Hepatitis B and C prevalence in waste pickers: a global meta-analysis.

BACKGROUND: The objective of this research was to use a meta-analysis to understand the prevalence of hepatitis B or C in waste pickers worldwide. METHODS: Epidemiological studies on hepatitis B and C in waste pickers were included adopting a systematic review with meta-analysis. Each selected article had its quality scored by all authors, evaluated according to the Loney's criteria, and evaluated for quality and bias verified with a funnel plot. RESULTS: After employing Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, there were 12 studies used for this meta-analysis. The rate of hepatitis B seropositivity was 0.15 (95% CI 0.10-0.20), and hepatitis C was 0.08 (95% CI 0.04-0.12). This information suggests that waste pickers are exposed to many risks associated with poor quality of life working conditions as well as low health literacy rates. CONCLUSION: The results of this meta-analysis confirm the vulnerability of waste pickers to hepatitis B and C infection and reinforce the importance of using personal protective equipment and immunizing workers.

Understanding mental health outcomes related to compassion fatigue in parents of children diagnosed with intellectual disability.

BACKGROUND: Parenting a child diagnosed with intellectual disability includes a variety of stressors. The degree to which stress affects these parents has been given little emphasis. Compassion fatigue includes experiencing an emotional response to being unable to relieve the suffering of a loved one, burnout, strain and stress on the caregiver. Compassion fatigue develops in parents of children diagnosed with intellectual disability due to their caregiving roles. METHOD: A phenomenological qualitative study was conducted using 25 semi-structured interviews to understand the mental health outcomes of parents caring for a child diagnosed with intellectual disability. RESULTS: The results showed that initial emotional reactions after receiving their child's diagnosis was a combination of anxiety, depression and compassion satisfaction. This study's findings suggest that parents of children diagnosed with intellectual disability experience moderate levels of compassion fatigue in the caring of their child. CONCLUSIONS: This research provides evidence that the caregiving of a child diagnosed with intellectual disability comes with a myriad of stressors that can lead to compassion fatigue.

Water quality index and sanitary and socioeconomic indicators in Minas Gerais, Brazil.

Minas Gerais is one of the 27 federative units of Brazil; it is the fourth state with the largest territorial area and the second in number of inhabitants. Since 1997, the monitoring of the surface water quality of the State of Minas Gerais has been carried out. In this study, generalized regression models were constructed to determine the correlation between the Water Quality Index (WQI) and the sanitary and socioeconomic variables: Municipal Population, Human Development Index (HDI), Gini Index, Percentage of Vulnerables to Poverty (Poverty), Monthly Per Capita Income, Percentage of Inadequate or Poor Sanitation. In addition to the sanitary and socioeconomic variables listed, it also used year of water quality monitoring, altitude of the monitoring point, and distance from the monitoring point to the urban center of the municipality. The results from the generalized models showed that the variables year, altitude, Gini Index, monthly per capita income, and poor sanitation variables were positively associated with WQI. In other words, high values of each variable increased WQI, while population variables HDI and poverty were negatively related to WQI, that is, a high population value, HDI, or poverty implies a low WQI value. Socioeconomic variables such as HDI, Gini Index, poorness, or poor sanitation percentage present the coefficients with the largest modulus. Thus, among the socioeconomic variables studied, these are the ones that most contribute to the variability of WQI. The year and altitude variables have positive regression coefficients, indicating that when these variables increase, WQI also increases. The positive correlation with the year shows that the surface water quality of Minas Gerais improved during the monitoring years.

AIDS-Affected Orphans in Sub-Saharan Africa: A Scoping Review on Outcome Differences in Rural and Urban Environments.

Currently, there are more than 11 million AIDS-affected orphans that suffer from various adverse effects, most of whom reside in sub-Saharan Africa. The difference between whether a child resides in a rural or urban environment can have a significant role in a child's education, health status and access to healthcare, and social or family relationships. A scoping review was conducted in order to understand any possible environment-based differences on orphans directly affected by HIV/AIDS in sub-Saharan Africa. There were 233 sources used for this review; however, 164 manuscripts focused more so on a general review of orphans within a rural or urban environment. Thus, after eliminating for various factors, 69 manuscripts were removed, which focused primarily on the social aspect of orphans due to HIV/AIDS. Rural environments provided more family support, while urban environments generally had more resources available to orphans (e.g. school fees). Unfortunately, both rural and urban environments were found to be fairly non-supportive of orphans and their development. This scoping review found, in general, that orphans in both urban and rural environments continue to suffer from the consequential effects of low parental support due to AIDS mortality. These conclusions suggest that specific support to orphans through school and social relationships encourage better development outcomes in sub-Saharan Africa.

A Qualitative Study on the Interconnected Nature of HIV, Water, and Family.

Human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) and poor access to water are two primary global health issues. Poor access to water may significantly affect families infected with HIV and result in adverse social and health consequences. A qualitative study used semi-structured interviews to understand health and social outcomes of families after the implementation of water interventions in rural Kenya. One major sub-theme emerged during this research, which included the effects of water on an HIV-affected family. Prior to the water interventions, common adverse health effects from lack of nutrition, water, and poor hygiene were experienced. After receiving access to water, nutrition and hygiene were improved and additional time was gained and used to reinforce relationships and spread awareness about HIV/AIDS. This study provides need-based evidence for access to safe drinking water in order to decrease adverse health outcomes and improve the quality of life for HIV-affected individuals.

Access to water provides economic relief through enhanced relationships in Kenya.

Introduction: Sub-Saharan Africa is comprised of low- and middle-income countries subject to the residual effects of chronic poverty. Poverty contributes to health disparities and social inequities. Public health strategies and solutions seek to remedy the effects of poverty. Providing access to quality water is one priority public health project that alleviates adverse health effects, but may have additional outcomes. Previous research has not thoroughly reviewed the economic relief and relationship changes from implemented water interventions. Methods: A qualitative phenomenological approach used 52 semi-structured interviews to understand relationship experiences among primary water gatherers and their families after implemented water interventions in a community. This study took place throughout the historically semi-arid eastern region in Kitui, Kenya, where community members have been beneficiaries of various water interventions. Results: Prior to the water intervention, relationships were strained because of economic hardships. Households experienced economic difficulties in paying for children's school fees, buying bricks for housing structures, having water for house gardens, trees for shade in the compound, crops and providing water for their animals. After receiving access to water, relationships improved, because families were able to discuss and address economic challenges. Additional financial revenue was gained and used to pay for water to make bricks to sell or use on housing structures, expand on house gardens and agricultural crops, build new businesses, purchase water for animals, and construct local water spouts near the household. Discussion: Access to water improved relationships, which encouraged economic growth. This information provides a critical component in understanding the interconnected nature between access to water, poverty and family relationships. Ultimately, this research suggests an increased need for access to quality water worldwide to improve both economic situations and relationships in low- and middle-income countries.

Proposing a re-adapted successful aging model addressing chronic diseases in low- and middle-income countries.

PURPOSE: Global aging is a phenomenon experienced throughout the world. Research demonstrates an increased incidence of chronic diseases due to global aging in low- and middle-income countries. Before addressing chronic diseases, a platform for change must be created. METHODS: A basic review was conducted on successful aging, adaptations to Rowe and Kahn's model of successful aging, and environmental challenges in low- and middle-income countries. RESULTS: The successful aging model by Rowe and Kahn includes trajectories based on various biological and environmental components and determines how lifetime experiences contribute to adverse health effects, such as chronic diseases, in aging populations. This model was primarily designed for high-income populations and may not be transferable to populations in low- and middle-income countries. Suggested changes to the current model have been made and include optimal health activities and access to health care, but have not considered environmental contaminants or hazards. A re-adapted model should be encompassing and consider the environment as well as successful aging elements, optimal aging activities, and access to health care. CONCLUSION: The overall goal of this commentary is to theoretically propose a novel successful aging model that may be used to target chronic diseases in aging populations in low- and middle-income countries. This model can then be used as a theoretical foundation for health promotion and disease prevention.

The global distribution of epidemiological studies involving waste pickers: A systematic review.

Waste pickers, who work with the collection of recyclable materials in search of a source of income, are subject to various risks and diseases that are very well researched. The aim of this systematic review was therefore to identify and analyze the results of epidemiological research on waste pickers over the last 20 years as well as to investigate the geographical distribution and quality of these studies. The studies were selected from the literature by creating search keys with representative keywords in different databases. This systematic review exceptionally includes research qualified according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. In total, 61 epidemiological studies with waste pickers were found in 15 different countries, with the largest number of studies carried out in the American continent compared to the African and Asian, respectively. Regarding the quality, 91.80 % were classified as excellent and 8.20 % as good. Although the results show a significant number of epidemiological studies with waste pickers, demonstrating scientific evidence, that there is still a lack of research focusing on waste pickers in different work scenarios, from different health perspectives and in different parts of the world, and it is not possible to highlight the trends in health research for this profession.

The maladies of water and war: addressing poor water quality in Iraq.

Water is essential in providing nutrients, but contaminated water contributes to poor population health. Water quality and availability can change in unstructured situations, such as war. To develop a practical strategy to address poor water quality resulting from intermittent wars in Iraq, I reviewed information from academic sources regarding waterborne diseases, conflict and war, water quality treatment, and malnutrition. The prevalence of disease was high in impoverished, malnourished populations exposed to contaminated water sources. The data aided in developing a strategy to improve water quality in Iraq, which encompasses remineralized water from desalination plants, health care reform, monitoring and evaluation systems, and educational public health interventions.

A qualitative study understanding immigrant Latinas, violence, and available mental health care.

Women from Latin American countries experience high levels of psychological and physical abuse and violence. Immigrant Latina women are often subjected to a patriarchal system in both family and government, which has resulted in a variety of complex and far-reaching outcomes. This qualitative study sought to understand the experiences of immigrant Latina women who were exposed to violence, as well as their access to mental health care. This study used 20 interviews with immigrant Latina women from El Salvador, Guatemala, and Mexico who had accessed mental health services in California. The primary themes that emerged from analysis of the data included motivating factors for seeking services (e.g., motherhood, community, hope, and mental health needs), barriers to accessing services (e.g., fatalism, marianismo, stigma, finances, language barriers, threats, abuse, and systemic insensitivity), and treatment and solutions (e.g., empathy, advocacy, and community approaches). These results appeared to be indicative of the importance of addressing sociopolitical, historical, and cultural trauma as an imperative component of effective treatment. In this context, the authors explore liberation psychology, a concept and approach that promotes social justice values and emphasizes the empowerment of immigrant Latina women in clinical practice. It is recommended that the historical sociocultural abuse of immigrant Latina women be thoughtfully considered and discussed in the therapeutic process to create lasting psychological change. Future research, policy efforts, and program development, including psychotherapeutic treatment modalities, should focus specifically on marginalized groups facing barriers to mental health care in order to increase access and effectiveness of treatment.

Understanding Patient-Provider Interaction, Treatment Acceptance, and Outcomes in Medically Unexplained Symptoms.

INTRODUCTION: Medically unexplained symptoms (MUS) is an umbrella term used for chronic and often disabling health symptoms and conditions that remain unexplained after standard medical examinations, testing, and/or appropriate workup. Patients with MUS tend to receive little to no treatment but remain distressed, stigmatized, and disabled by symptoms and iatrogenic factors. METHODS: A qualitative phenomenological study was conducted to explore daily challenges and psychosocial and iatrogenic factors affecting the management of MUS. RESULTS: The analysis of the interviews revealed that MUS could cause significant distress to patients, impairing their functioning and leading to permanent disability. Conventional healthcare cannot meet the medical needs of these patients and might be a potential source of harm to them. It should be noted that confirmation of conditions associated with clinically significant psychiatric premorbidity was not provided. CONCLUSION: Inconsistent diagnostic criteria, lack of proper training and research, diagnostic overshadowing, and implicit bias in healthcare professionals can lead to negative patient outcomes and the overuse of alternative or non-evidence-based services. Guidance, practice-based improvement ideas, and suggestions specific to improving patient-provider relationships can be applied to generate positive health effects.

A mixed methods study reviewing consumer experiences for oral health treatment in Medicaid-eligible children in Florida.

OBJECTIVES: Oral health is essential to a person's overall health, well-being, and dignity; unfortunately, dental caries, which can cause pain and difficulty eating, affect approximately 50 percent of children between 6 and 8 years old. This is in part because Medicaid-eligible children face numerous obstacles obtaining dental care. To date, there are 74 million Americans who do not have dental coverage or access to dental services, which is strongly associated with race, class, gender, and ethnicity. The objective of this research was to identify barriers to accessing and utilizing children's Medicaid oral health care and services, to evaluate care delivery and quality, and to assist in establishing a more consumer-driven approach. METHODS: A mixed methods study was conducted throughout the state of Florida, using qualitative and quantitative data collection to seek answers to these questions. There were 422 surveys and 39 interviews distributed to Medicaid-eligible families and individuals across the state; data collection focused on experiences with oral health care, gaps in current access to Medicaid dental care, and concerns when utilizing care. RESULTS: Our study shows the majority of barriers parents face when accessing Medicaid oral health care are due to logistical access issues, such as cost, appointment wait-times, and confusion surrounding which dental providers accept specific insurance plans. The findings also highlight how location, race, language, and ethnicity impact families who lack preventive dental health services access and how, in turn, families view their own access to dental services. CONCLUSION: Ultimately, there exists an avenue to implement programs and policies that address existing disparities in oral health to improve health outcomes by increasing access to care and reducing cultural and socioeconomic barriers.

Healthcare waste generation in hospitals per continent: a systematic review.

There are increasing worldwide concerns about the negative impacts of healthcare waste generated in hospitals, especially in low- and middle-income countries. Hazardous type of waste can contribute to adverse effects both in human populations and the environment because of its physical, chemical, and biological characteristics. A comprehensive view on increasing waste in the world has not been conducted to understand the breadth of the issue; thus, this paper sought to provide an analysis of hospitals' healthcare waste generation rate. Comparisons were made with Wilcoxon and Kruskal-Wallis tests for simple and multiple comparisons, to analyze nonparametric data, with post hoc by Nemenyi test. Median values indicated that hospital waste was the highest in North and South America (4.42, 1.64 kg/bed/day, respectively) and was almost nonexistent in Oceania (0.19 kg/bed/day), while the median rates for hazardous waste were the highest in Oceania (0.77 kg/bed/day). Africa was almost the lowest producer of waste in each category (0.19 and 0.39 kg/bed/day for hospital and hazardous waste, respectively). Over time, linear regression indicated that hazardous waste in Asia and Europe has increased, while in Oceania, the total waste also increased. Interestingly, in North America, it was observed a reduction in the generation for both total and hazardous waste. This information highlights the importance of understanding continent-specific characteristics and rates, which can be used to create a more individualized approach to addressing healthcare waste in the world.

Examining Opportunities, Challenges and Quality of Life in International Retirement Migration.

As the world has become more interconnected due to the invention and innovation of communication and transportation technologies, more individuals than ever before have been able to travel long distances. In recent years, a growing number of physically able adults in late adulthood have chosen to move across national borders to less costly countries in order to obtain better quality of life upon reaching retirement age. In light of this under-researched but increasingly popular retirement trajectory, this research aimed to provide more insight into the opportunities and challenges that international retired migrants have encountered while retiring abroad. Through the lens of humanistic theory, this research employed a systematic review of research literature, the majority of which were peer-reviewed studies published within the last five years. The reviewed studies (n = 22) conducted spanned four out of seven continents, with heavy emphasis on Europe, the Americas, and Asia. Research results indicated that many of the international retired migrants took advantage of the opportunities of pleasant weather, lower cost of living, and various amenities offered by their host countries to enhance their quality of life by engaging in an active and meaningful lifestyle. However, language barriers, lack of social support, rising healthcare costs, increases in the cost of living, uncertain political climate, and different healthcare practices in their host countries, presented considerable challenges to many international retirees.