros urbanos, parece muitas vezes esquecido, no que tange o cumprimento de estatutos e políticas públicas a favor desse grupo etário.


Objective: to identify the main causes of death among adolescents aged 10 to 19 years in a municipality in the state of Rio de Janeiro. Method: in this exploratory, descriptive, quantitative study, based on data collected from death records in the municipality of Rio das Ostras, the basic cause of death was the outcome. The data were processed in the statistics software, R. Results: of the 84 (100%) deaths observed, prevalence was higher among adolescents aged 17 to 19 years (49; 58.3%), males (71; 84.5%), and pardos (38; 45.2%). The main causes of deaths were firearm Injury / homicide (35; 41.7%) and accidents (32; 38.1%). Conclusion: one important step towards confronting and solving this serious problem is to acknowledge this vulnerability, especially in municipalities distant from urban centers, which often seem neglected as regards compliance with statutes and public policies in favor of this age group.


Objetivo: identificar las principales causas de muerte entre adolescentes de 10 a 19 años en un municipio del estado de Río de Janeiro. Método: en este estudio exploratorio, descriptivo, cuantitativo, basado en los datos recopilados de los registros de defunciones en el municipio de Rio das Ostras, la causa básica de la muerte fue el resultado. Los datos se procesaron en el programa estadístico R. Resultados: de las 84 (100%) muertes observadas, la prevalencia fue mayor entre los adolescentes de 17 a 19 años (49; 58.3%), varones (71; 84.5%) y pardos (38; 45,2%). Las principales causas de muerte fueron lesiones por arma de fuego / homicidio (35; 41.7%) y accidentes (32; 38.1%). Conclusión: un paso importante para enfrentar y resolver este grave problema es reconocer esta vulnerabilidad, especialmente en municipios alejados de los centros urbanos, que a menudo parecen descuidados en cuanto al cumplimiento de los estatutos y las políticas públicas a favor de este grupo de edad.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Accidentes/estadística & datos numéricos , Causas de Muerte , Poblaciones Vulnerables/estadística & datos numéricos , Homicidio/estadística & datos numéricos , Brasil , Epidemiología Descriptiva , Factores de Edad , Vulnerabilidad Social , Mortalidad Prematura
3.
Pan Afr Med J ; 35(Suppl 2): 142, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193957

RESUMEN

The COVID-19 pandemic continues to cause uncertainty to Uganda's food security among underprivileged households. The Corona virus Response Team inaugurated a relief food distribution campaign, ensuing from the countrywide COVID-19 lockdown to counter the rising food insecurities in many urban and rural poor households. However, the relief response campaign has received a lot of critics from both rural and urban communities who were planned as the beneficiaries. Three months into the COVID-19 pandemic the population reports; delays in the distribution, poor quality supplies, arrests and continued restrictions, slow paced distribution among household, and a negative impact on the health care system. As a learning from the current experience, we recommend; a multisectoral engagement, better planning, a decentralized food distribution, and formulation of clear food distribution guidelines to guide the future responses. Use of mobile cash transfers to reach out to the food insecure households can support local economies and lower the cost on middlemen and interrelated corruption.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Asistencia Alimentaria , Abastecimiento de Alimentos , Pandemias , Neumonía Viral/epidemiología , Composición Familiar , Asistencia Alimentaria/economía , Asistencia Alimentaria/organización & administración , Asistencia Alimentaria/estadística & datos numéricos , Abastecimiento de Alimentos/economía , Abastecimiento de Alimentos/estadística & datos numéricos , Humanos , Colaboración Intersectorial , Población Rural , Uganda/epidemiología , Poblaciones Vulnerables
4.
Int J Equity Health ; 19(1): 198, 2020 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-33158449

RESUMEN

While the coronavirus disease 2019 (COVID-19) pandemic is an ongoing worldwide, including South Korea (hereinafter Korea), it is impossible to predict the duration of the pandemic. To stop the spread of COVID-19, "social distancing," which included mandatory lockdown, and attention to personal hygiene are being adopted globally as non-pharmaceutical preventive strategies. In Korea, after maintaining strong social distancing rules for a while, the government transitioned to implementing "distancing in daily life" since May 6, 2020. The distancing in daily life was combined with infection prevention activities to stop the COVID-19 pandemic, while guaranteeing one's daily life and economic activities.In this regard, the Ministry of Health and Welfare in Korea disclosed key rules for personal quarantine. The five key rules for individual infection control are as follows: to stay at home for 3-4 days if you feel unwell, keep a distance of two arms' length from others, to wash your hands for 30 s and cough or sneeze into your sleeves, ventilate at least twice a day and disinfect regularly, and stay connected while physically distancing. However, for vulnerable populations, it is very difficult to follow such rules.Thus, we attempted to recommend how the society could support such vulnerable populations who may face difficulties in following these individual infection control rules. Through our recommendations for the weakest part of our society, we expect to strengthen the overall social structure.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Poblaciones Vulnerables , Infecciones por Coronavirus/epidemiología , Gobierno , Humanos , Higiene , Neumonía Viral/epidemiología , Cuarentena/legislación & jurisprudencia , República de Corea/epidemiología , Distancia Social
5.
J Acquir Immune Defic Syndr ; 85(4): e67-e69, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33136755

RESUMEN

BACKGROUND: COVID-19 is a new pandemic, and its impact by HIV status is unknown. National reporting does not include gender identity; therefore, data are absent on the impact of COVID-19 on transgender people, including those with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Areas (LITE) Study provide an opportunity to examine pre-COVID factors that may increase vulnerability to COVID-19-related harms among transgender women. SETTING: Atlanta, Baltimore, Boston, Miami, New York City, Washington, DC. METHODS: Baseline data from LITE were analyzed for demographic, psychosocial, and material factors that may affect vulnerability to COVID-related harms. RESULTS: The 1020 participants had high rates of poverty, unemployment, food insecurity, homelessness, and sex work. Transgender women with HIV (n = 273) were older, more likely to be Black, had lower educational attainment, and were more likely to experience material hardship. Mental and behavioral health symptoms were common and did not differ by HIV status. Barriers to health care included being mistreated, provider discomfort serving transgender women, and past negative experiences; as well as material hardships, such as cost and transportation. However, most reported access to material and social support-demonstrating resilience. CONCLUSIONS: Transgender women with HIV may be particularly vulnerable to pandemic harms. Mitigating this harm would benefit everyone, given the highly infectious nature of this coronavirus. Collecting gender identity in COVID-19 data is crucial to inform an effective public health response. Transgender-led organizations' response to this crisis serve as an important model for effective community-led interventions.


Asunto(s)
Infecciones por Coronavirus/psicología , Infecciones por VIH/complicaciones , Neumonía Viral/psicología , Personas Transgénero/psicología , Poblaciones Vulnerables/psicología , Boston , Infecciones por Coronavirus/complicaciones , Femenino , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Estudios Longitudinales , Masculino , Mid-Atlantic Region , Pandemias , Neumonía Viral/complicaciones , Carencia Psicosocial , Apoyo Social , Factores Socioeconómicos , Sudeste de Estados Unidos
7.
Epilepsy Behav ; 112: 107476, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33181895

RESUMEN

The current pandemic of coronavirus disease 2019 (COVID-19) that led to an unprecedented crisis with significant health, social, and economic repercussions presented more serious concerns for those living with some chronic conditions such as epilepsy. This study was aimed to find out impact of the COVID-19 pandemic on management of epilepsy. A cross-sectional study was conducted through telephone interviews, targeting 213 caregivers of pediatric patients with epilepsy, belonging to underserved areas of Faisalabad, Punjab, Pakistan. A simple questionnaire was designed to record the responses of participants relevant to the direct and indirect effects of COVID-19 pandemic and their knowledge about possible ways that can be accessed for the management of epilepsy during an ongoing pandemic. The current study, which holds 77% of the respondents from rural areas and 23% from urban settings, showed that partial measures of lockdown taken to stop or slow the spread of COVID-19 resulted in adverse economic and health outcomes in the said population including cancelation of follow-up visits, worsening of seizures, job loss, burden of antiepileptic drugs (AEDs) costs, and discontinuation of medicines. Furthermore, knowledge about alternative ways to access health facilities was found very poor among caregivers. Income sources of poor people disrupted by lockdown can lead to unintentional nonadherence to medication, which is a clear picture of inequitable distribution of resources. This study highlights the major issues faced by the caregivers during this ongoing pandemic of COVID-19.


Asunto(s)
Anticonvulsivantes , Infecciones por Coronavirus/prevención & control , Coronavirus , Epilepsia/tratamiento farmacológico , Accesibilidad a los Servicios de Salud , Neumonía Viral/prevención & control , Cuarentena/psicología , Aislamiento Social , Anticonvulsivantes/economía , Anticonvulsivantes/provisión & distribución , Anticonvulsivantes/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Estudios Transversales , Epilepsia/epidemiología , Femenino , Recursos en Salud , Humanos , Estudios Longitudinales , Masculino , Cumplimiento de la Medicación , Pakistán , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Convulsiones/epidemiología , Encuestas y Cuestionarios , Telemedicina , Poblaciones Vulnerables
8.
Biomedica ; 40(Supl. 2): 68-72, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152189

RESUMEN

Despite the positive response of Colombia's health system to the arrival of Venezuelan migrants, the new challenges that accompany the COVID-19 pandemic have triggered a closed-borders response that runs the risk of encouraging a negative view of migrants and increasing their health risks. This manuscript discusses the recommendations that could be proposed in the case of a country with limited resources such as Colombia to respond to the needs of the Venezuelan mixed migrant flows.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Emigración e Inmigración/legislación & jurisprudencia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Migrantes , Colombia/epidemiología , Infecciones por Coronavirus/epidemiología , Desinfección de las Manos , Disparidades en Atención de Salud , Humanos , Neumonía Viral/epidemiología , Salud Pública/legislación & jurisprudencia , Política Pública , Cuarentena , Venezuela/etnología , Poblaciones Vulnerables
9.
Artículo en Inglés | PAHO-IRIS | ID: phr-53008

RESUMEN

[ABSTRACT]. Objectives. To assess the status of the HIV epidemic and programmatic implementation in Jamaica while identifying strategies for achieving effective HIV control. Methods. The assessment included a review of the core indicators of the UNAIDS Global Monitoring Framework, a desk review of program reports, and unstructured interviews of stakeholders. Results. HIV prevalence among adults in Jamaica was 1.5% in 2018 with an estimated 32 617 persons living with HIV (PLHIV) and 27 324 persons (83.8%) diagnosed with HIV; 12 711 (39.0% of all PLHIV or 46.5% aware of their status) were on anti-retroviral therapy (ART) in the public health sector and 61.8% PLHIV on ART were virally suppressed. HIV prevalence among men who have sex with men remains high (31.4% in 2011, 29.6% in 2017) but has declined among female sex workers (12% in 1990, 2% in 2017). HIV prevalence among public sexually transmitted infection clinic attendees, prison inmates and the homeless has increased in recent years. During 2018 approximately 200 000 persons (14% of the population 15-49 years) were tested with 1 165 newly diagnosed PLHIV, indicating that many of the estimated 1 600 newly infected persons in 2018 were unaware of their status. Conclusions. Critical policy initiatives are needed to reduce barriers to HIV services, ensure young persons have access to condoms and contraceptives, affirm the rights of the marginalized, reduce stigma and discrimination, and introduce pre-exposure prophylaxis. While HIV spread in Jamaica has slowed, the UNAIDS Fast Track goals are lagging. The HIV program must be strengthened to effectively control the epidemic.


[RESUMEN]. Objetivos. Evaluar el estado de la epidemia de la infección por el VIH en Jamaica y de la ejecución programática, y determinar las estrategias para lograr un control eficaz de la infección por el VIH. Métodos. La evaluación incluyó una revisión de los indicadores básicos del Marco de Vigilancia Mundial del ONUSIDA, un estudio teórico de informes programáticos y entrevistas no estructuradas a los interesados directos. Resultados. La prevalencia de la infección por el VIH en adultos en Jamaica fue del 1,5% en el 2018, con unas 32 617 personas infectadas y unas 27 324 personas (83,8%) con diagnóstico de infección por el VIH; 12 711 personas (39,0% del total de personas con infección por el VIH, o el 46,5% de las que conocían su estado) estaban bajo tratamiento antirretroviral en el sector de salud pública, y el 61,8% de las personas con infección por el VIH que recibieron tratamiento antirretroviral alcanzó la supresión viral. La prevalencia de la infección por el VIH en hombres que tienen relaciones sexuales con hombres sigue siendo alta (31,4% en el 2011, 29,6% en el 2017), aunque ha descendido en las trabajadoras sexuales (12% en 1990, 2% en el 2017). En los últimos años, la prevalencia de la infección por el VIH en personas que acuden a centros públicos de atención de infecciones de transmisión sexual, presidiarios y personas sin hogar ha aumentado. En el 2018, aproximadamente 200 000 personas (14% de la población entre 15 y 49 años) se sometieron a la prueba de VIH, de las cuales 1 165 fueron diagnosticadas como personas recién infectadas por el HIV, lo cual indica que muchas de las 1 600 personas recién infectadas en el 2018 desconocían su estado. Conclusões. Se necesitan iniciativas políticas fundamentales para reducir los obstáculos que impiden el acceso a los servicios de atención de la infección por el VIH, asegurar que las personas jóvenes tengan acceso a preservativos y anticonceptivos, afirmar los derechos de las personas marginadas, reducir la estigmatización y la discriminación, e introducir la profilaxis previa a la exposición. Si bien la propagación de la infección por el VIH se ha desacelerado en Jamaica, el logro de los Objetivos de Respuesta Rápida del ONUSIDA está demorado. Debe fortalecerse el Programa contra el VIH para controlar eficazmente la epidemia.


[RESUMO]. Objetivos. Avaliar a situação da epidemia de HIV e a implementação do Programa Nacional de HIV na Jamaica, identificando estratégias eficazes para controlar o HIV. Métodos. A avaliação incluiu uma revisão dos indicadores-chave da Estrutura de Monitoramento Global do UNAIDS, uma revisão documental dos relatórios do programa e entrevistas não estruturadas com participantes. Resultados. A prevalência de infecção pelo HIV em adultos na Jamaica foi de 1,5% em 2018. Estima-se que haja 32.617 pessoas vivendo com o HIV (PVHIV), das quais 27.324 (83,8%) foram diagnosticadas; 12.711 (39,0% de todas as PVHIV, e 46,5% das que conhecem seu diagnóstico) estavam em terapia antirretroviral (TAR) no setor da saúde pública, e 61,8% das PVHIV em ART alcançaram a supressão viral. A prevalência de HIV entre homens que fazem sexo com homens continua alta (31,4% em 2011, 29,6% em 2017), mas diminuiu entre mulheres profissionais do sexo (12% em 1990, 2% em 2017). A prevalência de HIV entre os pacientes que frequentam clínicas públicas de atenção a infecções sexualmente transmissíveis, presidiários e desabrigados tem aumentado nos últimos anos. No ano de 2018, aproximadamente 200.000 pessoas (14% da população de 15 a 49 anos) foram testadas, sendo feitos 1.165 novos diagnósticos de infecção pelo HIV, o que indica que muitas das 1.600 pessoas recém-infectadas estimadas em 2018 não estavam cientes de sua infecção. Conclusões. São necessárias iniciativas políticas essenciais para reduzir as barreiras no acesso aos serviços de HIV, assegurar que os jovens tenham acesso a preservativos e métodos contraceptivos, afirmar os direitos dos marginalizados, reduzir o estigma e a discriminação e introduzir a profilaxia pré-exposição. Embora a propagação do HIV na Jamaica tenha perdido velocidade, o progresso para alcançar as metas da estratégia Fast Track do UNAIDS tem sido lento. Para controlar a epidemia de forma eficaz, é preciso fortalecer o Programa Nacional de HIV.


Asunto(s)
Infecciones por VIH , Poblaciones Vulnerables , Conducta Sexual , Jamaica , Infecciones por VIH , Poblaciones Vulnerables , Conducta Sexual , Infecciones por VIH , Poblaciones Vulnerables , Conducta Sexual
10.
Washington, D.C.; PAHO; 2020-11-09. (PAHO/NMH/MH/Covid-19/20-0044).
No convencional en Inglés | PAHO-IRIS | ID: phr-52999

RESUMEN

Major stressors such as the COVID-19 pandemic represent risk factors for the development, exacerbation and relapse of a range of mental, neurological and substance use (MNS) disorders, particularly in the most vulnerable groups. National studies from the Region of the Americas, demonstrate increases in distress, depression, anxiety, and insomnia, among other conditions, as a result of the COVID-19 pandemic. Furthermore, COVID-19 itself is associated with neurological and mental complications. This report is based on the results of a survey, developed by the World Health Organization (WHO) and implemented by the WHO and the Pan American Health Organization (PAHO), which was sent to designated mental health focal points in ministries of health of all WHO Member States. It uses data submitted by PAHO Member States in response to the survey to provide an overview of the impact of COVID-19 on MNS services in the Region of the Americas. This information will help to inform planning and response to mitigate the effects by countries in the Region.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Betacoronavirus , Salud Mental , Factores de Riesgo , Poblaciones Vulnerables , Trastornos Relacionados con Sustancias , Américas
13.
Eur Rev Med Pharmacol Sci ; 24(18): 9765-9767, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33015824

RESUMEN

Homeless persons and migrants in precarious housing conditions are vulnerable populations that have been peculiarly impacted by the Coronavirus Disease 19 (COVID-19) pandemic. These populations are more at risk of contracting COVID-19 as they often find it difficult to adhere to public health directives and, if exposed, may be more susceptible to illness or death due to the higher prevalence of underlying physical and mental comorbidities compared to the general population. In addition, vulnerable populations may have limited access to essential diagnostics and treatments, thus leading to untreated COVID-19 cases and their development into more severe forms. Health, social and government agencies should collaborate to develop services that support these communities, in accordance with the World Health Organization principles. Migrant and homeless centers have a central role, as they provide a significant contribution to prevent infection spread and favor access to early medical treatment to those affected, thus preventing more severe forms of infection.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Personas sin Hogar , Vivienda , Pandemias/prevención & control , Neumonía Viral/prevención & control , Migrantes , Poblaciones Vulnerables , Betacoronavirus , Humanos , Factores de Riesgo
14.
BMC Med Educ ; 20(1): 377, 2020 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-33092586

RESUMEN

BACKGROUND: The coronavirus pandemic has exerted significant impacts on primary care, causing rapid digital transformation, exacerbating social isolation, and disrupting medical student and General Practice [GP] trainee education. Here we report on a medical student telephone initiative set-up by a final year GP trainee (the equivalent of a family medicine resident), which aimed to support patients at high risk and vulnerable to the Coronavirus Disease of 2019 [Covid-19]. In addition, it was hoped the project would mitigate a digital divide, enable proactive anticipatory planning, and provide an active learning environment to compensate for the pandemic's impact on medical education. METHODS: Thirty-three medical students conducted daily telephone conversations with high risk and vulnerable patients as specified by the initial NHSE published lists. They confirmed public health messages, offered details for voluntary support groups, established need for medication delivery, explored levels of digital connectivity, and prompted discussions around end-of-life choices. Students had access to online reflective resources and daily remote debriefing sessions with the GP trainee. A convergent mixed-methods evaluation was subsequently undertaken, using quantitative process and descriptive data and individual qualitative interviews were conducted according to a maximal variation sampling strategy with students, General Practitioners [GPs], and the GP trainee. Inductive thematic analysis was then applied with cross-validation, respondent validation, and rich evidential illustration aiding integrity. RESULTS: Ninety-seven 'high risk' and 781 'vulnerable' calls were made. Individuals were generally aware of public heath information, but some struggled to interpret and apply it within their own lives. Therefore respondents felt students provided additional practical and psychological benefits, particularly with regard to strengthening the links with the community voluntary groups. The project was widely liked by students who reported high levels of skill development and widened awareness, particularly valuing the active learning environment and reflective feedback sessions. CONCLUSION: This study demonstrates utilization of medical students as wider assets within the primary health care team, with an initiative that enables support for vulnerable patients whilst promoting active medical education. Ongoing integration of students within 'normal' primary health care roles, such as chronic disease or mental health reviews, could provide similar opportunities for supported active and reflective learning.


Asunto(s)
Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Estudiantes de Medicina , Brecha Digital , Educación Médica/métodos , Humanos , Entrevistas como Asunto , Pandemias , Educación del Paciente como Asunto , Teléfono , Cuidado Terminal , Reino Unido , Poblaciones Vulnerables
15.
Rev Bras Enferm ; 73(suppl 2): e20200312, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33111778

RESUMEN

OBJECTIVE: To discuss the fundamental aspects in the establishment of preventive measures to tackle covid-19 among indigenous people in view of the motivations for seeking health care in villages of the Terra Indígena Buriti, Mato Grosso do Sul, Brazil. METHODS: Theoretical-reflective study based on assumptions of the National Health System and previous ethnographic research that enabled the identification of the motivations to seek health care in Buriti villages. RESULTS: Indigenous people seek health centers for health care programs assistance, treatment of cases they cannot resolve and to chat. Such motivations were the basis for discussing the indigenization process in the confrontation of the new coronavirus pandemic in indigenous lands. FINAL CONSIDERATIONS: The motivations for seeking health care show the physical and social vulnerability of the Terena ethnicity. The effectiveness of the social isolation measure in the villages depends on the dialogue with indigenous leaders, professional engagement and intersectoral actions.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Necesidades y Demandas de Servicios de Salud , Servicios de Salud del Indígena , Indios Sudamericanos/psicología , Motivación , Pandemias/prevención & control , Neumonía Viral/prevención & control , Brasil/epidemiología , Brasil/etnología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/psicología , Servicios de Salud del Indígena/organización & administración , Humanos , Indios Sudamericanos/etnología , Medicina Tradicional , Evaluación de Necesidades , Neumonía Viral/epidemiología , Neumonía Viral/etnología , Neumonía Viral/psicología , Poblaciones Vulnerables
16.
BMJ Glob Health ; 5(10)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33109636

RESUMEN

INTRODUCTION: We aimed to describe the distribution of excess mortality (EM) during the first weeks of the COVID-19 outbreak in the Stockholm Region, Sweden, according to age, sex and sociodemographic context. METHODS: Weekly all-cause mortality data were obtained from Statistics Sweden for the period 1 January 2015 to 17 May 2020. EM during the first 20 weeks of 2020 was estimated by comparing observed mortality rates with expected mortality rates during the five previous years (N=2 379 792). EM variation by socioeconomic status (tertiles of income, education, Swedish-born, gainful employment) and age distribution (share of 70+-year-old persons) was explored based on Demographic Statistics Area (DeSO) data. RESULTS: EM was first detected during the week of 23-29 March 2020. During the peak week of the epidemic (6-12 April 2020), an EM of 150% was observed (152% in 80+-year-old women; 183% in 80+-year-old men). During the same week, the highest EM was observed for DeSOs with lowest income (171%), lowest education (162%), lowest share of Swedish-born (178%) and lowest share of gainfully employed residents (174%). EM was further increased in areas with higher versus lower proportion of younger people (magnitude of increase: 1.2-1.7 times depending on socioeconomic measure). CONCLUSION: Living in areas characterised by lower socioeconomic status and younger populations was linked to excess mortality during the COVID-19 pandemic in the Stockholm Region. These conditions might have facilitated viral spread. Our findings highlight the well-documented vulnerability linked to increasing age and sociodemographic context for COVID-19-related death.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Poblaciones Vulnerables , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Betacoronavirus , Causas de Muerte , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Factores Socioeconómicos , Suecia/epidemiología
18.
Ann Glob Health ; 86(1): 135, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-33117656

RESUMEN

The intersection of digital health platforms and refugee health in the context of the novel 2019 coronavirus disease (COVID-19) has not yet been explored. We discuss the ability of a novel mobile health (mhealth) platform to be effectively adapted to improve health access for vulnerable displaced populations. In a preliminary analysis of 200 Syrian refugee women, we found positive user feedback and uptake of an mhealth application to increase access to preventive maternal and child health services for Syrian refugees under temporary protection in Turkey. Rapid adaptation of this application was successfully implemented during a global pandemic state to perform symptomatic assessment, disseminate health education, and bolster national prevention efforts. We propose that mhealth interventions can provide an innovative, cost-effective, and user-friendly approach to access the dynamic needs of refugees and other displaced populations, particularly during an emerging infectious disease outbreak.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Necesidades y Demandas de Servicios de Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Refugiados/estadística & datos numéricos , Telemedicina/organización & administración , Adulto , Niño , Preescolar , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/prevención & control , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & control , Turquia , Poblaciones Vulnerables/estadística & datos numéricos
19.
PLoS One ; 15(10): e0241166, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33119721

RESUMEN

BACKGROUND: The spread of coronavirus in the United States with nearly five and half million confirmed cases and over 170,000 deaths has strained public health and health care systems. While many have focused on clinical outcomes, less attention has been paid to vulnerability and risk of infection. In this study, we developed a planning tool that examines factors that affect vulnerability to COVID-19. METHODS: Across 46 variables, we defined five broad categories: 1) access to medical services, 2) underlying health conditions, 3) environmental exposures, 4) vulnerability to natural disasters, and 5) sociodemographic, behavioral, and lifestyle factors. The developed tool was validated by comparing the estimated overall vulnerability with the real-time reported normalized confirmed cases of COVID-19. ANALYSIS: A principal component analysis was undertaken to reduce the dimensions. In order to identify vulnerable census tracts, we conducted rank-based exceedance and K-means cluster analyses. RESULTS: All of the 5 vulnerability categories, as well as the overall vulnerability, showed significant (P-values <<0.05) and relatively strong correlations (0.203<ρ<0.57) with the normalized confirmed cases of COVID-19 at the census tract level. Our study showed a total of 722,357 (~17% of the County population) people, including 171,403 between the ages of 45-65 (~4% of County's population), and 76,719 seniors (~2% of County population), are at a higher risk based on the aforementioned categories. The exceedance and K-means cluster analysis demonstrated that census tracts in the northeastern, eastern, southeastern and northwestern regions of the County are at highest risk. CONCLUSION: Policymakers can use this planning tool to identify neighborhoods at high risk for becoming hot spots; efficiently match community resources with needs, and ensure that the most vulnerable have access to equipment, personnel, and medical interventions.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Medición de Riesgo , Poblaciones Vulnerables , Adulto , Anciano , Betacoronavirus , Análisis por Conglomerados , Humanos , Persona de Mediana Edad , Pandemias , Prevalencia , Salud Pública/métodos , Características de la Residencia , Análisis Espacial , Texas/epidemiología
20.
J Int AIDS Soc ; 23(10): e25632, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33119183

RESUMEN

INTRODUCTION: Key populations at elevated risk to contract or transmit HIV may also be at higher risk of COVID-19 complications and adverse outcomes associated with public health prevention measures. However, the conditions faced by specific populations vary according to social, structural and environmental factors, including stigma and discrimination, criminalization, social and economic safety nets and the local epidemiology of HIV and COVID-19, which determine risk of exposure and vulnerability to adverse health outcomes, as well as the ability to comply with measures such as physical distancing. This commentary identifies common vulnerabilities and cross-cutting themes in terms of the impacts of COVID-19 on key populations before addressing issues and concerns specific to particular populations. DISCUSSION: Cross-cutting themes include direct impacts such as disrupted access to essential medicines, commodities and services such as anti-retroviral treatment, HIV pre-exposure prophylaxis, opioid agonist treatment, viral load monitoring, HIV and sexually transmitted infections testing, condoms and syringes. Indirect impacts include significant collateral damage arising from prevention measures which restrict human rights, increase or impose criminal penalties, and expand police powers to target vulnerable and criminalized populations. Significant heterogeneity in the COVID-19 pandemic, the underlying HIV epidemic and the ability of key populations to protect themselves means that people who inject drugs and sex workers face particular challenges, including indirect impacts as a result of police targeting, loss of income and sometimes both. Geographical variations mean that transgender people and men who have sex with men in regions like Africa and the middle east remain criminalized, as well as stigmatized and discriminated against, increasing their vulnerability to adverse outcomes in relation to COVID-19. CONCLUSIONS: Disruptions to both licit and illicit supply chains, loss of income and livelihoods and changes in behaviour as a result of lockdowns and physical distancing have the potential to exacerbate the impacts of the COVID-19 pandemic on key populations. While these impacts will vary significantly, human-rights approaches to COVID-19 emergency laws and public health prevention measures that are population-specific and sensitive, will be key to reducing adverse health outcomes and ensuring that no one is left behind.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por VIH/epidemiología , Pandemias , Neumonía Viral/epidemiología , Minorías Sexuales y de Género , Poblaciones Vulnerables , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/prevención & control , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Humanos , Renta , Masculino , Pandemias/prevención & control , Neumonía Viral/complicaciones , Neumonía Viral/prevención & control , Profilaxis Pre-Exposición , Prisioneros , Salud Pública , Factores de Riesgo , Trabajadores Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Estigma Social , Carga Viral
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