Vulnerability Research Articles

Reflections on the Process of Allocation of the 380 Bonus Pen by the Peruvian Government to People in a Situation of Vulnerability as a Strategy Before the Covid Pandemic 19

ABSTRACT
 The main purpose of this research article is to explain the deficiencies in the process of assigning the 380 pen bond by the Peruvian government to vulnerable people as a strategy in the face of the COVID 19 pandemic. To do this, a qualitative research approach is used , having as emphasis an investigation of a documentary nature based on opinions, accounts, various documents and presidential message, issued during the month of March 2020, within the framework of the first four weeks of the quarantine approved and applied in Peru by the Peruvian government of President Martín Vizcarra Cornejo and whose strategy focuses on social isolation, to face the COVID 19 pandemic.
 Among the main conclusions of this article, it is highlighted that a reformulation of the recruitment, enumeration, evaluation and accreditation strategy of the condition of poor or extremely poor of a home is required, which should not be under the focus of requesting household demand. On the other hand, it is important to develop an information system focused exclusively on these households, which would allow a better identification of their progress in terms of their socioeconomic status. Lastly, it is necessary to develop permanent employment programs for vulnerable populations accompanied by programs or training in financial education that promote the culture of savings and links with the financial system, in such a way, in the face of a future incidence such as COVID 19, the Attention to those homes that are most needy by the State is timely and efficient.
 El presente artículo de investigación tiene como propósito central explicar las deficiencias en el proceso de asignación del bono de 380 pen por el gobierno peruano hacia pobladores en situación de vulnerabilidad como estrategia ante la pandemia COVID 19. Para ello, se utiliza un enfoque de investigación cualitativo, teniendo como énfasis una investigación de carácter documental sobre la base de opiniones, relatos, documentos diversos y mensaje presidencial, emitidos durante el mes de marzo 2020, en el marco de las cuatro primeras semanas de la cuarentena aprobada y aplicada en el Perú por el gobierno peruano del presidente Martín Vizcarra Cornejo y cuya estrategia se centra en el aislamiento social, para hacer frente a la pandemia COVID 19.
 Dentro de las principales conclusiones del presente artículo se destaca que se requiere de una reformulación de la estrategia de captación, empadronamiento, evaluación y acreditación de la condición de pobre o pobre extremo de un hogar, la cual no debería quedar bajo el enfoque de solicitud de demanda del hogar. De otra parte, resulta importante el desarrollo de un sistema de información focalizado exclusivamente a estos hogares el cual permitiría una mejor identificación de su avance en materia de su estado socioeconómico. Por último, resulta necesario desarrollar programas de empleo permanente hacia poblaciones vulnerables acompañado de programas o capacitación en materia de educación financiera que fomenten la cultura del ahorro y vinculación con el sistema financiero, de tal manera, ante una futura incidencia como el COVID 19, la atención de aquellos hogares efectivamente más necesitados por parte del Estado sea oportuna y eficiente.

Association between depressive symptoms in mothers and metabolic control in adolescents with type 1 diabetes.

Poor metabolic control in patients with Type 1 Diabetes Mellitus (T1DM) is associated with short- and long-term complications. Adolescents with T1DM present poorer metabolic control than pa tients of other age groups. Few studies have shown an association between mothers with depressive symptoms and the metabolic control of their adolescent children. To evaluate the associa tion between maternal depressive symptoms and metabolic control of their adolescents with T1DM. Cross-sectional observational study carried out with adolescents aged between 10 and 18 years, with T1DM diagnosis of at least 1 year ago and their mothers. The Beck Depression Inventory-II and the SALUFAM questionnaire were applied, and sociodemographic data were co llected. Glycosylated hemoglobin from capillary blood was used as a marker of metabolic control. 86 couples (mother-adolescent children) were studied. The average age of the adolescents was 14.04 years and the average evolution time of T1DM was 5.95 years. 27.325.6% of mothers had depressive symptoms, which was associated with worse metabolic control of their children (HbA1c of 7.66% and 8.91%, p-value <0.001). 17.9% of adolescents had depressive symptoms, which was not associated with maternal depressive symptoms or worse metabolic control. Maternal depressive symptoms were also associated with lower maternal and paternal educational levels, high number of children in the family, presence of other siblings with chronic illnesses, and high health vulnera bility (SALUFAM). The mother's depressive symptoms can be associated with worst metabolic control in T1MD adolescents. It is fundamental a multidisciplinary family approach to get better metabolic controls in T1DM adolescents.

Mathematical optimisation model for management of sago palm plantation expansions

Sago palm is an important indigenous crop grown in Southeast Asia. Its main product, sago starch, has the potential to be an alternative source of starch when compared to traditional starch derived from maize, sweet potato, cassava etc. Despite its potential, sago has remained as wild forest trees in swampy areas and unutilised for decades. Recently, Malaysia and Indonesia have shown interest in establishing estate plantations of sago palms. Although such a development may be welcomed, it is advisable to exercise caution during expansion of sago plantations. It is highly likely that unplanned expansions may result in large scale clearing of the tropical and peatland forests that are densely concentrated. In this respect, the vulnerability of these sensitive ecosystems during sago plantation expansions must be carefully accounted for. Therefore, in order to ensure planned and minimal sago plantation expansion, decision support tools that help to strategies land use changes (LUC) is crucial. Thus, this work presents a mathematical optimisation model of the type mixed integer linear programming (MILP) to plan for sago plantation expansions. The proposed model determines whether land expansion would be required when demands increase, accounting for the cost involved in expansion. A simple sago value chain has been solved to illustrate the proposed model. The results show that the optimised results avoided 4.3 % - 9.3 % of possible land area under expansion; 2.96 - 4.05 times of CO2 emission and 120.16 % - 189.14 % of cost savings.

Violência sexual na adolescência: contribuições da Psicologia

O presente artigo se dá como uma revisão bibliográfica, sistemática, qualitativa e descritiva, que utilizou como critério de seleção literaturas dos últimos 35 anos sobre os contextos e os impactos da violência sexual na adolescência, a partir do objetivo de investigar quais as contribuições da psicologia aos adolescentes vítimas de violência sexual, na medida em que estimula a exploração quanto aos seus conceitos, seus contextos e suas consequências psicológicas, por considerar a Psicologia como uma forte rede de apoio, capaz de ser uma importante ferramenta na construção de um ambiente seguro e acolhedor, como também de promoção a livre expressão da vítima quanto seus sofrimentos e sentimentos ocasionados pela violência e de seus tratamentos, sugerindo, por fim, uma aliança do fazer psicológico com certa intervenção por parte do poder público, a partir da construção de políticas e práticas tanto para prevenir e conscientizar, quanto para tratar os problemas de saúde e de segurança direcionados a sujeitos em situação de violências sexuais de alta vulnerabilidade, como os adolescentes em questão.

The social benefits of nature-based recreation for veterans: A scoping review

Veterans reintegrating into civilian life following military service often face a variety of social and psychological challenges that impact daily functioning and quality of life. Unfortunately, the social stigma associated with receiving supportive health services prevents many veterans from receiving assistance through traditional means. Others decline assistance out of a well-intentioned concern that using supportive resources will prevent other people with a greater need from receiving support. Also, researchers have found that the quality of a veteran’s social context, particularly regarding their perceptions of social support, are highly predictive of psychological wellbeing, including decreased vulnerability to post-traumatic stress disorder (PTSD) and decreased risk of suicide. Ultimately, the pervasive nature of psychological and social challenges among returning veterans, combined with the barriers to quality care and critical importance of social support reinforces the need for nontraditional ways of enhancing social support among the veteran community. Therefore, the purpose of this scoping review is to explore the potential social benefits of nature-based recreation (NBR) for veterans. Findings will be used to support the belief that recreation therapists have the potential to address the social needs of veterans by providing a variety of nature-based recreational therapy (RT) services.

Prevalence and Determinants of Anemia among Pregnant Women Attending Antenatal Clinic at Maternity and Children Hospital in Makkah City in September 2019

Background: Anemia among pregnant women is one of the most common public health problems in developing countries. World health organization (WHO) estimates shows nearly half of pregnant women were affected by anemia. It significantly increases fetal and maternal mortality and morbidity due to maternal vulnerability for infection and hemorrhage. Identify determinant factors of anemia among pregnant women in “Prevalence and determinants of anemia in third trimester. It is one of the most common preventable causes of maternal morbidities ranging from 22.6% to 54.0%. However, the prevalence and determinants that contribute to the occurrence of anemia were not extensively studied. Aim of the study: To evaluate the anemia and its determinants among pregnant women attending ANC at MCH in makkah city September 2019. To increase awareness of anemia during pregnancy and its adverse effects on the maternal and fetal outcomes. Method: Cross-sectional study conducted MCH in one of the most important cities in Saudi Arabia, which is Makkah. Sample population was pregnant women attending ANC in MCH in makkah city. Our total participants were (310) pregnant women. Results: The following variables were significantly associated with anemia: Age were (OR=0.333), Nationality status were (OR=1.830), Occupational status were (OR=0.649), Gestational age were (OR=0.580), History of drinking tea immediately after main meals (OR=0.557), Eating green vegetables were (OR=1.525), Eating animal products were (OR=1.651), Gravidity were (OR=2.192). Conclusion: Anemia is still a significant problem facing pregnant women and jeopardizing their outcomes. Diet during pregnancy, consuming tea/coffee immediately after food, meat consumption, previous heavy menstrual blood flow, and occupational status of women were significant factors associated with anemia among pregnant women so, it is recommended to increase the efforts toward the health education of women in childbearing age.

Reduced EGFR Level in eIF2α PhosphorylationDeficient Hepatocytes Is Responsible for Susceptibility to Oxidative Stress.

Reactive oxygen species (ROS) play a significant role in intracellular signaling and regulation, particularly when they are maintained at physiologic levels. However, excess ROS can cause cell damage and induce cell death. We recently reported that eIF2α phosphorylation protects hepatocytes from oxidative stress and liver fibrosis induced by fructose metabolism. Here, we found that hepatocyte-specific eIF2α phosphorylation-deficient mice have significantly reduced expression of the epidermal growth factor receptor (EGFR) and altered EGFR-mediated signaling pathways. EGFR-mediated signaling pathways are important for cell proliferation, differentiation, and survival in many tissues and cell types. Therefore, we studied whether the reduced amount of EGFR is responsible for the eIF2α phosphorylation-deficient hepatocytes’ vulnerability to oxidative stress. ROS such as hydrogen peroxide and superoxides induce both EGFR tyrosine phosphorylation and eIF2α phosphorylation. eIF2α phosphorylation-deficient primary hepatocytes, or EGFR knockdown cells, have decreased ROS scavenging ability compared to normal cells. Therefore, these cells are particularly susceptible to oxidative stress. However, overexpression of EGFR in these eIF2α phosphorylation-deficient primary hepatocytes increased ROS scavenging ability and alleviated ROS-mediated cell death. Therefore, we hypothesize that the reduced EGFR level in eIF2α phosphorylation-deficient hepatocytes is one of critical factors responsible for their susceptibility to oxidative stress.

Los dilemas de la inclusión financiera: contexto y mirada desde la realidad chilena

La inclusión financiera trata de un modelo expansivo de la oferta de los productos y servicios financieros al más amplio espectro de la población, fundado en que, especialmente por medio del crédito, se potencia una mayor participación en la actividad económica, configurando una estrategia público-privada para la superación de la pobreza. El modelo, sin embargo, debe prestar especial atención a la mayor vulnerabilidad de los sectores de menores ingresos, fortaleciendo las herramientas de protección del consumidor financiero. En el contexto chileno, en que se ha abrazado la inclusión financiera como un propósito gubernamental, debe trabajarse con especial celo en esta segunda dimensión para evitar la construcción de una sociedad sobreendeudada.

Exploring the neurobiology of OCD: clinical implications.

Despite heterogeneity in symptoms, there is growing realization that common neurobiological processes may contribute to OCD vulnerability and its persistence.

Credence Services: Role of Liability System in India

Consumer sovereignty is a myth in the healthcare services because of high information costs and bounded rationality. Moreover, producer sovereignty oriented surgeries and absence of social security system enhance patients’ vulnerability in India. Thus, the aggrieved patients approach consumer courts against deficiency in the services of physicians. Our study shows that these courts had received 57.61 per cent of the patients’ grievances that were related to surgery. The grievances reveal that the erroneous surgeries inflict harm on patients. As a result, patients’ incur healthcare costs and sufferings due to permanent disability, apart from premature deaths. Courts were able to decide only nine per cent, 23 per cent and 30 per cent of the total disposed of cases in favour of consumers at the National Commission, the State Commission of Andhra Pradesh and the District Forum of Nellore, Andhra Pradesh, respectively. This is due to causational link problem. Our analysis further posits that the law’s delay and costs on vexatious claims raise concerns about efficiency of the courts. The insight obtained is to alter physician behaviour by establishing an appropriate incentive structure to practise patient oriented health care.

Max-Neef en die strukturele kwesbaarheid van dagloners in Mbombela en Emalahleni, Suid-Afrika

Binne die konteks van die groterwordende werkloosheid en armoede in Suid-Afrika is dit belangrik om die kwesbaarheid van persone wat 'n lewe probeer maak in die informele sektor te bepaal, sodat ondersteunende beleid en strukture in plek gestel kan word. Die doel van die artikel was om die strukturele kwesbaarheid van dagloners te ondersoek deur n vergelyking te tref tussen twee gevallestudies. Dagloners in Emalahleni, 'n sosiaal-ekonomies kwynende myngemeenskap, en die meer sosiaal-ekonomies stabiele hoofstad Mbombela, in die provinsie Mpumalanga in Suid-Afrika, is hiervoor gebruik. Honderd-en-tien (110) vraelyste is voltooi met dagloners in die twee stede, die data is ontleed en die resultate met mekaar vergelyk. Max-Neef se fundamentele menslike behoefte (FMB)-matriks is gebruik om die multidimen-sionele analises te maak, te orden en te beskryf. Die resultate het duidelik aangedui dat die dagloners in Emalahleni meer struktureel kwesbaar is as die dagloners in Mbombela, met minder ondersteuningsisteme tot hul beskikking. Maatskaplike diensprofessies sal ernstige aandag daaraan moet skenk om veiligheidsnette te ontwikkel vir werkloses, beleid te formuleer wat werks- en inkomstemoontlikhede kan open en gesindhede en perspektiewe te verander van diegene wat hul bestaan in die informele sektor maak.

Vulnerability and seismic improvement of architectural heritage: the case of Palazzo Murena

Vulnerability and seismic improvement of architectural heritage: the case of Palazzo Murena

Segurança alimentar de famílias com pré-escolares da zona rural de um município do Vale do Paraíba paulista

Objetivo: Avaliar a situação de segurança alimentar de famílias com crianças pré-escolares da zona rural de um município do Vale do Paraíba paulista. Métodos: Estudo transversal e analítico, com questionário socioeconômico, demográfico e sobre o plantio de hortas e pomares nos domicílios, além da Escala Brasileira de Insegurança Alimentar. Os dados foram tratados por meio da estatística descritiva e os testes de hipóteses seguiram nível de significância de 5%. Resultados: Participaram da pesquisa 98 mães de crianças de quatro meses a seis anos de idade, moradoras da zona rural. Verificou-se que 51% das famílias estavam em situação de insegurança alimentar, prevalecendo a forma leve. Encontrou-se associação entre insegurança alimentar e as variáveis: escolaridade materna, renda familiar e recebimento de benefício social. Conclusão: Número considerável de famílias se encontrava em situação de insegurança alimentar; os fatores associados se relacionam com a vulnerabilidade social das famílias, demonstrando a necessidade de melhoria nas condições de vida e acesso aos alimentos para as famílias.

Effects of stress preconditioning on vulnerability of gastric and small intestinal mucosa to ulcerogenic action of indomethacin in rats.

The preconditioning effect of a mild stressor can reduce the ulcerogenic effect of a severe stressor on the gastric mucosa. The aim of the study was to investigate the effect of preconditioning stress on the gastric and the small intestinal injury caused by a single injection of indomethacin (IM) in conscious rats. Preliminary fasting (24 hours) rats were subjected IM administration (35 mg/kg, subcutaneously) with preconditioning stress (30 min cold-restraint at 10°C and further 1 hour keeping in cages at room temperature) or without stress. Plasma corticosterone level, heart rate (HR), blood pressure (BP) and somatic pain sensitivity (tail flick latency) were measured under circumstances of the gastrointestinal IM-induced injury in preliminary stressed and non-stressed rats. IM administration induced formation of gastric erosions well visible 4 hours after its injection. The healing of gastric erosions for 48 hours was accompanied by the development of a small intestinal injury. Corticosterone levels were elevated under formation of gastric erosions (4 hours after IM injection) but decreased following their healing (24 and 48 hours IM injection). Cold-restraint stress caused corticosterone rise 30 min after its onset. IM-induced gastrointestinal injury resulted in an increase of tail flick latencies (somatic hypoalgesia) and gradual decrease of systolic BP and increase of the HR. Stress preconditioning attenuated IM-induced gastric erosions as well as small intestinal injury 4 and 24 hours after its injection, respectively. The preconditioning also resulted in elimination of somatic hypoalgesia 4 hours after IM, but didn't influence an appearance of somatic hypoalgesia 24 and 48 hours after IM. Preconditioning stress recovered the HR and systolic BP (48 hours after IM). Elevated corticosterone level could be observed only in the 4th hour, but not in the 24th and 48th hours after IM administration. Thus, the data suggest that preconditioning stress reduces the vulnerability of the gastric and the small intestinal mucosa to ulcerogenic action of IM, stabilizes the hemodynamic parameters and normalizes somatic pain sensitivity.

No Room for Error: Reflections on My Sister.

An NP ponders the vulnerability of the seriously mentally ill.

Status research of village doctors′ vulnerability in Shandong province based on the set pair analysis

Objective To explore the current status of village doctors′ vulnerability in Shandong province in the context of ongoing healthcare reform. Methods A cross-section study was conducted from October 2015 to November 2015 based on a self-designed questionnaire for village doctors. The questionnaire included 6 parts: fundamental state, disturbance from surroundings, disturbance from job, emotional support, instrumental support and self-ability of village doctors. Mean and standard deviation were adopted to describe the level of disturbance and support. Quadrant analysis was adopted to analyze village doctors′ vulnerability. The set pair analysis was adopted to calculate the vulnerability index and sample cluster analysis was adopted to classify village doctors based on the vulnerability index. Results The total disturbance score was 3.39±0.46, and contribution from professional risk was the biggest(19.95%). The self-ability score was 3.33±0.40, and contribution from financial support was the smallest(4.09%). According to the set pair analysis, village doctors′ vulnerability total score was 0.49±0.06, ranging in a medium category. According to the sample cluster analysis, 27.2%(277/1 018)of the village doctors stayed at the upper category, as 30.3%(309/1 018) was defined as a medium category. According to the quadrant analysis, 35.5%(361/1 018)of the village doctors were found as in crisis vulnerability. Conclusions In general, village doctors′ vulnerability stays in the medium category. They have to fight against high disturbance from surroundings, with more emotional support and less financial support expected. Key words: Health human resource; Village doctor; Vulnerability; Set pair analysis; Shandong province

Connotation of village doctors′ vulnerability based on Delphi method

Objective To define the connotation of village doctors′ vulnerability. Methods On the basis of document analysis, Delphic method was used to consult and argument the connotation of village doctors′ vulnerability from October 2015 to November 2015. Results Twenty and 16 specialists were consulted in two rounds of the consulting. According to these consultations, the acceptance rate of the specialists for the seven consulting units increased from 74.29% to 93.16%. Conclusions The vulnerability of village doctors was identified, as a status in which their self-ability and support against their exterior environment could not to cope with the disturbances they faced, while the vulnerability was co-determined by disturbance and response ability of village doctors. Key words: Health human resource; Village doctor; Vulnerability; Connotation

Formation mechanism of the weakening of village clinic′ s medical service capacity in Shandong province

Objective To explore the formation mechanism of the weakening of village clinic′s medical service capacity in the context of new medical reform. Methods Purposive sampling method was used to enroll 38 rural doctors and managers of rural health centers and health offices in the interview from October 2015 to November 2015. And grounded theory was adopted to analyze reasons and their mechanism of the weakening of village clinic′ s medical service capacity. Results 29 first-grade categories and 7 second-grade categories were worked out in text encoding. With the implementation of the ongoing healthcare reform, support from financial, policy and technology increased significantly, but due to the synthetic action of unexpected negative effects of the reform, superposition and accumulation of disturbance and ineffective support, village clinic′ s medical service capacity began to weaken. Conclusions The weakened village clinic′ s medical service capacity is a result of the synthetic action of 3 reasons. The persistence of this status will intensify the vulnerability of rural health service system and be bad for the implementation of hierarchical medical policy and the strategy of rural vitalization. Measures should be taken to optimization the essential medicine system, establish a comprehensive assessment mechanism for basic medical service and basic public health service of village clinic, strength the strategic purchasing of medical insurance, improve the financial compensation mechanism, and complete training system of village doctors, aims to promoting sustainable development of village clinic. Key words: Village clinic; Village doctor; Medical service; Grounded theory; Vulnerability; Shandong province

Indigenous Smallholder Struggles in Peru: Nutrition Security, Agrobiodiversity, and Food Sovereignty amid Transforming Global Systems and Climate Change

Nutrition, food systems, and the biodiversity of food and agriculture (agrobiodiversity) are rapidly changing among indigenous smallholders in the Andean countries, across Latin America, and globally Urgent calls for food sovereignty recognize global transformations of nutrition, food systems, agriculture, and climate change amid geographically uneven development and vulnerability to these shocks that recently include the coronavirus/Covid-19 pandemic Collaborating with a praxis-oriented institution focused on social nutrition and public health in Peru, we conducted mixed-method research on landscape and livelihood transformations among indigenous smallholders in the Huanuco region Our approach utilizes place- and region-based research that integrates a relational framework of emergent agrobiodiversity interactions with a model of coupling/de-coupling in production-consumption linkages Conceptual insights and empirical results demonstrate varied but widespread food and nutrition insecurity, moderate agrobiodiversity, and innovative agrobiodiverse maize fields and home gardens Part-time farming and predominant purchased food are dual pillars amid precarious livelihoods and land use that condition food sovereignty prospects Cultural affect strongly influences emergent agrobiodiversity utilized in food consumption through relations of gender and intersectional social factors Global transformations fuel the substantial albeit partial decline of agrobiodiversity Emergent agrobiodiversity in food-growing spaces can enhance nutrition security and food sovereignty, lessen vulnerability, and strengthen agroecological adaptive capacity and resilience

THE OBLIGATIONS OF PEOPLE BENEFICIARIES OF THE MINIMUM VITAL INCOME: INFRACTIONS AND SANCTIONS AND THEIR POSSIBLE IMPACT ON THE COORDINATION OF SOCIAL SECURITY BENEFITS AT THE EUROPEAN LEVEL

THE OBLIGATIONS OF PEOPLE BENEFICIARIES OF THE MINIMUM VITAL INCOME: INFRACTIONS AND SANCTIONS AND THEIR POSSIBLE IMPACT ON THE COORDINATION OF SOCIAL SECURITY BENEFITS AT THE EUROPEAN LEVEL