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‣ AIDS in Latin America: assessing the current status of the epidemic and the ongoing response

BASTOS, Francisco I.; CACERES, Carlos; GALVAO, Jane; VERAS, Maria Amelia; CASTILHO, Euclides Ayres
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
Português
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Background This article provides a summary of the current status of the HIV/AIDS epidemic in Latin America, as well as an outline of the diverse responses to it. Methods A search of international databases (Pubmed and ISI-Web of Science), regional databases (Scielo and Lilacs), regional and national documents and UNAIDS reports. Data are presented according to subregion. Results In Mexico HIV remains concentrated among urban men who have sex with men (MSM), and has been growing among injecting drug users (IDU) and in rural areas in relation to migration. An increasing proportion of women among those affected is observed in all countries in Central America, the most affected region, as well as increasing the impact on other vulnerable groups, such as indigenous populations. The Andean Countries have urban epidemics concentrated among MSM. In Peru, non-traditional vulnerable populations were identified. In the Southern Cone heterosexual transmission became more relevant, probably in connection with IDU epidemics and is increasingly affecting lower income groups. Incidence rates have been declining since 2002 in Brazil, the first country to guarantee free, universal access to antiretrovirals, where one-third of drug-nave patients are still initiating treatment at an advanced stage. Generally...

‣ Indicadores de benchmarking dos serviços de saneamento voltados a populações vulneráveis; Benchmarking indicators of water supply and sanitation services aimed at vulnerable populations

Temóteo, Tássia Gaspar
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 04/04/2012 Português
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Diante da realidade de segregação residencial existente no Brasil, determinada pela heterogeneidade de renda, de condições sociais entre bairros e distritos, evidencia-se uma sociedade cada vez mais penneada por iniquidades sociais e ambientais. Somado a isto, há o fato do crescimento da concentração populacional em áreas urbanas. Este e outros fatores geram transformações nas estruturas das cidades acentuando conflitos referentes ao uso e ocupação do solo. Tais conflitos requerem agilidade de suprir demandas de fornecimento de serviços essenciais, tais como de abastecimento de água e esgotamento sanitário, especialmente quando se trata destes serviços às populações vulneráveis. Para apoio a medição e visualização desse cenário, de forma a elaborar políticas públicas e empresarias, é fundamental a utilização de indicadores, os quais, no entanto, não estão prontamente disponíveis. Emerge assim a necessidade de proposição de indicadores que mensurem o fornecimento dos serviços às populações vulneráveis em áreas urbanas. Neste contexto, com estudo de caso para o Estado de São Paulo, Brasil, a pesquisa teve como enfoque atuar na interface teórica e prática para proposição de indicadores. Foram realizadas...

‣ The Behavioral Model for Vulnerable Populations: application to medical care use and outcomes for homeless people.

Gelberg, L; Andersen, R M; Leake, B D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/2000 Português
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OBJECTIVES: (1) To present the Behavioral Model for Vulnerable Populations, a major revision of a leading model of access to care that is particularly applicable to vulnerable populations; and (2) to test the model in a prospective study designed to define and determine predictors of the course of health services utilization and physical health outcomes within one vulnerable population: homeless adults. We paid particular attention to the effects of mental health, substance use, residential history, competing needs, and victimization. METHODS: A community-based probability sample of 363 homeless individuals was interviewed and examined for four study conditions (high blood pressure, functional vision impairment, skin/leg/foot problems, and tuberculosis skin test positivity). Persons with at least one study condition were followed longitudinally for up to eight months. PRINCIPAL FINDINGS: Homeless adults had high rates of functional vision impairment (37 percent), skin/leg/foot problems (36 percent), and TB skin test positivity (31 percent), but a rate of high blood pressure similar to that of the general population (14 percent). Utilization was high for high blood pressure (81 percent) and TB skin test positivity (78 percent), but lower for vision impairment (33 percent) and skin/leg/foot problems (44 percent). Health status for high blood pressure...

‣ How Researchers Define Vulnerable Populations in HIV/AIDS Clinical Trials

Sengupta, Sohini; Lo, Bernard; Strauss, Ronald P.; Eron, Joseph; Gifford, Allen L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/2010 Português
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In this study, we interviewed researchers, asking them to define vulnerable populations in HIV/AIDS clinical trials, and provide feedback on the federal regulations for three vulnerable populations. Interview data informed a conceptual framework, and were content analyzed to identify acceptability or disagreement with the regulations. Beginning with several characteristics of vulnerable enrollees identified by researchers, the conceptual framework illustrates possible scenarios of how enrollees could be considered vulnerable in clinical research. Content analysis identified barriers affecting HIV/AIDS researchers’ ability to conduct clinical trials with pregnant women, prisoners, and children, for which the regulations specify additional protections. This study challenges current thinking about federal regulations’ group-based approach to defining vulnerable populations.

‣ Public Health Consequences on Vulnerable Populations from Acute Chemical Releases

Ruckart, Perri Zeitz; Orr, Maureen F.
Fonte: Libertas Academica Publicador: Libertas Academica
Tipo: Artigo de Revista Científica
Publicado em 09/07/2008 Português
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Data from a large, multi-state surveillance system on acute chemical releases were analyzed to describe the type of events that are potentially affecting vulnerable populations (children, elderly and hospitalized patients) in order to better prevent and plan for these types of incidents in the future. During 2003–2005, there were 231 events where vulnerable populations were within ¼ mile of the event and the area of impact was greater than 200 feet from the facility/point of release. Most events occurred on a weekday during times when day care centers or schools were likely to be in session. Equipment failure and human error caused a majority of the releases. Agencies involved in preparing for and responding to chemical emergencies should work with hospitals, nursing homes, day care centers, and schools to develop policies and procedures for initiating appropriate protective measures and managing the medical needs of patients. Chemical emergency response drills should involve the entire community to protect those that may be more susceptible to harm.

‣ Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care

Vanderbilt, Allison A.; Isringhausen, Kim T.; VanderWielen, Lynn M.; Wright, Marcie S.; Slashcheva, Lyubov D.; Madden, Molly A.
Fonte: Co-Action Publishing Publicador: Co-Action Publishing
Tipo: Artigo de Revista Científica
Publicado em 26/03/2013 Português
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Healthcare in the United States (US) is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.

‣ Identifying Frailty Among Vulnerable Populations

Salem, Benissa E.; Nyamathi, Adeline; Phillips, Linda R.; Mentes, Janet; Sarkisian, Catherine; Brecht, Lynn
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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Frailty is a significant public health issue which is experienced by homeless and other vulnerable adults; to date, a frailty framework has not been proposed to guide researchers who study this hard-to-reach population. The Frailty Framework among Homeless and other Vulnerable Populations (FFHVP) has been developed from empirical research and consultation with frailty experts in an effort to characterize antecedents, i.e. situational, health-related, behavioral, resource, biological, and environmental factors which contribute to physical, psychological and social frailty domains and impact adverse outcomes. As vulnerable populations continue to age, a greater understanding of frailty will enable the development of nursing interventions.

‣ Health Care of Vulnerable Populations Covered by Medicare and Medicaid

Hirsch, Marilyn B.
Fonte: CENTERS for MEDICARE & MEDICAID SERVICES Publicador: CENTERS for MEDICARE & MEDICAID SERVICES
Tipo: Artigo de Revista Científica
Publicado em //1994 Português
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This overview discusses articles published in this issue of the Health Care Financing Review, entitled “Health Care Needs of Vulnerable Populations.” Articles cover the following vulnerable population subgroups: pregnant women and children, persons with AIDS, the disabled, and the elderly. Issues covered in this collection include: expenditures, demographic factors, Medicaid and Medicare policy, service use, medical procedures, and data collection.

‣ Lessons Learned Obtaining Informed Consent in Research with Vulnerable Populations in Community Health Center Settings

Riden, Heather E; Grooms, Kya N; Clark, Cheryl; Cohen, Laura R; Gagne, Joshua J; Tovar, Dora A; Ommerborn, Mark J; Orton, Piper S; Johnson, Paula Adina
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Português
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Background: To improve equity in access to medical research, successful strategies are needed to recruit diverse populations. Here, we examine experiences of community health center (CHC) staff who guided an informed consent process to overcome recruitment barriers in a medical record review study. Methods: We conducted ten semi-structured interviews with CHC staff members. Interviews were audiotaped, transcribed, and structurally and thematically coded. We used NVivo, an ethnographic data management software program, to analyze themes related to recruitment challenges. Results: CHC interviewees reported that a key challenge to recruitment included the difficult balance between institutional review board (IRB) requirements for informed consent, and conveying an appropriate level of risk to patients. CHC staff perceived that the requirements of IRB certification itself posed a barrier to allowing diverse staff to participate in recruitment efforts. A key barrier to recruitment also included the lack of updated contact information on CHC patients. CHC interviewees reported that the successes they experienced reflected an alignment between study aims and CHC goals, and trusted relationships between CHCs and staff and the patients they recruited. Conclusions: Making IRB training more accessible to CHC-based staff...

‣ Modélisation systémique d’une pratique infirmière d’interface en contexte de vulnérabilité sociale

Richard, Lauralie
Fonte: Université de Montréal Publicador: Université de Montréal
Tipo: Thèse ou Mémoire numérique / Electronic Thesis or Dissertation
Português
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Dans les services de première ligne des Centres de santé et de services sociaux (CSSS) au Québec, les infirmières sont des acteurs clés des programmes destinés à des populations vulnérables. Ces programmes créent des opportunités pour les infirmières de développer une pratique à l’interface du CSSS et des ressources de la communauté afin d’agir pour réduire la vulnérabilité sociale. Des infirmières commencent d’ailleurs à se mobiliser au-delà de leurs frontières disciplinaires, organisationnelles et sectorielles pour s’engager dans l’environnement de personnes vulnérables, ce que nous désignons ici comme pratique infirmière d’interface. Aucune étude n’a toutefois été repérée en regard de cette pratique infirmière en émergence. Fondée sur une perspective constructiviste et systémique, de même qu’une analyse des conceptions de théoriciennes infirmières sur la pratique, notre recherche doctorale avait pour but de modéliser la pratique infirmière d’interface en contexte de vulnérabilité sociale. Elle a également constitué un cas à partir duquel contribuer aux savoirs théoriques sur le concept de pratique en sciences infirmières. Une étude qualitative exploratoire a été entreprise dans trois CSSS d’une région urbaine. Des entretiens semi-dirigés ont été réalisés avec quinze infirmières. La pratique d’interface de deux infirmières a ensuite fait l’objet d’une année d’observation directe et participante...

‣ Health

Haq, Inaam; Wang, Shiyong; Langenbrunner, John C.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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International experience shows that in the aftermath of a natural disaster, a transition strategy for restoring and maintaining health care services should be developed while planning for rebuilding a better health care system over the next 5-10 years. A rapid assessment should be carried out to determine the population profile and the epidemiological profile. The health needs of the people in the affected areas should be assessed without delay and periodically reassessed, with particular attention to existing and newly emerged vulnerable populations. The needs identified should be addressed in both the transition and reconstruction strategies. The transition phase should prioritize a rapid restoration and revitalization of an undisrupted supply of essential health care services. Reconstruction is often better led and coordinated by a strong national or provincial authority as this improves implementation effectiveness and equity. The roles and responsibilities should be clearly designed for different levels of government...

‣ Liberia : A Diagnostic of Social Protection

Borgarello, Andrea; Figazzolo, Laura; Weedon, Emily
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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Safety Nets are limited in Liberia and, although as a share of GDP, expenditures are higher than the regional average, the average benefit amount is equal to only 7-20 percent of the poverty line. The current system focuses on the country s most vulnerable populations but that the system is fragmented. Food insecurity is mainly addressed through food transfers aimed at preventing starvation and malnutrition. Unemployed people, including the large portion of the population engaged in informal employment, are targeted primarily by public works. Scaling-up Liberia s safety nets would require significant investments, which are not viable at the moment given the country s financial constraints. Efforts should hence focus on improving the overall safety net system within the existing budget.

‣ Different preventions methods lead to different choices? Questions on HIV/AIDS prevention for men who have sex with men and other vulnerable populations

Terto Jr.,Veriano
Fonte: Associação Brasileira de Saúde Coletiva Publicador: Associação Brasileira de Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2015 Português
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ABSTRACTOn the basis of an ethnographic narrative on sexual interactions observed in urban parks in large Brazilian cities, the article discusses the adoption of new strategies and methods for AIDS prevention in vulnerable populations, especially in men who have sex with men (MSM). By following some guiding questions, the text debates when, why, with whom, and in which context the new prevention methods should be adopted. It emphasizes, in agreement to the initial narrative, the importance of taking into account the prevention strategies created by the population itself to manage HIV risk infection. It also addresses how prevention practices and messages are adapted and recreated by individuals and groups in an attempt to suit them to their sexual desires, practices, and choices. In this perspective, the article recommends the inclusion of the experiences and voices of individuals and groups considered vulnerable in the new AIDS prevention methods and programs targeted to them.

‣ Integrating Disaster Response and Climate Resilience in Social Protection Programs in the Pacific Island Countries

Costella, Cecilia; Ivaschenko, Oleksiy
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Working Paper; Publications & Research :: Working Paper; Publications & Research
Português
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The Pacific island countries (PICs) are some of the most exposed to frequent natural disasters and climate shocks, and their vulnerability is increasing due to mounting effects of climate change as well as demographic and economic forces. Natural disasters hit the poorest hardest and have long-term consequences for human development. Social protection programs and systems have an important role in helping poor and vulnerable populations cope with the impacts of shocks as well as build long-term resilience. This paper discusses the potential role of social protection for disaster and climate risk reduction and management in PICs. It presents evidence and lessons from other regions, providing examples of tools and entry points for the development of climate, and disaster, responsive social protection interventions and context-specific recommendations for PICs.

‣ Public health planning for vulnerable populations and pandemic influenza

Cameron, Wendy K.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xvi, 61 p. : ill. ;
Português
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CHDS State/Local; This thesis addresses planning for vulnerable populations, those segments of each community that are normally independent but that may require special assistance during a health emergency such as an influenza pandemic. Analysis of plans from sixty of Georgia's 159 counties provides insight into the extent to which vulnerable populations are defined and identified; relevant agencies are engaged in planning; and opportunities are identified for improvement. Recommended strategies will enable local jurisdictions to more effectively plan for vulnerable populations. Some strategies have now been implemented and others are in progress.; Preparedness Unit Lead, Acute Disease Epidemiology Section, Georgia Department of Human Resources, Division of Public Health author (civilian).

‣ Protocol for an Integrated Bio-Behavioral Surveillance Study among Most At-risk Populations in Lebanon : Sex Workers, Injecting Drug Users, Men Who Have Sex with Men, and Prisoners

Afifi, Rima; DeJong, Jocelyn; El Barbir, Farah; El Khoury, Danielle; Ghanem, Maguy; Kassak, Kassem; Kreidiyyeh, Khalil; Mahfoud, Ziyad; Ramia, Sami; Shamra, Sarah
Fonte: Lebanon Ministry of Public Health Publicador: Lebanon Ministry of Public Health
Tipo: Economic & Sector Work :: Other Health Study; Economic & Sector Work
Português
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This report has grown out of the implementation of an Integrated Bio Behavioral Surveillance (IBBS) study among most at-risk populations in Lebanon. AIDS-related policies and programs in the Middle East and North Africa region are highly constrained by the lack of accurate information about the full scale of the epidemic. This is for a number of reasons, including limitations of existing surveillance, and intense stigma associated with the disease. Lebanon urgently requires greater understanding of its epidemic and high quality integrated bio-behavioral surveys of vulnerable populations are a prerequisite for greater understanding of low prevalence epidemics, such as Lebanon's. The costs of continuing to respond without adequate data or insight greatly outweigh the cost and complexities of such a survey. A Lebanese survey will also contribute to a greater regional understanding of the magnitude and dynamics of the Middle East's epidemics. The study aims to provide an estimate of HIV prevalence among four major vulnerable groups in Lebanon...

‣ Vietnam : Strengthening the Social Safety Net to Address New Poverty and Vulnerability Challenges

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Policy Note; Economic & Sector Work
Português
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As it transitions to Middle-Income Country (MIC) status, Vietnam is considering whether its social protection system is adequate to meet rapidly changing needs associated with strong economic growth, integration of its economy in regional and global markets, industrialization, urbanization and other economic and societal shifts. Vietnam's social safety net - programs with the following objectives: 1) alleviation of chronic poverty; 2) help to the poor in coping with the worst forms of shocks and transient poverty; and 3) promotion of human development for long-term poverty alleviation. This note aims to assess the system of social safety net programs currently in place in Vietnam and to gauge how well it covers the poor and vulnerable populations. This note highlights two messages: first, it identifies gaps in the current poverty reduction and social protection system - programs that help address urban vulnerability and poverty and that help the poor and vulnerable manage shocks - which could be closed through strengthened and more effective household-targeted social safety net programs. Second...

‣ Protecting Poor and Vulnerable Households in Indonesia

World Bank
Fonte: World Bank, Jakarta Publicador: World Bank, Jakarta
Tipo: Economic & Sector Work :: Public Expenditure Review; Economic & Sector Work
Português
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Despite strong economic growth and falling poverty over the last decade, many households continue to live on the edge of poverty. The last decade in Indonesia has seen a return to strong economic growth, and the poverty rate has fallen from 23.4 percent (1999) to 12.5 percent (2011). The falling overall poverty rate, however, partially masks a high degree of vulnerability: much of Indonesia's population is clustered just above the poverty line, consuming approximately Rp 233,000 per month in 2011 (about US$ 27 at 2011 nominal exchange rates). Around 24 percent of Indonesians live below the official near-poor line (with consumption of approximately 1.2 times the poverty line) while 38 percent of the population lives below 1.5 times the poverty line and is almost equally vulnerable. Even relatively small shocks to these vulnerable households can be enough to push them into poverty. This report, the first comprehensive assessment of its kind in Indonesia, assesses the extent to which current social assistance programs are providing an effective social safety net for poor and vulnerable households. The government and its development partners require an analytical base to inform their decisions about social assistance policy reform and program design and delivery. To support this...

‣ Humanitarian responses to mass violence perpetrated against vulnerable populations.

Gellert, G. A.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em 14/10/1995 Português
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This multidisciplinary review links three areas of legitimate inquiry for practitioners of medicine and public health. The first is occurrences of mass violence or genocide perpetrated against vulnerable populations, with a focus on the failure of national and international mechanisms to prevent or predict such violence. The second is evolving concepts of national sovereignty and an emerging framework in which the imperative to assist vulnerable populations supersedes a state's right to self determination. The last is how medical, public health, and other systems of surveillance and rapid assessment of mass violence can accelerate public awareness and facilitate structured, consistent political decision making to prevent mass violence and to provide international humanitarian assistance.

‣ Different preventions methods lead to different choices? Questions on HIV/AIDS prevention for men who have sex with men and other vulnerable populations

Terto Jr.,Veriano
Fonte: Associação Brasileira de Pós -Graduação em Saúde Coletiva Publicador: Associação Brasileira de Pós -Graduação em Saúde Coletiva
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2015 Português
Relevância na Pesquisa
680.141%
ABSTRACT On the basis of an ethnographic narrative on sexual interactions observed in urban parks in large Brazilian cities, the article discusses the adoption of new strategies and methods for AIDS prevention in vulnerable populations, especially in men who have sex with men (MSM). By following some guiding questions, the text debates when, why, with whom, and in which context the new prevention methods should be adopted. It emphasizes, in agreement to the initial narrative, the importance of taking into account the prevention strategies created by the population itself to manage HIV risk infection. It also addresses how prevention practices and messages are adapted and recreated by individuals and groups in an attempt to suit them to their sexual desires, practices, and choices. In this perspective, the article recommends the inclusion of the experiences and voices of individuals and groups considered vulnerable in the new AIDS prevention methods and programs targeted to them.