Precarious Health Conditions Research Articles

Quality of life of women from a quilombola community in northeastern Brazil.

Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire - bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.

Mushroom Tacos: Multicultural Festivals and Environmental Racism in a Rural Pennsylvania Town

ABSTRACT Advancing recent literature that critically examines multicultural efforts to generate socio-economic inclusion, this article studies how, in a small yet affluent Pennsylvania town, multicultural festivals are part of a social milieu in which Latinx immigrants face continuing erasure and exploitation – manifested in precarious health and housing conditions. Utilizing ethnographic and qualitative methods, I show that, although the town’s multicultural festivals aim to give a voice and recognize minority communities, they have in some cases contributed to an environment in which Latinx peoples have for decades been silenced and overlooked, resulting in heightened rates of health issues related to dangerous housing. From a semiotic theoretical approach, the disconnect between increasing performative-visibility and ongoing marginalization of Latinx immigrants can be explained by multicultural festivals relying upon floating signifiers, as well as issues of structural power. My findings shed light on the nuanced cultural ways that the structural social and material suffering of minoritized, immigrant populations is overlooked through the invocation of purportedly emancipatory acts, as well as the lingering effects of the structural force of White Supremacy.

First facts on the distribution of personal protective equipment during the coronavirus pandemic and facts revealed by medical entities in Brazil: a cross-sectional study.

The 2019 coronavirus pandemic (COVID-19) has revealed precarious public health conditions worldwide, where serious failures have occurred, similar to the distribution of personal protective equipment (PPE) to physicians in the government of Brazil. The objective of this investigation was to prove through facts that there have been failures in the distribution of PPE to medical professionals within a reasonable timeframe. Through a cross-sectional study, we sought to identify the information and data on the subject of "Distribution of PPE" from the official sites of all the national and regional medical representative entities. All medical representative entities, such as unions, councils, and federations, were identified by searching their existing websites, which were active on the World Wide Web, identifying facts, news, and official data regarding the supply of PPE on a daily basis and during the research period. It was evident from the identification of over 3,900 physician complaints and news reports that there was a failure to distribute PPE to medical professionals in Brazil over a reasonable period. Several physicians obtained PPE through the ruling of the courts. There was indeed a failure in the context of health service administration, which compromised the second level of the Maslow Scale, safety needs, and exposed these professionals to a greater risk than necessary, compromised the quality of work life, and directly compromised the doctor-patient relationship. The condition of the physicians cannot be forgotten during the COVID-19 pandemic.

Sustainability performance evaluation of municipal selective collection systems applied to a case study

Despite the existence of several waste recycling initiatives in Brazil, the national average of recyclable material recovery rates still remains below 3%. In this context, it is necessary to diagnose the performance of systems to implement improvement actions, considering the particularities of each system. In this study, we describe the application of a method capable of diagnosing the effectiveness of selective collection systems by identifying a general sustainability index, calculated based on 16 performance indicators. The study focused on the city of Volta Redonda and was organized into three stages: identification of the performance evaluation method; data collection and calculation of indicators; and calculation of the sustainability index. The index value found for the city was 0.47, which represents an unfavorable level of sustainability. In this case, Volta Redonda is making insufficient investments in its selective waste collection system. The factors that contributed to this low index are: an outdated solid waste management plan, low collection coverage, low recovery rate of recyclable materials, high rejection rate, high selective collection cost, outdated cost of selective collection service, precarious occupational health and safety conditions of members of waste picker cooperatives, and lack of registration of residences for donation of recyclable materials.

Percepções de profissionais de enfermagem sobre suas condições de trabalho e saúde no contexto da pandemia de COVID-19

Abstract Objective: to identify working conditions and their effects on nursing professionals’ health during the COVID-19 pandemic, based on the workers’ own perceptions. Methods: qualitative research carried out with 15 nursing professionals interviewed through online focus group. We analyzed the interviews content based on hermeneutics-dialectics. Results: nurses reported that the pandemic worsened their historic, chronic, and precarious working and health conditions, marked by increased workload, lack of personal protection equipment and material resources, shortage of professionals and devaluation of their jobs, generating a perceived dehumanization at work, with nurses feeling as “machines” and “numbers”. Mental suffering due to the risk of contamination, the frequent death of co-workers, patients, and family members, lack of societal support concerning protective measures, and the increasing demands for performance and productivity generates anxiety, depression, and stress. Conclusion: the COVID-19 pandemic enhanced nurses’ mental suffering and the precariousness of their work, urging the improvement of their working conditions and health promotion, essential for workers’ protection and dignity.

O morrer e o germinar: óbitos numa vila em formação no sertão da Bahia, 1891-1913

The article explores the civil and parish death records and analyses the circumstances of the formation of the district of Beija-Flor, which came to be called Bela Flor in 1895, which gave rise to the vila de Guanambi, in the backland of Bahia. In addition to the causes of death, it investigates aspects related to socioeconomic status, lack of medical care, illiteracy, local politics, gender, and ethnicity. It checks the extent of the district, identifying 71 places of death. The high occurrence of maternal deaths, neonatal tetanus, tuberculosis, and infections in general, including epidemic outbreaks in 1892 and 1896, as well as the high number of deaths of people under 50, reflect the precarious health conditions experienced between 1891 and 1913.

The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study.

The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended to Italy and several other countries. This article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyze the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, COVID-19 anxiety. In line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14, 51.15% females) taken from four regions: Lombardia, Veneto, Lazio, and Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models. Somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with mourning a loss of a beloved one due to COVID-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and COVID-19 related anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged. The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting COVID-19 within one month. In Italy, unlike the UK, lower household income and having (had) COVID-19 were not associated with poorer mental health. The psychological impact of COVID-19 can last for months; future research should explore all aspects of the psychological burden of COVID-19 in order to implement psychological interventions and promote psychological health.

A fundamental relação entre os âmbitos doméstico e o público na habitação social

A necessidade de condições adequadas de vida para a população, particularmente para os que vivem em áreas de vulnerabilidade social, é tema recorrente na literatura das ciências sociais aplicadas. Fatores como deficiência nas infraestruturas e nos serviços, exclusão do mercado imobiliário formal, segregação socioespacial e condições precárias de salubridade caracterizam esses territórios. A insegurança e hostilidade existentes tem resultado no afastamento da população dos espaços públicos e as residências se fecham para o exterior. Nesse contexto, o artigo tem como objetivo apontar a necessidade da relação entre os âmbitos doméstico e público como aspecto fundamental para a realização da vida dessas famílias. Para isso utiliza-se o método da pesquisa-ação, referenciando-se no percurso histórico da Habitação Social no Brasil e em conceitos e reflexões consolidadas, para aplicação em estudo de caso no Distrito Federal, Brasil. Os resultados alcançados evidenciaram a contribuição do resgate das conexões interior-exterior das moradias para a qualificação das condições de vida da população em situação de vulnerabilidade social.

Não há nada tão ruim que não possa piorar: uma análise bayesiana da pobreza

Este artigo visa compreender as relações existentes entre diferentes formas de pobreza e, assim, verificar se um determinado tipo de carência inibe a capacidade de o indivíduo superar de outras formas de privações. A abordagem utilizada para entender os mecanismos que regem as relações entre distintos níveis de pobreza remete-se a rede bayesiana. Os dados utilizados referem-se às informações sobre renda, saúde, educação e habitação para 5.565 municípios brasileiros entre 1970 e 2010, sendo a fonte de tais informações devida ao Instituto Brasileiro de Geografia e Estatística. Os resultados destacam a existência de relações entre as facetas da pobreza analisadas. Foram observadas influências diretas de todas as privações sobre as condições de saúde, indicando que precariedades em saúde normalmente surgem em ambientes onde outros tipos de carências afloram. O indicador de educação reflete informações sobre a privação monetária, sendo tal relação de caráter positivo. Por fim, carências monetárias são responsáveis por limitar, também, o acesso a uma moradia digna e a uma condição de vida mais salutar.

Influences of the Anglo-American Teaching System in Brazil: Contributions by the Parsons Mission (1921-1925)

The Brazilian first republic sought to organize society and amplify its potential for political and economic development, an objective hindered by the precarious health conditions of a population devastated by epidemics. An alliance between Brazil and the United States, mediated by the Rockefeller Foundation, gave birth to the arrival of Ethel Parsons in Brazil and the Parsons Mission, which developed strategies to implant a model for raising the standards of nursing in Brazil. This article offers background information about the Parsons Mission, and discusses its impact in public health and nursing education. History shows that the creation and organization of a public nursing health service, in addition to a nursing school based on Anglo-American models, were successful strategies in the construction of a new professional identity for nurses and for the recognition of nursing as a female profession.

PERCEPTIONS OF DOMESTIC WORKERS ON LABOR RIGHTS AND IMPACTS ON THEIR WORKING AND HEALTH CONDITIONS

ABSTRACT Objective: to understand the perceptions of domestic workers on the legislative changes and impacts on their working and health conditions. Method: a qualitative study, conducted in a city in the inland of São Paulo, between December 2016 and March 2017, conducted through individual interviews with 15 domestic workers, using the snowball strategy and theoretical saturation sampling. For data analysis, Hermeneutics-Dialectics was adopted. Results: domestic workers face precarious working and health conditions, permeated by a lack of information about their rights at work, as well as discrimination, devaluation, musculoskeletal problems, mental suffering and presenteeism. Improvements in recent years have been reported, but the workers claim greater reach for formal registration and valuation for domestic work. Conclusion: constant evaluation and dissemination of the legislative changes with the domestic workers is essential, so that chronic situations of devaluation and precariousness of domestic work are replaced by the empowerment and transformation capacity of these women.

Keeping our immigrants healthy: hygienist doctrine in the Hospedaria de Imigrantes da Ilha das Flores.

The Hospedaria de Imigrantes (Immigrant Lodgings) da Ilha das Flores was established in 1883 in accordance with the hygienist thinking of the time. Immigrants were isolated on the east coast of Guanabara Bay because of the epidemics of yellow fever which returned to the Imperial capital every summer since 1849-1850. Hygienists attributed the disease to the precarious health conditions in the city of Rio de Janeiro, which enabled germs to multiply and infect the atmosphere. As physicians reinterpreted the disease in light of Pasteurian theory, new procedures were adopted to receive immigrants, changing the structure and function of the facility on Ilha das Flores.

Oral Health of Hospitalized Brazilian Children: A Cross-Sectional Study

Objective: To evaluate the oral health conditions of hospitalized children, as well as describe the knowledge and practices of oral health care adopted by their parents/guardians. Material and Methods: The sample was composed of 46 children who had been hospitalized for at least five days, who had erupted teeth in the oral cavity and were accompanied by their parents/guardians. Information was collected in relation to: the oral health status of children (DMFT/DEF), the socioeconomic profile and access to information on health and oral hygiene of the parents/guardians and data regarding the hospitalization of the children. The data were analyzed using the Fisher, Pearson's and Mann Whitney's Chi-squared tests, with a confidence level of 95%. Results: 47.8% of the hospitalized children had experienced caries, and the most relevant component for the determination of the experience of caries was the presence of decayed teeth (0.50 to 1.94). A total of 97.8% of parents/guardians said they had not received information on oral health and hygiene, 100.0% had not received guidance on the sugar contained in medicines or the salivary decrease caused by the medications. 34.8% of the children did not perform oral hygiene during hospitalization. According to medical records, 58.7% took liquid medication orally. Conclusion: The hospitalized children had precarious oral health conditions, with the occurrence of carious lesions of the teeth. The presence of risk factors for dental caries in hospitalized children was observed (poor oral hygiene, low schooling and income of parents/guardians, limited knowledge of parents/guardians regarding health care and oral hygiene, consumption of medicines with cariogenic potential).

Seroprevalence of rodent-borne viruses in Afro-descendent communities in Brazil.

ABSTRACTDuring the Brazilian slavery period, many African migrants were brought to the American continent. Historically, some of these migrants escaped from the Brazilian gold mines and farms to which they had been brought and settled in remote valleys and this was the main mode of resistance to the slavery system. These runaway-slave descendant communities are called quilombos, a group with distinct ethnic identity, specific behavioral habits, including geographic isolation and conservative practices. The objective of this study was to investigate the prevalence of rodent-borne viruses in two Afro-descendent communities from Mato Grosso do Sul State, Midwestern Brazil. A total of 319 individuals from rural and urban quilombola communities were enrolled. Twelve (3.76%) had anti-rodent-borne virus IgG antibodies. Seven (2.19%) were anti-mammarenavirus reactive and nine (2.82%) had anti-orthohantavirus antibodies. The literature includes limited data on the health status of quilombola communities, but all the studies emphasize the disparity of attention of local healthcare personnel to these communities compared to the general population. The findings of this study highlight the vulnerability and the precarious health conditions of quilombola groups, especially those living in rural areas and thus, point to the need of preventive measures to improve access to healthcare for this ethnic group.

Influence of Urban Pollution on the Water Quality of the Groundwater of Six Municipalities of Abidjan

The groundwater, through the use of domestic wells, is for many populations the source of water they use daily. These wells are located mainly in neighbourhoods where sanitary conditions are very precarious and inadequate sanitation. It is therefore appropriate to highlight the influence of this unhealthy environment on the quality of the waters of the groundwater of Abidjan. Four sampling campaigns spread over the four climatic seasons were carried out. The analyzes of the water samples collected focused on the physicochemical and microbiological parameters commonly used for the quality of drinking water. The precariousness of the protection parameters and the proximity of the probable sources of pollution have been highlighted. Indeed, more than half of the wells are not covered. 55.86% of the septic tanks and 59.29% of the latrines are located upstream of the wells. 77.77% of latrines and 73.83% of septic tanks are below the safe distance of WHO (15 m). 30.17% of the wells and 34.48% have, respectively, nitrate and ammonium concentrations that are above the WHO standards 2011 (50 mg / L for nitrate and 0.01 mg / L for ammonium). This indicates that the well waters are of poor quality for drinking because of the possible impact of urban insalubrity. 41.38% of the wells provide turbid water (turbidity> 5 NTU), of which 21.55% contain organic matter beyond WHO standards 2011 (P.I.> 5 mg / L) and 100% contain excessive suspended matter. 98.27% of the wells are contaminated with total coliforms, 92.24% with faecal coliforms and 90.21% with faecal streptococci. This situation results in a faecal contamination index which varies between 9 and 12, it follows that 96.55% of the wells provide water from high to very high faecal contamination. All this indicates that the poor quality of the waters studied is related to the precarious health conditions of the study area.

Project HOPE: American nurses in Brazil (1973)

to describe the reality of nurses of Project HOPE and discuss the repercussion of their performance in relation to the reconfiguration of nursing in Alagoas State. social-historical study, whose primary sources were documents filed in the Laboratory of Documentation and Research in History of Nursing, granted by this project; oral testimonies resulting from the transcription of interviews of US nurses and the VeNeta Masson's'logbook, coordinator nurse of the ship. The discussion of the data was based on Pierre Bourdieu's theory. The project was submitted to the Ethics Committee and approved by it. The actions of the American nurses exposed the shortage of this type of professional in the area, as well as the precarious health conditions in the region. the symbolic capital of these nurses has contributed to the reconfiguration of the nursing field in Alagoas State.

Immunohistochemical analysis for the evaluation of agonal time in a clandestine migrant's death and forensic implications

We report a case of an adult migrant without identification who, during an illegal travel with other 16 clandestine compatriots in a bus inside a ship landed from the port of Igoumenitsa and directed to Ancona, dead of a heat stroke. Before arrival of the ship in the port, all clandestine migrants were found in precarious health conditions by a crew member of the shipping company inside the bus; one man was found in a dying state outside the bus, on the floor of the nursing anteroom of the ship ( Fig. 1 ). Circumstantial data revealed that one of them, the organizer of the illegal trip, impeded the escape of all the others migrants from the bus although the lack of oxygen. For judicial purposes and to demonstrate the crime of failure to assist a person in danger, it was useful to prove if the death of the man was preceded by a long agonal time (T). Specific analysis of immunohistochemical expression of inducible nitric oxide synthase (iNOS) in smooth muscle cells in a section of right renal artery ( Fig. 2 ) testified a protracted T, in accordance with necroscopic findings and testimonial evidence. A quantitative analysis to measure the signal intensity (SI) from cytoplasm was performed using a computer-aided drawing program, ImageJ software. Finally, for the estimation of agonal time (T), the following statistical formula was applied: T = {exp [−0.05 × SI + 10.149] [1] . T corresponded to 269 minutes, with a standard deviation of ± 14 minutes. All these elements were crucial to define the role of the migrant who arranged the crossing. The model of iNOS expression for estimation of T is useful in the field of clandestine migrant's deaths.

Professional career management and personal development for the employees of the Romanian medical system

Abstract The purpose of this article is to inform as many persons as possible on the present situation of doctors in Romania, to present more theoretical and practical elements that lead to the development of a sustainable career in the Romanian medical system. So I tried to get as much information about the current situation of the medical system, to obtain a certain confirmation of what was said by those working in the system. Gradually, I found out about the hospital problems, the insufficient budget allocated annually by the mismanagement, media campaigns of doctor denigration, the increasingly precarious health conditions of Romanians, the colossal businesses of the pharmaceutical industry, the heavily discussed and postponed Health Law, that managed to pull a lot of people in the street, and many other items that are not only intended to sound an alarm regarding the condition of medical workers in Romania. Besides the researches and the relationships on the medical education status, the situation of available positions, the distribution of doctors, their salaries, the legal and ethical operating framework, I undertook also a study among physicians (especially those being at their early career) to find out the elements that led them to choose this career and what is the current situation of medical career in Romania. For this, I chose questions that reflect the doctors’ satisfaction at workplace and how performance is influenced by the satisfaction level obtained from the medical services provided in the Romanian healthcare facilities. The study had both expected results, already knowing the current situation, but also unexpected, given the expectations of doctors. In more detail, there is a large number of young doctors that before thinking about work at a prestigious hospital abroad, think to what extent the current workplace in Romania offers support for family, pension, holidays etc. Thus, we considered appropriate to bring up within the paper the current possibilities for personal development, the personal brand in various mediums of communication. This paper could be a viable support to provide the necessary elements in creating an upward career path for young doctors. This paper aims primarily to present a current situation of the medical system, more statistical data (unfortunately, statistics regarding the Romanian medical system are not very up to date, most information relates to the year 2007-2009 - 2010), but also the Romanian situation seen from outside or media. The situation is far from being optimistic, the presented data are clear signals of alarm on the present status, but we hope that in the end, this paper has managed to arouse the interest of Romanian doctors with potential on the possibilities and opportunities for a career development in the homeland.

The Disease of the Italian Poet Giacomo Leopardi (1798-1837): A Case of Juvenile Ankylosing Spondylitis in the 19th Century?

Some authors sustained that the pessimistic thought of the Italian writer and philosopher Giacomo Leopardi (1798-1837) may be attributed to his unhappy life, characterized by several health problems. His philosophical theories appear as the result of depressive and melancholic state, related to his precarious health conditions, so limiting their intrinsic values. Several authors formulated various hypotheses on the diseases that Leopardi suffered from and postulated different theories on the cause of his early death. This article assumed that Leopardi may have been affected by juvenile ankylosing spondylitis, conditioning spinal deformities, relapsing-remitting uveitis, urinary tract and bowel tract problems, and acute arthritis. Chest deformity, as a complication of juvenile ankylosing spondylitis, may have caused progressive cardiorespiratory failure, worsened by recurrent bronchial and pulmonary complications, until his death caused by acute right ventricular heart failure. The acknowledgment of a physical cause of Leopardi's disease contributes to reevaluate his "cosmic pessimism" as an original expression of his thought, so leading a general revaluation of the figure of one of the most important European thinkers of the 19th century.

"Where Did We Go From There?": Beasts of the Southern Wild's Resistance to Civil Life

After 50 years from the battles for civil equality in the United States, this essay analyzes the film Beats of the Southern Wild (2012) and its African American characters’ refusal to participate into the civic life of their country. As a consequence of a hurricane that reminds of Katrina, the isolated community of Bathtub is forced to enter into contact with civic institutions with deleterious effect on both Hushpuppy, the 6-year-old protagonist, and her father. While the passage to civilized life has deadly consequences on the man’s precarious health conditions, Hushpuppy is forcedly transformed into an example of mainstream femininity. In this way, Beasts of the Southern Wild casts doubt on the importance of civic belonging as a rewarding act in one’s life. At the beginning of the new millennium, in years that are defined as post-civil rights as well as post-racial, the film shows the oppressive force of civil life and the state, which transforms rights into abuse of personal choices and lifestyle.