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Resumo: A presente pesquisa consiste na análise do contexto ético expresso por políticas institucionais quanto às mortes tratadas como indigentes em território brasileiro. Buscou-se observar os números e recortes sociais nos dados referentes ao corpo daquele que usualmente é tratado como indesejável. A noção ética aqui se expressa não como um ideal de alcance, mas como constrói-se o juízo de valor moral a partir da noção de indigência, e de como esse elemento naturaliza o descarte daquele que é não propriedade, que pertence, mas não está incluído na sociedade. Abstract: This paper consists on the analysis of the ethical context expressed by institutional policies regarding the deaths treated as indigent in Brazilian territory. One sought to observe the numbers and social cuts in the data referring to the body of the one who is usually treated as undesirable. The ethical notion here is expressed not as an ideal, but how the moral value judgment is constructed from the notion of indigence, and how this element naturalizes the disposal of those who are not property, who belong, but are not included in society.

International audience; The indigents have long been excluded from health policies in sub-Saharan Africa. Despite recent efforts by some countries to allow them free access to health services, they face a multitude of non-financial barriers that prevent them from accessing care. Interventions to address the multiple patient-level barriers to care, such as patient navigation interventions, could help reverse this trend. However, our scoping review showed that no navigation interventions in low-income countries targeted the indigents. The objective of this qualitative study is, therefore, to go beyond the lack of evidence and discuss relevant approaches to act in favor of health care equity. We interviewed 22 public health experts with the objective of finding out which actions related to patient navigation programs (identified in the scoping review for other target groups) could be relevant and/or adapted for the indigents. For each ability to access care described by Levesque and colleagues, we were thus able to list the potential opportunities and challenges of implementing each type of action for the indigents in sub-Saharan Africa. Overall, the experts all felt that patient navigation programs were very relevant to implement for the indigents. They emphasized the need for personalized follow-up and for holistic actions to consider the whole context of the situation of indigence. The recommendations made by the experts are valuable in guiding political decision-making, while leaving room for adaptation of the proposed guidelines according to different contexts.

Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox's proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89-10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62-5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12-3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09-2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years) (4). Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality. DDEUIT

In this study it was analysed the perception of different professionals working with persons experiencing homeless, specifically about the situation of homelessness institutions during the first weeks of the state of alarm as a consequence of the COVID-19 pandemic. The method employed was a qualitative analysis of thematic content. An ad hoc online questionary was designed including open questions about the perception of professionals about the management of the COVID-19 crisis in the services addressed to homeless people. A sample of 202 participants of almost all the autonomic communities of Spain was recruited (professionals of social education, social work, social integration and psychology). Main conclusions indicated that homelessness services had a lot of difficulties to adapt their circumstances to the confinement requirements. These circumstances influenced in the mental health of the professionals specially. Persons experiencing homelessness with mental health or addictions problems were persons that suffered more difficulties (highlighting situations of sheltering in temporary macro institutions as pavilions). Residential resources that limited the access of people and confine them, had less difficulties to manage the situation. A recapitulation of recommendations of the participants was included at the end of the paper just in case future epidemic situations could influence in these population En el presente estudio se analiza la percepción de distintos profesionales especialistas en el fenómeno del sinhogarismo, sobre la situación en las instituciones especializadas, durante las primeras semanas del estado de alarma consecuencia de la pandemia del COVID-19. El método empleado fue el análisis cualitativo de contenido temático. Se creó un cuestionario en línea ad hoc, con preguntas abiertas sobre la percepción de la gestión de la crisis del COVID-19 en los dispositivos dirigidos a personas en situación de sin-hogar. Se reclutó una muestra de 202 participantes, profesionales de la educación social, el trabajo social, la integración social y la psicología, de prácticamente todas las comunidades autónomas del estado español. Las principales conclusiones indican que los servicios tuvieron muchas dificultades para adaptarse a la situación de confinamiento, las cuales repercutieron especialmente en la salud mental de los y las profesionales. Las personas sin-hogar con problemas de salud mental y/o adicciones, especialmente aquellas que fueron confinadas en macroinstalaciones temporales, fueron las que sufrieron más dificultades. Los recursos residenciales de tamaño reducido, que limitaron su acceso y se confinaron, tuvieron más facilidad para gestionar la situación. El manuscrito finaliza con una recopilación de recomendaciones de las personas participantes, a tener en cuenta en caso de futuros rebrotes o epidemias que influyan en esta población

A bibliometric review was conducted to assess the available scientific knowledge regarding the use of Information and Communication Technologies (ICT) by Individuals Experiencing Homelessness (IEH) and reflect on the existing evidence that ICT use has on their health. A total of 50 published articles were selected after a process of systematic review from five databases containing record of publications up until 2016. All the studies were published in English, half of the works were published in the last three years and 48% of them included the description of ICT use as an objective. Despite the fact that experimental studies were rare, and sample sizes typically small, it was concluded that the studies analyzing the effect of ICT on health display benefits. ndeed, the use of such technology offers promising opportunities to explore new ways of intervention in prevention, harm reduction and health treatment of IEH

A bibliometric review was conducted to assess the available scientific knowledge regarding the use of Information and Communication Technologies (ICT) by Individuals Experiencing Homelessness (IEH) and reflect on the existing evidence that ICT use has on their health. A total of 50 published articles were selected after a process of systematic review from five databases containing record of publications up until 2016. All the studies were published in English, half of the works were published in the last three years and 48% of them included the description of ICT use as an objective. Despite the fact that experimental studies were rare, and sample sizes typically small, it was concluded that the studies analyzing the effect of ICT on health display benefits. ndeed, the use of such technology offers promising opportunities to explore new ways of intervention in prevention, harm reduction and health treatment of IEH.

Tot i el desenvolupament humà, social, polític i econòmic aconseguit en les darreres dècades, el tema del sensellarisme i com abordar aquest fenomen continua presentant reptes a l’hora d’intervenir, com la manca de recursos especialitzats i el baix nivell de lloguer social. L’objectiu d’aquest article és presentar els resultats d’un estudi sobre els reptes que es troben els professionals de l’àmbit socioeducatiu a l’hora d’intervenir amb persones sense llar i sobre els recursos dels quals disposen. La informació s’ha obtingut a través d’entrevistes individuals a quatre professionals que treballen a un centre de dia per a persones sense llar. Els resultats manifesten un baix nivell d’adaptació dels serveis per atendre a les persones, els quals responen des de la urgència, i la importància d’un habitatge per fer front a la situació de sensellarisme i millorar el benestar de la persona. L’estudi contribueix a identificar alguns dels reptes que es poden trobar els professionals en la intervenció amb persones sense llar Despite the human, social, political and economic development achieved in the last decades, the subject of the homelessness and how to tackle this phenomenon continues to present challenges when intervening, such as lack of specialised resources and the low level of social rent. The article’s aim is to present the results of a study on the challenges that professionals in the socio-educational field can find when intervening with homeless people and on the resources they have. The information was obtained through individual interviews with four professionals who work in a day centre for homeless people. The results state a low level of adaptation of the services to attend to people, which respond from the urgency, and the importance of a dwelling to cope with the situation of homelessness and improve the wellbeing of the person. The study contributes to identify some of the challenges that professionals can find in the intervention with homeless people

The universalisation of Social Networking Sites has prompted a debate about whether contact with relatives and friends online has a positive effect on psychological well-being, as it has on direct relationships with primary groups. The aim of this study is to analyze the use of social network sites in a sample of 164 individuals experiencing homelessness (IEH), and to establish the relationship between this usage and their levels of self-esteem and satisfaction with life, using a multiple linear regression model for each dependent variable. The main results show a high prevalence of Internet and social network sites usage amongst IEH, even slightly higher than in the population overall. The variables predicting a higher degree of well-being are related to the use of social network sites, especially keeping in touch with friends. The chronicity associated with length of time on the street is also a key factor. A debate exists regarding the benefits of social network sites on health, and the importance which education may have in improving access to specialized services La universalització de les xarxes socials en línia ha provocat un debat sobre si el contacte amb familiars i amics en línia té un efecte positiu en el benestar psicològic, com ho ha fet en les relacions directes amb grups primaris. L’objectiu d’aquest estudi és analitzar l’ús que es fa de les xarxes socials en línia en una mostra de 164 persones que experimenten una situació de sense llar (PES), i establir la relació amb els seus nivells d’autoestima i satisfacció amb la vida, a partir d’un model de regressió lineal múltiple per a cada variable dependent. Els principals resultats mostren una alta prevalença d’ús de llocs d’Internet i xarxes socials entre PES, fins i tot lleugerament més alt que la població general. Les variables predictores d’un major grau de benestar estan relacionades amb l’ús de llocs de xarxes socials, especialment a l’estar en contacte amb amics. La cronicitat associada amb la permanència al carrer és també un factor clau. Hi ha un debat sobre els beneficis de les xarxes socials en línia sobre la salut i la importància que la formació pot tenir per millorar l’accés als serveis especialitzat

Sol·licitant de l’informe: Gerència de Drets de Ciutadania, Participació i Transparència

Tradicionalment la intervenció del sensellarisme s’ha fet a través del model “en escala”, però aquest només funciona amb un perfil determinat del col·lectiu de persones sense llar. Des dels anys noranta als Estats Units s’ha anat desenvolupant un nou model conegut com a Housing First, el qual ha demostrat ser més eficaç pel que fa a la intervenció de persones sense llar cronificades. En aquesta investigació, principalment, es pretén analitzar el tipus d’intervenció que realitzen els professionals amb persones sense llar i com aquestes s’han vist modificades arran de la crisi sanitària de la COVID-19. En segon lloc es comparen les principals característiques dels diferents models, pel que fa a l’obtenció d’habitatge estable. Finalment, es contrasten les dades bibliogràfiques amb els discursos obtinguts de les entrevistes realitzades als professionals de l’àmbit. Traditionally the intervention of homlessness has been dealt through the Continuum Care model, but this only works with a specific profile of the collective of homeless people. Since the 1990s, the United States has been developing a new model known as Housing First, which has proven to be more effective in dealing with chronic homelessness. This research mainly aims to analyze the type of intervention carried out by professionals in relation to homeless people and how these have been modified in the wake of the COVID-19 health crisis. Secondly, the main characteristics of the different models are compared in terms of obtaining stable housing. Finally, the bibliographical data is contrasted with the discourses obtained from interviews with professionals in the field.