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1.
PLoS One ; 16(4): e0250236, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33857253

RESUMO

After a decade of civil war and the 2014-2016 West African Ebola outbreak, Sierra Leone now faces the COVID-19 pandemic with a fragile health system. As was demonstrated during Ebola, preparedness is key to limiting a health crisis' spread and impact on health systems and ensuring continued care for vulnerable populations including people living with HIV (PLHIV). To assess COVID-19 preparedness and inform interventions to ensure continuity of HIV services at health facilities (HFs) and community service points (CSPs), we conducted site readiness assessments in Freetown, the epicenter of COVID-19 in Sierra Leone. Data were collected at nine high-volume HIV HFs and seven CSPs in April 2020, a month after COVID-19 was declared a pandemic. CSPs comprised three community drop-in centers providing HIV counseling and testing services as well as HIV prevention services (e.g., condoms and lubricants) for key and priority populations and four community-based support groups serving PLHIV. At the time of assessment, CSPs did not provide antiretroviral therapy (ART) but were considered potential sites for expansion of differentiated service delivery (DSD)-a client-centered approach to HIV care-in the context of COVID-19. Overall, 5/9 HFs had trained staff on use of personal protective equipment (PPE) and prevention of COVID-19 transmission. Most had access to masks (5/9) and gloves (7/9) for management of suspected/confirmed COVID-19 cases, and 4/9 HFs had triage procedures for isolation of suspected cases. Conversely, few CSPs had access to masks (2/7) or gloves (2/7) and no staff were trained on PPE use or COVID-19 transmission. 7/9 HFs had adequate ART stock for multi-month dispensing though few had procedures for (3/9) or had trained staff in providing DSD (2/9). Among CSPs where measures were applicable, 2/4 had procedures for DSD, 1/3 had staff trained on DSD and none had adequate ART stock. Identification of gaps in COVID-19 preparedness is a critical step in providing support for infection control and modified service delivery. Findings from this assessment highlight gaps in COVID-19 preparedness measures at sites supporting PLHIV in Sierra Leone and indicate CSPs may require intensive supervision and training to ensure HIV services are uninterrupted while minimizing COVID-19 risk, especially if used as sites to scale up DSD.


Assuntos
/epidemiologia , Infecções por HIV/epidemiologia , /prevenção & controle , Controle de Doenças Transmissíveis , Surtos de Doenças , Instalações de Saúde , Humanos , Equipamento de Proteção Individual , Serra Leoa/epidemiologia , Seguridade Social
2.
Nat Hum Behav ; 5(4): 529-538, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33686204

RESUMO

COVID-19 has prompted unprecedented government action around the world. We introduce the Oxford COVID-19 Government Response Tracker (OxCGRT), a dataset that addresses the need for continuously updated, readily usable and comparable information on policy measures. From 1 January 2020, the data capture government policies related to closure and containment, health and economic policy for more than 180 countries, plus several countries' subnational jurisdictions. Policy responses are recorded on ordinal or continuous scales for 19 policy areas, capturing variation in degree of response. We present two motivating applications of the data, highlighting patterns in the timing of policy adoption and subsequent policy easing and reimposition, and illustrating how the data can be combined with behavioural and epidemiological indicators. This database enables researchers and policymakers to explore the empirical effects of policy responses on the spread of COVID-19 cases and deaths, as well as on economic and social welfare.


Assuntos
Controle de Doenças Transmissíveis , Governo , Política Pública , Seguridade Social , Busca de Comunicante , Bases de Dados Factuais , Apoio Financeiro , Política de Saúde , Humanos , Máscaras , Instituições Acadêmicas , Transportes , Viagem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33525441

RESUMO

During the COVID-19 pandemic, social interactions were restricted, including community services for disabled older adults. This study aimed to describe the change of use in community services related to long-term care insurance (LTCI) during the pandemic in Japan. A retrospective descriptive study was conducted using data collected via a cloud-based management support platform for older adult care provider "Kaipoke", by a private-sector company "SMS Co., Ltd.", in which care-managers of LTCI manage their office work. Data collection occurred from July 2019 to June 2020. Study subjects were LTCI service users aged 65 years and above. Subjects were living at home. We examined changes in the number of users of LTCI services before and after the COVID-19 pandemic began, using an interrupted time-series analysis. Results indicated that the use of outpatient services was reduced; however, home-visit services were maintained. The decrease in use was significant in the seven prefectures where the infection initially spread. There are concerns that older adults or surrounding caregivers can be affected by such changes in LTC service use. It is therefore necessary to implement sustainable measures from a long-term perspective and investigate their influence as part of future studies.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Seguro de Assistência de Longo Prazo , Pandemias , Idoso , Humanos , Análise de Séries Temporais Interrompida , Japão/epidemiologia , Estudos Retrospectivos , Seguridade Social
5.
PLoS One ; 16(1): e0245088, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33444366

RESUMO

This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Pessoas em Situação de Rua , Habitação , Seguridade Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quebeque
6.
Community Dent Health ; 38(1): 44-47, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33507648

RESUMO

Neoliberalism is the dominant ideology underpinning the operation of many governments. Its tenets include policies of economic liberalization such as privatization, deregulation, free trade and reduced public expenditures on infrastructure and social services. Champions of neoliberalism claim that expansion of global trade has rescued millions from abject poverty and that direct foreign investment successfully transfers technology to developing economies. However, critics have urged governments to pay greater attention to how neoliberalism shapes population health. Indigenous populations experience inequalities in ways that are unique and distinct from the experiences of other marginalised groups. This is largely due to colonial influences that have resulted in sustained loss of lands, identity, languages and the control to live life in a traditional, cultural way that is meaningful. Oral health is simultaneously a reflection of material circumstances, structural inequities and access to health services. Indigenous populations carry a disproportionate burden of oral health inequalities at a global level. In this commentary, we contend that neoliberalism has overwhelmingly contributed to these inequities in three ways: (1) increased dominance of transnational corporations; (2) privatization of health and; (3) the neoliberal emphasis on personal responsibility.


Assuntos
Disparidades nos Níveis de Saúde , Saúde Bucal , Saúde Global , Humanos , Pobreza , Seguridade Social
8.
Dtsch Med Wochenschr ; 146(3): 198-204, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33395708

RESUMO

The COVID-19 illness can occur as an occupational disease or work-related accident. According to the German list of occupational diseases, recognition as an occupational disease 3101 requires occupational exposure of an insured person who has been exposed to an increased risk of infection compared to the general population as a result of their occupational activity in one of the four areas: (1) health service or (2) social welfare sector, (3) laboratory or (4) during activities with increased risk of infection comparable to (1) to (3). The insurance cover covers employees, self-employed people - if not exempted from insurance cover - and honorary workers. The COVID-19 disease is subject to legal notification, mostly in conjunction with a contemporary SARS-CoV-2 virus detection. Regarding insured people who are not included within the aforementioned areas (1) to (4), the COVID-19 illness can be acknowledged as an occupational accident if the intense and direct contact with infected people - not intended as in the case of occupational disease 3101 - but otherwise situationally results from the insured activity itself.


Assuntos
/economia , Cobertura do Seguro , Doenças Profissionais/economia , Doenças Profissionais/etiologia , /isolamento & purificação , Notificação de Doenças/legislação & jurisprudência , Notificação de Doenças/normas , Alemanha , Ocupações em Saúde , Humanos , Cobertura do Seguro/economia , Cobertura do Seguro/normas , Laboratórios , Exposição Ocupacional , Fatores de Risco , Seguridade Social , Voluntários
10.
Fam Community Health ; 44(2): 78-80, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33351516

RESUMO

The COVID-19 pandemic has highlighted the importance of social determinants of health in affecting health outcomes. Populations with high social risk are disproportionately impacted by the virus and its economic consequences. Primary care practices have a unique opportunity to implement interventions to mitigate their patients' unmet social needs, such as food and income insecurity. In this commentary, we outline key considerations for clinics implementing programs that identify and address patients' social needs in a way that promotes equity, quality, and sustainability. We provide examples from our own experience at a federally qualified health center.


Assuntos
Equidade em Saúde , Atenção Primária à Saúde/métodos , Qualidade da Assistência à Saúde , Encaminhamento e Consulta/organização & administração , Determinantes Sociais da Saúde , Seguridade Social , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pandemias , Pobreza , Avaliação de Programas e Projetos de Saúde
11.
Gac. sanit. (Barc., Ed. impr.) ; 34(6): 615-623, nov.-dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200255

RESUMO

OBJETIVO: Evaluar el impacto del Plan de Promoción de la Autonomía Personal y Prevención de la Dependencia de Andalucía (2016-2020) en 13 organismos públicos participantes tras su primer año, y analizar la usabilidad y la fiabilidad de la escala de evaluación del impacto que se ha empleado. MÉTODO: El Plan aborda la promoción de la autonomía personal y la prevención de la discapacidad y la dependencia con un enfoque multisectorial. Se estructura en líneas, objetivos y actuaciones que han sido evaluadas mediante la escala Adoption Impact Ladder (AIL). El análisis de la validez simple, la viabilidad y la fiabilidad de la escala se ha realizado en 30 actuaciones evaluadas por 20 expertos de la Administración pública y un evaluador externo independiente. RESULTADOS: En 2017 se pusieron en marcha 176 actuaciones y programas del Plan. Se han implementado el 67,2% de las actuaciones propuestas y solo uno de los 16 objetivos no se ha asociado a actuaciones ejecutadas en el primer año. Siete de los 15 objetivos ejecutados fueron enteramente multisectoriales, involucrando a tres o más consejerías. La validez simple, la viabilidad y la fiabilidad interexaminadores de la escala AIL fueron buenas (κ: 0,72). CONCLUSIONES: El Plan ha proporcionado un marco novedoso para coordinar un amplio rango de políticas y actuaciones en la Administración pública de Andalucía. Por primera vez se presenta un análisis del impacto multisectorial que proporciona una guía efectiva para el seguimiento, la planificación y el establecimiento de prioridades públicas en salud, servicios sociales y atención a personas mayores y personas con discapacidad


OBJECTIVE: To evaluate the impact of the Plan for the promotion of personal autonomy and prevention of disability in Andalusia (2016-2020) in 13 public administrations during the first year of its implementation; and to analyse the usability and feasibility of the impact assessment ladder used. METHOD: The Plan addresses the promotion of personal autonomy and the prevention of disabilities and dependencies through a multisectoral approach. It is structured in strands or lines of work, objectives and actions that have been assessed through the Adoption Impact Ladder (AIL). The analysis of the face validity, feasibility and inter-rater reliability of the impact assessment ladder was carried out in 30 actions of the Plan that were rated by 20 experts from the 13 ministries and public agencies involved in the Plan, and an external rater. RESULTS: 176 actions and programmes were launched in 2017. Of these, 67.2% were implemented during the first year. Only one of the 16 objectives had no action initiated during the first year. Moreover, 7 out of 15 objectives implemented were fully multisectoral involving more than three Regional Ministries. The face validity, feasibility and inter-rater reliability of the AIL were good (κ: 0.72). CONCLUSIONS: This Plan has provided a novel framework to coordinate a broad range of proposed policies and actions within the public administration of Andalusia. For the first time, a multisectoral impact analysis has been conducted providing an effective guide for monitoring, planning and setting public priorities in health, social services, ageing and disabilities


Assuntos
Humanos , Implementação de Plano de Saúde/organização & administração , Promoção da Saúde/organização & administração , Seguridade Social/tendências , Fragilidade/prevenção & controle , Colaboração Intersetorial , Planejamento em Saúde/organização & administração , Espanha/epidemiologia , Autonomia Pessoal , Impactos na Saúde/estatística & dados numéricos , Envelhecimento Saudável , Políticas Públicas de Saúde
12.
PLoS One ; 15(12): e0244880, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33382827

RESUMO

The current aging service industry has problems in meeting the ever-increasing demand for the home-based elderly care service (HECS). Social organizations participating in HECS seems to be a promising way to address these problems but also raises new challenges, like uncoordinated cooperation among stakeholders, which could lead to low management efficiency and low service quality. However, Synergetic development can be promising to enhance the participation of social organizations and to improve social welfare. This study introduces a conceptual model to explore relationships between five determinants and synergetic development of social organizations participating in HECS. A structural equation model (SEM) based on questionnaire survey is used as a test methodology. The results indicated that stakeholder engagement plays a critical role in synergetic development in HECS, resource allocation can only be improved by institutional climate, and supervision capacity cannot facilitate information sharing. This study provides effective strategies and directions for the improvement of home-based elderly care services.


Assuntos
Serviços de Saúde para Idosos , Serviços de Assistência Domiciliar , Idoso , Humanos , Seguridade Social , Participação dos Interessados
13.
PLoS One ; 15(12): e0242803, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326451

RESUMO

Not everybody is benefiting equally from rising mean incomes. We discuss the mean-income population share (MPS), the population percentage of earners below mean income, whose evolution can capture how representative rising mean values are for middle income households. Tracking MPS and its associated income share MIS over time indicates to what extent economic growth is inclusive of both the middle and the bottom of the income distribution. We characterize MPS and MIS analytically under different growth scenarios and compare their parametric estimation using micro-level and grouped income data. Our empirical application with panel data of 16 high- and middle-income countries shows that in the last decades rising mean incomes have mostly not favored middle income households in relative perspective, while the overall welfare effects of the changes in MPS and the correlation structure with the Gini coefficient are mixed.


Assuntos
Renda/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Humanos , Pobreza/estatística & dados numéricos , Seguridade Social/estatística & dados numéricos , Fatores de Tempo
14.
Buenos Aires; GCBA. Dirección General de Estadística y Censos; nov. 2020. a) f: 20 l:17 p. tab, graf.(Población de Buenos Aires, 17, 29).
Monografia em Espanhol | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1146286

RESUMO

En este artículo analizamos los rasgos que asumió la estructura de clases de la Ciudad Autónoma de Buenos Aires (CABA) en el período 2004-2015. Utilizando como fuente de datos, principalmente, la Encuesta Anual de Hogares (EAH) relevada anualmente por la Dirección General de Estadística y Censos del Gobierno de la CABA, nos preguntamos acerca de cómo han evolucionado las clases sociales en términos de tamaño y composición, y cuánto se han distanciado o acercado respecto al bienestar material de los hogares que las conforman. Del análisis de los datos se desprende que la estructura de clases mantiene la configuración signada durante los años noventa, aunque con una relativa composición de la clase obrera calificada y la clase directivo-profesional. Por otro lado, el estudio de los ingresos y el acceso a la vivienda, en tanto dos activos del bienestar material de los hogares, muestra cierta reducción de la desigualdad respecto al primero, pero un fortalecimiento en las brechas respecto a la propiedad de la vivienda. (AU)


Assuntos
Classe Social , Mobilidade Social/tendências , Mobilidade Social/estatística & dados numéricos , Seguridade Social/tendências , Seguridade Social/estatística & dados numéricos , Fatores Socioeconômicos , Iniquidade Social/história , Iniquidade Social/estatística & dados numéricos , Habitação/tendências , Renda/estatística & dados numéricos
15.
PLoS One ; 15(10): e0239520, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027254

RESUMO

Efforts to mitigate global warming are often justified through calculations of the economic damages that may occur absent mitigation. The earliest such damage estimates were speculative mathematical representations, but some more recent studies provide empirical estimates of damages on economic growth that accumulate over time and result in larger damages than those estimated previously. These heightened damage estimates have been used to suggest that limiting global warming this century to 1.5 °C avoids tens of trillions of 2010 US$ in damage to gross world product relative to limiting global warming to 2.0 °C. However, in order to estimate the net effect on gross world product, mitigation costs associated with decarbonizing the world's energy systems must be subtracted from the benefits of avoided damages. Here, we follow previous work to parameterize the aforementioned heightened damage estimates into a schematic global climate-economy model (DICE) so that they can be weighed against mainstream estimates of mitigation costs in a unified framework. We investigate the net effect of mitigation on gross world product through finite time horizons under a spectrum of exogenously defined levels of mitigation stringency. We find that even under heightened damage estimates, the additional mitigation costs of limiting global warming to 1.5 °C (relative to 2.0 °C) are higher than the additional avoided damages this century under most parameter combinations considered. Specifically, using our central parameter values, limiting global warming to 1.5 °C results in a net loss of gross world product of roughly forty trillion US$ relative to 2 °C and achieving either 1.5 °C or 2.0 °C require a net sacrifice of gross world product, relative to a no-mitigation case, though 2100 with a 3%/year discount rate. However, the benefits of more stringent mitigation accumulate over time and our calculations indicate that stabilizing warming at 1.5 °C or 2.0 °C by 2100 would eventually confer net benefits of thousands of trillions of US$ in gross world product by 2300. The results emphasize the temporal asymmetry between the costs of mitigation and benefits of avoided damages from climate change and thus the long timeframe for which climate change mitigation investment pays off.


Assuntos
Aquecimento Global/economia , Modelos Teóricos , Dióxido de Carbono/análise , Seguridade Social
16.
Nihon Koshu Eisei Zasshi ; 67(9): 582-592, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33041284

RESUMO

Objectives To build a healthy and safe community, it is important to provide direct services, such as health, medical, and social welfare services. However, it is also crucial to enhance the community's social capital by promoting self-help and mutual aid within the community. The development and utilization of resources/networks as well as community empowerment are possible methods to enhance social capital, but there is no conclusive method to facilitate effective coordination within the community. The purpose of this study is to clarify the community building process. This is achieved through qualitative research on community social coordinators (CSCs) who worked in an area that was significantly damaged by the Great East Japan Earthquake.Methods A qualitative approach was employed to assess 10 individuals who worked as CSCs in a city within Miyagi Prefecture. Semi-structured interviews were conducted, which were between 40-90 minutes in length. A modified grounded theory approach (M-GTA) was used to analyze the data obtained from the interviews.Results The CSCs "built a relationship with the community," "assessed the community," and "intervened in the community." While assessing the community, they considered both its strengths and weaknesses, not limiting the fields it covered. To "solve the issues in the community," the CSCs "intervened in the community by themselves," "supported the autonomy of the residents," and "connected the residents to resources." This intervention was facilitated through "cooperation with the community" or "cooperation with other supporters."Conclusion Three stages were observed in the community building process. First, the CSCs built a relationship with the community. They then assessed the community, and intervened as required. It was found that the intervention-which was based on the CSCs' assessment of the community's strengths and weaknesses-was facilitated by the cooperation of the community or that of other supporters. Additionally, the CSCs aimed to promote the autonomy of the residents.


Assuntos
Desastres , Capital Social , Planejamento Social , Seguridade Social , Serviço Social , Assistentes Sociais , Adulto , Terremotos , Emprego , Feminino , Humanos , Japão , Masculino , Autonomia Relacional
18.
PLoS One ; 15(10): e0239211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027307

RESUMO

BACKGROUND: The prevalence of psychological complaints is known to be very high in populations of asylum seekers. Despite this, data on the health care system's ability to adequately meet these high-risk populations' mental health needs are scarce. This article investigates how well the German outpatient health care system is able to detect and adequately treat them. METHODS: To this end, we combined data from a cross-sectional survey with billing data from the local social welfare office from the year 2015. Using descriptive statistics, the data of the cross-sectional study are used to quantify the psychological health care needs of asylum seekers while the secondary data analysis indicates the actual access to and extent of psychological treatment. RESULTS: In the cross-sectional study, 54% of patients were screened positive for symptoms of depression, 41% for symptoms of anxiety disorder and 18% for symptoms of Posttraumatic Stress Disorder. In total, 59% were screened positive for at least one of these three disorders. However, when contrasting these screening-based prevalences with the prevalences based on data from the health care system, a mismatch becomes apparent: According to the social welfare office's billing data, only 2.6% of asylum seekers received the diagnosis of depression, 1.4% were diagnosed with anxiety disorder and 2.9% with Posttraumatic Stress Disorder (PTSD). In combination, 4.9% were diagnosed with at least one of these three disorders. Overall, less than one tenth of asylum seekers with symptoms of depression, anxiety or PTSD received the corresponding diagnosis by the health care system. Among those who were diagnosed, about 45% received no treatment at all, while 38% were treated with drugs alone. Only 1% of all patients received psychotherapy. CONCLUSIONS: Psychological complaints are very common among asylum seekers, yet only a small proportion of this population receives the corresponding diagnoses and treatment. While various factors can contribute to these shortcomings, there is an urgent need to systematically address this deficit and introduce measures to improve mental health care for this high-risk population.


Assuntos
Saúde Mental , Refugiados/psicologia , Adolescente , Adulto , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Estudos Transversais , Depressão/diagnóstico , Depressão/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia , Seguridade Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Inquéritos e Questionários , Adulto Jovem
20.
Soc Work Public Health ; 35(7): 617-632, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970544

RESUMO

The COVID-19 pandemic has been particularly overwhelming for communities of color in the United States. In addition to the higher levels of underlying health conditions, circumstances related to a history of oppression and unequal access to opportunities and services are apparent. Social service programs will need to be re-developed to accommodate a new reality, both in terms of how people connect with services and how social work professionals provide them. Professional social work organizations' codes of ethics are analyzed, along with the theoretical framework of structural competency. It is an ethical imperative that social welfare policy and practice advance as culturally competent, racial equity, and empowerment-based programs. Child welfare is portrayed as an example where the pandemic could provide an opportunity to learn from the past to construct a more compassionate, competent, and ethical future.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Política Pública , Racismo/ética , Seguridade Social/ética , Serviço Social/ética , Betacoronavirus , Competência Cultural , Humanos , Pandemias , Estados Unidos/epidemiologia
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