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1.
Rev. enferm. UERJ ; 28: e39729, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116093

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Acidentes/estatística & dados numéricos , Causas de Morte , Populações Vulneráveis/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Brasil , Epidemiologia Descritiva , Fatores Etários , Vulnerabilidade Social , Mortalidade Prematura
2.
Rev. enferm. UERJ ; 28: e39222, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116097

RESUMO

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.


Assuntos
Humanos , Populações Vulneráveis , Vulnerabilidade em Saúde , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/tendências , Equidade em Saúde , Acolhimento
3.
J Addict Med ; 14(6): e293-e296, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33156267

RESUMO

: The COVID-19 pandemic is likely to exacerbate existing anxiety and substance use disorders (SUDs) and increase vulnerability among individuals previously free of these conditions. Numerous pandemic-related stressors-coronavirus infection fears, social distancing and isolation, activity restrictions, financial insecurity and unemployment, caregiving or childcare responsibilities-place a substantial burden both on the general population and on many health care providers. Anxiety symptoms such as worry, tension, irritability, difficulty concentrating, and sleep disruption are increasingly prevalent. For individuals in SUD treatment, anxiety can complicate efforts to achieve treatment goals. In this commentary, we outline the potential impact of anxiety on substance use problems during the COVID-19 crisis and describe key behavioral, pharmacological, and digital health treatment considerations. We highlight populations of special concern due to heightened vulnerability and challenges accessing services, strategies to support health care providers, and directions for future research.


Assuntos
Transtornos de Ansiedade/terapia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Transtornos de Ansiedade/etiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Acesso aos Serviços de Saúde , Humanos , Controle de Infecções , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Populações Vulneráveis
5.
J Acquir Immune Defic Syndr ; 85(4): e67-e69, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33136755

RESUMO

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.


Assuntos
Infecções por Coronavirus/psicologia , Infecções por HIV/complicações , Pneumonia Viral/psicologia , Pessoas Transgênero/psicologia , Populações Vulneráveis/psicologia , Boston , Infecções por Coronavirus/complicações , Feminino , Acesso aos Serviços de Saúde/tendências , Humanos , Estudos Longitudinais , Masculino , Mid-Atlantic Region , Pandemias , Pneumonia Viral/complicações , Carência Psicossocial , Apoio Social , Fatores Socioeconômicos , Sudeste dos Estados Unidos
6.
Int J Equity Health ; 19(1): 198, 2020 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-33158449

RESUMO

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.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Populações Vulneráveis , Infecções por Coronavirus/epidemiologia , Governo , Humanos , Higiene , Pneumonia Viral/epidemiologia , Quarentena/legislação & jurisprudência , República da Coreia/epidemiologia , Distância Social
8.
Epilepsy Behav ; 112: 107476, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33181895

RESUMO

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.


Assuntos
Anticonvulsivantes , Infecções por Coronavirus/prevenção & controle , Coronavirus , Epilepsia/tratamento farmacológico , Acesso aos Serviços de Saúde , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Isolamento Social , Anticonvulsivantes/economia , Anticonvulsivantes/provisão & distribução , Anticonvulsivantes/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Epilepsia/epidemiologia , Feminino , Recursos em Saúde , Humanos , Estudos Longitudinais , Masculino , Adesão à Medicação , Paquistão , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Convulsões/epidemiologia , Inquéritos e Questionários , Telemedicina , Populações Vulneráveis
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.
Pan Afr Med J ; 35(Suppl 2): 142, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193957

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência Alimentar , Abastecimento de Alimentos , Pandemias , Pneumonia Viral/epidemiologia , Características da Família , Assistência Alimentar/economia , Assistência Alimentar/organização & administração , Assistência Alimentar/estatística & dados numéricos , Abastecimento de Alimentos/economia , Abastecimento de Alimentos/estatística & dados numéricos , Humanos , Colaboração Intersetorial , População Rural , Uganda/epidemiologia , Populações Vulneráveis
11.
Artigo em Inglês | PAHO-IRIS | ID: phr-53008

RESUMO

[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.


Assuntos
Infecções por HIV , Populações Vulneráveis , Comportamento Sexual , Jamaica , Infecções por HIV , Populações Vulneráveis , Comportamento Sexual , Infecções por HIV , Populações Vulneráveis , Comportamento Sexual
12.
Washington, D.C.; PAHO; 2020-11-09. (PAHO/NMH/MH/Covid-19/20-0044).
Não convencional em Inglês | PAHO-IRIS | ID: phr-52999

RESUMO

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.


Assuntos
Infecções por Coronavirus , Coronavirus , Betacoronavirus , Saúde Mental , Fatores de Risco , Populações Vulneráveis , Transtornos Relacionados ao Uso de Substâncias , América
13.
Psicothema ; 32(4): 501-507, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33073755

RESUMO

BACKGROUND: A pandemic disaster has specific effects on mental health, however, little is known about those specific effects in children and adolescents. Thus, the aim of this study is to describe the psychological impact of the COVID-19 pandemic on a sample of children and adolescents and to compare the results with previous national data and other studies to determine variations. METHOD: A total of 459 children and adolescents in residential care, foster families, kinship families, or family strengthening programs under SOS Children's Villages Spain were evaluated using the SDQ to measure internalizing and externalizing problems and using KIDSCREEN-10 index to measure heath related quality of life. An independent sample t-test, one-way ANOVA and the chi-square test were used. RESULTS: The children and adolescents in this study had worse psychological wellbeing than those in the 2017 Spanish reference, that is, before the COVID-19 outbreak. Quality of life remained the same. No differences between care modalities were found. CONCLUSION: It is necessary to monitor the mental health status of children and adolescents to prevent possible problems. Additionally, it is necessary to use well-known assessment instruments because it is essential to have a reference to other situations and populations.


Assuntos
Betacoronavirus , Criança Adotada/psicologia , Criança Acolhida/psicologia , Criança Institucionalizada/psicologia , Infecções por Coronavirus/psicologia , Pandemias , Pneumonia Viral/psicologia , Psicologia do Adolescente , Psicologia da Criança , Adolescente , Criança , Características da Família , Feminino , Cuidados no Lar de Adoção , Humanos , Masculino , Qualidade de Vida/psicologia , Quarentena/psicologia , Instituições Residenciais , Espanha , Populações Vulneráveis
14.
PLoS One ; 15(10): e0240709, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064771

RESUMO

At present nearly half of the world's population is under some form of government restriction to curb the spread of COVID-19, an extremely contagious disease. In Bangladesh, in the wake of five deaths and 48 infections from COVID-19, between March 24 and May 30, 2020, the government imposed a nationwide lockdown. While this lockdown restricted the spread of COVID-19, in the absence of effective support, it can generate severe food and nutrition insecurity for daily wage-based workers. Of the 61 million employed labor force in Bangladesh, nearly 35% of them are paid on a daily basis. This study examines the food security and welfare impacts of the COVID-19 induced lockdown on daily wage workers both in the farm and nonfarm sectors in Bangladesh. Using information from more than 50,000 respondents complied with the 2016-17 Household Income and Expenditure Survey (HIES) in Bangladesh, this study estimates daily wage rates as Bangladesh Taka (BDT) 272.2 in the farm sector and BDT 361.5 in the nonfarm sector. Using the estimated daily wage earnings, this study estimates that a one-day complete lockdown generates a US$64.2 million equivalent economic loss only considering the wage loss of the daily wage workers. After estimating the daily per capita food expenditure separately for farm and nonfarm households, this study estimates a minimum compensation package for the daily wage-based farm and nonfarm households around the US $ 1 per day per household to ensure minimum food security for the daily wage-based worker households.


Assuntos
Betacoronavirus , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Abastecimento de Alimentos , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Política Pública/economia , Quarentena/economia , Populações Vulneráveis , Adulto , Bangladesh/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Características da Família , Fazendas , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Pobreza , Quarentena/métodos , Salários e Benefícios , Inquéritos e Questionários , Desemprego
15.
R I Med J (2013) ; 103(9): 41-46, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33126788

RESUMO

The COVID-19 pandemic has exacerbated the effects of existing health disparities throughout the United States. While Hispanic/Latino individuals account for only 16% of the Rhode Island (RI) population, Rhode Island Department of Health (RIDOH) data show that 45% of COVID-19 cases and 36% of individuals who have been hospitalized identify as Hispanic/Latino. Clínica Esperanza/Hope Clinic (CEHC) mobilized a comprehensive effort to offer telehealth visits, health education and accessible, walk-up COVID-19 testing for low-income, uninsured and Spanish-speaking individuals living in Rhode Island. With support from CEHC volunteers, the City of Providence, the State of Rhode Island, and local foundations, CEHC has administered 1,649 individual COVID-19 tests as of October 2020. The overall COVID-19 test positivity rate at CEHC was 23%, peaking in April at 48%. Additionally, CEHC has distributed more than 1,600 meal boxes to patients experiencing food insecurity, provided emergency financial resources, while rapidly scaling up healthcare services for the increasing numbers of uninsured individuals in RI.


Assuntos
Instituições de Assistência Ambulatorial , Infecções por Coronavirus/diagnóstico , Apoio Financeiro , Abastecimento de Alimentos , Educação em Saúde , Hispano-Americanos , Pessoas sem Cobertura de Seguro de Saúde , Pneumonia Viral/diagnóstico , Telemedicina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Técnicas de Laboratório Clínico , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Rhode Island , Populações Vulneráveis , Adulto Jovem
16.
J Int AIDS Soc ; 23(10): e25632, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33119183

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Minorias Sexuais e de Gênero , Populações Vulneráveis , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Feminino , Infecções por HIV/complicações , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Renda , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Profilaxia Pré-Exposição , Prisioneiros , Saúde Pública , Fatores de Risco , Profissionais do Sexo , Doenças Sexualmente Transmissíveis/prevenção & controle , Estigma Social , Carga Viral
17.
BMC Med Educ ; 20(1): 377, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092586

RESUMO

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.


Assuntos
Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Estudantes de Medicina , Exclusão Digital , Educação Médica/métodos , Humanos , Entrevistas como Assunto , Pandemias , Educação de Pacientes como Assunto , Telefone , Assistência Terminal , Reino Unido , Populações Vulneráveis
19.
BMC Nephrol ; 21(1): 449, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33109103

RESUMO

The pandemic of coronavirus disease 2019 (CoVID-19) has been an unprecedented period. The disease afflicts multiple organ systems, with acute kidney injury (AKI) a major complication in seriously ill patients. The incidence of AKI in patients with CoVID-19 is variable across numerous international studies, but the high incidence of AKI and its associated worse outcomes in the critical care setting are a consistent finding. A multitude of patterns and mechanisms of AKI have been elucidated, and novel strategies to address shortage of renal replacement therapy equipment have been implemented. The disease also has had consequences on longitudinal management of patients with chronic kidney disease and end stage kidney disease. Kidney transplant recipients may be especially susceptible to CoVID-19 as a result of immunosuppression, with preliminary studies demonstrating high mortality rates. Increased surveillance of disease with low threshold for testing and adjustment of immunosuppression regimen during acute periods of illness have been recommended.


Assuntos
Lesão Renal Aguda/etiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Falência Renal Crônica/terapia , Transplante de Rim , Pneumonia Viral/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/terapia , Fatores Etários , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Cuidados Críticos , Disparidades em Assistência à Saúde , Humanos , Imunossupressão/efeitos adversos , Imunossupressão/métodos , Incidência , Falência Renal Crônica/complicações , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Transplante de Rim/mortalidade , Pandemias , Peptidil Dipeptidase A , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Insuficiência Renal Crônica/complicações , Terapia de Substituição Renal/instrumentação , Fatores de Risco , Fatores Sexuais , Transplantados , Populações Vulneráveis
20.
Rev Bras Enferm ; 73(suppl 2): e20200312, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33111778

RESUMO

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.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde do Indígena , Índios Sul-Americanos/psicologia , Motivação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Brasil/epidemiologia , Brasil/etnologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/psicologia , Serviços de Saúde do Indígena/organização & administração , Humanos , Índios Sul-Americanos/etnologia , Medicina Tradicional , Determinação de Necessidades de Cuidados de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Pneumonia Viral/psicologia , Populações Vulneráveis
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