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2.
Rev. psicanal ; 26(3): http://revista.sppa.org.br/index.php/RPdaSPPA/article/view/470/490, dez. 2019.
Artigo em Português | LILACS | ID: biblio-1050026

RESUMO

O grupo formado a partir da parceria SMED ­ SPPA, que há mais de doze anos trabalha com o estudo e com a aplicação de técnicas que disponibilizem o conhecimento psicanalítico na formação continuada de profissionais voltados à educação infantil, expandiu-se para um grupo de pesquisa interinstitucional e interdisciplinar com a finalidade de estudar as Rodas de conversa SMED ­ SPPA através de metodologia desenvolvida ao longo desses anos. O presente artigo descreve sucintamente a história da parceria entre as duas instituições, apresentando também a Fase 1 do Projeto de Pesquisa Diálogo entre educação e psicanálise: rodas de conversa entre SMED e SPPA. Trata-se de pesquisa naturalística com abordagem qualitativa exploratória. Trabalha-se com uma amostra de dois grupos, compostos, cada um, por vinte educadores, um assessor pedagógico da SMED e dois psicanalistas da SPPA. Para a coleta de dados, são utilizados os seguintes instrumentos: gravação de vídeos das reuniões; cadernos de campo escritos pelos psicanalistas e assessores e, por fim, questionários sobre expectativas a serem preenchidos pelos educadores. As narrativas que emergem da transcrição dos vídeos são analisadas pelo método de Bardin. Aproveitar-se-á a primeira experiência de campo (Fase 1) para a definição das categorias temáticas significativas, de tal forma que a sua relevância seja testada em uma segunda rodada do trabalho de campo (AU)


The group formed from the SMED ­ SPPA partnership, which for over twelve years has been working with the study and application of techniques that provide psychoanalytic knowledge in the continuing education of professionals focused on early childhood education, formed an interinstitutional and interdisciplinary research group. The purpose of this research is to study the SMED ­ SPPA Conversation circles, a methodology developed over the years and which is a product of this partnership. This article briefly describes the history of the partnership between the two institutions, and also presents Phase 1 of the Research Project Dialogue between education and psychoanalysis: conversation circles between SMED and SPPA. It is a naturalistic research with exploratory qualitative approach. We work with a sample with two groups, each consisting of twenty educators, one SMED pedagogical advisor and two SPPA psychoanalysts. For data collection, the following instruments are used: video recording of meetings; field notebooks written by psychoanalysts and advisors; questionnaires about expectations to be fulfilled by educators. The narratives that emerge from the transcription of the videos will be analyzed by Bardin's method. The first field experiment (Phase 1) will be used to define meaningful thematic categories, so that their relevance is tested in a second round of fieldwork


El grupo formado a partir de la asociación SMED ­ SPPA, que durante más de doce años ha estado trabajando con el estudio y la aplicación de técnicas que proporcionan conocimiento psicoanalítico en la educación continua de profesionales centrados en la educación infantil, formó un grupo de investigación interinstitucional e interdisciplinario. El propósito de esta investigación es estudiar las ruedas de conversación SMED ­ SPPA, una metodología desarrollada a lo largo de los años y que es un producto de esta asociación. Este artículo describe brevemente la historia de la asociación entre las dos instituciones y también presenta la Fase 1 del Proyecto de Investigación Diálogo entre educación y psicoanálisis: ruedas de conversación entre SMED y SPPA. Es una investigación naturalista con enfoque cualitativo exploratorio. Trabajamos con una muestra con dos grupos, cada uno compuesto por veinte educadores, un asesor pedagógico de SMED y dos psicoanalistas de SPPA. Para la recolección de datos, se utilizan los siguientes instrumentos: grabación de video de reuniones; cuadernos de campo escritos por psicoanalistas y asesores; cuestionarios sobre expectativas que deben cumplir los educadores. Las narraciones que emergen de la transcripción de los videos son analizadas por el método de Bardin. El primer experimento de campo (Fase 1) se utilizará para definir categorías temáticas significativas, de modo que su relevancia se evalúe en una segunda ronda de trabajo de campo


Assuntos
Marginalização Social , Serviços Comunitários de Saúde Mental , Aconselhamento , Discriminação Social , Técnicas de Observação do Comportamento
3.
Aust N Z J Public Health ; 43(6): 582-588, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31577863

RESUMO

OBJECTIVE: To quantify barriers to healthcare for young people (12-24 years) and identify socio-demographic correlates and predictors. METHODS: This cross-sectional survey targeted young people living in New South Wales, Australia, with oversampling of marginalised groups. Principles Component Analysis (PCA) identified clusters of barriers. Ordinal regression identified predictors of each barrier cluster. RESULTS: A total of 1,416 young people completed surveys. Participants with chronic conditions and increasing psychological distress reported a greater number of barriers. Of 11 potential barriers to visiting a health service, cost was most common (45.8%). The PCA identified three clusters: structural barriers (61.3%), attitudinal barriers (44.1%) and barriers relating to emerging autonomy (33.8%). CONCLUSIONS: Barriers to healthcare reported by young people are multi-dimensional and have changed over time. Structural barriers, especially cost, are the most prominent among young people. Approaches to overcome structural barriers need to be addressed to better support marginalised young people's healthcare access. Implications for public health: Understanding predictors of different barrier types can inform more targeted approaches to improving access. Equitable access to healthcare is a priority for early diagnosis and treatment in young people, especially reducing out of pocket costs.


Assuntos
Atitude do Pessoal de Saúde , Assistência à Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Internet , Masculino , New South Wales , Marginalização Social , Inquéritos e Questionários , Populações Vulneráveis , Adulto Jovem
4.
RECIIS (Online) ; 13(3): 647-657, jul.-set. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1021549

RESUMO

Este estudo analisou a aplicação das práticas discursivas e produção de sentidos na descrição e interpretação dos sentidos dados a diferentes fenômenos em saúde mental no Brasil. Trata-se de uma revisão bibliográfica baseada na literatura especializada, a partir da consulta a estudos científicos selecionados utilizando a Biblioteca Virtual em Saúde (BVS) com as palavras-chave 'práticas discursivas' e 'produção de sentidos', no título, resumo ou assunto, resultando na seleção de 21 estudos, dada sua relação com a saúde mental. A aplicação desta teoria se deu na abordagem profissional e usuário, assistência terapêutica, formação profissional, maternidade, paternidade, adoção e percepção pessoal de fenômenos como crise, vulnerabilidade social, doença, cuidado, self, exclusão social e violência. Compreender esses fenômenos possibilita a reflexão sobre a práxis de profissionais de saúde mental e afins, contribuindo com estratégias de acolhimento e formação de vínculo na relação entre profissional e usuário a partir da interpretação dos sentidos.


This study has analyzed the application of discursive practices and production of meanings in the description and interpretation of the meanings given to different phenomena in mental health in Brazil. This is a bibliographical review based on specialized literature from the inquiry to selected scientific studies employing the Virtual Health Library (VHL) with the following keywords: 'discursive practices' and 'production of meanings', in the title, abstract or subject, resulting in the selection of 21 studies, given their relation to the mental health. The application of this theory is on the professional approach and user, therapeutic assistance, professional training, maternity, paternity, adoption and personal perception of phenomena such as crisis, social vulnerability, illness, care, self, social exclusion and violence. Understanding these phenomena enables the reflection about the praxis of mental health professionals and the like, contributing with strategies of integration and formation of links in the relationship between the professional and the user from the interpretation of the meanings.


Este estudio analizó la aplicación de las prácticas discursivas y producción de los sentidos en la descripción e interpretación de los sentidos dados a diferentes fenómenos en salud mental en Brasil. Se trata de una revisión bibliográfica basada en la literatura especializada, a partir de la consulta a estudios científicos utilizando la Biblioteca Virtual en Salud (BVS) con las palabras clave: 'prácticas discursivas' y 'producción de sentidos', en el título, resumen o asunto, resultando en la selección de 21 estudios, dada su relación con la salud mental. La aplicación de esta teoría se dio en el enfoque profesional y usuario, asistencia terapéutica, formación profesional, maternidad, paternidad, adopción, y percepción personal de fenómenos como crisis, vulnerabilidad social, enfermedad, cuidado, self, exclusión social y violencia. Comprender estos fenómenos posibilita la reflexión sobre la praxis de profesionales de salud mental y afines, contribuyendo con estrategias de acogida y formación de vinculo en la relación entre profesional y usuario a partir de los sentidos.


Assuntos
Humanos , Psicologia Social , Saúde Mental , Comunicação , Assistência Integral à Saúde , Saúde Holística , Linguagem , Relações Médico-Paciente , Brasil , Revisão , Discurso , Vulnerabilidade Social , Marginalização Social , Serviços de Saúde Mental
5.
RECIIS (Online) ; 13(3): 658-670, jul.-set. 2019. ilus, graf
Artigo em Português | LILACS | ID: biblio-1021559

RESUMO

Como grupo social estigmatizado, pessoas transgêneras são alvo de violência e invisibilização de suas demandas. Partindo da constatação preliminar de que o discurso científico tem naturalizado e localizado a verdade sobre o gênero nas estruturas corporais, desenvolvemos uma pesquisa, no âmbito de um mestrado acadêmico, cujo objetivo foi caracterizar modos de visibilidade de pessoas trans na produção científica brasileira. A estratégia metodológica foi delinear um panorama dessa produção. O trabalho consistiu na busca de estudos na SciELO CI, na WoS e no Scopus; na análise de autores, instituições, áreas do conhecimento e países envolvidos; e na análise de assunto. O corpus identificado foi de 293 estudos. Os resultados revelam uma diversificação nas áreas de pesquisa e necessidade de atendimento integral adequado, do fomento à pesquisa, de discussão de gênero nas escolas e do cuidado ao nomear grupos estigmatizados. O objetivo do artigo é apresentar esse panorama.


As a result of being a stigmatized social group, transgender people are victmis of violence and invisibility of their demands. Based on the preliminary perception that the scientific discourse has naturalized and localized the truth about gender in the body structures, we developed a research within the scope of an academic master degree whose objective was to characterize modes of visibility of trans people in Brazilian scientific production. The methodological strategy was to outline an overview of this production. The work consisted in searching for studies in SciELO CI, WoS and Scopus; in the analysis of authors, institutions, areas of knowledge and countries involved; and in the subject analysis. The corpus identified was formed from 293 studies. The results reveal a diversification in the areas of research and the need for adequate integral care, promotion of research, gender discussion in schools and care in naming stigmatized groups. The purpose of the article is to present this overview.


Como grupo estigmatizado, las personas transgénero son objeto de violencia e invisibilización de sus demandas. A partir de la constatación preliminar de que el discurso científico ha naturalizado y localizado la verdad sobre el género en las estructuras corporales, desarrollamos una investigación durante el grado de máster académico cuyo objetivo fue caracterizar modos de visibilidad de personas trans en la producción científica brasileña. La estrategia metodológica fue delinear un panorama de esa producción. El trabajo consistió en la búsqueda de estudios en la SciELO CI, en la WoS y en el Scopus; en el análisis de autores, instituciones, áreas del conocimiento y países comprometidos; y en el análisis de asunto. Contamos con la identificación de un corpus de 293 estudios. Los resultados revelan diversificación en las áreas de investigación y necesidad de atención integral adecuada, del fomento a la investigación, de discusión de género en las escuelas y del cuidado al nombrar grupos estigmatizados. El objetivo del artículo es presentar ese panorama.


Assuntos
Humanos , Violência , Disparidades nos Níveis de Saúde , Estigma Social , Comunicação em Saúde , Pessoas Transgênero , Minorias Sexuais e de Gênero , Síndrome de Imunodeficiência Adquirida , HIV , Atividades Científicas e Tecnológicas , Políticas Públicas de Saúde , Marginalização Social
6.
Artigo em Inglês | MEDLINE | ID: mdl-31438546

RESUMO

The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear that lessons from the past can be quickly forgotten-or be incomplete in the first instance. In this article, we seek to understand the health challenges facing marginalised people by elaborating on the multiple dimensions of marginalisation in the case of the West Africa Ebola epidemic. We trace and unpack modes of marginalisation, beginning with the "outbreak narrative" and its main components and go on to examine other framings, including the prioritisation of the present over the past, the positioning of 'Us versus Them'; and the marginalisation-in responses to the outbreak-of traditional medicine, cultural practices and other practices around farming and hunting. Finally, we reflect on the 'lessons learned' framing, highlighting what is included and what is left out. In conclusion, we stress the need to acknowledge-and be responsive to-the ethical, normative framings of such marginalisation.


Assuntos
Doença pelo Vírus Ebola/epidemiologia , África Ocidental/epidemiologia , Surtos de Doenças , Humanos , Marginalização Social
7.
Rev Esp Salud Publica ; 932019 Jul 10.
Artigo em Espanhol | MEDLINE | ID: mdl-31290485

RESUMO

"Hidden populations" are difficult to identify because they have stigmatizing or illegal characteristics. For that reason, determining their size or prevalence in certain contexts is complicated. In those populations, traditional or direct methods, as population surveys, do not usually serve for this purpose, but indirect methods, based on incomplete data sources, can be useful.This work completes the original article published in Revista Española de Salud Pública in 2017: "Indirect methods to estimate hidden populations". Different methods are exposed, showing their indications and bias. To make an estimation as real as possible it is necessary to evaluate carefully the data available and analyze the risk of bias.


Assuntos
Interpretação Estatística de Dados , Vigilância em Saúde Pública/métodos , Marginalização Social , Estigma Social , Imigrantes Indocumentados/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Viés , Humanos , Espanha/epidemiologia
8.
Salud Publica Mex ; 61(3): 249-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276340

RESUMO

OBJECTIVE: To analyze the mortality trend of lung cancer (LC) in Mexico, according to the municipality marginalization index (MMI) by age group and sex, during the period 1998-2016. MATERIALS AND METHODS: The information on mortality, population and MMI was obtained from the National Institute of Statistics and Geography (INEGI) and the National Council of Population (Conapo). The adjusted LC mortality rate trends were analyzed using the joinpoint regression analysis. A total of 126 132 deaths were included. RESULTS: The adjusted LC mortality rate decreased from 7.83 to 4.97 100 000 inhabitants during the period from 1998-2016, but the decrease was found to be less in women and in areas with very high marginalization. CONCLUSIONS: Unequal reduction in LC mortality according to the degree of marginalization are related to early diagnosis, timely treatment and inequity in medical services. This inequity affects mainly the populations of women, highly marginalized groups and older populations.


Assuntos
Neoplasias Pulmonares/mortalidade , Adulto , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mortalidade/tendências , Marginalização Social , Fatores de Tempo
9.
J Addict Nurs ; 30(2): 101-107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162213

RESUMO

The experience and meaning attributed to care by nurses and received by nine persons who inject drugs during a healthcare encounter in the acute care medical setting was examined. A descriptive case study approach using an interpersonal nursing model served as the theoretic framework. Four overarching themes were discovered: marginalization, defensiveness, repeated victimization, and understanding addiction. Findings suggest that role support, application of an interpersonal nursing theory, and implementations of addiction-trained healthcare teams were missing from the hospital experience of persons who inject drugs. However, when the nurse connected with the patient who injects drugs on an interpersonal level, positive outcomes followed.


Assuntos
Atitude Frente a Saúde , Cuidados de Enfermagem/psicologia , Abuso de Substâncias por Via Intravenosa/psicologia , Adulto , Vítimas de Crime/psicologia , Mecanismos de Defesa , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/normas , Satisfação do Paciente , Percepção , Autocuidado , Autoimagem , Marginalização Social/psicologia , Estereotipagem , Abuso de Substâncias por Via Intravenosa/enfermagem , Tempo para o Tratamento , Confiança , Adulto Jovem
10.
Pediatrics ; 144(1)2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31235609

RESUMO

BACKGROUND: Because little is known about long-term effects of adolescent protective factors across multiple health domains, we examined associations between adolescent connectedness and multiple health-related outcomes in adulthood. METHODS: We used weighted data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 14 800). Linear and logistic models were used to examine associations between family and school connectedness in adolescence and self-reported health risk behaviors and experiences in adulthood, including emotional distress, suicidal thoughts and attempts, physical violence victimization and perpetration, intimate partner physical and sexual violence victimization, multiple sex partners, condom use, sexually transmitted infection (STI) diagnosis, prescription drug misuse, and other illicit drug use. RESULTS: In multivariable analyses, school connectedness in adolescence had independent protective associations in adulthood, reducing emotional distress and odds of suicidal ideation, physical violence victimization and perpetration, multiple sex partners, STI diagnosis, prescription drug misuse, and other illicit drug use. Similarly, family connectedness had protective effects for emotional distress, all violence indicators, including intimate partner violence, multiple sex partners, STI diagnosis, and both substance use indicators. Compared to individuals with low scores for each type of connectedness, having high levels of both school and family connectedness was associated with 48% to 66% lower odds of health risk behaviors and experiences in adulthood, depending on the outcome. CONCLUSIONS: Family and school connectedness may have long-lasting protective effects across multiple health outcomes related to mental health, violence, sexual behavior, and substance use. Increasing both family and school connectedness during adolescence has the potential to promote overall health in adulthood.


Assuntos
Saúde do Adolescente , Relações Familiares/psicologia , Instituições Acadêmicas , Distância Social , Identificação Social , Isolamento Social/psicologia , Marginalização Social/psicologia , Adolescente , Adulto , Comportamento Perigoso , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Modelos Logísticos , Estudos Longitudinais , Masculino , Saúde Mental , Fatores de Proteção , Psicologia do Adolescente , Autorrelato
11.
BMC Public Health ; 19(Suppl 4): 553, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196009

RESUMO

BACKGROUND: The high number of adolescents and young adults harbouring suicidal ideation, as reported by the Ministry of Health Malaysia, is alarming. This cross-sectional study aims to examine the association between social support and spiritual wellbeing in predicting suicidal ideation among Malaysian adolescents. METHODS: A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB). RESULTS: The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents. CONCLUSION: Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.


Assuntos
Marginalização Social/psicologia , Apoio Social , Espiritualidade , Ideação Suicida , Adolescente , Estudos Transversais , Feminino , Amigos/psicologia , Humanos , Malásia , Masculino , Fatores de Risco , População Urbana/estatística & dados numéricos , Adulto Jovem
12.
BMC Public Health ; 19(1): 732, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185954

RESUMO

BACKGROUND: Women in India are often asked to make informal payments for maternal health care services that the government has mandated to be free. This paper is a descriptive case study of a social accountability project undertaken by SAHAYOG, a nongovernmental organization in Uttar Pradesh, India. SAHAYOG worked with community-based organizations and a grassroots forum comprised of low caste, Muslim, and tribal women to decrease the prevalence of health provider demands that women and their families make informal payments. METHODS: The study entailed document review; interviews and focus group discussions with program implementers, governmental stakeholders, and community activists; and participant observation in health facilities. RESULTS: The study found that SAHAYOG adapted their strategy over time to engender greater empowerment and satisfaction among program participants, as well as greater impact on the health system. Participants gained knowledge resources and agency; they learned about their entitlements, had access to mechanisms for complaints, and, despite risk of retaliation, many felt capable of demanding their rights in a variety of fora. However, only program participants seemed successfully able to avoid making informal payments to the health sector; health providers still demanded that other women make payments. Several features of the micro and macro context shaped the trajectory of SAHAYOG's efforts, including deeply rooted caste dynamics, low provider commitment to ending informal payments, the embeddedness of informal payments, human resources scarcity, and the overlapping private interests of pharmaceutical companies and providers. CONCLUSION: Though changes were manifest in certain fora, providers have not necessarily embraced the notion of low caste, tribal, or Muslim women as citizens with entitlements, especially in the context of free government services for childbirth. Grassroots advocates, CBOs, and SAHAYOG assumed a supremely difficult task. Project strategy changes may have made the task somewhat less difficult, but given the population making the rights claims and the rights they were claiming, widespread changes in demands for informal payments may require a much larger and stronger coalition.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde Materna/economia , Parto/psicologia , Pobreza/psicologia , Marginalização Social/psicologia , Adulto , Medo , Feminino , Grupos Focais , Gastos em Saúde/legislação & jurisprudência , Humanos , Índia , Islamismo/psicologia , Organizações , Grupos Populacionais/psicologia , Pobreza/economia , Gravidez , Classe Social , Responsabilidade Social
13.
Licere (Online) ; 22(02): i:18-f:47, junho.2019. ilus
Artigo em Português | LILACS | ID: biblio-1007636

RESUMO

O objetivo deste trabalho foi mapear e analisar os espaços públicos de esporte e lazer disponíveis no Morro da Formiga, favela localizada no bairro da Tijuca, na cidade do Rio de Janeiro. Trata-se de uma pesquisa de campo, em que foram realizadas observações in loco dos espaços de lazer sobre as condições de conservação e acessibilidade para a população. O Morro da Formiga tem espaços de lazer muito frequentados pelos moradores, como a escola de samba Império da Tijuca, o baile funk e os bares. No entanto, as praças públicas e programas de prática de atividades físicas têm graves problemas para sua efetivação, o que restringe fortemente a utilização desses espaços. Concluímos que, a despeito das iniciativas de lazer que se fomentam pelo próprio interesse dos moradores, a insuficiente promoção e conservação dos espaços públicos de esporte e lazer refletem a produção e distribuição desigual das políticas públicas na cidade.


The aim of this text was to map and analyze the public sports and leisure spaces available in Morro da Formiga, a favela located in the Tijuca neighborhood, in the city of Rio de Janeiro. This is a field research, in which observations were made in loco of the leisure spaces about of the conditions of conservation and accessibility for the population as a whole. The Morro da Formiga has leisure spaces very frequented by residents, such as the samba school Império da Tijuca, funk dancing and bars. However, public squares and programs of physical activities practice have serious problems for their effectiveness, which strongly restricts the use of these spaces. We conclude that, in spite of the leisure initiatives that are fostered by the residents' own interest, the insufficient promotion and conservation of the public spaces of sports and leisure reflects the unequal production and distribution of public policies in the city.


Assuntos
Humanos , Política Pública , Segurança , Condições Sociais , Violência , Áreas de Pobreza , Área Urbana , Características Culturais , Iniquidade Social , Estigma Social , Marginalização Social , Direitos Socioeconômicos , Atividades de Lazer
14.
Folia Phoniatr Logop ; 71(2-3): 83-93, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31085926

RESUMO

BACKGROUND: The purpose of this paper is to describe the content and process of a literacy and language support model that was implemented with young children from marginalised communities, where no access to speech and language pathologist (SLP) services exists. The importance of language for literacy development is emphasised with explicit strategies for classroom application. METHOD: The SLP introduced an intervention programme to Early Childhood Development (ECD) kindergarten teachers, as part of a pre- and post-test literacy study. The strategies included oral reading, one-on-one reading and paired-reading. The participants provided informed consent. The intervention was presented to the experimental (Exp) group during the study process and to the comparison group after the study was completed. RESULTS: Post-intervention findings revealed a significant improvement in the Exp group scores on concepts about print. The ECD teachers reported a difference in the children's awareness of printed materials, confirming that the approaches introduced by the SLP are central in teachers' instruction. This finding supports the contribution that emergent literacy and language support models would have for children, especially those from marginalised communities, where access to resources are limited. Furthermore, the collaboration between SLP and the ECD staff will strengthen these support structures. Thus, explicit early intervention develops skills for school-readiness and academic success; this forms part of the solution in providing early access to language and literacy programmes in developing countries.


Assuntos
Educação , Marginalização Social , Capacitação de Professores/organização & administração , Pré-Escolar , Estudos de Avaliação como Assunto , Feminino , Humanos , Renda , Masculino , Leitura , Fatores de Risco , Professores Escolares , Fatores Socioeconômicos , África do Sul , Patologia da Fala e Linguagem , Capacitação de Professores/métodos , Materiais de Ensino
18.
AIDS Behav ; 23(12): 3267-3276, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30924066

RESUMO

The potential for changes in socio-economic status, such as employment exits, to increase HIV infection risk are not well examined among people who inject illicit drugs (PWID). We used longstanding cohort data from Vancouver, Canada, to longitudinally assess associations between employment cessation and outcomes with documented linkages to HIV infection risk among PWID. From 2005 to 2015, 1222 participants reported 1154 employment exits. Employment exits were significantly associated with transitions into unstable housing; moving to the inner-city; initiating informal, prohibited or illegal income generation; high risk drug use practices; and exiting methadone maintenance therapy. HIV infection rates were higher among participants with lower long-term labour market engagement. These findings suggest that employment cessation coincides with initiating exposure to aspects of socioeconomic marginalization and drug use associated with HIV infection risk. Support for employment retention that prevents poverty entrenchment and harmful drug use could contribute to HIV prevention measures for PWID.


Assuntos
Emprego , Infecções por HIV/psicologia , Habitação , Acontecimentos que Mudam a Vida , Marginalização Social , Abuso de Substâncias por Via Intravenosa/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Canadá , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Estado Civil , Metadona/uso terapêutico , Pessoa de Meia-Idade , Tratamento de Substituição de Opiáceos , Meio Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
20.
Int J Equity Health ; 18(1): 41, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832651

RESUMO

BACKGROUND: Young people have unique social, emotional and developmental needs that require a welcoming and responsive health system, and policies that support their access to health care. Those who are socially or culturally marginalised may face additional challenges in navigating health care, contributing to health inequity. The aim of this study was to understand health system navigation, including the role of technology, for young people belonging to one or more marginalised groups, in order to inform youth health policy in New South Wales, Australia. METHODS: This qualitative longitudinal study involved 2-4 interviews each over 6 to 12 months with marginalised young people aged 12-24 years living in NSW. The analysis used Nvivo software and grounded theory. RESULTS: We interviewed 41 young people at baseline who were living in rural or remote areas, sexuality and/or gender diverse, refugee, homeless, and/or Aboriginal. A retention rate of over 85% was achieved. Nineteen belonged to more than one marginalised group allowing an exploration of intersectionality. General practitioners (family physicians) were the most commonly accessed service throughout the study period. Participants were ambivalent about their healthcare journeys. Qualitative analysis identified five themes: 1. Technology brings opportunities to understand, connect and engage with services 2. Healthcare journeys are shaped by decisions weighing up convenience, engagement, effectiveness and affordability. 3. Marginalised young people perceive and experience multiple forms of discrimination leading to forgone care. 4. Multiple marginalisation makes health system navigation more challenging 5. The impact of health system complexity and fragmentation may be mitigated by system knowledge and navigation support CONCLUSIONS: The compounding effects of multiple discrimination and access barriers were experienced more strongly for young people belonging to mutiple marginalised groups. We identify several areas for improving clinical practice and policy. Integrating technology and social media into processes that facilitate access and navigation, providing respectful and welcoming services that recognise diversity, improving health literacy and involving professionals in advocacy and navigation support may help to address these issues.


Assuntos
Assistência à Saúde/organização & administração , Equidade em Saúde , Acesso aos Serviços de Saúde , Marginalização Social , Adolescente , Criança , Feminino , Política de Saúde , Humanos , Estudos Longitudinais , Masculino , New South Wales , Pesquisa Qualitativa , Adulto Jovem
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