Salud Colectiva最新文献

This article analyzes the social and health challenges linked to sex work and the interventions carried out within this arena, taking into consideration the ways in which prostitution is socially marginalized. Basing our analysis on the experiences and understandings of sex workers practicing in the city of Oporto (Portugal), we attempt to understand the main forms of vulnerability faced by this group, along with the ways in which they experience the relationship with State services and social and health interventions that target them. Qualitative field research was conducted involving a case study of an intervention project. Data collection was carried out from March to June 2019, and included documentary research, participant observation, and semi-structured interviews with project staff and six sex workers. Among the results of our study, we found that sex workers are subject to severe constraints, limiting their use of informal support networks and their access to State social protection and healthcare services. Moreover, although the intervention project based on harm reduction intended to support these women and was indeed valued, it had a strong epidemiological prevention bias favoring an individualistic and assistentialist approach, while failing to address other social vulnerabilities identified by the women themselves.

In Chile, one out of every ten men presents signs or symptoms of depression each year. However, few studies within Chile or other Latin American countries address the qualitative or narrative aspects of depression in men. Therefore, the objective of this study was to assess the narrative construction of depression and its symptoms in men. This qualitative study was based on interviews with nine Chilean men who had gone through an experience of this nature, which were conducted between June and October 2020. A life history methodology was used to explore depressive processes involved in each individual's biography as well as the symptoms reported in each case. The results show that these men experienced a constellation of symptoms during depression, some of which are atypical as they do not match those described in diagnostic manuals. Three types of narratives were identified, and were termed frustration, breakdown, and insecurity.

As the basis for a theory of the co-occurrence of epidemic and pandemic processes, the article begins with a discussion of the concept of syndemic, created during the HIV/AIDS epidemic to understand the social, behavioral, and cultural components of emerging diseases, as is the case of the current COVID-19 pandemic. Secondly, the notion of infodemic is highlighted, which has great potential to better understand the impacts of the pandemic from approaches that are generally neglected in conventional epidemiological research. Third, in order to illustrate these points, a "micro-archaeological" case study of the infodemic resulting from the COVID-19 pandemic is presented, focusing on the specific situation in Brazil. Then, the correlations between scientific evidence, intervention models, and measures to control the pandemic are comparatively analyzed in different countries, as well as their adoption or rejection in the Brazilian context, which is structured by deep economic inequalities, social inequities, and health inequities.

This article aims to present a conceptual framework for the comprehensive performance of the physiotherapist in health systems. First, I discuss conceptual aspects of the profession, the object of study, and the field of practice. The adoption of broader conceptual approaches focusing on health and not just disability stand out. Second, I discuss four theories of Physiotherapy: model of Pathokinesiology; movement continuum theory; model of movement ability measure; and International Classification of Functioning, Disability, and Health. Third, I present a theoretical framework proposed for the performance of the physiotherapist in health systems. The theoretical framework indicates the performance in primary care, secondary care, tertiary care, surveillance, and health management. The model seeks to establish an articulated practice of the physiotherapist in health promotion, prevention of diseases and disabilities, cure, and rehabilitation.

Leftover and expired medicines in households must be disposed of in such a way as to ensure the population's safety, while generating the lowest possible negative impact on the environment. In this context, the aim of this study was to explore drug disposal practices related to home medicine cabinets among medical students in Quito, Ecuador. Between December 2018 and January 2019, 498 students from different semesters were surveyed. Data show that up to 30.3% of students had flushed their medicines down the toilet at least once, while 7.2% acknowledged that they had removed the medicines from their packaging to deposit them in a household garbage disposal. A secondary aim of the study was to analyze expired and leftover drugs in participants' medicine cabinets. Metformin was the most common medication found, followed by acetaminophen, spironolactone, and ibuprofen. This study shows the urgent need to develop multisectoral strategies for the implementation of policies on pharmaceutical domestic waste, which will make it possible to control and reduce the negative impact on both the environment and public health.

Benzodiazepines and "Z-drugs" (BZD/Z) are overprescribed in many countries. This study evaluates their consumption in a social security sector health insurance provider with national coverage in Argentina. With a descriptive and observational approach, outpatient dispensations of BZD/Zs were analyzed for people over 18 years old from April 2020 to March 2021, disaggregated by sex, age, active ingredient, and half-life. An annual prevalence of use of 11.6% was found among the 431,445 adult affiliates, with higher rates in women and in those over age 60. Overall consumption of BZD/Zs was 77.6 defined daily doses (DDD) per 1000 enrollee-days. The average user received 5.1 annual dispensations and the equivalent of 1.4 DDD for each day of the year. BZD/Zs with long half-life were the most used. We found high levels of BZD/Z consumption and for longer periods than recommended. It is necessary to improve the quality of consumption and reduce the negative impact of inappropriate use of these drugs among treated individuals.

With the purpose of analyzing women's perceptions and classifying their modes of understanding a positive human papillomavirus (HPV+) test, we conducted 38 in-depth interviews with women who had received an HPV diagnosis (normal and abnormal Pap smear), screened in Jujuy's public health system in 2016. A typology based on women's understandings of the result was developed: 1) understanding; 2) lack of understanding; a) underestimation; b) overestimation; c) confusion. The interviewees who experienced confusion over the results reported contradictory perceptions in relation to a positive HPV test and its severity; those who underestimated it tended to mention the absence of symptoms and expressed little concern over the result; while those who overestimated it considered themselves sick and described concern, narrating a biographical disruption and physical pain. These findings confirm the need to improve the delivery of results and the provision of information in order to decrease psychosocial impact and increase follow-up adherence in HPV-positive women.

Equity is an unresolved issue on the Spanish healthcare agenda. This paper explores the importance that health professionals give to social determinants of health and the means they possess to address them. It also analyzes the relationship between food insecurity and increases in certain diseases. One of its objectives is to ascertain how increasing uncertainty is being addressed in primary healthcare services. We present a qualitative study carried out in six primary care centers in the cities of Reus and Tarragona between 2018 and 2019, involving 19 practitioners active in the areas of nursing, family practice, and social work. Results indicate that the lack of resources in primary care centers makes it difficult to integrate a social determinants of health approach, and thus to mitigate inequalities. Furthermore, a lack of structural actions diminishes the ability to respond to citizens' healthcare needs.