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1.
Rev Med Liege ; 76(1): 50-55, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-33443329

RESUMO

This review is devoted to all health professionals in order to raise awareness of the psychopathological consequences of forced migration on the mental health of children. First, we will talk about the psychological consequences of immigration in a global way, and then we will discuss about some specific situations. We will finish with prevention and care of these vulnerable children.


Assuntos
Refugiados , Criança , Emigração e Imigração , Humanos , Saúde Mental
3.
Lancet Psychiatry ; 8(1): 36-47, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33156999

RESUMO

BACKGROUND: Understanding the time-varying association of pre-migration and post-migration stressors in refugees' mental health could help in designing tailored health promotion services at different resettlement stages and improving the efficiency of resource allocation. In this study, we explored these time-varying associations. METHODS: We used data from the first four waves (October, 2013, to February, 2017) of a national refugee-based longitudinal study, the Building a New Life in Australia (BNLA) project. Post-traumatic stress disorder (PTSD) and high risk of severe mental illness (HR-SMI) were used to assess mental health. The independent variables included the number of potentially traumatic events experienced during the pre-migration process, and a range of post-migration stressors. We used logistic regression models to analyse the relative importance of variables and time-varying associations between the pre-migration potentially traumatic events, post-migration resettlement stressors, and refugees' mental health. Analyses were stratified by gender, and sociodemographic covariates included age, marital status, education level, country of birth, and weekly income. RESULTS: 2399 participants were surveyed in Wave 1 of the BNLA project in 2013-14, of whom 2009 (83·7%) responded in Wave 2 in 2014-15, 1894 (78·9%) in Wave 3 in 2015-16, and 1929 (80·4%) in Wave 4 in 2016-17. The three most important factors associated with mental health in each wave differed for male and female refugees, but the socioeconomic stressors of loneliness and adjustment to life in Australia were consistently prominent. Positive associations between socioeconomic stressors and mental ill-health were found for both genders, with a peak at Wave 2 (adjusted odds ratio [AOR] among men, 1·60 [95% CI 1·26-2·03], p=0.0001 for PTSD; AOR 1·86 [1·35-2·55], p=0·0001 for HR-SMI; and among women, AOR 1·81 [1·27-2·57], p=0·0009 for PTSD; AOR 2·24 [1·49-3·38], p=0·0001 for HR-SMI). Associations between loneliness and mental health fluctuated, but were significant for both genders in Wave 4 (among men, AOR 1·90 [1·21-2·99], p=0·0051 for PTSD; AOR 3·70 [2·18-6·27], p<0·0001 for HR-SMI; and among women, AOR 3·65 [2·08-6·39], p<0·0001 for PTSD; AOR 3·68 [2·02-6·69], p<0·0001 for HR-SMI). The association between difficulties in adjustment to life in Australia and male refugees' mental ill-health increased continuously during the resettlement period. INTERPRETATION: Gender-specific and time-sensitive services should be considered to improve refugees' mental health. For both genders, improved economic conditions that complement social security benefits deserve attention and are relevant throughout the resettlement process. At the later stage of resettlement, services to reduce loneliness could be carried out, and reducing stressors related to adjustment to life in the host country is especially needed for male refugees. FUNDING: None.


Assuntos
Emigração e Imigração , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/complicações , Adulto , Austrália/epidemiologia , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Saúde Mental/estatística & dados numéricos , Saúde Mental/tendências , Pessoa de Meia-Idade , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
4.
Am J Public Health ; 111(1): 110-115, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33211577

RESUMO

Immigration detention centers are densely populated facilities in which restrictive conditions limit detainees' abilities to engage in social distancing or hygiene practices designed to prevent the spread of COVID-19. With tens of thousands of adults and children in more than 200 immigration detention centers across the United States, immigration detention centers are likely to experience COVID-19 outbreaks and add substantially to the population of those infected.Despite compelling evidence indicating a heightened risk of infection among detainees, state and federal governments have done little to protect the health of detained im-migrants. An evidence-based public health framework must guide the COVID-19 response in immigration detention centers.We draw on the hierarchy of controls framework to demonstrate how immigration detention centers are failing to implement even the least effective control strategies. Drawing on this framework and recent legal and medical advocacy efforts, we argue that safely releasing detainees from immigration detention centers into their communities is the most effective way to prevent COVID-19 outbreaks in immigration detention settings. Failure to do so will result in infection and death among those detained and deepen existing health and social inequities.


Assuntos
Emigração e Imigração/legislação & jurisprudência , Migrantes/estatística & dados numéricos , Adulto , /transmissão , Criança , Humanos , Estados Unidos
5.
Global Health ; 16(1): 118, 2020 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334370

RESUMO

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Assuntos
/prevenção & controle , Emigração e Imigração/estatística & dados numéricos , Direitos Humanos/normas , Malária/transmissão , /epidemiologia , Recessão Econômica/estatística & dados numéricos , Direitos Humanos/tendências , Humanos , Malária/epidemiologia , Refugiados/estatística & dados numéricos , Venezuela/epidemiologia
6.
Prof Inferm ; 73(3): 129-130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33355771

RESUMO

The COVID-19 pandemic has exposed the vulnerabilities of nursing supply flows, domestically and internationally. Its impact at the country-level has further highlighted preexisting nurse supply gaps and the effect of staffing shortages. Internationally, the pandemic has disrupted global supply chains. The world has witnessed the closing of borders, the interruption of travel, and, in some countries, the restriction of outflows. The State of the World's Nursing Report (SOWN) (WHO, 2020) noted a shortfall of almost six million nurses immediately pre-COVID-19, a shortage suffered particularly by low- and middle-income countries. This is of major concern given that increased international outflows of nurses in the new post-COVID era could undermine, even more than before, the readiness of those countries to meet healthcare demands (ICN, 2020). In this default scenario, some, but not all, highincome destination countries will continue to rely on international inflow of nurses to a significant extent, as they did pre-COVID- 19, further exacerbating the suffering of poor countries. Put simply, without country-level policy changes related to the nursing workforce and backed by international organisations, pre-COVID-19 trends of increased nurse flows from low- to high-income countries will likely continue. In this scenario, the iniquitous maldistribution of nurses may become more pronounced. This "do nothing" option risks undermining both country-level progress towards the attainment of Universal Health.


Assuntos
/enfermagem , Emigração e Imigração/tendências , Pessoal de Saúde/organização & administração , Enfermeiras e Enfermeiros/provisão & distribução , /epidemiologia , Países Desenvolvidos , Países em Desenvolvimento , Política de Saúde , Humanos , Internacionalidade , Enfermeiras e Enfermeiros/organização & administração , Recursos Humanos de Enfermagem/provisão & distribução
7.
Artigo em Espanhol | PAHO-IRIS | ID: phr-53157

RESUMO

[RESUMEN]. Objetivo. Identificar el conocimiento, acceso y uso del sistema de salud por parte de adolescentes migrantes, y las barreras para el acceso y uso del sistema de salud en dicha población en Chile. Métodos. Estudio exploratorio observacional, de corte transversal, aplicado en jornada participativa con adolescentes migrantes (N=30) de tres comunas de la ciudad de Santiago, Chile. Estudio multimétodos. Se aplicó una encuesta basal sobre el proceso migratorio y las experiencias en el sistema de salud, con análisis descriptivo de datos. Desde lo cualitativo, se realizaron grupos de discusión (n=5) y talleres participativos (n=2) con adolescentes migrantes. Resultados. El 60% de adolescentes afirmó desconocer si está inscrito en el sistema de salud, y la mitad no lo ha utilizado. Se identificó que el tiempo de residencia es un factor relevante para el uso efectivo de algunas prestaciones de salud. Se reconocieron barreras administrativas para acceder al sistema de salud, como situación migratoria, percepción de obligatoriedad de compañía de adultos, y experiencias de discriminación en la atención. Se identificaron necesidades específicas en salud sexual y reproductiva, como acceso a preservativos, y salud mental en relación a la atención de especialistas. Como facilitadores del acceso y uso se destacaron las experiencias de buen trato, y la presencia del sector salud en las escuelas. Conclusiones. Se identificó desconocimiento del sistema de salud, y diversas barreras de acceso y uso de este por parte de adolescentes migrantes. En base a los resultados se proponen recomendaciones generales para el país y la región referidas a la promoción de la salud de este grupo.


[ABSTRACT]. Objective. To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile. Methods. Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents. Results. Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted. Conclusions. Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.


Assuntos
Emigração e Imigração , Adolescente , Sistemas de Saúde , América Latina , Chile , Emigração e Imigração , Adolescente , Sistemas de Saúde , América Latina
8.
Clin Dermatol ; 38(5): 520-522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33280796

RESUMO

Immigration has been considered a common human behavior, but it is usually the result of severe conditions that force people to leave their countries. For specialized physicians who have invested years of study, training, hard work, and money to establish a successful career, the decision to leave behind everything to start over is as difficult as for the rest of the people. Adapting to a new country requires a good deal of patience, persistence, and resilience to reinvent oneself, exploring and developing new areas, plus using knowledge and experiences previously acquired. This paper reflects the anxieties, fears, and hopes of a dermatologist driven by the dynamics of a migratory process. The reflections are framed with verses of the goddess Fortune, extracted from a medieval Codex, as a way to compare how Fortune's whims can change circumstances to keep us moving upward and downward during our lives.


Assuntos
Dermatologistas/psicologia , Emigrantes e Imigrantes/psicologia , Emigração e Imigração , Manuscritos como Assunto , Ansiedade , Medo , Feminino , Esperança , Humanos , Masculino , Estados Unidos , Venezuela
9.
Biomedica ; 40(Supl. 2): 68-72, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152189

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Emigração e Imigração/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Migrantes , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Desinfecção das Mãos , Disparidades em Assistência à Saúde , Humanos , Pneumonia Viral/epidemiologia , Saúde Pública/legislação & jurisprudência , Política Pública , Quarentena , Venezuela/etnologia , Populações Vulneráveis
10.
mSphere ; 5(6)2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177213

RESUMO

After the first case of coronavirus disease 2019 (COVID-19) in Japan on 15 January 2020, multiple nationwide COVID-19 clusters were identified by the end of February. The Japanese government focused on mitigating the emerging COVID-19 clusters by conducting active nationwide epidemiological surveillance. However, an increasing number of cases continued to appear until early April 2020, many with unclear infection routes and no recent history of travel outside Japan. We aimed to evaluate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome sequences from the COVID-19 cases that appeared until early April 2020 and to characterize their genealogical networks in order to demonstrate possible routes of spread in Japan. Nasopharyngeal specimens were collected from patients, and reverse transcription-quantitative PCR tests for SARS-CoV-2 were performed. Positive RNA samples were subjected to whole-genome sequencing, and a haplotype network analysis was performed. Some of the primary clusters identified during January and February 2020 in Japan descended directly from the Wuhan-Hu-1-related isolates from China and other distinct clusters. Clusters were almost contained until mid-March; the haplotype network analysis demonstrated that the COVID-19 cases from late March through early April may have created an additional large cluster related to the outbreak in Europe, leading to additional spread within Japan. In conclusion, genome surveillance has suggested that there were at least two distinct SARS-CoV-2 introductions into Japan from China and other countries.IMPORTANCE This study aimed to evaluate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome sequences from COVID-19 cases and to characterize their genealogical networks to demonstrate possible routes of spread in Japan. We found that there were at least two distinct SARS-CoV-2 introductions into Japan, initially from China and subsequently from other countries, including Europe. Our findings can help understand how SARS-CoV-2 entered Japan and contribute to increased knowledge of SARS-CoV-2 in Asia and its association with implemented stay-at-home/shelter-in-place/self-restraint/lockdown measures. This study suggested that it is necessary to formulate a more efficient containment strategy using real-time genome surveillance to support epidemiological field investigations in order to highlight potential infection linkages and mitigate the next wave of COVID-19 in Japan.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , RNA Viral/análise , Sequenciamento Completo do Genoma , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Emigração e Imigração , Haplótipos , Política de Saúde , Humanos , Japão/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
11.
Proc Biol Sci ; 287(1938): 20201182, 2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33143582

RESUMO

Density-dependent and extrinsic mortality are predicted to accelerate reproductive maturation. The first 5 years of life is a proposed sensitive period for life-history regulation. This study examines the ways in which local mortality during this sensitive period was related to subsequent marriage timing in nineteenth-century Belgium (n women = 11 892; n men = 14 140). Local mortality during the sensitive period was inversely associated with age at first marriage for men and women controlling for literacy, occupational status, population growth and migration. Cox regression indicated decreased time to marriage for women (HR = 1.661, 95% CI: 1.542-1.789) and men (HR = 1.327, 95% CI: 1.238-1.422) from high mortality municipalities. Rising population growth rates were associated with earlier marriage for men and women. Migration in general was associated with later marriage for men and women. Consistent with life-history predictions, harsh ecological conditions during early life such as famine coincided with earlier marriage.


Assuntos
Fome Epidêmica/tendências , Mortalidade/tendências , Adulto , Bélgica/epidemiologia , Demografia , Países Desenvolvidos , Emigração e Imigração , Feminino , Fertilidade , Humanos , Masculino , Dinâmica Populacional , Crescimento Demográfico , Fatores Socioeconômicos
12.
PLoS One ; 15(11): e0241852, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33151980

RESUMO

Screening asylum-seekers for active pulmonary tuberculosis is common practice among many European countries with low incidence of tuberculosis. The reported yields vary substantially, partly due to the heterogeneous and dynamic nature of asylum-seeking populations. Rather than screening all new arrivals (indiscriminate screening), a few countries apply targeted screening based on incidence of tuberculosis in asylum-seekers' country of origin. However, evaluations of its cost-effectiveness have been scarce. The aim of this modelling study was to assess whether the introduction of a screening threshold based on the tuberculosis incidence in the country of origin is sensible from an economic perspective. To this end, we compare the current, indiscriminate screening policy for pulmonary tuberculosis in Germany with a hypothetical targeted screening programme using several potential screening thresholds based on WHO-reported incidence of tuberculosis in countries of origin. Screening data is taken from a large German federal state over 14 years (2002-2015). Incremental cost-effectiveness is measured as cost per case found and cost per case prevented. Our analysis shows that incremental cost-effectiveness ratios (ICERs) of screening asylum-seekers from countries with an incidence of 50 to 250/100,000 range between 15,000€ and 17,000€ per additional case found when compared to lower thresholds. The ICER for screening asylum-seekers from countries with an incidence <50/100,000 is 112,000€ per additional case found. Costs per case prevented show a similar increase in costs. The high cost per case found and per case prevented at the <50/100,000 threshold scenario suggests this threshold to be a sensible cut-off for targeted screening. Acknowledging that no screening measure can find all cases of tuberculosis, and that reactivation of latent infections makes up a large proportion of foreign-born cases, targeting asylum-seekers from countries with an incidence above 50/100,000 is likely to be a more reasonable screening measure for the prevention and control of tuberculosis than indiscriminate screening measures.


Assuntos
Controle de Doenças Transmissíveis/métodos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Análise Custo-Benefício/métodos , Emigração e Imigração/tendências , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Programas de Rastreamento/métodos , Modelos Teóricos , Refugiados , Pesquisa , Tuberculose/epidemiologia
13.
Global Health ; 16(1): 113, 2020 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-33218359

RESUMO

Welfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants' healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. Amplifying the relationship between welfare state transformations and the production of inequalities, the Covid-19 pandemic may fuel exclusionary rhetoric and politics; or it may serve as an impetus to reconsider the costs that one group's exclusion from health can entail for all members of society.The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.


Assuntos
/economia , Dissidências e Disputas , Emigrantes e Imigrantes , Política de Saúde/economia , Acesso aos Serviços de Saúde/economia , Formulação de Políticas , Migrantes , Países Desenvolvidos , Emigração e Imigração , Europa (Continente)/epidemiologia , Acesso aos Serviços de Saúde/ética , Humanos , Pandemias , Política , Saúde da População , Pesquisa , Alocação de Recursos , Seguridade Social , Fatores Socioeconômicos
14.
Artigo em Inglês | MEDLINE | ID: mdl-33142992

RESUMO

Increased migration has led to increased prejudice towards immigrant populations. This study aims to analyse attitudes towards immigration among student nurses in three universities, two in Spain and one in Portugal. Methodology: A descriptive, transversal, prospective study was carried out among student nurses (n = 624), using the Attitude towards Immigration in Nursing scale. Results: Nursing students showed some positive attitudes towards immigration, such as that immigrants should have the right to maintain their customs or that immigrants should have free access to healthcare and education, in contrast to some negative attitudes, such as that crime rates have increased due to immigration or that immigrants receive more social welfare assistance than natives. Significant differences in attitudes were revealed between students from the three universities. Discussion: Training in transcultural nursing is necessary for all nursing students in order to reduce negative attitudes towards the immigrant population and increase the awareness and sensitivity of future healthcare staff in caring for patients of all backgrounds.


Assuntos
Atitude do Pessoal de Saúde , Emigração e Imigração , Qualidade de Vida/psicologia , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Portugal , Estudos Prospectivos , Espanha , Universidades , Adulto Jovem
15.
Comput Math Methods Med ; 2020: 5379278, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33178332

RESUMO

The novel coronavirus (COVID-19) pandemic continues to be a global health problem whose impact has been significantly felt in South Africa. With the global spread increasing and infecting millions, containment efforts by countries have largely focused on lockdowns and social distancing to minimise contact between persons. Social distancing has been touted as the best form of response in managing a rapid increase in the number of infected cases. In this paper, we present a deterministic model to describe the impact of social distancing on the transmission dynamics of COVID-19 in South Africa. The model is fitted to data from March 5 to April 13, 2020, on the cumulative number of infected cases, and a scenario analysis on different levels of social distancing is presented. The model shows that with the levels of social distancing under the initial lockdown level between March 26 and April 13, 2020, there would be a projected continued rise in the number of infected cases. The model also looks at the impact of relaxing the social distancing measures after the initial announcement of the lockdown. It is shown that relaxation of social distancing by 2% can result in a 23% rise in the number of cumulative cases whilst an increase in the level of social distancing by 2% would reduce the number of cumulative cases by about 18%. The model results accurately predicted the number of cases after the initial lockdown level was relaxed towards the end of April 2020. These results have implications on the management and policy direction in the early phase of the epidemic.


Assuntos
/epidemiologia , Modelos Biológicos , Pandemias , /prevenção & controle , Biologia Computacional , Simulação por Computador , Emigração e Imigração/estatística & dados numéricos , Humanos , Conceitos Matemáticos , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Quarentena/estatística & dados numéricos , África do Sul/epidemiologia
16.
Pneumologie ; 74(11): 719-741, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33202436

RESUMO

The German Central Committee for the Fight against Tuberculosis (DZK) celebrates this year its 125th birthday. On this occasion, the DZK as one of the oldest TB organizations worldwide is looking back on the development during its history and records the results in a comprehensive book, summarized in this article. In the book, the various political changes with their impact on the DZK are mirrored, starting with the German Empire, the Weimar Republic, the so-called "Third Reich", the two German states separated after the Second World War and the current FRG. Tuberculosis (TB) was the dominant widespread disease in the 19th century, today it is the leading infectious disease worldwide. As a consequence of migration, this affects also Germany. After meanwhile - in particular in 2015/16 - risen numbers of new cases (especially of those not born in Germany, which in 2019 accounted for 72 % of all cases), the impact of drug-resistant tuberculosis (in 2019, 11.4 % of all new cases had some resistance (384 cases), including 87 cases of MDR-TB, and of these 8 cases of XDR-TB and 27 cases of pre-XDR-TB), as well as the high proportion (81,5 %) - in 2019 - of open and thus very infectious pulmonary TB among new TB cases in Germany, impressively show that TB continues to be a health problem that should not be underestimated and that is increasingly concentrated in risk groups (socially disadvantaged persons, people from high-prevalence countries, homeless people, drug addicts, alcoholics, HIV-infected persons). The DZK therefore continues to play an important role in TB control as a link between the national and international organizations responsible for combating TB.


Assuntos
Antituberculosos/uso terapêutico , Controle de Infecções/história , Tuberculose/tratamento farmacológico , Tuberculose/história , Emigração e Imigração , Alemanha/epidemiologia , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Prevalência , Fatores de Risco , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
17.
Rev Infirm ; 69(264): 39-40, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33129477

RESUMO

Some health care institutions in Quebec have nursing teams composed mainly of French professionals. For those who are considering a professional experience in Quebec, a French nurse offers feedback on recruitment in France and on the immigration procedures that allowed her to take up a position in Montreal in 2019.


Assuntos
Prática Profissional , Assistência à Saúde , Emigração e Imigração , Feminino , França , Humanos , Quebeque
18.
PLoS One ; 15(11): e0242148, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33237944

RESUMO

In many Western societies there are rising concerns about increasing polarization in public debate. However, statistics on private attitudes paint a different picture: the average attitudes in societies are more moderate and remain rather stable over time. The present paper presents an agent-based model of how such discrepancies between public opinion and private attitudes develop at the scale of micro-societies. Based on social psychological theorizing, the model distinguishes between two types of agents: a) those seeking to gain or maintain a good reputation and status, and b) those seeking to promote group harmony by reaching consensus. We characterized these different types of agents by different decision rules for either voicing their opinion or remaining silent, based on the behavior of their proximal network. Results of the model simulations show that even when the private attitudes of the agents are held constant, publicly expressed opinions can oscillate and (depending on the reputational concerns of individual actors) situations can occur in which minorities as well as majorities are silenced. We conclude that the macro-level consequences of micro-level decisions to either voice an opinion or remain silent provide a foundation for better understanding how public opinions are shaped. Moreover, we discuss the conditions under which public opinion could be considered a good representation of private attitudes in a society.


Assuntos
Atitude , Opinião Pública , Mídias Sociais , Comportamento , Redes Comunitárias , Simulação por Computador , Consenso , Cultura , Tomada de Decisões , Emigração e Imigração , Humanos , Internet , Modelos Estatísticos , Países Baixos , Grupo Associado , Apoio Social , Teoria Social , Sociedades , Estados Unidos
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